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Biomedical subjects

Anne Eskild

Publications and source records attributed to Anne Eskild.

At least 19 recordsLinked to original sources
PubMed2006

[Abortion among young women--the importance of family environment factors and social class].

BACKGROUND: The aim of the study was to investigate possible associations between social background, other aspects of childhood environment and induced abortion among young women. MATERIAL AND METHODS: Norwegian girls (N = 2,198), comprising a representative sample, were followed up through three data collections from they were in their teens in 1992 till they were young adult women (20 - 27 years) seven years later. A questionnaire was used to collect the data and the analyses were conducted by Cox regression. The response rate for the first data collection was 97%. The cumulative response rate over all three data collections was 69 %. RESULTS: In young adulthood we uncovered a steady reduction of induced abortion rates with increasing educational level. Women who had grown up in Northern Norway had higher rates than other women. There was a lower risk for induced abortion when parents were well educated and had fairly good jobs. Further, there were associations to parental divorce, weak parental monitoring and parental alcohol abuse. INTERPRETATION: A host of socioeconomic factors are associated with abortion risk. We need more thorough knowledge about these factors. We can, however, conclude that preventive efforts in this area should be targeted towards groups with risk factors.

Abortion, Legal↗
PubMed2006

[Requested abortions in Oslo 2000-2003].

BACKGROUND: Women of non-Western origin are over-represented among women requesting induced abortion before the end of the 12th week of pregnancy, in Oslo, Norway. Our aim was to find out if that was also the case for women requesting induced abortion after week 12. MATERIAL AND METHODS: We assessed differences between Western and non-Western women in duration of pregnancy at request for induced abortion and the proportion accepted for abortion. All women requesting induced abortion after the 12th week of pregnancy at Ullevål University Hospital, Oslo from January 2000 to September 2003 (n = 378) were included. Information about the number of fertile women in Oslo according to ethnic background was found in the municipality of Oslo's statistical office. Other data were obtained from patient medical records. RESULTS: 23% (87/378) of all women requesting late induced abortion and 15.5% (20,636/132,843) of women aged 15-50 years in Oslo had non-Western background (p < 0.05). The mean gestational age at the time of requested abortion among non-Western women was 16.4 weeks and among Western women it was 15.6 weeks (p = 0.01). There was a non-significant increased risk of having the abortion request rejected for non-Western as compared to Western women (adjusted odds ratio 1.6; 95% CI 0.5-5.5), after control for gestational age and maternal age. INTERPRETATION: It is known that non-Western women in Oslo are over-represented among women giving birth and women requesting induced abortion in general. This study shows that non-western women are also over-represented among women requesting induced abortion after the 12th pregnancy week.

Abortion, Legal↗
PubMed2006

Pelvic girdle pain in pregnancy: the impact on function.

BACKGROUND: The aim of this study was to determine the prevalence of self-reported pelvic girdle pain in pregnancy and study the impact on function, the use of crutches, and waking up at night, according to location of pain. METHODS: A population-based questionnaire study was performed among all women 18-40 years in two communities in Norway in 1998-99. A total of 1,817 women with a prior delivery constituted the study sample. Pelvic girdle pain was grouped into five categories: pain in anterior pelvis, in posterior pelvis, in anterior and unilateral posterior pelvis, in anterior and bilateral posterior pelvis (a complete pelvic girdle syndrome), and pelvic pain with no information on location. RESULTS: A total of 46% (843/1,817) reported pelvic girdle pain in pregnancy at one location or more. Nineteen percent reported pain in anterior pelvis only, 14% in posterior pelvis only, 4% in anterior and unilateral posterior pelvis, and 5% reported a complete pelvic girdle syndrome. A total of 7% of all pregnant women used crutches during pregnancy and 15% reported waking up at night frequently due to pelvic girdle pain. A complete pelvic girdle syndrome, as compared to pain in the anterior pelvis only, was strongly associated with the use of crutches (adjusted odds ratio (OR) 4.3; 95% confidence interval (CI) 2.5-7.4) and with waking up at night due to pain (OR 4.6; 95% CI 2.7-7.2). CONCLUSION: Pain related to the pelvic joints is common among pregnant women in Norway and may cause serious functional problems.

