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Cedergren, Marie
Alternative names
Publications (10 of 45) Show all publications
Lundgren, C., Brudin, L., Wanby, A.-S. & Cedergren, M. (2018). Ante- and intrapartum risk factors for neonatal hypoxic ischemic encephalopathy. The Journal of Maternal-Fetal & Neonatal Medicine, 31(12), 1595-1601
Open this publication in new window or tab >>Ante- and intrapartum risk factors for neonatal hypoxic ischemic encephalopathy
2018 (English)In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 31, no 12, p. 1595-1601Article in journal (Refereed) Published
Abstract [en]

To identify obstetrical risk factors for the diagnosis of neonatal hypoxic ischemic encephalopathy (HIE). A secondary aim was to determine the incidence of HIE.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
CTG; Hypoxic ischemic encephalopathy; acute obstetrical events; nulliparity; risk factor
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-146142 (URN)10.1080/14767058.2017.1321628 (DOI)28486858 (PubMedID)
Available from: 2018-03-29 Created: 2018-03-29 Last updated: 2018-04-13
Lilliecreutz, C. & Cedergren, M. (2017). Dags att implementera nya rön om graviditetsdiabetes. Läkartidningen, 114
Open this publication in new window or tab >>Dags att implementera nya rön om graviditetsdiabetes
2017 (English)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114Article in journal, Editorial material (Other academic) Published
Abstract [en]

n/a

National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-146145 (URN)28485757 (PubMedID)
Available from: 2018-03-29 Created: 2018-03-29 Last updated: 2018-05-01
Blomberg, M. (2016). Avoiding the first cesarean section-results of structured organizational and cultural changes. Acta Obstetricia et Gynecologica Scandinavica, 95(5), 580-586
Open this publication in new window or tab >>Avoiding the first cesarean section-results of structured organizational and cultural changes
2016 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 95, no 5, p. 580-586Article in journal (Refereed) Published
Abstract [en]

IntroductionIn 2006 the overall rates of instrumental deliveries (10%) and cesarean sections (CS) (20%) were high in our unit. We decided to improve quality of care by offering more women a safe and attractive normal vaginal delivery. The target group was primarily nulliparous women at term with spontaneous onset of labor and cephalic presentation. Material and methodsImplementation of a nine-item list of structured organizational and cultural change in Linkoping 2006-15. The nine items include monitoring of obstetric results, recruitment of a midwife coordinator, risk classification of women, introduction of three different midwife competence levels, improved teamwork, obstetrical morning round, fetal monitoring skills, obstetrical skills training, and public promotion of the strategy. ResultsThe CS rate in nulliparous women at term with spontaneous onset of labor decreased from 10% in 2006 to 3% in 2015. During the same period the overall CS rate dropped from 20% to 11%. The prevalence of children born at the unit with umbilical cord pH <7 and Apgar score <4 at 5 min were the same over the years studied. At present, 95.2% of women delivering at our unit are satisfied with their delivery experience. ConclusionsThe CS rates have declined after implementing the nine items of organizational and cultural changes. It seems that a specific and persistent multidisciplinary activity with a focus on the Robson group 1 can reduce CS rates without increased risk of neonatal complications.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2016
Keywords
Cesarean section; improvement; intervention; nulliparous; Robson group 1
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-128137 (URN)10.1111/aogs.12872 (DOI)000374349400014 ()26870916 (PubMedID)
Available from: 2016-05-19 Created: 2016-05-19 Last updated: 2017-11-30
Sydsjö, G., Blomberg, M., Palmquist, S., Angerbjörn, L., Bladh, M. & Josefsson, A. (2015). Effects of continuous midwifery labour support for women with severe fear of childbirth. BMC Pregnancy and Childbirth, 15(115)
Open this publication in new window or tab >>Effects of continuous midwifery labour support for women with severe fear of childbirth
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2015 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, no 115Article in journal (Refereed) Published
Abstract [en]

Background: Continuous support by a midwife during childbirth has shown positive effects on the duration of active labour, use of pain relief and frequency of caesarean section (CS) in women without fear of childbirth (FOC). We have evaluated how continuous support by a specially assigned midwife during childbirth affects birth outcome and the subjective experience of women with severe FOC. Methods: A case-control pilot study with an index group of 14 women with severe FOC and a reference group of 28 women without FOC giving birth. In this study the index group received continuous support during childbirth. Results: The women with severe FOC more often had an induction of labour. The parous women with severe FOC had a shorter duration of active labour compared to the parous reference women (p = 0.047). There was no difference in caesarean section frequency between the two groups. Women with severe FOC experienced a very high anxiety level during childbirth (OR = 20.000, 95 % CI: 3.036-131.731). Conclusion: Women with severe FOC might benefit from continuous support by a midwife during childbirth. Midwives should acknowledge the importance of continuous support in order to enhance the experience of childbirth in women with severe FOC.

