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Leijon, Ingemar
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Hammar, M., Larsson, E., Bladh, M., Finnström, O., Gäddlin, P.-O., Leijon, I., . . . Sydsjö, G. (2018). A long-term follow-up study of men born with very low birth weight and their reproductive hormone profile. Systems biology in reproductive medicine, 64(3), 207-215
Open this publication in new window or tab >>A long-term follow-up study of men born with very low birth weight and their reproductive hormone profile
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2018 (English)In: Systems biology in reproductive medicine, ISSN 1939-6376, Vol. 64, no 3, p. 207-215Article in journal (Refereed) Published
Abstract [en]

Environmental factors during the fetal period may adversely affect reproductive functions in men being born with very low birth weight (VLBW, <1500 g). The objective of this prospective, controlled cohort study was to investigate if VLBW men have an altered reproductive hormone profile compared with men born at term. The study group initially consisted of all VLBW boys live-born between 1 February 1987 and 30 April 1988 in the south-east region of Sweden (n = 47). A control child was chosen born at term, at the same hospital, with the same parity, without malformations, and next in order after each VLBW child who survived the first four weeks (n = 45). The present follow-up was performed when the men were 26-28 years of age and included measurements of serum hormone levels, hair testosterone concentration, and anthropometric data. Also life-style questionnaires were collected from 26 VLBW men and 19 controls. The VLBW group (n = 26) had higher median levels of serum estradiol, 84.5 pmol/L than controls (n = 19), 57.5 pmol/L (p = 0.008). There was no significant correlation between serum estradiol and BMI (r = 0.06, p = 0.74). There were no differences in other hormone levels or the reproductive pattern between the groups. In conclusion, even though there was a statistically significant difference in estradiol levels between the groups, both groups had low normal mean levels of questionable clinical significance. The reproductive pattern was similar in the two groups and in this study being born VLBW does not seem to affect these measured aspects of reproduction.

ABBREVIATIONS: ADHD: attention deficit hyperactive disorder; AGA: average for gestational age; BMI: body mass index; CP: cerebral palsy; DHT: dihydrotestosterone; FSH: follicle stimulating hormone; LBW: low birth weight; LH: luteinizing hormone; SAD: sagittal abdominal diameter; SGA: small for gestational age; SHBG: sex hormone binding globulin; TSH: thyroid stimulating hormone; T3: triiodothyronine; T4: thyroxin; VLBW: very low birth weight.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Very low birth weight, follow-up study, preterm, reproduction
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-148117 (URN)10.1080/19396368.2018.1448901 (DOI)000432658800007 ()29583035 (PubMedID)2-s2.0-85044443280 (Scopus ID)
Note

Funding agencies: County Council of Ostergotland (ALF grants); Futurum-the Academy for Health and Care, Region Jonkoping County, Sweden

Available from: 2018-05-30 Created: 2018-05-30 Last updated: 2019-04-10Bibliographically approved
Leijon, I., Ingemansson, F., Nelson Follin, N., Wadsby, M. & Samuelsson, S. (2016). Reading deficits in very low birthweight children are associated withvocabulary and attention issues at the age of seven. Acta Paediatrica, 105(1), 60-68
Open this publication in new window or tab >>Reading deficits in very low birthweight children are associated withvocabulary and attention issues at the age of seven
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2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 1, p. 60-68Article in journal (Refereed) Published
Abstract [en]

