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  • 1.
    Bylund, Bengt
    et al.
    Västerviks sjukhus.
    Cervin, Torsten
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Gäddlin, Per-Olof
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Leijon, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Mård, Selina
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Samuelsson, Stefan
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Sandstedt, Per
    Wärngård, Olof
    Very low birth weight children at 9 years:  School performance and behaviour in relation to risk factors2000In: Prenatal and Neonatal Medicine, ISSN 1359-8635, E-ISSN 1473-0774, Vol. 5, no 2, p. 124-133Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate the school performance and behavior of very low-birth-weight children in comparison with controls, and relate the findings to risk factors.

    Methods All children with birth weight below 1501 g (VLBW) and normal birth weight (NBW) controls, born in the south-east region of Sweden during a 15-month period in 1987-88, were enrolled in a prospective follow-up study; 81 % (n = 70) and 82% (n = 72), respectively, were re-examined at the age of 9 years regarding growth, neurological status, neurofunctional classification and academic achievement tests (Raven's matrices, mathematics, vocabulary, reading ability). The need for special education at school was assessed and four behavioral problem scores were also assessed (hyperactivity, fine motor skills, gross motor skills, social skills). Children with known handicaps were not re-examined.

    Results VLBW children were shorter and lighter than controls, and differed from them with regard to neurological functional classification. As a group, they produced poorer results in all academic achievement tests except vocabulary, and also in two out of four behavioral subscales (hyperactivity and fine motor skills). When the comparison was restricted to children with normal Raven scores, almost all the differences disappeared. VLBW children had more reading difficulties but were less often than expected defined as dyslexic compared to NEW children.

  • 2.
    Finnström, Orvar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Bylund, Bengt
    Västerviks sjukhus.
    Cervin, Torsten
    Centralsjukhuset i Kalmar.
    Gäddlin, Per-Olof
    Linköping University, Department of Molecular and Clinical Medicine.
    Leijon, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Mård, Selina
    Linköping University, Department of Behavioural Sciences.
    Samuelsson, Stefan
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Teaching and Learning in School, Teacher Education and other Educational Settings.
    Sandstedt, Per
    hälsouniversitetet i Linköping.
    Wärngård, Olof
    Norrköpings sjukhus.
    Mycket lågviktiga barn vid 9 års ålder. De flesta klarar sig bra men barn med skolsvårigheter är överrepresenterade2000In: Svenska läkartidningen, ISSN 0371-439X, Vol. 97, p. 3492-3498Article in journal (Refereed)
  • 3.
    Finnström, Orvar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Gäddlin, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics.
    Leijon, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Samuelsson, S
    Wadsby, Marie
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry.
    Very-low-birth-weight children at school age: Academic achievement, behavior and self-esteem and relation to risk factors2003In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 14, no 2, p. 75-84Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate school performance, behavior and self-esteem of children with very low birth weight (VLBW). Methods: All children with birth weight below 1501 g (VLBW) and normal birth weight controls, born in the south-east region of Sweden during a 15-month period in 1987-88, were enrolled in a prospective follow-up study. At the age of 9 years, 81% and 82%, respectively, were re-examined regarding growth, neurofunctional classification, academic achievement tests, need for special education and behavioral problems. At 12 years, 89% and 76%, respectively, were re-examined regarding growth, neurofunctional classification, visual acuity and self-esteem. Results: VLBW children were shorter and lighter, and differed from the controls with regard to neurological functional classification. They produced poorer results in most academic achievement tests. When the comparison was restricted to children with normal intelligence, almost all the differences in other academic achievements disappeared. VLBW children had more reading difficulties but were less often than expected defined as dyslexics compared to control children. We did not find any major disparity in visual acuity and self-esteem between the groups. Low Apgar scores, intracranial hemorrhage and the need for mechanical ventilation neonatally were associated with poorer results in most outcome measures. Neurofunctional assessments in early childhood were associated with most outcome measures. The mother's education was related to delayed reading skills and need for special education. Conclusions: Although VLBW children performed less well in most academic achievement tests and on some behavioral subscales, those who had a normal intellectual capacity did not differ in any important aspects from the controls.

  • 4.
    Gäddlin, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics .
    Long-term follow-up of very low birthweight children: A prospective study from the southeast region of Sweden2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: The survival rates for very low birthweight (VLBW; birthweight ≤1500 g) children are increasing, but they run a greater risk than controls of developing neurosensory disabilities and other functional problems during childhood. However, there is a great need for more knowledge regarding long-term outcome to adulthood in VLBW subjects.

