Biomedical subjects

A Berglund

Publications and source records attributed to A Berglund.

At least 19 recordsLinked to original sources

PubMed2005

Dimensional change of a calcium aluminate cement for posterior restorations in aqueous and dry media.

OBJECTIVES: A calcium aluminate cement has recently been developed, with claims of being an alternative to dental amalgam and resin composites in posterior cavities. However, its' mechanical properties are not well evaluated and the aim of the study was therefore, to evaluate its' dimensional stability over time. METHODS: The dimensional changes of the cement, Doxadent, and two composite resins, Esthet-X and InTen-S, were tested during 360 d. The specimens were stored at 37+/-1 degrees C either in 100% air humidity (dry) or immersed in distilled water (wet), except for the first 24h when all specimens were stored at 100% air humidity and 37+/-1 degrees C. RESULTS: During the first 24h, Doxadent decreased in volume with 0.04%, while InTen-S and Esthet-X decreased with 1.60 and 1.75%, respectively. From d 1-360, the dry Doxadent specimens increased in volume with 2.0% and in weight with 5.5%, while the corresponding increase for the wet specimens were 4.1 and 6.3%, respectively. The volume of both composites increased 0.8% or less in dry and wet conditions, while the increase in weight for InTen-S was 1.2% for the wet specimens and 0.6% for the dry. The corresponding figures for Esthet-X were 0.7 and 0.2%. SIGNIFICANCE: Doxadent was less dimensionally stable than the composites tested. Doxadent increased 2 times more in volume immersed in water than in 100% air humidity, while the increase in weight was almost similar. The clinical implications of the results found in the present study are uncertain. A material that continues to absorb water during prolonged periods and continues to react is questionable for clinical use.

Absorption↗

PubMed2005

Changes in health over time in patients with symptoms allegedly caused by their dental restorative materials.

OBJECTIVES: In Sweden, many patients with symptoms allegedly caused by their dental materials have exchanged their restorations, but the effects of the exchange have been insufficiently investigated. Therefore, the aim of the study was to describe the change in health over time for these patients and the hypothesis was that the patients could be divided based on their symptoms and that the ability to recover differs between these groups. Furthermore, we also examined if other factors such as replacement of dental restorative materials and follow-up time had any impact on the perceived health status. METHODS: A questionnaire was sent to 614 patients who had been referred to the School of Dentistry, Umeå, Sweden, with symptoms allegedly caused by dental restorative materials. The response rate was 55%. RESULTS: The risk of having any further complaints was higher for patients with complex symptoms (P = 0.03) and these patients had exchanged their restorations to a significantly larger extent than the others (P = 0.03). The remaining complaints was more frequent among men (P = 0.02). Exchange of dental restorative materials had no significant impact on the ability to recover completely. However, the patients who had exchanged their restorations completely perceived a significantly larger alleviation of their symptoms than the others (P < 0.01), although the frequency of most of the symptoms had increased. CONCLUSIONS: Patients with complex symptoms had a more unfavorable long-term prognosis concerning persistent complaints than those with localized symptoms only. Furthermore, the results indicate that the patients might experience health improvements after removal of their dental restorative materials. The reason for this improvement, however, is unclear. Further analyses regarding other possible explanations than the 'odontological/medical' are needed.

Adolescent↗

PubMed2004

Improved survival in patients with peritoneal metastases from colorectal cancer: a preliminary study.

Patients with peritoneal or local metastases from colorectal cancer have a poor prognosis. However, aggressive treatments by debulking surgery and infusional intraperitoneal (i.p.) chemotherapy have been tried and appear to benefit selected patients. We assayed the effects of debulking surgery and i.p. chemotherapy with respect to survival and compared the results with matched control patients treated by intravenous (i.v.) chemotherapy. In all, 18 patients with peritoneal and/or local metastases from colorectal adenocarcinoma underwent debulking surgery followed by 5-fluorouracil (5-FU) 550 mg m(-2) day(-1) i.p. and leucovorin (LV) 60 mg m(-2) day(-1) i.v. The chemotherapy was started the day after surgery and was given daily for 6 days and repeated monthly for totally eight courses. The control patients, matched for age, gender, performance status and metastatic site, were randomly selected from controlled clinical chemotherapy trials and treated with i.v. 5-FU+LV or i.v. methotrexate+5-FU+LV. There was no treatment-related mortality. The median survival among i.p. patients was 32 months compared to 14 months in the control group. In all, 11 patients who underwent macroscopically radical surgery had a longer survival than those who were not radically operated (P=0.02). These results indicate that patients with peritoneal metastases and/or locally advanced cancers but without distant metastases may benefit from cytoreductive surgery combined with i.p. chemotherapy.

