Uwe Ewald

Uwe Ewald
Uppsala University | UU · Department of Women's and Children's Health

prof., MD

About

222
Publications
34,526
Reads
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8,847
Citations
Citations since 2016
25 Research Items
4228 Citations
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20162017201820192020202120220200400600
20162017201820192020202120220200400600
20162017201820192020202120220200400600
Introduction
Uwe Ewald retired Head at the NICU at the Children's University Hospital, Uppsala, Sweden. Senior researcher at Dept. Women´s and Children´s Health, Uppsala University, Sweden. Main research areas are Clincal Neonatology, Family Centered Care, Breast Feeding and Knowledge Implementation.
Additional affiliations
August 1976 - present
Uppsala University
August 1976 - present
Uppsala University Hospital
Position
  • Head of Department

Publications

Publications (222)
Article
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Background Most qualitative research on breastfeeding the preterm or low-birthweight (LBW) infant has focused on negative insights; there are no comprehensive insights into how, when and why mothers experience positive breastfeeding experiences. We aimed to address this knowledge gap by exploring what characterizes and facilitates a positive breast...
Article
Full-text available
Background Perinatal events which result in compromised oxygen delivery to the fetus can lead to Birth Asphyxia (BA). While the incidence, risk factors and outcomes of BA have been characterized, less is known in low resource settings. Aim To determine the incidence of Birth Asphyxia (BA) in Nepal and to evaluate associated risk factors and outcom...
Article
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Background Worldwide, every year, 6-10 million babies require resuscitation at birth, according to estimates based on limited data regarding for “non-breathing” babies. This paper aims to describe the incidence of “non-crying” and “non-breathing” babies after birth, the need for basic resuscitation with bag-and-mask and death before discharge. Meth...
Article
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Background: Improving quality of intrapartum care will reduce intrapartum stillbirth and neonatal mortality, especially in resource-poor settings. Basic neonatal resuscitation can reduce intrapartum stillbirth and early neonatal mortality, if delivered in a high-quality health system, but there is a dearth of evidence on how to scale up such evide...
Article
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Background: Experiments have shown improved cardiovascular stability in lambs if umbilical cord clamping is postponed until positive pressure ventilation is started. Studies on intact cord resuscitation on human term infants are sparse. The purpose of this study was to evaluate differences in clinical outcomes in non-breathing infants between grou...
Article
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Background: Improving the performance of health workers on neonatal resuscitation will be critical to ensure that the babies are effectively ventilated. We conducted a study to evaluate whether a bag-and-mask ventilation with monitor is effective in improving neonatal resuscitation practice in a simulated setting. Methods: This is a cross-over d...
Article
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Background – Each year, 2.2 million intrapartum-related deaths (intrapartum stillbirths and first day neonatal deaths) occur worldwide with 99% of them taking place in low- and middle-income countries. Despite the accelerated increase in the proportion of deliveries taking place in health facilities in these settings, the stillborn and neonatal mor...
Article
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Aim This paper examines the change in neonatal resuscitation practices after the implementation of the Helping Babies Breathe (HBB) program. Methods A systematic review was carried out on studies reporting the impact of HBB programs among the literature found in Medline, POPLINE, LILACS, African Index Medicus, Cochrane, Web of Science, and Index M...
Preprint
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The aim of this meta-ethnographic study is to develop a conceptual understanding of the facilitators for positive breastfeeding experiences and the needs for breastfeeding support in mothers of preterm and/or LBW infants. Review question: What facilitators for positive breastfeeding experiences can be identified for mothers of preterm and/or LBW i...
Article
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Background Little is know about whether the effects of community engagement interventions for child survival in low-income and middle-income settings are sustained. Seasonal variation and secular trend may blur the data. Neonatal mortality was reduced in a cluster-randomised trial in Vietnam where laywomen facilitated groups composed of local stake...
Article
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Introduction Nepal Perinatal Quality Improvement Project (NePeriQIP) intends to scale up a quality improvement (QI) intervention for perinatal care according to WHO/National guidelines in hospitals of Nepal using the existing health system structures. The intervention builds on previous research on the implementation of Helping Babies Breathe-quali...
