[Show abstract][Hide abstract] ABSTRACT: Background:
Deficits in information processing may be a core deficit after fetal alcohol exposure. This study was designed to investigate the possible effects of weekly low to moderate maternal alcohol consumption and binge drinking episodes in early pregnancy on choice reaction time (CRT) and information processing time (IPT) in young children.
Participants were sampled based on maternal alcohol consumption during pregnancy. At the age of 60-64 months, 1,333 children were administered a modified version of the Sternberg paradigm to assess CRT and IPT. In addition, a test of general intelligence (WPPSI-R) was administered.
Adjusted for a wide range of potential confounders, this study showed no significant effects of average weekly maternal alcohol consumption during pregnancy on CRT or IPT. There was, however, an indication of slower CRT associated with binge drinking episodes in gestational weeks 1-4.
This study observed no significant effects of average weekly maternal alcohol consumption during pregnancy on CRT or IPT as assessed by the Sternberg paradigm. However, there were some indications of CRT being associated with binge drinking during very early pregnancy. Further large-scale studies are needed to investigate effects of different patterns of maternal alcohol consumption on basic cognitive processes in offspring.
PLoS ONE 09/2015; 10(9):e0138611. DOI:10.1371/journal.pone.0138611 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective Little is known about the potential health effects of eating organic food either in the general population or during pregnancy. The aim of this study was to examine associations between organic food consumption during pregnancy and the risk of pre-eclampsia among nulliparous Norwegian women.
Design Prospective cohort study.
Setting Norway, years 2002–2008.
Participants 28 192 pregnant women (nulliparous, answered food frequency questionnaire and general health questionnaire in mid-pregnancy and no missing information on height, body weight or gestational weight gain).
Main outcome measure Relative risk was estimated as ORs by performing binary logistic regression with pre-eclampsia as the outcome and organic food consumption as the exposure.
Results The prevalence of pre-eclampsia in the study sample was 5.3% (n=1491). Women who reported to have eaten organic vegetables ‘often’ or ‘mostly’ (n=2493, 8.8%) had lower risk of pre-eclampsia than those who reported ‘never/rarely’ or ‘sometimes’ (crude OR=0.76, 95% CI 0.61 to 0.96; adjusted OR=0.79, 95% CI 0.62 to 0.99). The lower risk associated with high organic vegetable consumption was evident also when adjusting for overall dietary quality, assessed as scores on a healthy food pattern derived by principal component analysis. No associations with pre-eclampsia were found for high intake of organic fruit, cereals, eggs or milk, or a combined index reflecting organic consumption.
Conclusions These results show that choosing organically grown vegetables during pregnancy was associated with reduced risk of pre-eclampsia. Possible explanations for an association between pre-eclampsia and use of organic vegetables could be that organic vegetables may change the exposure to pesticides, secondary plant metabolites and/or influence the composition of the gut microbiota.
BMJ Open 09/2014; 4(9):e006143. DOI:10.1136/bmjopen-2014-006143 · 2.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The study “Successive Small-for-Gestational Age Births” (SGA study) was initiated and is sponsored by the National Institutes of Health (N.I.H.) in the U.S.A. Its purpose is to describe and characterize the different types of intra-uterine growth retardation and their consequences, to assess the associated risk factors, and to provide a basis for preventive measures. Starting in 1986, it runs concurrently in Bergen and Trondheim (Norway), Uppsala (Sweden) and Birmingham, Alabama (U.S.A), recruiting pregnant para 1 and 2 mothers at high risk of having an SGA birth and a random (control) sample of the total pregnant population. Data collection will end in late 1989, when the last-born children have reached 13 months of age. At the present symposium, investigators from all four study centers and the N.I.H. described the study design and discussed problems of methodology. Strict standardization of parameters to determine gestational age (ultrasound, menstrual dates) is a prerequisite for comparison of results over time and between study centers. Some preliminary results were presented.
[Show abstract][Hide abstract] ABSTRACT: It has been suggested that even mild exposure to alcohol, caffeine, smoking, and poor diet may have adverse long-term neurodevelopmental effects. In addition, there is evidence that timing of high exposures (e.g. binge drinking) can have particularly negative effects. This paper describes the design and implementation of The Lifestyle During Pregnancy Study addressing major methodological challenges for studies in this field. The study examines the effects of lifestyle during pregnancy on offspring neurodevelopment.
In 2003, we initiated a prospective follow-up of 1750 mother-child pairs, sampled on the basis of maternal alcohol drinking patterns from The Danish National Birth Cohort (DNBC), a study of 101,042 pregnancies enrolled 1997-2003. Data collection in the DNBC involved four prenatal and postnatal maternal interviews, providing detailed information on maternal alcohol drinking patterns before and during pregnancy, caffeine intake, smoking, diet, and other lifestyle, medical, and sociodemographic factors.