Adenocarcinoma↗

PubMed2004

Phase I study of UFT plus leucovorin with radiotherapy in patients with inextirpable non-rectal gastrointestinal cancer.

BACKGROUND AND PURPOSE: Chemoradiotherapy is increasingly used in the primary management of patients with loco-regionally advanced gastrointestinal (GI) cancer. Oral chemotherapy with uracil and tegafur (UFT) plus leucovorin (LV) may represent a convenient way of delivering protracted infusion of fluorouracil. Our goal was to evaluate the safety of UFT plus LV combined with radiation and determine the maximum-tolerated dose (MTD) and a recommended dose for further testing. PATIENTS AND METHODS: Patients with inextirpable GI cancer received escalating doses of UFT (starting at 300 mg/m(2)/d with 50 mg/m(2)/d increments between consecutive cohorts) and fixed doses of LV (90 mg/d). UFT and LV were given 5 days per week concurrently with radiation to 50 Gy (2 Gy/fraction). RESULTS: Twenty-five patients were treated, and 22 received the planned treatment. Three patients were withdrawn from treatment, two due to disease-progression and one due to toxicity. The MTD of UFT with radiation was 400 mg/m(2)/d with 90 mg/d of LV. Diarrhoea was the main dose limiting toxicity (DLT). Since some toxicity (3/12 DLTs) was seen in the expanded cohort at the level below, but none (0/9 DLT) at the starting level, the recommended dose chosen for further testing is 300-350 mg/m(2)/d depending upon the size of the target volume. CONCLUSION: Concomitant chemoradiation with oral UFT plus LV is feasible and well tolerated and should be further investigated since tumour responses were frequently seen.

Administration, Oral↗

PubMed2002

Tumour markers as early predictors of response to chemotherapy in advanced colorectal carcinoma.

BACKGROUND: To evaluate the reliability and validity of serum carcinoembryonic antigen (CEA), tissue polypeptide-specific antigen (TPS), vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in monitoring palliative chemotherapy in advanced colorectal cancer (ACRC). METHODS: Serum was prospectively collected from 87 patients with ACRC treated with first-line 5-fluorouracil and leucovorin before and 2, 4 and 10 weeks after induction. RESULTS: Eight patients had normal baseline TPS levels, and these patients had a favourable outcome with prolonged survival and a higher rate of objective responses than patients with elevated TPS levels. At 10 weeks, all responders had a decreasing TPS value. The sensitivity for a decrease of >25% using TPS was 83% and 86% for objective and subjective responses, respectively, and the specificity was 65% and 72%, respectively. CEA had, in the same setting, a sensitivity of 45% and 46%, respectively, and the specificity was 88%. VEGF was elevated in 54% of the patients and bFGF in 15% of the patients. The VEGF values decreased during therapy in 94% of the patients, but the changes in serial VEGF values did not correlate with survival or response. Tumour markers used together did not enhance the predictive values of TPS alone. CONCLUSIONS: Repeated measurements of CEA, VEGF and bFGF in serum are of limited value in monitoring chemotherapy in ACRC. TPS seems to be of greater interest, but does not predict exactly which patients are going to have a positive outcome of palliative chemotherapy.

Adenocarcinoma↗

PubMed2001

The association between exposure to a rear-end collision and future health complaints.

Different symptoms, together with neck pain, have been attributed to persons with persistent complaints after a previous motor vehicle crash (MVC) and are sometimes referred to as the "late whiplash syndrome." A cohort study was conducted to determine whether exposure to a rear-end collision, with or without whiplash injury, is associated with future health complaints. The results regarding future neck or shoulder pain have previously been described, and the objective of the present report was to focus on outcomes other than neck pain. Included in the study were persons 18 to 65 years of age and covered by traffic insurance at one of the largest insurance companies in Sweden. Claim reports were collected from the period November 1987 to April 1988. Drivers exposed to a rear-end collision were divided into two subgroups: those with reported whiplash injury (n = 232) and those without reported whiplash injury (n = 204). For comparison, 3688 subjects who were unexposed to MVCs were selected, with consideration taken to the age and gender distribution in the exposed subgroups. The prevalence of different health complaints among the study subjects was estimated according to a mailed questionnaire at follow-up in 1994, 7 years after the rear-end collision. When exposed subjects with whiplash injury were compared to unexposed subjects, increased relative risks in the range of 1.6-3.7 were seen for headache, thoracic and low back pain, as well as for fatigue, sleep disturbances and ill health. No corresponding increased risks were found among the exposed subjects without reported whiplash injury. We conclude that rear-end collisions resulting in reported whiplash injuries seem to have a substantial impact on health complaints, even a long time after the collision. There is a need to identify factors that predict a non-favorable outcome in order to improve clinical management.