AimThis Swedish study compared reading skills between seven-year-old children with a very low birthweight (VLBW) and controls with a normal birthweight, exploring associations between reading variables and cognition, parent-rated behaviour, perinatal factors and family factors. MethodsWe studied 51 VLBW children, with no major neurodevelopmental impairments and attending their first year at a regular school, and compared them with the 51 sex- and age-matched controls. The test battery, carried out at 7.80.4years of age, included reading skills, the Wechsler Intelligence Scale for Children - III and the Child Behaviour Checklist. ResultsVery low birthweight children with a mean birthweight of 1105g (+/- 291g) and a gestational age of 28.8 (+/- 2.2) weeks scored significantly lower in all reading subtests and cognition and demonstrated more behavioural problems than normal birthweight controls. We also found significant associations between poor vocabulary, combined with attention problems, and phonological awareness, rapid naming and spelling control. Perinatal factors had no association with reading function, and socio-economic factors had very few. ConclusionVery low birthweight children demonstrated deficits in all reading domains and had poorer cognition and more behavioural problems at the age of seven, with reading ability related to vocabulary and attention.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
Behavioural problems; Parental factors; Reading ability; School children; Very low birthweight
National Category
Clinical Medicine Educational Sciences
Identifiers
urn:nbn:se:liu:diva-124471 (URN)10.1111/apa.13094 (DOI)000367728500022 ()26098907 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden; Futurum - The Academy of Health Care; Jonkoping County Council; Ostergotland County Council; Linkoping University

Available from: 2016-02-02 Created: 2016-02-01 Last updated: 2017-11-30Bibliographically approved
Wadsby, M., Nelson, N., Ingemansson, F., Samuelsson, S. & Leijon, I. (2014). Behaviour problems and cortisol levels in very-low-birth-weight children. Nordic Journal of Psychiatry, 68(8), 626-632
Open this publication in new window or tab >>Behaviour problems and cortisol levels in very-low-birth-weight children
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2014 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 8, p. 626-632Article in journal (Refereed) Published
Abstract [en]

Background. There are still diverging results concerning the behaviour of children with very-low-birth-weight (VLBW) and they have been questioned to display different levels of stress hormone than normal-birth-weight (NBW) children. Aims. This study examined behaviour and the stress hormone cortisol in children with VLBW at the ages of 7 and 9 years compared with children with NBW. Results. Fifty-one VLBW and 50 NBW children were studied with the Child Behavior Checklist. Cortisol rhythm was measured through saliva samples three times a day for 2 days. VLBW children displayed more behavioural problems than NBW children, specifically social and attention problems, although still within normal ranges. They showed lower cortisol levels both at 7 and 9 years of age. No strong association between behaviour and cortisol levels was shown. Conclusion. VLBW children display more behaviour problems compared with NBW children but both groups score are within the normal range. Down-regulation of their hypothalamic-pituitary-adrenal (HPA) function in terms of lower cortisol levels is also noted.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keywords
Behaviour problems; Follow-up study; Stress hormone; Very-low-birth-weight
National Category
Clinical Medicine Educational Sciences
Identifiers
urn:nbn:se:liu:diva-112627 (URN)10.3109/08039488.2014.907341 (DOI)000343980600015 ()24802123 (PubMedID)
Available from: 2014-12-08 Created: 2014-12-05 Last updated: 2017-12-05
Leijon, I. (2010). Factors of importance for neurodevelopment in preterm infants. Acta Paediatrica, 99(5), 642-644
Open this publication in new window or tab >>Factors of importance for neurodevelopment in preterm infants
2010 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 5, p. 642-644Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2010
Keywords
Cognitive development, Follow-up studies, Preterm children
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-54787 (URN)10.1111/j.1651-2227.2010.01743.x (DOI)000276034800004 ()20219050 (PubMedID)2-s2.0-77950197076 (Scopus ID)
Available from: 2010-04-09 Created: 2010-04-09 Last updated: 2017-12-12Bibliographically approved
Leijon, I. (2010). Svenska 20-åringar med mycket låg födelsevikt mår oväntat bra: Självskattad hälsa, utbildning och livskvalitet som hos andra jämnåriga. Läkartidningen, 107(11), 748-752
Open this publication in new window or tab >>Svenska 20-åringar med mycket låg födelsevikt mår oväntat bra: Självskattad hälsa, utbildning och livskvalitet som hos andra jämnåriga
2010 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 11, p. 748-752Article in journal (Refereed) Published
Abstract [sv]

Totalt 85 barn med mycket låg födelsevikt (≤1 500 g) och normalviktiga kontroller födda 1987–1988 i syd­öst­ra Sverige har utvärderats dels vid 15 års ålder beträffande funktionshinder och genomgångna sjukdomar, MRI-hjärna (lågviktiga), kognition och synfunktion, dels vid 20 års ålder beträffande utbildning och livskvalitet.

