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Ivars, K., Nelson Follin, N., Theodorsson, A., Theodorsson, E., Ström, J. & Mörelius, E. (2016). Correction: Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants. PLoS ONE, 11(3), Article ID e0151888.
Open this publication in new window or tab >>Correction: Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 3, article id e0151888Article in journal, Editorial material (Other academic) Published
Abstract [en]

BACKGROUND:

Cortisol concentrations in plasma display a circadian rhythm in adults and children older than one year. Earlier studies report divergent results regarding when cortisol circadian rhythm is established. The present study aims to investigate at what age infants develop a circadian rhythm, as well as the possible influences of behavioral regularity and daily life trauma on when the rhythm is established. Furthermore, we determine age-related reference intervals for cortisol concentrations in saliva during the first year of life.

METHODS:

130 healthy full-term infants were included in a prospective, longitudinal study with saliva sampling on two consecutive days, in the morning (07:30-09:30), noon (10:00-12:00) and evening (19:30-21:30), each month from birth until the infant was twelve months old. Information about development of behavioral regularity and potential exposure to trauma was obtained from the parents through the Baby Behavior Questionnaire and the Life Incidence of Traumatic Events checklist.

RESULTS:

A significant group-level circadian rhythm of salivary cortisol secretion was established at one month, and remained throughout the first year of life, although there was considerable individual variability. No correlation was found between development of cortisol circadian rhythm and the results from either the Baby Behavior Questionnaire or the Life Incidence of Traumatic Events checklist. The study presents salivary cortisol reference intervals for infants during the first twelve months of life.

CONCLUSIONS:

Cortisol circadian rhythm in infants is already established by one month of age, earlier than previous studies have shown. The current study also provides first year age-related reference intervals for salivary cortisol levels in healthy, full-term infants.

Place, publisher, year, edition, pages
Public Library of Science, 2016
National Category
Pediatrics Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:liu:diva-127497 (URN)10.1371/journal.pone.0151888 (DOI)26086734 (PubMedID)
Available from: 2016-04-28 Created: 2016-04-28 Last updated: 2017-11-30Bibliographically approved
Mörelius, E. (2016). Early maternal contact has an impact on the preterm infants’ brain system that manage stress.. In: : . Paper presented at 3rd PNAE Congress on Paediatric Nursing, Porto, Portugal. 26th to 27th May 2016 Porto, Portugal.
Open this publication in new window or tab >>Early maternal contact has an impact on the preterm infants’ brain system that manage stress.
2016 (English)Conference paper, Oral presentation only (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-129081 (URN)
Conference
3rd PNAE Congress on Paediatric Nursing, Porto, Portugal. 26th to 27th May 2016 Porto, Portugal
Available from: 2016-06-10 Created: 2016-06-10 Last updated: 2016-06-27
Mörelius, E., He, H.-G. & Shorey, S. (2016). Salivary Cortisol Reactivity in Preterm Infants in Neonatal Intensive Care: An Integrative Review. International Journal of Environmental Research and Public Health, 13(3), E337
Open this publication in new window or tab >>Salivary Cortisol Reactivity in Preterm Infants in Neonatal Intensive Care: An Integrative Review
2016 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, Vol. 13, no 3, p. E337-Article, review/survey (Refereed) Published
Abstract [en]

Recently, more and more researchers have been using salivary cortisol reactivity to evaluate stress in preterm infants in the neonatal intensive care unit (NICU). The aim of this integrative literature review was to summarize the evidence of interventions leading to a change in salivary cortisol from the baseline in preterm infants in the NICU. The electronic databases of PubMed, CINAHL, Web of Science, and Scopus were searched for relevant studies. The inclusion criteria were studies with preterm infants exposed to an intervention evaluated by salivary cortisol reactivity before discharge from the NICU, which were published in English. In total, 16 studies were included. Eye-screening examination and heel lance provoked an increase in the salivary cortisol level. Music, prone position, and co-bedding among twins decreased the salivary cortisol level. Several studies reported a low rate of successful saliva sampling or did not use control groups. Future studies need to focus on non-painful interventions in order to learn more about salivary cortisol regulation in preterm infants. Moreover, these studies should use study designs comprising homogenous gestational and postnatal age groups, control groups, and reliable analysis methods that are able to detect cortisol in small amounts of saliva.                  