At the age of 5 years, the children and their mothers participated in a comprehensive assessment of neurobehavioural development focusing on global cognition, specific cognitive functions, and behaviour. Two new tests assessing attention and speed of information processing among children were developed, and data on important potential confounders such as maternal intelligence quotient, vision, and hearing abilities were collected. Efforts were made to standardise procedures and obtain high inter-rater reliability.
We expect that the study will illuminate the significance or lack of significance of maternal lifestyle during pregnancy and contribute to better understanding the effects of alcohol drinking during pregnancy at low to moderate consumption levels.
Scandinavian Journal of Public Health 03/2010; 38(2):208-19. DOI:10.1177/1403494809357093 · 1.83 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Leukemia incidence in childhood has been shown to increase with birth weight. The purpose of this paper is to study whether the incidence of other childhood cancers also increases with birth weight.
The Norwegian Medical Birth Registry was linked to the Norwegian Cancer Registry. The data consisted of 1.65 million children, of whom 3252 had a cancer diagnosis before age 16 years. The diagnoses were divided into 1010 leukemia cases, 870 cancer cases of the central nervous system (CNS), and 1370 remaining cancers.
The increase in hazard rate for all cancers with a 1 kg increase in birth weight was 1.23 (95% confidence interval = 1.14-1.32) after adjustment. For leukemia the increase was 1.29 (1.14-1.47), for CNS cancers 1.07 (0.93-1.23), and for the remaining cancer diagnoses 1.29 (1.16-1.40).
There seems to be a general relationship between heavier birth weight and cancer incidence in childhood.
[Show abstract][Hide abstract] ABSTRACT: Methodology varies greatly in whiplash studies; therefore, results are not directly comparable. Headache seems to be present in 50% to more than 75% of cases in the acute stage, and in 20% to 30% of cases in the early chronic stage. Headache naturally occurs frequently (> 75% of the cases ) in patients who consult headache specialists due to protracted symptoms. Malingering may explain some cases, and continuation/activation of prewhiplash headache may explain other cases. De novo headache also seems to occur. This headache may partly have cervicogenic headache characteristics: side-locked unilaterality and occipital onset. In one study, this type of headache was present in 8% at 6 weeks and 1% at 6 years. It was more rare than postwhiplash, unspecified headache. De novo postwhiplash headache may consist of cervicogenic headache and of noncervicogenic headache (probably in the acute phase).
Current Pain and Headache Reports 02/2009; 13(1):52-8. DOI:10.1007/s11916-009-0011-3 · 2.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The tendency to repeat birth weight in successive birth was first published in 1977. The study was based on 81 400 mothers who had their first and second singleton birth within the study period 1967-73, based on information in the Medical Birth Registry of Norway. The paper was presented at a large NICHD (National Center of Child Health and Human Development, NIH) seminar focusing on preterm birth. This meeting started a creative, international long lasting collaboration, a series of papers and book chapters has been published. It seemed like mothers are programmed to give birth to babies of a certain size and age. And if they depart from this norm the baby is at an increased risk of mortality. Also, the tendency to repeat gestational age and birth weight exists across generations, with the same increased risk if the pattern is departed from. This means that if a mother who herself was of low birth weight give birth to a likewise small baby, then that baby has improved survival compared to a likewise small baby where the mother was relatively heavy. This effect across generations is also present on the paternal in addition to the maternal side. Recently the medical birth registration data set has provided possibilities to examine the effect of changing partners from one pregnancy to the next one. Also, half siblings (maternal and paternal) is another valuable data source to explore. Soon 3 generational repeater studies will become available as the first births in the registry by now become grandmothers and grandfathers.
[Show abstract][Hide abstract] ABSTRACT: To study migraine without aura (MwoA) prevalence in the commune of Vågå, Norway; 1838 (18- to 65-year-old) individuals were included. A special search was made for cervicogenic characteristics in MwoA, as it has been claimed that such characteristics may frequently be present. A comparison with cervicogenic headache (CEH) was made.
The MwoA and tension-type headache (T-TH) diagnosis was based on IHS criteria. CEH diagnosis was based on the principles of The Cervicogenic Headache International Study Group.