Accidents, Traffic↗

PubMed2001

High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas.

Peripheral T cell lymphomas (PTCL) have a poorer prognosis after conventional treatment than do high-grade B cell lymphomas. The place for high-dose therapy (HDT) with autologous stem cell support in these patients is still not clear. Forty patients, 10 women and 30 men, median age 41.5 years (range 16-61) with PTCL were treated with HDT and autologous stem cell support at The Norwegian Radium Hospital, Oslo, Norway and The University Hospital, Uppsala, Sweden, between February 1990 and September 1999. The histologic subtypes were: PTCL unspecified, 20 patients; intestinal, two patients; angioimmunoblastic (AILD), two patients; angiocentric, two patients and anaplastic large cell lymphoma (ALCL), 14 patients. All patients had chemosensitive disease and had received anthracycline-containing regimens prior to transplantation. At the time of HDT, 17 patients were in first PR or CR and 23 were in second or third PR or CR. Conditioning regimens were BEAM in 15 patients, BEAC in 14 patients, cyclophosphamide and total body irradiation (TBI) in eight patients, BEAC, without etoposide and TBI in one patient and mitoxantrone and melphalan in two patients. There were three (7.5%) treatment-related deaths. The estimated overall survival (OS) at 3 years was 58%, the event-free survival (EFS) 48% and the relapse-free survival (RFS) 56%, with a median follow-up of 36 months (range 7-100) for surviving patients. The patients with ALCL tended to have a better prognosis compared to those with other PTCL subtypes, OS 79% vs 44%, respectively. In conclusion, patients with chemosensitive PTCL who are failing to achieve CR with first-line chemotherapy or are in relapse can successfully be treated with HDT and autologous stem cell support.

Adolescent↗

PubMed2001

An automated fluorescent single strand conformation polymorphism technique for high throughput mutation screening.

OBJECTIVE: To develop a high throughput mutational detection method by multiple fluorescence-labeled polymerase chain reaction (PCR) products. METHODS: A total of 27 known mutations including 22 substitutions, 3 insertions (1, 2 and 7 bp) and 2 deletions (1 and 2 bp) in the hepatocyte nuclear factor (HNF)-4 alpha, glucokinase and HNF-1 alpha genes were tested. During nested PCR, amplified fragments were labeled with three fluorescent dyes. PCR products were visualized with an ABI-377 fluorescence sequencer using 5% glycerol or 10% sucrose in non-denaturing gel conditions. RESULTS: Twenty-five of 27 variants (93%) could be detected by combining 5% glycerol and 10% sucrose gel matrix conditions. Twenty-two of 27 (82%) and 18 of 27 (67%) variants were identified using 5% glycerol and 10% sucrose conditions, respectively. CONCLUSION: This fluorescence-based PCR single strand conformation polymorphism technique represents a simple, non-hazardous, time-saving and sensitive method for high throughput mutation detection.

Basic Helix-Loop-Helix Leucine Zipper Transcriptio↗

PubMed2000

Male and female mate choice affects offspring quality in a sex-role-reversed pipefish.

Where both sexes invest substantially in offspring, both females and males should discriminate between potential partners when choosing mates. The degree of choosiness should relate to the costs of choice and to the potential benefits to be gained. We measured offspring quality from experimentally staged matings with preferred and non-preferred partners in a sex-role-reversed pipefish, Syngnathus typhle L. Here, a substantial male investment in offspring results in a lower potential reproductive rate in males than in females, and access to males limits female reproductive success rather than vice versa. Thus, males are choosier than females and females compete more intensely over mates than do males. Broods from preferred matings were superior at escaping predation, when either males or females were allowed to choose a partner. However, only 'choosing' females benefited in terms of faster-growing offspring. Our results have important implications for mate-choice research: here we show that even the more competitive and less choosy sex may contribute significantly to sexual selection through mate choice.