Place, publisher, year, edition, pages
Basel: MDPI, 2016
Keywords
cortisol; infants; neonatal care; nursing; pain; preterm; saliva; stress
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-126359 (URN)10.3390/ijerph13030337 (DOI)000373528600002 ()26999185 (PubMedID)
Available from: 2016-03-22 Created: 2016-03-22 Last updated: 2018-01-10Bibliographically approved
Mörelius, E. (2016). Samspel mellan nyfödda barn och deras föräldrar. Barnbladet (1), 6-8
Open this publication in new window or tab >>Samspel mellan nyfödda barn och deras föräldrar
2016 (Swedish)In: Barnbladet, ISSN 0349-1994, no 1, p. 6-8Article in journal (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Bjuv: Riksföreningen för Barnsjuksköterskor, 2016
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-126103 (URN)
Available from: 2016-03-14 Created: 2016-03-14 Last updated: 2016-05-04Bibliographically approved
Shorey, S., He, H.-G. & Mörelius, E. (2016). Skin-to-skin contact by fathers and the impact on infant and paternal outcomes: an integrative review. Midwifery, 40, 207-217
Open this publication in new window or tab >>Skin-to-skin contact by fathers and the impact on infant and paternal outcomes: an integrative review
2016 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 40, p. 207-217Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVE:

to summarise research evidence on the impact of father-infant skin-to-skin contact on infant and paternal outcomes.

DESIGN:

an integrative literature review.

DATA SOURCES:

PubMed, ScienceDirect, PsycINFO, and Cumulative Index to Nursing & Allied Health.

REVIEW METHODS:

studies included were: (1) published in English between January 1995 to September 2015; (2) primary researches; and (3) focused on fathers providing skin-to-skin contact with their infants and its impact on infant and paternal outcomes. The Joanna Briggs Institute's Critical Appraisal Checklists were used to appraise the scientific rigour of the studies.

FINDINGS:

twelve studies (10 quantitative and two qualitative) were included in this review. Father-infant skin-to-skin contact had positive impacts on infants' outcomes, including temperature and pain, bio-physiological markers, behavioural response, as well as paternal outcomes, which include parental role attainment, paternal interaction behaviour, and paternal stress and anxiety.

CONCLUSIONS:

a father's involvement in providing skin-to-skin contact seems to be feasible and beneficial to both infants and fathers. However, there has been a scarcity of literature that exclusively examines fathers' involvement and perceptions related to skin-to-skin contact in the postpartum period. Future research should examine skin-to-skin contact by fathers and its associated benefits, as well as fathers' perceptions on father-infant SSC among varied populations.

IMPLICATIONS FOR PRACTICE:

a father's involvement in providing skin-to-skin contact should be promoted during the postnatal period. Father-infant skin-to-skin contact is a valuable alternative, especially during the unavailability of mothers due to special circumstances, including medical emergencies and caesarean section.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Fathers; Infant; Kangaroo care; Literature review; Skin-to-skin care; Skin-to-skin contact
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-130587 (URN)10.1016/j.midw.2016.07.007 (DOI)000382308900029 ()27476026 (PubMedID)
Available from: 2016-08-17 Created: 2016-08-17 Last updated: 2017-05-03
Mörelius, E. (2016). Stressade elever. Elevhälsan (1), 8-12
Open this publication in new window or tab >>Stressade elever
2016 (Swedish)In: Elevhälsan, ISSN 2000-5296, no 1, p. 8-12Article in journal (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Stockholm: Gothia Förlag AB, 2016
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-126105 (URN)
Available from: 2016-03-14 Created: 2016-03-14 Last updated: 2016-05-04Bibliographically approved
Mörelius, E.-l., Örtenstrand, A., Theodorsson, E. & Frostell, A. (2015). A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding. Early Human Development, 91(1), 63-70
Open this publication in new window or tab >>A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding
2015 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 91, no 1, p. 63-70Article in journal (Refereed) Published
Abstract [en]

AIM:

To evaluate the effects of almost continuous skin-to-skin contact (SSC) on salivary cortisol, parental stress, parental depression, and breastfeeding.

STUDY DESIGN:

This is a randomised study engaging families of late preterm infants (32-35weeks gestation). Salivary cortisol reactivity was measured in infants during a nappy change at one month corrected age, and in infants and mothers during still-face at four month corrected age. Both parents completed the Swedish Parenthood Stress Questionnaire (SPSQ) at one month and the Edinburgh Postnatal Depression Scale (EPDS) at one and four months. Ainsworth's sensitivity scale was used to control for parental sensitivity.

SUBJECTS:

Thirty-seven families from two different neonatal care units in Sweden, randomised to either almost continuous SSC or standard care (SC).

RESULTS:

Infants randomised to SSC had a lower salivary cortisol reactivity at one month (p=0.01). There was a correlation between the mothers' and the preterm infants' salivary cortisol levels at four months in the SSC group (ρ=0.65, p=0.005), but not in the SC group (ρ=0.14, p=0.63). Fathers in SSC scored lower on the SPSQ sub-scale spouse relationship problems compared to fathers in SC (p<0.05).

