Anna-Karin Edstedt Bonamy

Karolinska Institutet | KI · Department of Medicine, Solna

Background: In small clinical studies, preterm birth was associated with altered cardiac structure and increased cardiovascular mortality in the young. Objectives: The goal of this study was to determine the association between preterm birth and risk of incident heart failure (HF) in children and young adults. Methods: This register-based coho...

Pregnancy characteristics are associated with risk of cardiovascular diseases, but their independent associations with hypertension or blood pressure (BP) levels remain uncertain. We linked the Swedish Medical Birth Register with Västerbotten Intervention Program data (Northern Sweden). Using linear and logistic regression, we related pregnancy fac...

Background: Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. Objectives: The aim of this work was to study regional variations in PDA treatment in very preterm infants (≤31 weeks of gestation),...

Background: The optimal timing of pharmacological treatment for patent ductus arteriosus (PDA) in extremely preterm infants is unknown. Objective: To investigate whether timing of pharmacological PDA treatment is associated with a risk of secondary PDA surgery or death before 3 months of age, or bronchopulmonary dysplasia (BPD) in extremely pret...

The aim was to investigate the association of gestational age (GA), echocardiographic markers and levels of plasma N-terminal pro-B-type natriuretic peptide (NTproBNP) with the closure rate of a haemodynamically significant patent ductus arteriosus (hsPDA). Ninety-eight Swedish extremely preterm infants, mean GA 25.7 weeks (standard deviation 1.3),...

Background Loss to follow-up is a major challenge for very preterm (VPT) cohorts; attrition is associated with social disadvantage and parents with impaired children may participate less in research. We investigated the impact of loss to follow-up on the estimated prevalence of neurodevelopmental impairment in a VPT cohort using different methodolo...

Background/Aims: Extra-uterine growth restriction (EUGR) is common among very preterm (VPT) infants and has been associated with impaired neurodevelopment. Some research suggests that adverse effects of EUGR may be more severe in boys. We investigated EUGR and neurodevelopment at 2 years of corrected age (CA) by sex in a VPT birth cohort. Methods...

Background: Smartphones have made it possible for patients to digitally report symptoms before physical primary care visits. Using machine learning (ML), these data offer an opportunity to support decisions about the appropriate level of care (triage). Objective: The purpose of this study was to explore the interrater reliability between human p...

Background Maternal overweight and obesity might increase risks of adiposity and cardiovascular and metabolic diseases in offspring. We examined associations between maternal overweight and obesity severity and risk of cardiovascular diseases in young offspring. Methods In this population-based cohort study, we used data from live singleton births...

This Swedish register-based cohort study determined the separate and joint contribution of preeclampsia and multi-fetal pregnancy on a woman’s risk of cardiovascular disease (CVD) later in life. The study included 892 425 first deliveries between 1973 and 2010 of women born 1950 until 1971, identified in the Swedish Medical Birth Register. A compos...

Aim This study investigated patent ductus arteriosus (PDA) treatment and neurodevelopmental outcomes when extremely preterm born children reached 6.5 years. Method Our cohort was 435 children with neonatal PDA treatment data and neurodevelopmental follow‐up data, born in 2004‐2007, who participated in the Extremely Preterm Infants in Sweden Study....

BACKGROUND Smartphones have made it possible for patients to digitally report symptoms before physical primary care visits. Using machine learning (ML), these data offer an opportunity to support decisions about the appropriate level of care (triage). OBJECTIVE The purpose of this study was to explore the interrater reliability between human physi...

In this prospective cohort study of healthy full-term infants, we hypothesized that high-sensitivity cardiac troponin T (hs-cTnT) would be elevated in cord blood, compared with adult reference values, and that it would further increase over the first days of age. Cardiac troponin T has been shown to be significantly increased in healthy full-term n...

Objective To determine whether the variation in neurodevelopmental disability rates between populations persists after adjustment for demographic, maternal and infant characteristics for an international very preterm (VPT) birth cohort using a standardised approach to neurodevelopmental assessment at 2 years of age. Design Prospective standardised...

Aim: Postnatal hypoglycaemia in newborn infants remains an important clinical problem where prolonged periods of hypoglycaemia are associated with poor neurodevelopmental outcome. The aim was to develop an evidence based national guideline with the purpose to optimise prevention, diagnosis and treatment of hypoglycaemia in newborn infants with a g...

Background & aim: Extremely preterm infants face substantial neonatal morbidity. Nutrition is important to promote optimal growth and organ development in order to reduce late neonatal complications. The aim of this study was to examine the associations of early nutritional intakes on growth and risks of bronchopulmonary dysplasia (BPD) and retino...

Background: Exposure to traffic noise has been associated with hypertension in adults but the evidence in adolescents is limited. We investigated long-term road traffic noise exposure, maternal occupational noise during pregnancy and other factors in relation to blood pressure and prehypertension at 16 years of age. Methods: Systolic and diastol...

Background: Adverse developmental programming by early-life exposures might account for higher blood pressure (BP) in children born extremely preterm. We assessed associations between nutrition, growth and hyperglycemia early in infancy, and BP at 6.5 years of age in children born extremely preterm. Methods: Data regarding perinatal exposures incl...