Animals↗

PubMed2000

Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury.

BACKGROUND AND METHODS: The incidence and prognosis of whiplash injury from motor vehicle collisions may be related to eligibility for compensation for pain and suffering. On January 1, 1995, the tort-compensation system for traffic injuries, which included payments for pain and suffering, in Saskatchewan, Canada, was changed to a no-fault system, which did not include such payments. To determine whether this change was associated with a decrease in claims and improved recovery after whiplash injury, we studied a population-based cohort of persons who filed insurance claims for traffic injuries between July 1, 1994, and December 31, 1995. RESULTS: Of 9006 potentially eligible claimants, 7462 (83 percent) met our criteria for whiplash injury. The six-month cumulative incidence of claims was 417 per 100,000 persons in the last six months of the tort system, as compared with 302 and 296 per 100,000, respectively, in the first and second six-month periods of the no-fault system. The incidence of claims was higher for women than for men in each period; the incidence decreased by 43 percent for men and by 15 percent for women between the tort period and the two no-fault periods combined. The median time from the date of injury to the closure of a claim decreased from 433 days (95 percent confidence interval, 409 to 457) to 194 days (95 percent confidence interval, 182 to 206) and 203 days (95 percent confidence interval, 193 to 213), respectively. The intensity of neck pain, the level of physical functioning, and the presence or absence of depressive symptoms were strongly associated with the time to claim closure in both systems. CONCLUSIONS: The elimination of compensation for pain and suffering is associated with a decreased incidence and improved prognosis of whiplash injury.

Accidents, Traffic↗

PubMed2000

The Bateman gradient and the cause of sexual selection in a sex-role-reversed pipefish.

As a conspicuous evolutionary mechanism, sexual selection has received much attention from theorists and empiricists. Although the importance of the mating system to sexual selection has long been appreciated, the precise relationship remains obscure. In a classic experimental study based on parentage assessment using visible genetic markers, more than 50 years ago A. J. Bateman proposed that the cause of sexual selection in Drosophila is 'the stronger correlation, in males (relative to females), between number of mates and fertility (number of progeny)'. Half a century later, molecular genetic techniques for assigning parentage now permit mirror-image experimental tests of the 'Bateman gradient' using sex-role-reversed species. Here we show that, in the male-pregnant pipefish Syngnathus typhle, females exhibit a stronger positive association between number of mates and fertility than do males and that this relationship responds in the predicted fashion to changes in the adult sex ratio. These findings give empirical support to the idea that the relationship between mating success and number of progeny, as characterized by the Bateman gradient, is a central feature of the genetic mating system affecting the strength and direction of sexual selection.

Animals↗

PubMed2000

Structure-property model for membrane partitioning of oligopeptides.

The aim of this study was to develop a structure-property model for membrane partitioning of oligopeptides using statistical design methods and multivariate data analysis. A set of 20 tetrapeptides with optional N-methylations at residues 2 and 4 was designed by a D-optimal design procedure. After synthesis and purification, the membrane partitioning abilities of the peptides were tested in two chromatographic systems with phospholipids as the stationary phase: immobilized artificial membrane chromatography (IAM) and immobilized liposome chromatography (ILC). The relationship between these measures and three different sets of calculated descriptors was analyzed by partial least-squares projection to latent structures (PLS). The descriptors used were the molecular surface area, Molsurf parameters, and Volsurf parameters. All three models were of good statistical quality and supported that a large hydrogen-bonding potential and the presence of a negative charge impair membrane partitioning, whereas hydrophobic parameters promote partitioning. The findings are in accordance with what has been found for absorption of known drugs and have implications for the design of peptide-like drugs with good oral bioavailability.

Chromatography, High Pressure Liquid↗

PubMed2000

The association between exposure to a rear-end collision and future neck or shoulder pain: a cohort study.