    Aims: To evaluate long-term outcomes in a regional cohort of VLBW children born in 1987-88 regarding hospital readmissions, morbidity, neurological conditions, cognitive function, reading skills, school achievements, behaviour, growth, general health, and social functioning in relation to gender, neonatal risk factors, disability and Magnetic Resonance Imaging (MRI) findings.

    Study design: Prospective longitudinal case-controlled long-term regional follow-up.

    Material and Methods: A total of 86 (80.4%) children (47 boys out of 60 and 39 girls out of 47 live-borns) survived the neonatal period and were recruited to the follow-up study. A total of 86 term controls (45 boys and 41 girls) were included from the newborn period. Readmissions, hospital diagnoses, need of habilitation and child psychiatric care were checked in registers to 15 years of age. The VLBW children were enrolled in the follow-up study at 40 weeks gestational age and at 4, 9, and 15 years of age in assessing neurological conditions. At 15 years of age, the groups were assessed in cognition (WISC III), reading skills, school outcome, behaviour, vision and growth. Fifty-nine (69%) VLBW children were examined using cerebral MRI. Physical and mental health, weight and height, education, and socio-economic situation were assessed at 20 years of age in 77/85 VLBW and 69/84 control subjects by means of postal questionnaires.

    Results: VLBW boys had three times more readmissions compared with control boys (p=0.003). Gestational age below 30 weeks, birthweight less than 1000 g, and mechanical ventilation were neonatal risk factors for readmissions. Five (5.8%) children had moderate/severe cerebral palsy, 5 (5.8%) had attention deficit hyperactivity disorder, and 1 was blind due to retinopathy of prematurity.

    VLBW children were inferior in neurological function in comparison with controls at 40 weeks of gestational age and 4 and 15 years of age. Fourteen of 56 (25%) VLBW children without overt disability had abnormal MRI findings. Mechanical and/or intraventricular haemorrhages (IVH) were significantly related to less favourable neurological outcome. VLBW children performed significantly lower than their controls on a few reading variables and on WISC III. Half of them 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. Small head circumference correlated with low IQ. Mechanical ventilation and IVH correlated with lower IQ and poorer reading skills. At 20 years of age, the VLBW subjects did not differ significantly from the controls in self-perceived health, education, occupation and way of living.

    Conclusions: Most VLBW subjects were without major health problems up to 20 years of age and had attended mainstream schools. The presence of IVH and mechanical ventilation during the neonatal period negatively influenced health outcomes. VLBW children without overt neurological disability performed somewhat less well in neurological examinations in comparison with controls. VLBW children achieved poorer results in cognitive tests, but reading skills made a catch-up to 15 years of age. A majority of VLBW subjects managed transition to adulthood similar to that of controls.

    List of papers
    1. Hospital readmissions and morbidity in a fifteen-year follow-up of very low birthweight children in Southeast Sweden
    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
    2. 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
    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
    3. Academic achievement, behavioural outcomes and MRI findings at 15 years of age in very low birthweight children
    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
    Show others...
    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
    4. Health, quality of life, educational level, and occupation in early adulthood in very low birthweight subjects in south-east Sweden
    Open this publication in new window or tab >>Health, quality of life, educational level, and occupation in early adulthood in very low birthweight subjects in south-east Sweden
    (English)Manuscript (Other academic)
    Abstract [en]

    Objectives: To study health, quality of life, educational level and occupation in very low birthweight children (VLBW; ≤1500 g) in early adulthood and relationship to neonatal risk factors and handicap.

    Design: Prospective long-term follow-up study.

    Setting: Regional cohort.

    Participants: Twenty-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.

    Outcome Measures: Postal questionnaires: 1. A study-specific form with questions about health, tobacco and alcohol use, weight and height, education, occupation and socio-economic situation. 2. Medical Outcomes Study, Short Form (SF-36). 3. Sense of Coherence (SOC).

    Results: VLBW subjects did not differ significantly from the controls in self-perceived health, use of tobacco, education, occupation and way of living, or scoring on SF-36 and SOC. Sixteen had cerebral palsy, attention deficit hyperactivity disorder, or isolated mental retardation, and those differed significantly from controls on SF-36 in physical functioning and physical health score, but not on SOC. VLBW subjects were significantly lighter and shorter than their controls. Extremely low birthweight (ELBW), bronchopulmonary dysplasia and intraventricular haemorrhage were significantly associated with poorer scores on physical functioning and physical health score.

    Conclusions: A majority of VLBW subjects were healthy at 20 years of age and managed transition to adulthood similar to controls. A minority had handicaps that influenced their physical function. ELBW and severe neonatal complications were associated with poorer self-perceived physical health in early adulthood.