Adolescent↗
PubMed2006

Use of psychotropic medications in treating mood disorders during lactation : practical recommendations.

Many new mothers who need antidepressant or mood-stabilising drug treatment may wish to breastfeed their infants, but are hesitant to do so because of possible harmful effects of the medication on the infant. This article reviews current data on drug excretion into breast milk and the effects on the breast-fed child, and provides recommendations for the use of the different psychotropic drugs in lactating women. Relevant literature was identified through systematic searches of MEDLINE, EMBASE and the Science Citation Index Expanded (ISI) from 1966 to February 2005. The present knowledge is based on the accumulation of case studies. No randomised controlled trials in breast-fed infants have been performed and there is a lack of long-term follow-up studies. Use of SSRIs and TCAs (except doxepin) is compatible with breastfeeding. However, if treatment with an SSRI is started in the postpartum period, fluoxetine and citalopram may not be drugs of first choice. With regard to other antidepressants, such as venlafaxine, trazodone, mirtazapine, reboxetine, moclobemide and other MAOIs, very little knowledge exists. Breastfeeding should be avoided while using lithium. Carbamazepine and sodium valproate (valproic acid) are generally better tolerated by the breast-fed infant than lithium. Data on lamotrigine are still sparse. Knowledge is also scarce on the novel antipsychotics and thus recommendations in lactating women cannot be made for these agents. It is unwise to expose infants unnecessarily to drugs that may have severe adverse effects. As such, clozapine should probably be avoided because of the risk of agranulocytosis. Our knowledge of the impact of drug exposure through breast milk is still limited. Infant drug exposure is, however, generally higher during pregnancy through placental passage than through breast milk. Despite the low dosage transferred to the infant through breast milk, premature infants and infants with neonatal diseases or inherited disturbances in metabolism may be vulnerable to such exposure.

Animals↗
PubMed2005

Previous maternal infection with Toxoplasma gondii and the risk of fetal death.

OBJECTIVE: The purpose of this study was to assess the association between previous maternal Toxoplasma gondii (T gondii) infection and risk of fetal death. STUDY DESIGN: This was a population-based prospective cohort of 29,912 pregnant women without acute T gondii infection in Norway. RESULTS: In the study population, 2937 (9.8%) women had evidence of previous maternal T gondii infection, and 299 (1.0%) had fetal deaths. We found no association between previous T gondii infection and risk of fetal death at > or = 20 weeks of gestation. We did find a trend for an increased risk of fetal death at > or = 16 and <20 weeks of gestation. However, we noted no association between previous T gondii infection and risk of fetal death at all birth weight categories (> or = 1000, > or = 500 and <1000, and <500 g). CONCLUSION: These data do not indicate an increased risk of fetal death at > or = 20 weeks of gestation in women with previous maternal T gondii infection.

Birth Weight↗
PubMed2005

Recurrent risk of anal sphincter laceration among women with vaginal deliveries.

OBJECTIVE: The first aim of this study was to estimate the impact of anal sphincter laceration during the first delivery on the risk of recurrence in the second delivery. The second aim was to estimate the absolute risk of anal sphincter laceration in the second delivery according to the history of anal sphincter laceration and birth weight. METHODS: In this population-based cohort study, the study sample comprised all women included in the Norwegian Medical Birth Registry with 2 consecutive singleton vaginal deliveries during the period 1967-1998 (n = 486,463). The impact of prior anal sphincter laceration on recurrent anal sphincter laceration was estimated as crude and adjusted odds ratios (ORs). RESULTS: Anal sphincter laceration during first delivery increased the risk for a sphincter laceration in the next delivery, (adjusted OR 4.3, 95% confidence interval [CI] 3.8-4.8). Other risk factors were birth weight (adjusted OR 23.6, 95% CI 16.5-33.6, birth weight > 5,000 g versus birth weight < 3,000 grams), use of forceps (adjusted OR 5.1, 95% CI 4.3-6.0), use of vacuum (adjusted OR 1.4, 95% CI 1.1-1.7), and period of delivery (adjusted OR 4.3, 95% CI 3.7-5.0 for 1995-1998 versus 1967-1975). The absolute risks for anal sphincter laceration at second delivery for women with prior laceration were 1.3% (95% CI 0.4-3.2%) for birth weight less than 3,000 g and 23.3% (95% CI 11.8-38.6%) for birth weight more than 5,000 g. CONCLUSION: Only 10% of women with anal sphincter laceration at second delivery had a history of prior laceration. Prior anal sphincter laceration is associated with increased risk of laceration in second delivery, in particular in women who carry children with high birth weight. LEVEL OF EVIDENCE: II-2.