There were 562 cases of MwoA; prevalence: 31%. There were 425 cases of 'pure' MwoA, i.e. without coexisting T-TH. These 'pure' cases were used for extracting MwoA symptoms. The female/male ratio was 1.69, the corresponding ratio in CEH being 0.71. Typical MwoA symptoms such as nausea/photophobia were most frequently found in migraine. This difference amounted to a factor of > or =2.6. On the other hand, typical CEH traits, like mechanical pain provocation and 'posterior' onset of exacerbations, occurred more frequently in CEH than in MwoA. The difference amounted to a factor of two or more.
MwoA and CEH have clearly different characteristics. The differences between MwoA and CEH are staggering. It is unlikely that migraine and CEH are linked in a nosological sense.
[Show abstract][Hide abstract] ABSTRACT: To describe the prevalence and various clinical characteristics of cervicogenic headache (CEH) in the population at large.
CEH was searched for in Vågå, Norway, where 1838 18 to 65-year-old citizens, i.e. 88.6% of this age group, underwent an interview/clinical examination. The Cervicogenic Headache International Study Group criteria include: (I) unilaterality of head pain, (II) reduction, range of movement, neck, (III/IV) ipsilateral shoulder/arm discomfort, (V/VI) mechanical provocation of similar pain, objectively or subjectively.
A prevalence of 4.1% was found. In 41 cases with the highest number of CEH criteria ('core' cases), there was a male preponderance (F/M: 0.71). While cervicogenic traits (mechanical precipitation etc.) were frequently present in CEH, 'migraine traits', like nausea, vomiting, and throbbing seemed to be rarely present. In 97% of the cases, pain exacerbations began in the neck/occipital region.
CEH may be one of the three large, recurrent headaches. In this series, there was no female preponderance. Nuchal onset of pain is a characteristic trait.
[Show abstract][Hide abstract] ABSTRACT: Thus far, few factors with a causal relation to preterm birth have been identified. Many studies have focused on the woman's diet, but most have been discouraging. The aim of the present study was to examine if maternal intake of a Mediterranean-type diet (MD) is associated with reduced risk of preterm birth.
The Danish National Birth Cohort assessed diet in mid-pregnancy by food frequency questionnaires (FFQ). Women consuming MD were those who ate fish twice a week or more, used olive or rape seed oil, consumed 5+ fruits and vegetables a day, ate meat (other than poultry and fish) at most twice a week, and drank at most 2 cups of coffee a day.
Of 35,530 non-smoking women, 1,137 (3.2%) fulfilled all MD criteria, and 540 (1.5%) none. Odds ratios for preterm birth and early preterm birth were 0.61 (95% Confidence Interval (CI): 0.35-1.05) and 0.28 (0.11-0.76), respectively, in MD women compared to women fulfilling none of the MD criteria.
Shifting towards a MD during pregnancy may reduce the risk of early delivery in Danish women.
[Show abstract][Hide abstract] ABSTRACT: The scope of optometry differs worldwide. In Norway the vast majority of optometrists perform ophthalmoscopy as part of their routine examinations. The aim of this study was to describe the frequency of suspected retinopathies in patients seen for routine optometric examination and to determine how optometrists deal with these patients.
212 optometrists participated in a questionnaire survey and a practice registration during November 2004 - May 2005. In the practice registration, details for 20 consecutive patient encounters were recorded. Data were analysed by chi-square tests and multiple logistic regression.
All optometrist stated that ocular history taking was an integrated part of their routine examination, while general health and diabetes history were routinely addressed by 59% and 42% of the optometrists, respectively. During the practice registration 4,052 patient encounters were recorded. Ophthalmoscopy was performed in 88% of the patients, of which 2% were dilated fundus examinations. Retinopathy was suspected in 106 patients, of whom 31 did not report a previous history of ocular or systemic disease. Old age (75+), hypertension and diabetes strongly predicted retinopathy with odds ratio (95% CI) of 6.4 (4.2 to 9.9), 3.8 (2.4 to 6.0) and 2.5 (1.4 to 4.7), respectively. Diabetic retinopathy was seen in 10% of diabetic patients and suspected in 0.2% of patients with no established history of diabetes. Retinopathy was not confirmed in 9 out 18 patients with a history of diabetic retinopathy; seven of these had undergone laser treatment. Out of the 106 patients with findings of retinopathy, 28 were referred to an ophthalmologist or a general practitioner (GP), written reports were sent to a GP in 16 cases, ten patients were urged to contact their GP for further follow up, while 52 were considered in need of routine optometric follow up only.
Optometric practice provides a low threshold setting for detecting cases of ocular disease and retinal manifestations of systemic disease in the population. At present diagnosis of retinopathy in Norwegian optometric practice is unreliable. There are potentials for improving the optometrists' routine examination, their patient management patterns and collaboration routines with medical doctors.