Background: Congenital heart defects are more frequent in offspring of mothers with overweight or obesity. However, associations between maternal overweight and obesity, and risks of complex and specific heart defects are not clear. Objectives: This study sought to analyze associations between maternal overweight and obesity severity and rates o...

Aim Children born very preterm require additional specialist care because of the health and developmental risks associated with preterm birth, but information on their health service use is sparse. We sought to describe the use of specialist services by children born very preterm in Europe. Method We analysed data from the multi‐regional, populati...

Aim Using snus, an oral moist tobacco, has increased among pregnant women in Sweden, the only European Union country where sales are legal. This study evaluated whether snus generated similar concentrations of nicotine and its metabolites in breast milk to cigarette smoking. Methods We analysed 49 breast milk samples from 33 nursing mother – 13 sn...

Breastfeeding confers multiple benefits for the health and development of very preterm infants, but there is scarce information on the duration of breastfeeding after discharge from the neonatal intensive care unit (NICU). We used data from the Effective Perinatal Intensive Care in Europe population‐based cohort of births below 32 weeks of gestatio...

Introduction: Oral moist snuff is widely used in Sweden also in pregnancy. Maternal snuff use has been associated with increased risks of adverse pregnancy outcomes in epidemiological studies. Self-reported maternal snuff use has not been validated previously. The main objective of this study was to validate self-reported snuff use in pregnancy in...

Aim: This study investigated the different strategies used in 11 European countries to prevent hypothermia, which continues to affect a large proportion of preterm births in the region. Methods: We examined the association between the reported use of hypothermia prevention strategies in delivery rooms and body temperatures on admission to neonat...

Objective To investigate the variation in severe neonatal morbidity among very preterm (VPT) infants across European regions and whether morbidity rates are higher in regions with low compared with high mortality rates. Design Area-based cohort study of all births before 32 weeks of gestational age. Setting 16 regions in 11 European countries in...

Background Advances in perinatal medicine have increased infant survival after very preterm birth. Although this progress is welcome, there is increasing concern that preterm birth is an emerging risk factor for hypertension at young age, with implications for the lifetime risk of cardiovascular disease. Methods and Results We measured casual bloo...

Breast milk feeding (BMF) is associated with lower neonatal morbidity in the very preterm infant (<32 weeks gestation) and breastfeeding is beneficial for maternal health. Previous studies show large variations in BMF after very preterm birth and recognize the need for targeted breastfeeding support in the neonatal intensive care units (NICU). In a...

Importance Administration-to-birth intervals of antenatal corticosteroids (ANS) vary. The significance of this variation is unclear. Specifically, to our knowledge, the shortest effective administration-to-birth interval is unknown. Objective To explore the associations between ANS administration-to-birth interval and survival and morbidity among...

Aim: This study assessed the prevalence of small for gestational age (SGA) among very preterm (VPT) infants using national and European intrauterine references. Methods: We generated country-specific and common European intrauterine growth references for 11 European countries, according to Gardosi's approach and Hadlock's fetal growth model, by...

Background and objective: Stillbirth and in-hospital mortality rates associated with very preterm births (VPT) vary widely across Europe. International comparisons are complicated by a lack of standardized data collection and differences in definitions, registration, and reporting. This study aims to determine what proportion of the variation in s...

Objectives The use of magnesium sulfate (MgSO4) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4 in women delivering before 32 weeks of gestation by indication. Methods We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort study of births before 32 we...

Importance: The results of preclinical studies suggest that anesthetic drugs administered to neonatal animals cause widespread neuronal apoptosis and later neurocognitive impairment. Adequately powered studies in the pediatric surgical population are scarce, and it is unclear whether such preclinical findings are relevant for the pediatric setting...

Background Preterm birth increases risk for adult cardiovascular disease. We hypothesized that arteries in 6-year-old children born preterm are narrower, with thicker intima-media and stiffer than in peers born at term.Methods Children born extremely preterm (EXP, n=176, birthweights: 348-1161g) and at term (CTRL, n=174, birthweights: 2430-4315g) w...

Objective: To study the associations of maternal tobacco use (smoking or use of snuff) and risk of extremely preterm birth, and if tobacco cessation before antenatal booking influences this risk. To study the association between tobacco use and spontaneous or medically indicated onset of delivery. Design: Population-based cohort study. Setting:...

Background: As a result of antenatal screening, abortion of fetuses with Down syndrome has become increasingly common. Little is known about the cardiovascular phenotype in infants with Down syndrome born today. Methods: Population-based cohort study based on national health registers including 2588 infants with Down syndrome, live-born in Swede...

Background: -Reproductive factors provide an early window into a woman's coronary heart disease (CHD) risk, however their contribution to CHD risk stratification is uncertain. Methods and results: -In the Women's Health Initiative Observational Study, we constructed Cox proportional hazards models for CHD including age, pregnancy status, number...