Data
Table S1 Parent‐infant characteristics.
Article
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Background Each year 700,000 infants die due to intrapartum-related complications. Implementation of Helping Babies Breathe (HBB)-a simplified neonatal resuscitation protocol in low-resource clinical settings has shown to reduce intrapartum stillbirths and first-day neonatal mortality. However, there is a lack of evidence on the effect of different...
Article
Aim: The use of simulation-based team training in neonatal resuscitation has increased in Sweden during the last decade, but no formal evaluation of this training method has been performed. This study evaluated the effect of simulation-based team training on the self-assessed ability of personnel to perform neonatal resuscitation. Methods: We ev...
Article
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Aim: Helping Babies Breathe (HBB) is a neonatal resuscitation protocol proven to reduce intrapartum-related mortality in low-income settings. The aim of this study was to describe the timing and causes of neonatal in-hospital deaths before and after HBB training at a maternity health facility in Nepal. Methods: A prospective cohort study was con...
Article
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Aim: Little is known about the amount of physical parent-infant closeness in neonatal intensive care units (NICUs) and this study explored that issue in six European countries. Methods: The parents of 328 preterm infants were recruited in 11 NICUs in Finland, Estonia, Sweden, Norway, Italy and Spain. They filled in daily diaries about how much t...
Article
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Background: The global burden of stillbirth and neonatal deaths remains a challenge in low-income countries. Training in neonatal resuscitation can reduce intrapartum stillbirth and early neonatal mortality. Previous results demonstrate that infants who previously would have been registered as stillbirths are successfully resuscitated after such tr...
Article
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Background: Family-centred care (FCC) is a state-of-the-art practice in neonatal intensive care units (NICU) based on its shown benefits on the well-being of both infants and parents. However, there is no systematic knowledge about how FCC is implemented in different European contexts. Objectives: To describe parents' presence and the quality of...
Article
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Background Each year, 1.2 million intrapartum stillbirths occur globally. In Nepal, about 50 % of the total number of stillbirths occur during the intrapartum period. An understanding of the risk factors associated with intrapartum stillbirth will facilitate the development of preventative strategies to reduce the associated burden of death. This s...
Article
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Background Newborns are at the greatest risk for dying during the intrapartum period, including labor and delivery, and the first day of life. Fetal heart rate monitoring (FHRM) and partogram use to track labor progress are evidence-based techniques that can help to identify maternal and fetal risk factors so that these can be addressed early. The...
Article
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Importance: Active perinatal care increases the rate of survival of extremely preterm infants, but there are concerns that improved survival might increase the rate of disabled survivors. Objective: To determine the neurodevelopmental outcomes of a national cohort of children 6.5 years of age who had been born extremely preterm (<27 weeks' gesta...
Article
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Background and objective: Newborns are at the highest risk of dying around the time of birth, due to intrapartum-related complications. Our study's objective was to improve adherence to the Helping Babies Breathe (HBB) neonatal resuscitation protocol and reduce perinatal mortality by using a quality improvement cycle (QIC) in a tertiary hospital i...
Article
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Background: Globally, 15 million babies were born prematurely in 2012, with 37.6 % of them in South Asia. About 32.4 million infants were born small for gestational age (SGA) in 2010, with more than half of these births occurring in South Asia. In Nepal, 14 % of babies were born preterm and 39.3 % were born SGA in 2010. We conducted a study in a t...
Article
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Background Globally, at least 2.65 million stillbirths occur every year, of which more than half are during the antepartum period. The proportion of intrapartum stillbirths has substantially declined with improved obstetric care; however, the number of antepartum stillbirths has not decreased as greatly. Attempts to lower this number may be hampere...
Article
Bronchopulmonary dysplasia (BPD) is a frequent chronic lung disease in preterm infants and we aimed to identify factors associated with this condition in infants with respiratory distress syndrome (RDS). This case-control study, using national Swedish data, included 2,255 preterm infants, born before 33 gestational weeks. The 667 BPD cases were oxy...