I gruppen med mycket låg födelsevikt var 15 barn (18 procent) kända vid barnhabiliteringen. I denna grupp hade pojkar fler vårdtillfällen, och 23 procent av barnen utan neurologisk funktionsnedsättning hade cerebrala MRI-förändringar. Av testade hade 20 procent IQ <70. Dess­utom förekom astigmatism, strabism och syntolkningsproblem oftare i denna grupp.

Självskattad hälsa, utbildning och livskvalitet skilde sig inte mellan grupperna vid övergången till vuxenålder.Förutom uppföljningar inom barnhälsovård/barnmedicin rekommenderas psykologbedömning före skolstart och riktad ögonläkarundersökning under skolperioden.

Place, publisher, year, edition, pages
Lakartidningen, 2010
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-57016 (URN)
Available from: 2010-06-14 Created: 2010-06-09 Last updated: 2017-12-12
Gaddlin, P.-O., Finnström, O., Sydsjö, G. & Leijon, I. (2009). Most very low birth weight subjects do well as adults. ACTA PAEDIATRICA, 98(9), 1513-1520
Open this publication in new window or tab >>Most very low birth weight subjects do well as adults
2009 (English)In: ACTA PAEDIATRICA, ISSN 0803-5253, Vol. 98, no 9, p. 1513-1520Article in journal (Refereed) Published
Abstract [en]

Aim: To study health, quality of life, educational level and occupation in very low birth weight (VLBW) children in early adulthood and the relationship of the findings to neonatal risk factors and later handicap. Methods: This is a prospective long-term follow-up study of a regional cohort of 20-year-old VLBW subjects (n = 77) of all surviving VLBW children (n = 86) and 69/86 term controls born in 1987-1988 in the south-east of Sweden. Postal questionnaires were used: 1. A study-specific form, 2. Medical Outcomes Study, Short Form (SF-36), 3. Sense of Coherence. Results: VLBW subjects did not differ significantly from their controls in self-perceived health, use of tobacco, education, occupation and way of living, or scoring on SF-36 and Sense of Coherence. Sixteen had cerebral palsy, attention deficit hyperactivity disorder or isolated mental retardation, and these subjects differed significantly from controls on SF-36 in physical functioning and physical health score, but not on Sense of Coherence. VLBW subjects were significantly lighter and shorter than their controls. Extremely low birth weight (ELBW), bronchopulmonary dysplasia and intraventricular haemorrhage were significantly associated with poorer scores on physical function. Conclusion: The 20-year old VLBW subjects reported perceived health and managed transition to adulthood similar to controls. Handicapped subjects had poorer self-perceived physical function. ELBW and severe neonatal complications were associated with poorer self-perceived physical health.

Keywords
Adulthood, Follow-up study, Health, Quality of life, Very low birth weight infants
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-19807 (URN)10.1111/j.1651-2227.2009.01368.x (DOI)
Available from: 2009-08-11 Created: 2009-08-10 Last updated: 2009-08-11
Gäddlin, P.-O., Finnström, O., Wang, C. & Leijon, I. (2008). A fifteen-year follow-up of neurological conditions in VLBW children without overt disability: Relation to gender, neonatal risk factors, and end stage MRI findings. Early Human Development, 84(5), 343-349
Open this publication in new window or tab >>A fifteen-year follow-up of neurological conditions in VLBW children without overt disability: Relation to gender, neonatal risk factors, and end stage MRI findings
2008 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 84, no 5, p. 343-349Article in journal (Refereed) Published
Abstract [en]

Background: Very low birthweight (VLBW; birth weight ≤ 1500 g) children run a greater risk than controls of developing neurosensory disabilities, but also minor neurological disturbances.