BMC Health Services Research 02/2008; 8:38. DOI:10.1186/1472-6963-8-38 · 1.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The decline in perinatal mortality in a Swedish county during a six year period is examined and analyzed by use of perinatal audit. The decline coincided with an increased rate of in utero transfers of infants, particularly those with low birth weights, to the specialized county hospital. The perinatal audit revealed that the proportion of deaths which were classified as potentially avoidable, decreased significantly over the study period.
[Show abstract][Hide abstract] ABSTRACT: Mediterranean diet has been shown to reduce the incidence of preterm birth. We wanted to investigate whether a Mediterranean-type diet (MD) could be associated with a lower risk of preterm birth in the Norwegian Mother and Child Cohort Study (MoBa).
The data collection was conducted as part of MoBa at the Norwegian Institute of Public Health. In MoBa, women answer a Food Frequency Questionnaire (FFQ) at week 18-22 of pregnancy. The MD criteria were intake of fish > or =2 times a week, fruit and vegetables > or =5 times a day, use of olive/canola oil, red meat intake < or = times 2 a week, and < or =2 cups of coffee a day.
A total of 569 women (2.2%) met the MD criteria, 25,397 women (97.2%) met 1-4 criteria, and 159 women (0.01%) met none of the MD criteria. The number of preterm births in the MD group was 26 (4.6%), in those who met 1-4 criteria it was 1,148 (4.5%), and in those who met none of the criteria it was 10 (6.3%). The women who met the MD criteria did not have reduced risk of preterm birth compared with women meeting none of the MD criteria (OR: 0.73; 95% CI: 0.32, 1.68). Intake of fish twice or more a week was associated with a lower risk of preterm birth (OR: 0.84; 95% CI: 0.74, 0.95).
The women who fulfilled the criteria of a MD did not have a reduced risk of preterm birth.
[Show abstract][Hide abstract] ABSTRACT: The aim of the present study was to describe the prevalence of tension-type headache (T-TH) in rural Norway, and 1838 citizens aged 18-65 years were included. Features indicating neck involvement were also looked for. T-TH was compared with migraine without aura and with cervicogenic headache (CEH) considering both these features and typical migraine traits. Face-to-face interviews were carried out, based on an elaborate questionnaire. The IHS criteria, first version, were used for T-TH diagnosis. A T-TH prevalence of 34% was found. In T-TH and migraine without aura, typical CEH features, such as reduced range of motion in the neck and mechanical provocation of pain, were far less prominent than in CEH. Typical migraine traits, e.g. photophobia, were much less frequently present in T-TH and CEH than in migraine without aura. T-TH is, in all probability, not a CEH variant and vice versa.
[Show abstract][Hide abstract] ABSTRACT: To describe optometric practitioners and their encountering patients.
All members of the Norwegian Association of Optometrists working in the community (n = 761) were invited to participate in a questionnaire survey; questionnaire responders (n = 508) were asked to take part in a practice registration. Data collection was carried out between November 2004 and May 2005 using a questionnaire and a practice registration form.
Five hundred and eight optometrists responded to the questionnaire; of these 212 participated in the practice registration, in which 4052 patient encounters were recorded. All optometrists reported taking patient history in the areas of vision and ocular health; 55% asked questions about general health for all patients. More than 80% collaborated with general practitioners and ophthalmologists. The patient encounters were with 1699 men and 2216 women; 60% of patients were aged 45 years or older. Patients reported a history of ocular disease and other conditions of relevance for ocular health in 12% and 17% of encounters, respectively. One per cent had low vision [best corrected visual acuity (BCVA) < 0.33] and 2% were visually impaired (BCVA < 0.5). Ophthalmoscopy was performed for 88% of patients; dilated fundus examinations were carried out for 2%; clinical findings of cataract were reported for 11%; and retinopathy was suspected in 3%. Six per cent of patients were referred to a general practitioner or ophthalmologist.
Optometrists generally collaborate with general practitioners and ophthalmologists. They take history, investigate and assess patients with ocular problems. A significant number of patients had primary or secondary ocular disease. This illustrates the role of optometrists as healthcare workers.
[Show abstract][Hide abstract] ABSTRACT: In the Vågå study of headache epidemiology, 1838 parishioners in the age group 18-65 years were included (88.6% of the relevant population). Each individual was questioned in a face-to-face situation. In this population, a search of rare unilateral headaches was also made, in spite of their presumed rarity. Trigeminal neuralgia was present in two cases. Two individuals with SUNCT traits were observed. Hemicrania continua may have been present in one individual. Also observed were: optic neuritis (n=1), herpes zoster (n=4); a case of unilateral headache upon neck rotation (chronic paroxysmal hemicrania variant? or "forme fruste" of the neck-tongue syndrome?); masseter muscle spasm (n=1); temporo-mandibular joint dislocation (n=1); and possible carotidynia (n=3). A particularly intriguing form of headache was a unilateral, neuralgiform (?) pain, associated with ipsilateral, regular jabs and allodynia, a combination observed in eight females. A couple of conditions that entirely defy rubrication are also reported.