Article
Background and aims Children born very preterm are at increased risk for visual motor impairment. Our aim was to investigate whether ifmpaired oculomotor function is associated with morphological and ADC (Apparent Diffusion Coefficient) changes on brain MRI. Method Visual tracking ability (eye and head movements) was measured at 4 months corrected...
Article
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Each year an estimated 10 million newborns require assistance to initiate breathing, and about 900 000 die due to intrapartum-related complications. Further research is required in several areas concerning neonatal resuscitation, particularly in settings with limited resources where the highest proportion of intrapartum-related deaths occur. The ai...
Article
AimEarly parental bonding with preterm babies is particularly important, and the aim of our study was to explore when parents experienced what they regarded as important events for the first time while their infant was in the neonatal intensive care unit (NICU). Methods The study was part of a longitudinal project on Kangaroo Mother Care at two Swe...
Article
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Osteogenesis imperfecta (OI) can be recognized prenatally with ultrasound. Transplantation of mesenchymal stem cells (MSCs) has the potential to ameliorate skeletal damage. We report the clinical course of two patients with OI who received prenatal human fetal MSC (hfMSC) transplantation and postnatal boosting with same-donor MSCs. We have previous...
Article
To investigate the ophthalmological outcome of very preterm children at 2.5 years corrected age (CA) and perform a test of visuospatial and cognitive abilities. A population-based, prospective study (LOVIS study) in Uppsala County, Sweden, comprised 111 very preterm children (<32 w gestational age (GA)) born between 1 January 2004 and 31 December 2...
Data
Full-text available
Trial protocol. (PDF)
Data
Neonatal mortality outcome analysed by nested case-referent approach. (DOCX)
Data
Vietnamese translation of the abstract by NTN and DPH. (DOCX)
Article
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Background: Facilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve mat...
Article
Active perinatal care increases survival of extremely preterm infants; however, improved survival might be associated with increased disability among survivors. To determine neurodevelopmental outcome in extremely preterm children at 2.5 years (corrected age). Population-based prospective cohort of consecutive extremely preterm infants born before...
Article
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Background: Treatment with multipotent mesenchymal stromal cells (MSC) has the potential to ameliorate mesodermal disorders. Objective: To treat severe osteogenesis imperfecta (OI) with fetal MSC. Methods: Ten years ago, we treated a fetus with OI type III (COL1A2: c.3008G>A, p.Gly1003Asp) in utero with fetal HLA-mismatched MSC. The procedure was u...
Article
Objective: The role of adipokines in the regulation of energy substrate production in non-diabetic pregnant women has not been elucidated. We hypothesize that serum concentrations of adiponectin are related to fetal growth via maternal fat mass, insulin resistance and glucose production, and further, that serum levels of leptin are associated with...
Article
Full-text available
Congenital cytomegalovirus (CMV) infection is the most common congenital infection causing childhood morbidity. The pathogenetic mechanisms behind long-term sequelae are unclear, but long-standing viremia as a consequence of the inability to convert the virus to a latent state has been suggested to be involved. Whereas primary CMV infection in adul...
Article
Objective: To investigate the duration of effects and health consequences of earlier antenatal corticosteroid exposure in infants born late preterm or term. Design: Observational cohort study. Setting: Children born after gestational week 34 in Sweden, 1976-1997, whose mothers were hospitalized for imminent preterm delivery. The children were...
Article
To describe initiation and extent of parents’ application of skin-to-skin care (SSC) with their preterm infants at two Swedish neonatal intensive care units. The duration of SSC was recorded in 104 infants’ medical charts during their hospital stay, and the parents answered a questionnaire. Both parents were involved in the practice of SSC. Three i...
Article
Full-text available
Background Reducing neonatal death has been an emerging challenge in low and middle income countries in the past decade. The development of the low cost interventions and their effective delivery are needed to reduce deaths from birth asphyxia. This study will assess the impact of a simplified neonatal resuscitation protocol provided by Helping Bab...