Neck pain is the most frequently reported feature in connection with whiplash injury, but it is also a common complaint in the general population. Therefore it is crucial to include an unexposed comparison group when evaluating the association between neck pain and a previous motor vehicle crash (MVC). To determine whether exposure to a rear-end collision, without or with whiplash injury, is associated with future neck or shoulder pain, a cohort study was conducted. The study population consisted of persons covered by traffic insurance at one of the largest insurance companies in Sweden. Claim reports were collected from the period November 1987 to April 1988. Drivers exposed to a rear-end collision were divided into two subgroups, without reported whiplash injury (n = 204) and with reported whiplash injury (n = 232). Two comparison groups, unexposed to MVCs, consisting of 1599 and 2089 persons, were selected with consideration taken to the age and gender distribution in the exposed subgroups. A questionnaire concerning neck or shoulder pain and other subjective health complaints was mailed to all the study subjects at follow-up in 1994, 7 years after the rear-end collision. The relative risk of neck or shoulder pain at follow-up was 1.3 (95% CI 0.8-2.0) in the exposed subjects without whiplash injury compared with the unexposed. The corresponding relative risk in subjects with whiplash injury was 2.7 (95% CI 2.1-3. 5). We conclude that there is no increased risk of future neck or shoulder pain in drivers who did not report whiplash injury in connection with a rear-end collision 7 years earlier. In drivers with reported whiplash injury, the risk of neck or shoulder pain 7 years after the collision was increased nearly three-fold compared with that in unexposed subjects.

Accidents, Traffic↗

PubMed2000

Long-term follow-up of autologous stem-cell transplantation for follicular and transformed follicular lymphoma.

Despite the fact that follicular lymphomas are both chemo- and radiosensitive, the disease is generally non-curable. These lymphomas often undergo transformation to a more malignant state. In order to improve the prognosis, high-dose treatment with stem cell support has been tested, but its role in the treatment of this disease is still unclear. Fourteen men and eight women with a median age of 45 yr (34-59) were treated with high-dose therapy with autologous stem cell transplantation between 1987 and 1996. The patients were selected to undergo intensive therapy because of an estimated short survival (median < 3 yr), even though they had chemosensitive disease and adequate performance status. Eleven patients' lymphomas had transformed, and the other eleven patients had one or more unfavourable prognostic signs such as advanced stage, bulky disease, multiple relapses, or short remission duration. The conditioning regimen has varied over the period, but BEAC (Becenum, etoposide, cytarabine, cyclophosphamide) or etoposide/cyclophosphamide with or without total body irradiation (TBI) was used in most patients. Nine patients had their stem cells purged. After a median follow-up time of 74 months overall survival was 81% and disease-free survival 72%. One toxic procedure-related death occured. There was no difference in outcome between patients with a transformed lymphoma compared to those without transformation. The patients treated with TBI had a significantly worse outcome. Toxicity was also much higher in TBI-treated patients, including four cases of secondary malignancy (three myelodysplastic syndrome (MDS) cases and one patient with breast carcinoma). This retrospective study, with the longest follow-up time so far reported, shows a promising 6-yr DFS of 72% in a group of follicular lymphoma patients with a bad prognosis. The outcome of patients with transformed lymphoma compared to historical controls is especially encouraging. The high incidence of MDS is worrying. The role of TBI should be questioned because this and other studies have not shown any advantage of using TBI. In the absence of randomised trials the role of high-dose treatment for patients with follicular lymphoma is still not defined.

Adult↗

PubMed2000

Risk assessment at the end of pregnancy is a poor predictor for complications at delivery.

OBJECTIVE: To evaluate the usefulness of prenatal risk assessment for prediction of need for obstetric interventions. DESIGN: Area based retrospective study. SETTING: Västerås Central Hospital, Sweden, with all antenatal care units in the area. SUBJECTS: All women delivered at the only delivery ward in the area, after attending antenatal care at the affiliated ANC-units in 1990 (n = 2008) and 1992 (n = 1874). MAIN OUTCOME MEASURES: Obstetric interventions at delivery. RESULTS: During the two years 81% and 83% of the study population delivered an infant in vertex presentation at term but 15% and 17% without risk factors or complications at the end of pregnancy had complications during delivery. The relative risk for interventions when risk factors were present was 2.2 and with spontaneous onset of labor 1.3/1.4. Low risk primiparae had unforeseen complications in 25% and multiparae in 10%. Relative risk for multiparae with risk factors and spontaneous labor was 2.2/1.8 and for primiparae 1.4/1.6. CONCLUSIONS: Individual prediction of obstetric emergencies has low accuracy, which should be included in the information to women as well as in discussions with health pianners.

Apgar Score↗

PubMed1999

In vitro corrosion resistance of titanium made using different fabrication methods.