Place, publisher, year, edition, pages
BioMed Central / Springer Verlag (Germany), 2015
Keywords
Fear of childbirth; Support; Obstetric outcome
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-120291 (URN)10.1186/s12884-015-0548-6 (DOI)000357446300001 ()25976219 (PubMedID)
Note

Funding Agencies|ALF, County Council of Ostergotland, Sweden

Available from: 2015-07-24 Created: 2015-07-24 Last updated: 2017-12-04
Blomberg, M. (2015). Fetma under graviditet ökar risken för både kvinna och barn: Kompetent omhändertagande kan minska riskökningen. Läkartidningen, 112(48), 2156
Open this publication in new window or tab >>Fetma under graviditet ökar risken för både kvinna och barn: Kompetent omhändertagande kan minska riskökningen
2015 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 48, p. 2156-Article in journal (Refereed) Published
Abstract [sv]

Fetma hos en gravid kvinna innebär ökad risk för missbildning hos fostret. Vid screeningultraljud upptäcks färre missbildningar än hos barn till normalviktiga kvinnor, men KUB-metoden för att upptäcka Downs syndrom är lika effektiv i alla BMI-grupper. Fetma hos kvinnan innebär ökad risk för gestationsdiabetes, preeklampsi, prematur förlossning och intrauterin fosterdöd. Öppningsskedet under förlossningen är förlängt hos kvinnor med BMI >30, men krystskedet är snabbt. Det finns ökad risk för atonisk postpartumblödning, vilket kan indicera profylaktisk behandling med uterotonika. Fetma hos kvinnan medför fler allvarliga komplikationer hos barnet under första levnadsveckan oavsett förlossningssätt.

National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-126417 (URN)
Available from: 2016-03-23 Created: 2016-03-23 Last updated: 2017-11-30
Lindholm, E. S., Altman, D., Norman, M. & Blomberg, M. (2015). Health Care Consumption during Pregnancy in relation to Maternal Body Mass Index: A Swedish Population Based Observational Study. Journal of Obesity, 2015, 7, Article ID 215683.
Open this publication in new window or tab >>Health Care Consumption during Pregnancy in relation to Maternal Body Mass Index: A Swedish Population Based Observational Study
2015 (English)In: Journal of Obesity, ISSN 2090-0708, E-ISSN 2090-0716, Vol. 2015, p. 7-, article id 215683Article in journal (Refereed) Published
Abstract [en]

Objective. To assess whether antenatal health care consumption is associated with maternal body mass index (BMI). Design. A register based observational study. Methods. The Swedish Medical Birth Register, the Maternal Health Care Register, and the Inpatient Register were used to determine antenatal health care consumption according to BMI categories for primiparous women with singleton pregnancies, from 2006 to 2008, . Pairwise comparisons among BMI groups are obtained post hoc by Tukey HSD test. Result. Obese women were more often admitted for in-patient care (), had longer antenatal hospital stays (), and were more often sick-listed by an obstetrician () during their pregnancy, compared to women with normal weight women. Preeclampsia was more than four times as common, hypertension five times as common, and gestational diabetes 11 times as common when comparing in-patient care, obese to normal weight women ( for all comparisons). Underweight mothers had longer stay in hospitals () and hydronephrosis and hyperemesis gravidarum were more than twice as common (both ). Conclusion. Obese and underweight mothers consumed significantly more health care resources and obese women were significantly more often sick-listed during their pregnancy when compared to pregnant women of normal weight.