Aim: It is common in Sweden to discharge infants early from a neonatal intensive care unit (NICU) and provide hospital-assisted neonatal home care (HANHC), as an alternative to hospital care, for infants with a persisting need for specialised care. This study assessed the safety of HANHC by reviewing hospital re-admissions. Methods: We retrospec...

The primary aim of the Swedish national population registration system is to obtain data that (1) reflect the composition, relationship and identities of the Swedish population and (2) can be used as the basis for correct decisions and measures by government and other regulatory authorities. For this purpose, Sweden has established two population r...

Introduction: Pregnancy factors provide an early window into future cardiovascular disease (CVD) risk in women. It is uncertain which factors, when considered together, independently relate to later lipid levels. Methods: We used Swedish National Medical Birth Register data linked with the Vasterbotten Intervention Programme cohort. We related preg...

Introduction: Pregnancy is considered a maternal cardiometabolic stress test. However, it is uncertain when considered together, which set of pregnancy characteristics independently relate to later hypertension (HTN) in women. Methods: We used Swedish Medical Birth Register data linked with the Vasterbotten Intervention Programme cohort from Northe...

Most of us would probably agree that mankind's survival has until modern age always depended on breastfeeding. It is also non-controversial that minimising mother-infant separation enhances breastfeeding. Nevertheless, there is currently a relatively pronounced polarization on the issue of mother-infant co-sleeping (same surface bed-sharing). Count...

Very low birth weight (VLBW) and prematurity have beenassociated with an increased risk of high blood pressure (BP). We comparedBP and salivary cortisol responses to a stressful situation between adolescents with a VLBW and controls. We compared three groups aged 12-17 years:30born VLBW but appropriate for gestational age(AGA) at a meanof 27 weeks,...

Breast milk is associated with a lower risk of neonatal morbidity in very preterm infants. Despite the benefits, the duration of breastfeeding is shorter in very preterm infants than in term infants. This study aimed to investigate how early provision of mother's own milk (MOM) and maternal and infant characteristics are related to breast milk feed...

To investigate associations between maternal overweight and obesity and infant mortality outcomes, including cause-specific mortality. Population based cohort study. 1 857 822 live single births in Sweden 1992-2010. Associations between maternal body mass index (BMI) in early pregnancy and risks of infant, neonatal, and postneonatal mortality, over...

Objective: To investigate the predictors of maternal milk feeds (MMFs) in extremely preterm (EPT) infants during neonatal stay. Study design: Maternal characteristics, obstetrical data and infant characteristics were correlated to MMFs in 97 EPT infants during the first 6 weeks of life and at hospital discharge. Result: High MMFs (>90%) at sec...

Background and aims There is concern that declines in mortality after very preterm birth are accompanied by higher morbidity as more fragile babies survive. We investigated whether rates of severe neonatal morbidity were higher in regions with low versus high mortality. Methods The EPICE cohort included all births between 22+0 and 31+6 weeks of ges...

Background and aim Preterm birth has been associated with myocardial remodelling, arrested vascular growth, higher blood pressure and ventricular hypertrophy later in life. The aim of this study was to evaluate left heart structure and function in 6-year-old children born extremely preterm. Method Children born extremely preterm (EXP; <27 weeks of...

Background Cardiac Troponin-T (cTNT) has been proposed as a useful marker of PDA-severity in preterm infants. Longitudinal-data on cTNT in extremely preterm infants is scarce. Methods We included 60 infants born before 28 weeks of gestation at the Karolinska University Hospital in Stockholm Sweden and measured cTnT at 3 days (range 2–4) and 7 days...

Background and aim Preterm birth has been associated with myocardial remodelling, arrested vascular growth, higher blood pressure and ventricular hypertrophy later in life. The aim of this study was to evaluate arterial dimensions and intima media thickness in 6-year-old children born extremely preterm. Method Children born extremely preterm (EXP;...

Background Strategies to prevent heat loss in the delivery room after very preterm birth have been proven effective in randomised controlled trials. Nevertheless, we hypothesise that hypothermia at admission to neonatal care is still common and contributes to mortality after very preterm birth. Methods The EPICE cohort included all births between 2...

Preterm birth is associated with overall cardiovascular mortality in young adulthood, but which specific conditions that underlie this association is unknown. We studied mortality and morbidity from cerebrovascular and ischemic heart disease in individuals born preterm. In a nationwide Swedish study, we included 1,306,943 individuals without congen...

Month of birth-a proxy for a variety of prenatal and early postnatal exposures including nutritional status, ambient temperature and infections-has been linked to mortality risk in adult life. We assessed the relation between month of birth and cause-specific mortality risk from cardiovascular diseases, infections, tumors and external causes-in age...

To determine if maternal use of snuff (containing high levels of nicotine, low levels of nitrosamines and no combustion products) is associated with an increased risk of oral cleft malformations in the infant and whether cessation of snuff use or smoking before the antenatal booking influences the risk. A population-based cohort study was conducted...

To test acetylcholine-induced endothelium-dependent vasodilatation in obese children without co-morbidities, compared with normal weight controls, and to analyse associations between vasodilatation and other potential risk factors. Endothelium-dependent vasodilatation was induced by transdermal iontophoresis of acetylcholine in 54 obese children (8...