Aims: To assess neurological status from the neonatal period up to fifteen years of age in VLBW children without overt neurological disability in relation to gender, neonatal risk factors, and Magnetic Resonance Imaging (MRI) findings of the brain.

Study design: A population based follow-up study of VLBW children and their controls.

Subjects: Eighty VLBW children without overt disability, in a cohort of 86 surviving VLBW children, were enrolled in a follow-up study at 40 weeks gestational age and at 4, 9, and 15 years of age. 56 VLBW children were examined with cerebral MRI at 15 years of age.

Outcome measures: Neurological test scores. MRI findings, principally white matter damage (WMD).

Results: VLBW children were inferior in neurological assessments in comparison with controls at 40 weeks gestational age and 4 and 15 years of age. VLBW girls did not differ from their controls at 9 and 15 years. Fourteen of 56 (25%) VLBW children had abnormal MRI findings and 13 were evaluated as mild WMD. Children with WMD did not differ in neurological outcome from those without WMD at any examination. Mechanical ventilation and/or intraventricular haemorrhage (IVH) during the neonatal period were significantly related to less a favourable outcome at follow-up examinations.

Conclusion: A cohort of VLBW children without overt neurological disability had a poorer neurological condition up to adolescence in comparison with controls. A quarter of the VLBW children had mild WMD but without relation to the neurological functions. Mechanical ventilation and IVH were related to poorer neurological outcome.

Place, publisher, year, edition, pages
Elsevier, 2008
Keywords
Very low birthweight infants, Follow-up study, Magnetic Resonance Imaging, Neurological function, Neonatal risk factors
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-15485 (URN)10.1016/j.earlhumdev.2007.09.013 (DOI)
Available from: 2008-12-04 Created: 2008-11-11 Last updated: 2017-12-14Bibliographically approved
Gäddlin, P.-O., Finnström, O., Samuelsson, S., Wadsby, M., Wang, C. & Leijon, I. (2008). Academic achievement, behavioural outcomes and MRI findings at 15 years of age in very low birthweight children. Acta Paediatrica, 97(10), 1426-1432
Open this publication in new window or tab >>Academic achievement, behavioural outcomes and MRI findings at 15 years of age in very low birthweight children
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2008 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 10, p. 1426-1432Article in journal (Refereed) Published
Abstract [en]

Aim: To assess cognitive, academic, and behavioural functions in 15-year-old very low birthweight (VLBW) children and relate results to gender, neonatal risk factors, growth, and Magnetic Resonance Imaging (MRI) findings.

Methods: 61/86 VLBW children and 57/86 term controls born in the south-east region of Sweden were assessed regarding cognition (WISC III), school outcome, behaviour, and growth. VLBW children were examined using cerebral MRI.

Results: VLBW children performed significantly lower than their term controls on WISC III and 49% had IQ lower than 85. Ten VLBW children with IQ <70 had not been clinically identified earlier and a majority of these children attended mainstream school. VLBW girls had significantly lower total problems scores. Using MRI, white matter damage (WMD) was detected in 16 (27%) children. VLBW boys with WMD had significantly lower IQ than those without. Small occipito-frontal circumference correlated with low IQ. Mechanical ventilation and intraventricular haemorrhage (IVH) showed significant correlations with lower IQ and reading skills.

Conclusion: VLBW children achieved poorer results compared with their controls in cognitive tests. Mechanical ventilation and IVH were related to poorer academic outcome. Many of the children with low IQ had not been identified earlier. Therefore, we recommend that VLBW children undergo an IQ test before beginning school in order to receive adequate support.