Adult↗
PubMed2005

Maternal antibodies against cytomegalovirus in pregnancy and the risk of fetal death and low birth weight.

BACKGROUND: The aim of this study was to assess the impact of maternal cytomegalovirus (CMV) antibody status in pregnancy on the risk of fetal death and of low birth weight. METHODS: The study of fetal death risk was a nested case-control study. Cases were all women within a cohort of 35,940 pregnant women in Norway 1992--94, who experienced fetal death after 16th week of gestation (n=281). Controls were 957 randomly selected women with live born children. Both groups were identified through linkage to the Norwegian Medical Birth Registry. The risk of low birth weight was studied in the live born children. RESULTS: Seventy-two percent (203/281) of the cases and 69% (662/957) of the controls had CMV immunoglobulin G (IgG) antibodies in the first trimester (P=0.3). 0.4% (1/281) of the cases and 0.7% (7/957) had CMV IgM antibodies in the first trimester (P=0.7). Among 322 initially CMV antibody-negative women, 11% (6/55) of the cases and 9% (24/267) of the controls had occurrence of CMV IgG and/or IgM antibodies (P=0.7) during pregnancy. Also, after control for maternal age, parity, and follow-up time, no association between CMV antibodies and fetal death was found. CMV antibody status was not associated with low birth weight. CONCLUSIONS: This study does not support a causal relation between CMV infection in pregnancy and fetal death or low birth weight.

Antibodies, Viral↗
PubMed2005

Epstein-Barr virus infection during pregnancy and the risk of adverse pregnancy outcome.

OBJECTIVES: To study the association between Epstein-Barr virus (EBV) antibody status in early pregnancy and pregnancy outcomes including fetal death, length of gestation and fetal weight and length at birth. DESIGN: Nested control study. SETTING: Population based health registers. POPULATION: The source population comprised 35,940 pregnant women. Cases were all (280) women with fetal death and a random sample of 940 women with a live born child. METHOD: Information on pregnancy outcome was obtained from the Norwegian Medical Birth Registry. Serum samples from the first trimester were tested for EBV antibodies. In women seronegative for EBV, further serum from late pregnancy was analysed to detect seroconversion. Main outcome measures Vital status, length of gestation, weight and length at birth. RESULTS: There was no association between EBV antibody status and fetal death. Women with significant EBV reactivation had a significantly shorter duration of pregnancy, and associated lighter babies, compared with women without significant reactivation (stillborn: 176 vs 197 days, P=0.16, and live born: 271 vs 279 days, P=0.03, respectively). CONCLUSION: Significant reactivation of EBV infection during pregnancy may influence pregnancy duration.

Adolescent↗
PubMed2005

Survival after surgery for congenital heart defects: does reduced early mortality predict improved long-term survival?