Article
Full-text available
In this paper, we highlight the need for acknowledging the importance and impact of both physical and emotional closeness between the preterm infant and parent in the neonatal intensive care unit. Physical closeness refers to being spatially close and emotional closeness to parental feelings of being emotionally connected to the infant (experiencin...
Article
Purpose: To discuss treatment modalities for aggressive posterior retinopathy of prematurity (AP-ROP). Methods: The medical charts of all infants with AP-ROP at Uppsala University Hospital, Sweden, during a 2-year period (2009 and 2010) were reviewed. Eight infants (16 eyes) with a mean gestational age of 23.8 weeks and a mean birth weight of 592 g...
Article
The standard diagnostic test (blood culture) for suspected neonatal sepsis has limitations in sensitivity and specificity, and 16S polymerase chain reaction (PCR) has been suggested as a new diagnostic tool for neonatal sepsis. To develop and evaluate a new real-time PCR method for detection of bacterial DNA in blood samples collected from infants...
Article
To ascertain the causes of neonatal death in a province in northern Vietnam and analyse their distribution over age at death, birth weight and place of delivery. Verbal autopsy interviews using a questionnaire derived from WHO standard and adapted to Vietnamese conditions was performed on all neonatal deaths occurring in Quang Ninh province from Ju...
Article
Full-text available
Background: Infants born very preterm (VPT) i.e.< 32w gestational age (GA) have increased risk of developing impaired visual perception. Previously we have found that visual motion perception in VPT infants, evaluated by smooth pursuit eye movements (SP) was significantly reduced at both 2 and 4 months corrected age (CA) compared to term infants. S...
Article
Full-text available
Background Active perinatal care increases the survival of extremely preterm infants but there are concerns that improved survival might increase the rate of disabled survivors. Objective To determine neurodevelopmental outcome at 6.5 years of age in extremely preterm children (EPT, <27 weeks) in a Swedish National cohort. Design/methods Poulation-...
Article
Full-text available
Globally, almost 4 million newborns die during the first 4 weeks of life every year. By increased use of evidence-based knowledge in the healthcare system a large proportion of these neonatal deaths could be prevented. But there is a severe lack of knowledge on effective methods for successful implementation of evidence into practice, particularly...
Poster
Conclusion:The three-ruler manual-ocular method has a high inter-rater reliability when identifying the age at the onset of the pubertal growth spurt in Swedish school health growth curves. Thus, the method could be of use in individual cases as well as in retrospective studies.
Article
To investigate the association between perinatal risk factors and neonatal complications and early oculo-motor development in very preterm infants. Perinatal risk factors were identified, and the potential association with early oculo-motor development was evaluated by measuring smooth pursuit eye movements (SP) at 2 and 4 months' corrected age (CA...
Article
These are commentaries on a Cochrane review, published in this issue of EBCH, first published as: Pinelli J, Symington AJ. Non-nutritive sucking for promoting physiologic stability and nutrition in preterm infants. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD001071. DOI: 10.1002/14 651 858.CD001071.pub2. Further information f...
Data
All levels of categories from the analysis. A detailed presentation of all main categories, categories, and subcategories derived from the analysis.
Article
to report anthropometry and morbidity among term low birth weight infants and anthropometry of their first time mothers during the first six months in relation to breastfeeding practice. we examined data from a randomized controlled trial in Manila, the Philippines. Of the 204 mothers randomized, 68 mothers received eight postpartum breastfeeding c...
Article
To investigate the use of Kangaroo Mother Care (KMC) and its association with breastfeeding at 1 to 6 months of corrected age in mothers of very preterm (VPT) and preterm (PT) infants. Prospective longitudinal study. Setting: Neonatal Intensive Care Units in four counties in Sweden. The study included 103 VPT (< 32 gestational weeks) and 197 PT (32...
Article
Full-text available
Nearly four million neonatal deaths occur annually in the world despite existing evidence-based knowledge with the potential to prevent many of these deaths. Effective knowledge translation (KT) could help to bridge this know-do gap in global health. The aim of this study was to explore aspects of KT at the primary healthcare level in a northern pr...