Keywords
Cognitive function, MRI findings, Neonatal risk factors, School performance, Very low birthweight infants
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-15486 (URN)10.1111/j.1651-2227.2008.00925.x (DOI)
Available from: 2008-12-04 Created: 2008-11-11 Last updated: 2017-12-14Bibliographically approved
Gäddlin, P.-O., Finnström, O., Hellgren, K. & Leijon, I. (2007). Hospital readmissions and morbidity in a fifteen-year follow-up of very low birthweight children in Southeast Sweden. Acta Paediatrica, 96(4), 499-505
Open this publication in new window or tab >>Hospital readmissions and morbidity in a fifteen-year follow-up of very low birthweight children in Southeast Sweden
2007 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 4, p. 499-505Article in journal (Refereed) Published
Abstract [en]

Aim: To study the effect of very low birthweight on hospital care and morbidity, and their relationship to gender, birthweight, and neonatal complications.

Methods: 85 very low birthweight (VLBW; ≤1500 g) children and term controls born in 1987-1988 in south-east region of Sweden were checked in registers regarding readmissions and diagnoses, need for habilitation and child psychiatric care up to 15 years of age. Ophthalmological examinations were made at age 4 in 64 of VLBW and 61 of control children, and at age 15 in 59 of VLBW and 55 of control children.

Results: VLBW boys had three times more readmissions compared with normal weight control boys (p=0.003). Neonatal risk factors for readmissions were gestational age under 30 weeks (OR 3.1), birthweight less than 1000 g (OR 4.6), mechanical ventilation (OR 9.5), and more than 60 days’ stay in neonatal ward (OR 5.0). A minority of VLBW children had an impairment/handicap such as cerebral palsy (CP) in five (5.9 %) children, attention deficit hyperactivity disorders (ADHD) in five children, and blindness due to retinopathy of prematurity in one child. One child in the control group had ADHD. At the 15-year examination median visual acuity in the best eye was better in the control group (1.6) than in the VLBW group (1.3) (p=0.009). 32% of VLBW children and 11% of controls had latent or manifest strabismus (p=0.007).

Conclusion: Risk factors for readmissions were gender, low gestational age, birthweight <1000 g or mechanical ventilation. A minority of VLBW children had a handicap that influenced their daily life activities at 15 years of age.

Place, publisher, year, edition, pages
Wiley InterScience, 2007
Keywords
Follow-up studies, Gender, Hospital readmission, Morbidity, Very low birth weight
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-15483 (URN)10.1111/j.1651-2227.2007.00183.x (DOI)
Available from: 2008-12-04 Created: 2008-11-11 Last updated: 2017-12-14Bibliographically approved
Samuelsson, S., Finnström, O., Flodmark, O., Gäddlin, P.-O., Leijon, I. & Wadsby, M. (2006). A longitudinal study of reading skills among very-low-birthweight children: Is there a catch-up?. Journal of Pediatric Psychology, 31(9), 967-977
Open this publication in new window or tab >>A longitudinal study of reading skills among very-low-birthweight children: Is there a catch-up?
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2006 (English)In: Journal of Pediatric Psychology, ISSN 0146-8693, E-ISSN 1465-735X, Vol. 31, no 9, p. 967-977Article in journal (Refereed) Published
Abstract [en]

Objective: To examine the development of reading skills among very-low-birthweight (VLBW) children and to what extent reading difficulties at 9 years of age persist unchanged, are attenuated, or are enhanced at 15 years of age. Methods: Fifty-six VLBW and 52 normal birthweight (NBW) children were assessed on word decoding, word recognition, and reading comprehension at 9 and 15 years of age. Results: VLBW children showed deficits in reading skill at 9 years of age, while most differences obtained at 15 years of age did not reach significance. VLBW children improved their reading comprehension between 9 and 15 years of age more than NBW children, and when controlling for individual differences in IQ, VLBW children improved both their reading comprehension and word-recognition skill. Conclusion: The results suggest that VLBW children display positive changes over time in reading skills. © The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.

Keywords
longitudinal study, low-birthweight, reading skills
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-34829 (URN)10.1093/jpepsy/jsj108 (DOI)23510 (Local ID)23510 (Archive number)23510 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
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