AIM: The objectives of this study were 1) to compare early mortality (first 30 d after surgery) and long-term survival between two cohorts of patients operated on for congenital cardiac defects, and 2) to evaluate the impact of possible changes in early mortality on long-term survival. METHODS: 945 patients with congenital cardiac defects, born in 1990-1999 and operated on in the same period were examined in a retrospective cohort study. The patients were divided into three groups: "univentricular cardiac defects", "severe cardiac defects" and "less severe cardiac defects". The study population was divided into two cohorts: group 1 included patients born and operated on in 1990-1994; group 2 included patients born and operated on in 1995-1999. The survival patterns in the two groups were compared. RESULTS: For all patients, except those with univentricular cardiac defects, early mortality (30 d after surgery) was reduced. Among patients with severe cardiac defects, early mortality was reduced from 18.6% in group 1 to 2.9% in group 2. Among patients with less severe cardiac defects, early mortality was reduced from 6.2% to 1.9%. The improved outcome was maintained during the following 5 y. Overall relative risk of death during follow-up was reduced to 0.31 (95% CI: 0.15-0.56) for patients with severe cardiac defects, and to 0.53 (95% CI: 0.31-0.93) for patients with less severe cardiac defects born and operated on in 1995-1999. CONCLUSION: Early mortality has been substantially reduced in congenital heart defect patients, and corresponds with significantly improved long-term survival.

Child, Preschool↗
PubMed2005

Treating mood disorders during pregnancy: safety considerations.

Mood disorders in pregnancy may have a negative effect on self care and pregnancy outcome that affects the mother directly and the child indirectly. Thus, some women may require pharmacological treatment. Pharmacotherapy of mood disorders during pregnancy implies specific considerations. This paper presents an updated review of available studies on the treatment of mood disorders and present knowledge on teratogenicity, neonatal effects and long-term neurobehavioural effects for the different psychotropic drugs, including treatment with selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), other antidepressants, benzodiazepines, lithium, carbamazepine/valproic acid, lamotrigine and novel antipsychotics. However, the existing knowledge on the use of antidepressants and mood stabilising agents during pregnancy is hampered by a lack of results from randomised controlled trials.SSRIs and TCAs have not been associated with an increased risk of major malformations, but poor neonatal adaptation has been described. Benzodiazepines used in the first trimester have been associated with orofacial clefts. Mood stabilisers such as lithium, carbamazepine and valproic acid (sodium valproate) are associated with an increased risk of fetal malformations. Both benzodiazepines and lithium may cause adaptation problems in the newborn. In utero exposure to novel antipsychotics has not been associated with congenital malformations; however, the data are still limited. The knowledge about long-term neurobehavioural effects in the offspring is still limited for all agents and requires further investigation. Possible adverse effects of fetal exposure must be balanced against the adverse effects of an untreated maternal mood disorder.

Adult↗
PubMed2004

Recurrence risk of preeclampsia in twin and singleton pregnancies.

The etiology of preeclampsia is unknown. The relatively high risk of recurrence of preeclampsia in subsequent pregnancies to the same mother suggests a genetic basis for the disease, but the mode of inheritance is uncertain. We compare the risk of preeclampsia in second pregnancies for mothers whose first preeclamptic pregnancy was either a singleton or a twin pregnancy. The crude and adjusted recurrence risks of preeclampsia in twin and singleton pregnancies were estimated in a population-based register including the first and second pregnancies of 550218 women registered in the Medical Birth Registry of Norway, 1967-1998. The recurrence risk of preeclampsia in second pregnancy for women with a singleton pregnancy with preeclampsia the first time was 14.1% (95% CI: 13.6-14.6). For women with a first time twin pregnancy the recurrence risk was lower, 6.8% (CI: 4.3-10.1), P < 0.001. Thus, the crude excess risk for recurrent preeclampsia was 7.3% (95% CI: 4.5-10.0) in women with a first time singleton as compared to women with a first time twin pregnancy. The recurrence risk of preeclampsia is lower when the first pregnancy was a twin as compared to a singleton pregnancy. This observation is consistent with a polygenic liability model.

Adult↗
PubMed2004

A population-based study of extra-cardiac anomalies in children with congenital cardiac malformations.