The corrosion of cast or milled ASTM Grade II CP titanium with different surface conditions was studied by potentiodynamic anodic polarization and immersion testing. Specimens were fabricated using three dental titanium casting systems and from machined titanium. Three surface conditions were tested: (1) sandblasted with surface reaction layers remaining; (2) polished surface without surface reaction layers; and (3) sandblasted surface without surface reaction layers. An acidic saline solution (0.1 M lactic acid/0.1 M NaC1 [pH = 2]) and an artificial saliva were used as the corrosion media. Anodic polarization was performed starting at 50 mV below the rest potential and terminating at +2250 mV vs Ag/AgCl. Two surface conditions (sandblasted with the surface reaction layers and polished without such layers) were examined in the immersion test. Specimens were immersed in the corrosion media at 37 degrees C for six months. The recovered solution was analyzed by an atomic absorption spectrophotometer for titanium dissolution. A distinctive passive region on the polarization diagram, ranging from approximately 0 to approximately +1300 mV, was observed for all specimens in both media. Great similarity was observed for all the sandblasted specimens which had larger primary passive current densities and passive regions compared to the polished ones. A current density peak at approximately +1600 mV seen for all the specimens with sandblasted surfaces was less well defined for the polished specimens. Immersion testing in the acidic saline solution revealed no significant differences among the polished specimens. A significant increase (P < 0.05) in titanium dissolution was found for the sandblasted specimens with surface reaction layers remaining on the surfaces made with phosphate-bonded SiO2/Al2O3 investment compared to the polished ones. Significant differences were also found between sandblasted specimens with the surface reaction layers resulting from different investment materials and different casting methods. Measurable amounts of titanium were not found for all specimens in the artificial saliva after six months. It is evident that the corrosion behavior of cast CP titanium is similar to that of machined titanium. The surface roughness appears to be a more prominent factor than do the surface reaction layers on the polarization behavior of the CP titanium under the present experimental conditions. Surface roughness and the presence of the surface reaction layers both affect the dissolution of titanium.

Biocompatible Materials↗

PubMed1999

Clustered microsatellite mutations in the pipefish Syngnathus typhle.

Clustered mutations are copies of a mutant allele that enter a population's gene pool together due to replication from a premeiotic germline mutation and distribution to multiple successful gametes of an individual. Although the phenomenon has been studied in Drosophila and noted in a few other species, the topic has received scant attention despite claims of being of major importance to population genetics theory. Here we capitalize upon the reproductive biology of male-pregnant pipefishes to document the occurrence of clustered microsatellite mutations and to estimate their rates and patterns from family data. Among a total of 3195 embryos genetically screened from 110 families, 40% of the 35 detected de novo mutant alleles resided in documented mutational clusters. Most of the microsatellite mutations appeared to involve small-integer changes in repeat copy number, and they arose in approximately equal frequency in paternal and maternal germlines. These findings extend observations on clustered mutations to another organismal group and motivate a broader critique of the mutation cluster phenomenon. They also carry implications for the evolution of microsatellites with respect to mutational models and homoplasy among alleles.

Animals↗

PubMed1999

The usefulness of initial risk assessment as a predictor of pregnancy complications and premature delivery.

BACKGROUND: Risk assessment is an essential component of all programs for surveillance of pregnancy. The objective of the study is to assess the usefulness of initial risk status as predictor for pregnancy complications and premature delivery. METHODS: A retrospective, area-based study including all women giving birth at Västerås Central Hospital, Sweden in 1990 (2,008) and 1992 (1,874). Data was collected before and after the introduction of a reduced routine surveillance program. The study populations were classified in a low-risk group and three risk groups according to presence of risk factors at booking (initial risk factors), development of pregnancy complications (later risk factors) or a combination of both. Relative risk for premature delivery and predictive value of initial risk factors for pregnancy complications were analyzed. RESULTS: The relative risk for premature delivery was significantly increased in all three risk categories both years except for the group with only initial risk factors in 1990. Risk factors were present at booking in 27% (1990) and 26% (1992). Pregnancy complications developed in 35% and 28%, respectively. The positive predictive value of initial risk factors for pregnancy complications was 40% and 33%, adding little useful information. CONCLUSION: The relative risk for premature delivery was correlated to obstetric risk but was moderately increased with initial risk factors only. The initial risk status is a poor predictor of pregnancy complications and cannot alone be used for individual planning of surveillance during pregnancy. Even for low risk women routine programs must be structured to secure adequate identification of current complications.

Female↗