    Keywords
    Adult, Health, Infant Very Low Birth Weight, Follow-Up Studies, Quality of Life
    National Category
    Pediatrics
    Identifiers
    urn:nbn:se:liu:diva-15487 (URN)
    Available from: 2008-12-04 Created: 2008-11-11 Last updated: 2010-01-14Bibliographically approved
  • 5.
    Gäddlin, Per-Olof
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Hellgren, Kerstin
    Department of Ophthalmology, University Hospital, Uppsala, and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Leijon, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Hospital readmissions and morbidity in a fifteen-year follow-up of very low birthweight children in Southeast Sweden2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 4, p. 499-505Article in journal (Refereed)
    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.

  • 6.
    Gäddlin, Per-Olof
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Samuelsson, Stefan
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Wang, Chen
    Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
    Leijon, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Academic achievement, behavioural outcomes and MRI findings at 15 years of age in very low birthweight children2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 10, p. 1426-1432Article in journal (Refereed)
    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.

  • 7.
    Gäddlin, Per-Olof
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Leijon, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Health, quality of life, educational level, and occupation in early adulthood in very low birthweight subjects in south-east SwedenManuscript (Other academic)
    Abstract [en]

    Objectives: To study health, quality of life, educational level and occupation in very low birthweight children (VLBW; ≤1500 g) in early adulthood and relationship to neonatal risk factors and handicap.

    Design: Prospective long-term follow-up study.

    Setting: Regional cohort.

    Participants: Twenty-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.

    Outcome Measures: Postal questionnaires: 1. A study-specific form with questions about health, tobacco and alcohol use, weight and height, education, occupation and socio-economic situation. 2. Medical Outcomes Study, Short Form (SF-36). 3. Sense of Coherence (SOC).

    Results: VLBW subjects did not differ significantly from the controls in self-perceived health, use of tobacco, education, occupation and way of living, or scoring on SF-36 and SOC. Sixteen had cerebral palsy, attention deficit hyperactivity disorder, or isolated mental retardation, and those differed significantly from controls on SF-36 in physical functioning and physical health score, but not on SOC. VLBW subjects were significantly lighter and shorter than their controls. Extremely low birthweight (ELBW), bronchopulmonary dysplasia and intraventricular haemorrhage were significantly associated with poorer scores on physical functioning and physical health score.

    Conclusions: A majority of VLBW subjects were healthy at 20 years of age and managed transition to adulthood similar to controls. A minority had handicaps that influenced their physical function. ELBW and severe neonatal complications were associated with poorer self-perceived physical health in early adulthood.

  • 8.
    Gäddlin, Per-Olof
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Wang, Chen
    Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
    Leijon, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    A fifteen-year follow-up of neurological conditions in VLBW children without overt disability: Relation to gender, neonatal risk factors, and end stage MRI findings2008In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 84, no 5, p. 343-349Article in journal (Refereed)
    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.

  • 9.
    Gäddlin, Per-Olof
    et al.
    Linköping University, Department of Molecular and Clinical Medicine.
    Leijon, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Mård, Selina
    Linköping University, Department of Behavioural Sciences.
    Samuelsson, Stefan
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Teaching and Learning in School, Teacher Education and other Educational Settings.
    Very low birthweight children at 9 and 12 years: School performance, behaviour and self-image2003In: Journal of Maternal-Fetal and Neonatal Medicine, Vol. 14Article in journal (Refereed)
  • 10.
    Leijon, Ingemar
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus Linköping/Motala.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus Linköping/Motala.
    Gäddlin, Per-Olof
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Futurum, Sweden.
    Nelson Follin, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus Linköping/Motala. Karolinska Univ Hosp, Sweden.
    Hammar, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Chemistry. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Self-reported mental health and cortisol activity at 27-28 years of age in individuals born with very low birthweight2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed)
    Abstract [en]

    Aim

    To assess mental health outcomes of very low birthweight (VLBW, <1500 g) subjects to adulthood and to examine salivary cortisol and hair cortisol levels and their relation to birth characteristics and mental health.

    Methods

    A Swedish regional cohort of 56 VLBW subjects and 55 full‐term controls were assessed at the ages 27‐28 with adult self‐reported scales and the mean of 2 days diurnal salivary cortisol and hair cortisol. The cohorts had been assessed at 15 years of age with youth self‐reported scales.