The Journal of Headache and Pain 03/2007; 8(1):19-27. DOI:10.1007/s10194-006-0292-4 · 2.80 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Cigarette smoking during pregnancy is causally related to birthweight, but we do not know whether fetal growth restriction is a continuous process or, if not, at what stage of pregnancy it affects weight gain.
A random sample of para 1 and 2 mothers, drawn from the population of pregnant women in Bergen and Trondheim, Norway, and Uppsala, Sweden, were examined by a detailed questionnaire concerning smoking habits, menstrual history and pregnancy dating, and subjected to morphometric sonography of their fetuses in or around week 17. Of the 547 study participants, 31.9% were smokers. Gestational age was primarily determined by the last menstrual period [LMP], except in those with irregular cycles, and in 30 cases (6.6% of those with regular cycles) in whom the biparietal diameter [BPD]-determined age deviated >14 days from the LMP-based date.
The analysis did not reveal any statistically significant differences between the fetuses of non-smokers, light smokers (0-9 cigarettes per day) and heavy (10+ cigarettes per day) smokers, regarding BPD, mean abdominal diameter [MAD] femur length [FL], and a 'body contour index': [BPD+FL]/MAD.
Tobacco-induced fetal growth restriction probably begins after gestational week 17.
[Show abstract][Hide abstract] ABSTRACT: During the Vågå headache epidemiology study, there were indications that various types of work, such as carpentry and hairdressing, frequently seemed to be linked to a combination of neckache and headache.
A post hoc study was conducted among 1838, 18- to 65-year-old Vågå citizens, looking for patients with combined neck/headache.
Face-to-face interview was conducted.
Combined neckache and headache were detected in 121 (6.6%) individuals. The bilateral headache originated in the neck; it was mild/moderate, symptom-poor, and frequently provoked by awkward neck positions. No such headache occurred without a neckache. Headache in this group of patients resembles tractor drivers' headache, except for the provoking factor itself.
This headache is not listed in headache classification systems/textbooks on headache. This headache must be distinguished from the unilateral cervicogenic headache proper because of the different treatment perspectives.
[Show abstract][Hide abstract] ABSTRACT: Previous studies have demonstrated the tendency to repeat gestational age and birthweight in successive pregnancies and that this tendency is associated with infant survival. Thus, newborn outcome and survival is less favourable if the gestational age and size departs from this maternal tendency. This paper aims to study diseases or conditions that might be associated with this effect. Data were provided through a linkage between three Danish health registries: the Danish Fertility Database, the National Hospital Registry, and the Registry for Preventive Medicine. Such linkage was possible due to the use of unique ID-person numbers. The study included all 8219 second-order low-birthweight (LBW) singleton Danish births, 1980–94, of whom 7811 were liveborn. It was also required that the mother's first delivery took place during that period. The analysis considered 7803 of these births; eight were excluded due to insufficient information. Of the second-order LBW children, 26% had an elder sibling who was also LBW.
Early neonatal mortality of a ‘non-repeat’ LBW birth was 1.3 times higher than ‘repeat’ LBW births [53.8 vs. 41.2 per 1000; RR 1.31; 95% CI 1.03, 1.65], as was infant mortality [78.4 vs. 60.8 per 1000; RR 1.30; 95% CI 1.06, 1.56]. Also, proportionately more LBW repeat births had Apgar scores of ≥7 after 1 and 5 min. Overall, repeat second-order LBW babies weighed 68 g more than non-repeat LBW babies (P < 0.001). At term, the weight difference was 160 g higher among repeat LBW births (P < 0.001). The mean number of hospitalisations during the first year of life was lower among repeat than non-repeat LBW babies (2.30 vs. 2.46, P < 0.001), while the mean duration of stay was 23.71 vs. 23.97 days (P > 0.05). Newborn immaturity was the most common diagnosis for hospitalisation, and infections the second most common. There were no differences between repeat and non-repeat LBW births in the proportion with each diagnosis. Apart from the differences in birthweight, we were unable to explain the improved survival for repeat compared with non-repeat LBW babies. Except for differences in Apgar scores, we observed no differences in morbidity based on registered hospitalisations during infancy.