National Category
Obstetrics, Gynecology and Reproductive Medicine General Practice
Identifiers
urn:nbn:se:liu:diva-126418 (URN)10.1155/2015/215683 (DOI)26101664 (PubMedID)
Available from: 2016-03-23 Created: 2016-03-23 Last updated: 2018-01-10
Claesson, I.-M., Hultgren, E. & Blomberg, M. (2015). Lifestyle habits and womens attitudes towards discussing them at a visit for contraceptive advice. Sexual & Reproductive HealthCare, 6(3), 114-118
Open this publication in new window or tab >>Lifestyle habits and womens attitudes towards discussing them at a visit for contraceptive advice
2015 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 6, no 3, p. 114-118Article in journal (Refereed) Published
Abstract [en]

Objective: The aims of this study was to use visits for contraceptive counselling as opportunities for examining womens actual life style habits with the main focus being placed on alcohol consumption but also to evaluate the womens opinions about discussing their alcohol and tobacco habits and their weight status. Methods: A total of 535/802 (67%) women completed a study-specific anonymous questionnaire after a contraceptive counselling visit with a midwife. Results: A majority of the women thought that a discussion concerning alcohol habits at a contraceptive counselling session was important (85.5%) and not intrusive (86.4%) neither embarrassing (81.7%). Women with high-risk drinking habits were younger, more often tobacco users and more often planning for childbirth in the future, compared with women who did not display high-risk drinking behaviour. A significantly higher percentage of women who practiced high-risk drinking thought that a discussion of alcohol was intrusive (10.9%) and embarrassing (46.7%), compared with women not practicing highrisk alcohol consumption. Most women (72.9%) stated that no other caregiver during the preceding year except the midwife had discussed drinking habits with them. The weight was a good thing that the midwife brought up for discussion according to 82.5% of the women but the discussions about weight was more often found embarrassing (18.4%) than the discussion about alcohol habits. Conclusion: Women who came for contraceptive counselling found the discussion concerning alcohol habits important, not intrusive or embarrassing and a good thing to be brought up by the midwife. (C) 2014 Elsevier B.V. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2015
Keywords
Contraception; Counselling; Alcohol drinking; Life style; Tobacco; Body weight
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-122106 (URN)10.1016/j.srhc.2014.08.002 (DOI)000361580000001 ()
Note

Funding Agencies|Swedish Risk Drinking Project

Available from: 2015-10-19 Created: 2015-10-19 Last updated: 2017-12-01
Svenvik, M., Brudin, L. & Blomberg, M. (2015). Preterm Birth: A Prominent Risk Factor for Low Apgar Scores. BioMed Research International, Article ID 978079.
Open this publication in new window or tab >>Preterm Birth: A Prominent Risk Factor for Low Apgar Scores
2015 (English)In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, article id 978079Article in journal (Refereed) Published
Abstract [en]

Objective. To determine predictive risk factors for Apgar scores less than 7 at 5 minutes at two hospitals providing tertiary care and secondary care, respectively. Methods. A retrospective registry cohort study of 21126 births (2006-2010) using data from digital medical records. Risk factors were analyzed by logistic regression analyses. Results. AS(5min) less than 7 was multivariately associated with the following: preterm birth; gestational week 32 + 0-36 + 6, OR = 3.9 (95% CI 2.9-5.3); week 28 + 0-31 + 6, OR = 8 (5-12); week less than 28 + 0, OR = 15 (8-29); postterm birth, OR = 2.0 (1.7-2.3); multiple pregnancy, OR = 3.53 (1.79-6.96); previous cesarean section, OR = 3.67 (2.31-5.81); BMI 25-29, OR = 1.30 (1.09-1.55); BMI greater than= 30 OR = 1.70 (1.20-2.41); nonnormal CTG at admission, OR = 1.98 (1.48-2.66). greater than= 1-para was associated with a decreased risk for AS(5min) less than 7, OR = 0.34 (0.25-0.47). In the univariate logistic regression analysis AS(5min) less than 7 was associated with tertiary level care, OR = 1.48 (1.17-1.87); however, in the multivariate analysis there was no significant difference. Conclusion. A number of partially preventable risk factors were identified, preterm birth being the most evident. Further, no significant difference between the two hospital levels regarding the risk for low Apgar scores was detected.

Place, publisher, year, edition, pages
HINDAWI PUBLISHING CORPORATION, 2015
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-122075 (URN)10.1155/2015/978079 (DOI)000360755200001 ()26413554 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden

Available from: 2015-12-18 Created: 2015-10-19 Last updated: 2017-12-01
Hildebrand, E., Abrandt Dahlgren, M., Sved, C., Gottvall, T., Blomberg, M. & Janerot Sjöberg, B. (2014). Impact of a standardized training program on midwive’s ability to assess fetal heart anatomy by ultrasound. BMC Medical Imaging, 14(20)
Open this publication in new window or tab >>Impact of a standardized training program on midwive’s ability to assess fetal heart anatomy by ultrasound
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2014 (English)In: BMC Medical Imaging, ISSN 1471-2342, E-ISSN 1471-2342, Vol. 14, no 20Article in journal (Refereed) Published
Abstract [en]

Background: Studies of prenatal detection of congenital heart disease (CDH) in the UK, Italy, and Norway indicate that it should be possible to improve the prenatal detection rate of CDH in Sweden. These studies have shown that training programs, visualization of the outflow tracts and color-Doppler all can help to speed up and improve the detection rate and accuracy. We aimed to introduce a more accurate standardized fetal cardiac ultrasound screening protocol in Sweden.