    Results

    There were no differences between the groups in youth self‐reported scales and adult self‐reported scores. The 24 participating VLBW girls scored lower on youth self‐reported scales externalising and total problem scores than the control girls. In adulthood, the 21 participating VLBW women had significantly higher morning concentrations of salivary cortisol than control women, P = .014. No significant associations were found between cortisol concentrations and adult self‐reported scales internalising, externalising and total scores.

    Conclusion

    Self‐reported mental health in VLBW subjects was comparable with normal birthweight controls indicating a satisfying transition from adolescence to adulthood. VLBW females had higher morning salivary cortisol concentrations, suggesting a gender difference. We found no correlations between cortisol and mental health.

  • 11.
    Mai, Xiaomei
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Gäddlin, Per-Olof
    Central Hospital, Jönköping, Sweden.
    Nilsson, Lennart
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Finnström, Orvar
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Björkstén, Bengt
    Centre for Allergy Research and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Jenmalm, Maria C.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Leijon, Ingemar
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Asthma, lung function and allergy in 12-year-old children with very low birth weight: a prospective study2003In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 14, no 3, p. 184-192Article in journal (Refereed)
    Abstract [en]

    We assessed the relationship between very low birth weight (VLBW) (≤1500 g) and the development of asthma, lung function and atopy. The study groups comprised 74 of all 86 (86%) VLBW and 64 of all 86 (74%) matched term children who were prospectively followed for 12 years. A questionnaire on asthmatic and allergic symptoms was completed and skin prick tests, spirometry and hypertonic saline provocation tests were performed at 12 years of age. Cytokine secretion was analysed in stimulated blood leukocyte cultures in 28 VLBW and 23 term children. A history of asthma was more frequent among the VLBW children, as compared with the term children at age 12 (22% vs. 9%, p = 0.046). Among the VLBW children, very preterm birth (gestational age: week 25 to 29) (RR 2.5, 95%CI 1.1–5.8), neonatal mechanical ventilation (RR 2.8, 95%CI 1.2–6.4) and neonatal oxygen supplementation (RR 4.3, 95%CI 1.3–14.0) were significantly associated with a history of asthma by the age of 12 years in univariate analyses. In multivariate logistic regression, neonatal oxygen supplementation ≥ 9 days was the only remaining significant risk factor for a history of asthma (adjusted OR 6.7, 95%CI 1.0–44). The VLBW children who required mechanical ventilation during the neonatal period were more likely to have bronchial hyperresponsiveness than those not requiring mechanical ventilation (60% vs. 28%, p = 0.050). The spirometric values were similar among the VLBW and the term children at 12 years. Very low birth weight was not significantly related to allergic rhinoconjunctivitis, eczema or positive skin prick tests. Furthermore, the levels of IL-4, IL-5 and IFN-γ in stimulated cell cultures were similar in the VLBW and the term children. A history of asthma by 12 years of age was twice as common among the VLBW as the term children, and neonatal oxygen supplementation seemed to be associated with the increased risk. Furthermore, mechanical ventilation during the neonatal period was associated with bronchial hyperresponsiveness at age 12. Very low birth weight per se was not, however, related to atopy.

  • 12.
    Mai, Xiaomei
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics.
    Gäddlin, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics.
    Nilsson, Lennart
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Leijon, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Early rapid weight gain and current overweight in relation to asthma in adolescents born with very low birth weight2005In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 16, no 5, p. 380-385Article in journal (Refereed)
    Abstract [en]

    Early catch-up growth and subsequent overweight are suggested to be associated with later cardiovascular diseases and later type II diabetes. However, the impact of early catch-up growth and childhood overweight on the development of asthma has been less studied, particularly in children born with very low birth weight (VLBW). A birth cohort of 74 VLBW children (birth weight ≤ 1500 g) was followed from birth and investigated on asthma at 12 yr of age. Early rapid weight gain was in one way defined as an increase of weight ≥1 standard deviation score (SDS) at 6 months of corrected postnatal age. Current overweight was defined by body mass index (BMI) exceeding 21.2 and 21.7 kg/m2, respectively, for boys and girls at 12 yr of age. Current asthma was diagnosed by a pediatrician, according to asthma ever in combination with a positive response to hypertonic saline bronchial provocation test and/or wheeze at physical examination at 12 yr old. Being overweight at 12 yr of age was associated with an increased risk for current asthma in the VLBW children [crude odds ratio (OR): 5.5, 95% confidence interval (CI): 1.3-22.2]. After adjustment for early weight gain and neonatal risk, the OR of overweight increased nearly three times (adjusted OR: 15.3, 95% CI: 2.5-90.6). Early rapid weight gain seemed to be inversely associated with current asthma (adjusted OR: 0.49 for an increase of weight equal to 1 SDS, 95% CI: 0.23-1.02, p = 0.06). In addition, early rapid weight gain was inversely associated with the magnitude of bronchial responsiveness at 12 yr (coefficient -1.15, p < 0.01). There was a strong and positive association between overweight and asthma at 12 yr of age in the VLBW children. This strong association had been reduced by early rapid weight gain, possibly via the reduction of bronchial responsiveness. © 2005 Blackwell Munksgaard.