We describe the prevalence of extra-cardiac anomalies in children with congenital cardiac malformations, and their impact on survival, compared to the outcome in children with the congenital cardiac lesions as the only recognised anomaly. Our population comprises the 3527 children born with congenital cardiac anomalies between 1990 and 1999, and registered at the largest tertiary centre for Paediatric Cardiology in Norway. Extra-cardiac anomalies were found in one-fifth of the population, with Down's syndrome accounting for nearly one-third. Survival improved for children born between 1995 and 1999 compared with those born in the period from 1990 to 1994 for all groups, except for children with additional extra-cardiac anomalies in the absence of Down's syndrome. The results were the same for children undergoing surgical treatment of their cardiac malformation. The survival in children with Down's syndrome improved in comparable fashion to those without extra-cardiac anomalies. Children with extra-cardiac anomalies in the absence of Down's syndrome represent a heterogeneous group, with varying patterns of survival. Survival did not improve in these latter patients during the period of our study.

Abnormalities, Multiple↗
PubMed2004

The use of oral misoprostol for pre-abortion cervical priming: a randomised controlled trial of 400 versus 200 microg in first trimester pregnancies.

OBJECTIVE: To compare the impact of 200 and 400 microg oral misoprostol on pre-operative cervical priming in both primi- and multigravidae prior to first trimester termination of pregnancy. Pre-operative cervical dilatation and bleeding were assessed. DESIGN: Randomised controlled trial. SETTING: Norwegian university teaching hospital. SAMPLE: Five hundred and fifty-one women undergoing surgical termination of pregnancy between 7 and 12 weeks of gestation. METHODS: Patients were randomised to either 200 or 400 microg of oral misoprostol 10-16 hours before vacuum aspiration. The degree of cervical dilatation prior to abortion by vacuum aspiration was measured. Pre-operative bleeding and pain were recorded and vaginal bleeding was measured. MAIN OUTCOME MEASURES: Degree of pre-operative cervical dilatation and pre-operative bleeding. RESULTS: The mean cervical dilatation was 5.8 mm (SD 1.7) for the women who received 400 microg misoprostol and 5.4 mm (SD 1.4) for those who received 200 microg (P= 0.004). The pre-operative dilatation was larger in multigravidae than in primigravidae in both dosage groups. The odds ratio (OR) of pre-operative bleeding was 3.3 (95% confidence interval [CI] 2.1-5.0) in the 400 microg dosage group, as compared with the group receiving 200 microg misoprostol. The occurrence of bleeding was dose-dependent. Frequency of bleeding was similar in multigravidae compared with primigravidae in the 400 microg dosage group, whereas the occurrence of bleeding was less in primigravidae than multigravidae in the 200 microg dosage group. Only 89 out of 551 patients bled one or more grams. The volumes measured were not statistically significantly different. Complications were minor, and were distributed equally between the two dosage groups. CONCLUSIONS: The 200 microg oral misoprostol compared with the 400 microg oral misoprostol given 10-16 hours before first trimester surgical abortions results in less pre-operative vaginal bleeding and in a statistically, although not clinically significant reduction in cervical dilatation.

Abortifacient Agents, Nonsteroidal↗
PubMed2003

[Postnatal care in a cross-cultural and historical perspective].

BACKGROUND: In most societies, birth and the immediate postpartum period are considered a time of vulnerability for mother and child. Rituals for major changes in the life cycle are common in most societies. The aim of this study was to present some examples of postpartum customs in a cross-cultural and historical perspective. We also present research on associations between postnatal care and mental health. MATERIAL AND METHODS: A systematic search was performed in Medline and the Science Citation Index Expanded (ISI) from 1966 until March 2003. Reference lists in books about pregnancy and birth from the library of the University of Oslo were used to get additional information. RESULTS: The postnatal period is defined as approximately 40 days in most cultures; most societies have special postnatal customs that include special diet, isolation, rest and help in the household. The resemblance between different cultures is striking. Many postnatal customs from rural societies that were common before 1950 have disappeared. The focus on rest and help in the household for the mother after delivery has been reduced. INTERPRETATION: We need more knowledge about the impact of different kinds of postnatal care on the mother's wellbeing.