Methods: A novel pedagogical model for training midwives in standardized cardiac imaging was developed, a model using a think-aloud analysis during a pre- and post-course test and a subsequent group reflection. The self-estimated difficulties and knowledge gaps of four midwives were identified. A two-day course with mixed lectures, demonstrations and handson sessions was followed by a feedback session one month later consisting of an interview and check-up. The long-term effects were tested two years later.

Results: At the post-course test the self-assessed uncertainty was lower than at the pre-course test. The qualitative evaluation showed that the color Doppler images were difficult to interpret, but the training seems to have enhanced the familiarity with the new technique. The ability to perform the method remained at the new level at follow-up both three months and two years later.

Conclusions: Our results indicate that by implementing new imaging modalities and providing hands-on training, uncertainty can be reduced and time decreased, but they also show that continuous on-site training with clinical and technical back-up is important.

Keywords
Color Doppler, Congenital heart disease, Detection of congenital heart defects, Fetal heart scanning, Learning program, Prenatal cardiology, Second trimester screening, Standardized training program, Ultrasound screening
National Category
Other Clinical Medicine Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-104181 (URN)10.1186/1471-2342-14-20 (DOI)000336853200001 ()
Available from: 2014-02-10 Created: 2014-02-10 Last updated: 2017-12-06Bibliographically approved
Blomberg, M., Birch Tyrberg, R. & Kjölhede, P. (2014). Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study. BMJ Open, 4(11), e005840
Open this publication in new window or tab >>Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study
2014 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 4, no 11, p. e005840-Article in journal (Refereed) Published
Abstract [en]

Objectives: To evaluate the associations between maternal age and obstetric and neonatal outcomes in primiparous women with emphasis on teenagers and older women. Design: A population-based cohort study. Setting: The Swedish Medical Birth Register. Participants: Primiparous women with singleton births from 1992 through 2010 (N=798 674) were divided into seven age groups: less than17 years, 17-19 years and an additional five 5-year classes. The reference group consisted of the women aged 25-29 years. Primary outcome: Obstetric and neonatal outcome. Results: The teenager groups had significantly more vaginal births (adjusted OR (aOR) 2.04 (1.79 to 2.32) and 1.95 (1.88 to 2.02) for age less than17 years and 1719 years, respectively); fewer caesarean sections (aOR 0.57 (0.48 to 0.67) and 0.55 (0.53 to 0.58)), and instrumental vaginal births (aOR 0.43 (0.36 to 0.52) and 0.50 (0.48 to 0.53)) compared with the reference group. The opposite was found among older women reaching a fourfold increased OR for caesarean section. The teenagers showed no increased risk of adverse neonatal outcome but presented an increased risk of prematurity less than32 weeks (aOR 1.66 (1.10 to 2.51) and 1.20 (1.04 to 1.38)). Women with advancing age (greater than= 30 years) revealed significantly increased risk of prematurity, perineal lacerations, preeclampsia, abruption, placenta previa, postpartum haemorrhage and unfavourable neonatal outcomes compared with the reference group. Conclusions: For clinicians counselling young women it is of importance to highlight the obstetrically positive consequences that fewer maternal complications and favourable neonatal outcomes are expected. The results imply that there is a need for individualising antenatal surveillance programmes and obstetric care based on age grouping in order to attempt to improve the outcomes in the age groups with less favourable obstetric and neonatal outcomes. Such changes in surveillance programmes and obstetric interventions need to be evaluated in further studies.

Place, publisher, year, edition, pages
BMJ Publishing Group: Open Access / BMJ Journals, 2014
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-113224 (URN)10.1136/bmjopen-2014-005840 (DOI)000345762300028 ()25387756 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland; Linkoping University

Available from: 2015-01-12 Created: 2015-01-12 Last updated: 2017-12-05
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