  • 13.
    Nelson, Nina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Orlenius, Bo
    Barn- och ungdomsmedicinska kliniken, VIN .
    Bylund, Bengt
    Barn- och Ungdomsmedicinska kliniken, Västervik .
    Gäddlin, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics.
    Jonsson, Nils-Olof
    Barn- och Ungdomsmedicinska kliniken, Jönköping .
    Ansved, Pär
    Barn- och Ungdomsmedicinska kliniken, Kalmar .
    Odelram, Hannes
    Barn- och Ungdomsmedicinska kliniken, Motala .
    Fredriksson, Magnus
    Barn- och Ungdomsmedicinska kliniken, Visby .
    Stora skillnader i vården av nyfödda vid åtta svenska BB-avdelningar2006In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, no 1-2, p. 34-37Article in journal (Refereed)
  • 14.
    Roback, Kerstin
    et al.
    Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment. Linköping University, The Institute of Technology.
    Gäddlin, Per-Olof
    Division of Pediatrics, County Hospital Ryhov, Jönköping, Sweden.
    Nelson, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Persson, Jan
    Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment. Linköping University, The Institute of Technology.
    Adoption of medical devices: Perspectives of professionals in Swedish neonatal intensive care2007In: Technology and Health Care, ISSN 0928-7329, Vol. 15, no 3, p. 157-179Article in journal (Refereed)
    Abstract [en]

    Advances in biomedical engineering enable us to treat increasingly severe conditions. This implies an increased need for regulation and priority setting in healthcare, to ensure appropriate safety cautions and to avoid accelerating expenditures. This interview study investigates the mechanisms behind the adoption and use of medical devices through the subjective experiences of hospital staff working with devices for neonatal intensive care. The adoption was found to be primarily initiated by vendor activities, but professionals preferably sought information about functionality from close colleagues. Full integration of devices was sometimes not achieved, and even though the adopting units had good introduction routines, there was no systematic follow-up of how adopted devices had been integrated in the work practices. Diffusion variations were, however, mainly found for temporarily tested devices and not for permanently available technologies. Three factors were found to be the major explanatory variables of the adoption of medical devices: (1) the subjective expected value of the device, (2) information and learning, and (3) the innovativeness of the adopting unit.

  • 15.
    Roback, Kerstin
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment.
    Gäddlin, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics.
    Nelson, Nina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Persson, Jan
    Linköping University, The Institute of Technology. Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment.
    Managing Technological Change in the Innovative Hospital: Experiences from Neonatal Intensive Care2006In: World Congress on Medical Physics and Biomedical Engineering,2006, 2006Conference paper (Refereed)
    Abstract [en]

      

  • 16.
    Samuelsson, Stefan
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Teaching and Learning in School, Teacher Education and other Educational Settings.
    Bylund, Bengt
    Västerviks sjukhus.
    Cervin, Torsten
    Centralsjukhuset i Kalmar.
    Finnström, Orvar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Gäddlin, Per-Olof
    Linköping University, Department of Molecular and Clinical Medicine.
    Leijon, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Mård, Selina
    Linköping University, Department of Behavioural Sciences.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Sandstedt, Per
    Hälsouniversitetet i Linköping.
    Wärngård, Olof
    Norrköpings sjukhus.
    The prevalence of reading disabilities among very low birth weight children at nine years of age - Dyslexics or poor readers?1999In: Dyslexia-An International Journal of Research and Practíce, Vol. 5, p. 94-112Article in journal (Refereed)
  • 17.
    Samuelsson, Stefan
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Teaching and Learning in School, Teacher Education and other Educational Settings.
    Finnström, Orvar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Flodmark, Olof
    Dept of Neuroradiology, KS, Stockholm .
    Gäddlin, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics.
    Leijon, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Wadsby, Marie
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry.
    A longitudinal study of reading skills among very-low-birthweight children: Is there a catch-up?2006In: Journal of Pediatric Psychology, ISSN 0146-8693, E-ISSN 1465-735X, Vol. 31, no 9, p. 967-977Article in journal (Refereed)
    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.

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