CONCLUSIONS:

Almost continuous SSC decreases infants' cortisol reactivity in response to handling, improves the concordance between mothers' and infants' salivary cortisol levels, and decreases fathers' experiences of spouse relationship problems.

Keywords
Cortisol; Kangaroo Mother Care; Neonatal Care; Preterm infants; Stress
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-113796 (URN)10.1016/j.earlhumdev.2014.12.005 (DOI)000349592600011 ()25545453 (PubMedID)
Note

The authors gratefully acknowledge the participating families, Lisbet de Jounge, Birgitta Lundin, Elisabeth Olhager, and Ihsan Sarman, and staff members at the Neonatal Intensive Care Units at Linkoping University Hospital and at Sachs' Children's Hospital in Stockholm. This study was supported by the County Council of Ostergotland (LiO-12134, LiO-17711, LiO-278801), South Sweden Nursing Society (SSSH-2008), Halsofonden (LiU-2009), and Linkoping University.

Available from: 2015-01-30 Created: 2015-01-30 Last updated: 2017-12-05
Mörelius, E. (2015). Barn och stress (2ed.). In: Inger Hallström, Tor Lindberg (Ed.), Pediatrisk omvårdnad: (pp. 72-78). Stockholm: Liber
Open this publication in new window or tab >>Barn och stress
2015 (Swedish)In: Pediatrisk omvårdnad / [ed] Inger Hallström, Tor Lindberg, Stockholm: Liber, 2015, 2, p. 72-78Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2015 Edition: 2
Keywords
Stress hos barn
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-126106 (URN)9789147115099 (ISBN)
Available from: 2016-03-14 Created: 2016-03-14 Last updated: 2016-05-04Bibliographically approved
Ivars, K., Nelson Follin, N., Theodorsson, A., Theodorsson, E., Ström, J. & Mörelius, E. (2015). Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants. PLoS ONE, 10(6), Article ID e0129502.
Open this publication in new window or tab >>Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants
Show others...
2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 6, article id e0129502Article in journal (Refereed) Published
Abstract [en]

Background Cortisol concentrations in plasma display a circadian rhythm in adults and children older than one year. Earlier studies report divergent results regarding when cortisol circadian rhythm is established. The present study aims to investigate at what age infants develop a circadian rhythm, as well as the possible influences of behavioral regularity and daily life trauma on when the rhythm is established. Furthermore, we determine age-related reference intervals for cortisol concentrations in saliva during the first year of life. Methods 130 healthy full-term infants were included in a prospective, longitudinal study with saliva sampling on two consecutive days, in the morning (07:30-09:30), noon (10:00-12:00) and evening (19:30-21:30), each month from birth until the infant was twelve months old. Information about development of behavioral regularity and potential exposure to trauma was obtained from the parents through the Baby Behavior Questionnaire and the Life Incidence of Traumatic Events checklist. Results A significant group-level circadian rhythm of salivary cortisol secretion was established at one month, and remained throughout the first year of life, although there was considerable individual variability. No correlation was found between development of cortisol circadian rhythm and the results from either the Baby Behavior Questionnaire or the Life Incidence of Traumatic Events checklist. The study presents salivary cortisol reference intervals for infants during the first twelve months of life. Conclusions Cortisol circadian rhythm in infants is already established by one month of age, earlier than previous studies have shown. The current study also provides first year age-related reference intervals for salivary cortisol levels in healthy, full-term infants.

Place, publisher, year, edition, pages
Public Library of Science, 2015
National Category
Clinical Medicine Sociology
Identifiers
urn:nbn:se:liu:diva-120229 (URN)10.1371/journal.pone.0129502 (DOI)000356567500051 ()26086734 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland, Sweden; Medical Research Council of Southeast Sweden, FORSS

Available from: 2015-07-21 Created: 2015-07-20 Last updated: 2017-12-04Bibliographically approved
Mörelius, E. (2015). Early maternal contact has an impact on the preterm infant’s brain-systems that manage stress. In: : . Paper presented at 3rd NUS-NUH International Nursing Conference and 20th joint Singapore- Malaysia nursing conference, Singapore 18-20 November 2015.
Open this publication in new window or tab >>Early maternal contact has an impact on the preterm infant’s brain-systems that manage stress
2015 (English)Conference paper, Oral presentation only (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-126360 (URN)
Conference
3rd NUS-NUH International Nursing Conference and 20th joint Singapore- Malaysia nursing conference, Singapore 18-20 November 2015
Available from: 2016-03-22 Created: 2016-03-22 Last updated: 2016-05-04
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3256-5407

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