Anthropology↗
PubMed2003

HIV and hepatitis C virus risk in new and longer-term injecting drug users in Oslo, Norway.

Research has focused on understanding injecting drug use initiation in the era of HIV/AIDS. However, differences between new and longer-term injecting drug users (IDUs) have not received as much attention. This study examined injecting initiation experience, risk and risk reduction practices, and self-reported HIV and hepatitis C virus (HCV) testing practices and infection among new (injecting < or =4 years) and longer-term IDUs. Data from 3 cross-sectional surveys in 1992, 1994, and 1997 of syringe exchange program (SEP) users in Oslo, Norway, were used. Approximately one fifth of IDUs were new injectors. New IDUs were increasingly indistinguishable from longer-term IDUs in terms of socio-demographics, risk practices, and HIV and HCV testing. The prevalence of HIV infection remained low (5%); in contrast, approximately two thirds of all SEP users reported being HCV-infected. Known HCV infection status had no impact on syringe sharing; most HCV-infected SEP users reported sharing syringes, regardless of the duration of injecting. The only variable associated with HCV infection was injecting < or =4 years (adjusted odds ratio = 0.2; 95% confidence interval = 0.1-0.4). Increased similarity in age between new and longer-term IDUs may have contributed to the rapid spread of HCV infection by facilitating mixing patterns between HCV-infected and -susceptible IDUs.

Adolescent↗
PubMed2003

A comparison of anxiety and depressive symptomatology in postpartum and non-postpartum mothers.

BACKGROUND: The aim of the study was to compare the distribution of symptoms of anxiety and depression among postpartum as compared with non-postpartum mothers, and to estimate the impact of the postpartum period on the risk of anxiety and depression when adjusted for other risk factors. METHODS: A questionnaire survey approaching all women 18-40 years of age in two municipalities in Norway during the period 1998-1999 was conducted. A total of 2,730 women were included, of whom 416 were in the postpartum period. Only women with one or more deliveries (n = 1,794) were included in the multivariate analyses. RESULTS: The crude prevalence of anxiety and depression was lower in postpartum as compared to non-postpartum mothers. However, when controlling for other risk factors, the odds ratio for anxiety was 1.2 (95% CI: 0.6-2.3) and for depression 1.8 (95% CI: 1.1-2.9) during the postpartum period. CONCLUSION: The overall risk of anxiety appeared to be the same in both groups, whereas the risk of depression was increased in the postpartum group.

Adolescent↗
PubMed2003

Legal access to needles and syringes/needle exchange programmes versus HIV counselling and testing to prevent transmission of HIV among intravenous drug users: a comparative study of Denmark, Norway and Sweden.

BACKGROUND: Countries have adopted different strategies to prevent the transmission of HIV among intravenous drug users. Legal access to needles and syringes/needle exchange programmes as part of such a strategy has been heavily debated. HIV counselling and testing has also been part of prevention strategies. The objective of this study was to discuss the effectiveness of legal access to needles and syringes/ needle exchange programmes versus HIV counselling and testing among intravenous drug users (IDUs) as part of HIV prevention strategies. METHODS: Differences in HIV prevention strategies in Denmark, Norway and Sweden among IDUs are described. Outcome variables of effectiveness were HIV incidence rates over time. These were estimated by back calculation methods from 1980 through 1996, using data from the national HIV and AIDS registers. RESULTS: A comparison of HIV prevention strategies in Denmark, Norway and Sweden suggests that a high level of HIV counselling and testing might be more effective than legal access to needles and syringes/needle exchange programmes. Sweden and Norway, with higher levels of HIV counselling and testing, have had significantly lower incidence rates of HIV among IDUs than Denmark where there was legal access to needles and syringes and a lower level of HIV counselling and testing. In Sweden there was no legal access to drug injection equipment. CONCLUSION: Promotion and accessibility of HIV counselling and testing among intravenous drug users should be considered in countries where such a strategy is not adopted or has low priority.

AIDS Serodiagnosis↗