Paternal and maternal birthweight and offspring risk of macrosomia at term gestations: A nationwide population study

Background There is a paucity of data on whether parents' macrosomia (birthweight ≥4500 g) status influences the risk of macrosomia in the offspring. The role of maternal overweight in the generational effect of macrosomia is not known. Objective To estimate the risk of macrosomia by parental birthweight at term and evaluate if this risk varied with maternal body mass index (BMI, kg/m2) early in pregnancy. Methods We used data from the Medical Birth Registry of Norway on all singleton term births (37–42 gestational weeks) during 1967–2017. The primary exposure was parental macrosomia, and the outcome was macrosomia in the second generation. The secondary exposure was maternal BMI. We used binomial regression to calculate relative risk (RR) with a 95% confidence interval. We assessed potential unmeasured confounding and selection bias using a probabilistic bias analysis and performed analyses with and without imputation for variables with missing values. Results The data included 647,957 singleton parent-offspring trios born at term. The prevalence of macrosomia was 3.2% (n = 41,396) in the parental generation and 4.0% (n = 25,673) in the offspring generation. Macrosomia in parents was associated with an increased risk of macrosomia in offspring, with the RR for both parents were born macrosomic being 6.53 (95% confidence interval [CI] 5.31, 8.05), only mother macrosomic 3.37 (95% CI 3.17, 3.57) and only father macrosomic RR 2.22 (95% CI 2.12, 2.33). These risks increased by maternal BMI in early pregnancy: if both parents were born macrosomic, 17% of infants were macrosomic among mothers with normal BMI. If both parents were macrosomic and the mothers were obese, 31% of offspring were macrosomic. Macrosomia-related adverse outcomes did not differ with parental macrosomia status. Conclusions Parents' weight at birth and maternal BMI appear to be strongly associated with macrosomia in the offspring delivered at term gestations.publishedVersio

Social and life skills in adolescents who have self-harmed: analysis of survey responses from a national sample of adolescents in Norway

publishedVersio

Association of COVID-19 Vaccination During Pregnancy With Incidence of SARS-CoV-2 Infection in Infants

IMPORTANCE: Pregnant women are recommended to receive COVID-19 vaccination to reduce risk of severe COVID-19. Whether vaccination during pregnancy also provides passive protection to infants after birth remains unclear. OBJECTIVE: To determine whether COVID-19 vaccination in pregnancy was associated with reduced risk of COVID-19 in infants up to age 4 months during COVID-19 pandemic periods dominated by Delta and Omicron variants. DESIGN, SETTING, AND PARTICIPANTS: This nationwide, register-based cohort study included all live-born infants born in Norway between September 1, 2021, and February 28, 2022. EXPOSURES: Maternal messenger RNA COVID-19 vaccination during second or third trimester compared with no vaccination before or during pregnancy. MAIN OUTCOMES AND MEASURES: The risk of a positive polymerase chain reaction test result for SARS-CoV-2 during an infant's first 4 months of life by maternal vaccination status during pregnancy with either dose 2 or 3 was estimated, as stratified by periods dominated by the Delta variant (between September 1 and December 31, 2021) or Omicron variant (after January 1, 2022, to the end of follow-up on April 4, 2022). A Cox proportional hazard regression was used, adjusting for maternal age, parity, education, maternal country of birth, and county of residence. RESULTS: Of 21 643 live-born infants, 9739 (45.0%) were born to women who received a second or third dose of a COVID-19 vaccine during pregnancy. The first 4 months of life incidence rate of a positive test for SARS-CoV-2 was 5.8 per 10 000 follow-up days. Infants of mothers vaccinated during pregnancy had a lower risk of a positive test compared with infants of unvaccinated mothers and lower risk during the Delta variant-dominated period (incidence rate, 1.2 vs 3.0 per 10 000 follow-up days; adjusted hazard ratio, 0.29; 95% CI, 0.19-0.46) compared with the Omicron period (incidence rate, 7.0 vs 10.9 per 10 000 follow-up days; adjusted hazard ratio, 0.67; 95% CI, 0.57-0.79). CONCLUSIONS AND RELEVANCE: The results of this Norwegian population-based cohort study suggested a lower risk of a positive test for SARS-CoV-2 during the first 4 months of life among infants born to mothers who were vaccinated during pregnancy. Maternal COVID-19 vaccination may provide passive protection to young infants, for whom COVID-19 vaccines are currently not available

DNA methylation in newborns conceived by assisted reproductive technology

Assisted reproductive technology (ART) may affect fetal development through epigenetic mechanisms as the timing of ART procedures coincides with the extensive epigenetic remodeling occurring between fertilization and embryo implantation. However, it is unknown to what extent ART procedures alter the fetal epigenome. Underlying parental characteristics and subfertility may also play a role. Here we identify differences in cord blood DNA methylation, measured using the Illumina EPIC platform, between 962 ART conceived and 983 naturally conceived singleton newborns. We show that ART conceived newborns display widespread differences in DNA methylation, and overall less methylation across the genome. There were 607 genome-wide differentially methylated CpGs. We find differences in 176 known genes, including genes related to growth, neurodevelopment, and other health outcomes that have been associated with ART. Both fresh and frozen embryo transfer show DNA methylation differences. Associations persist after controlling for parents’ DNA methylation, and are not explained by parental subfertility.publishedVersio

Health at age 17 in Norwegian adolescents: Mental and physical status in the national cohort born in 2001

Aims: We present self-reported data on physical and mental health at age 17 years from 82% of Norwegians born in 2001. Methods: In Norway, the Armed Forces require that each resident who reaches the age of 17 years completes a self-administered declaration of health that is used for military selection. The declaration collects information on height and weight, various clinically diagnosed diseases, mental and behavioural disorders, and other health conditions where clinical diagnosis is not required. In 2018, there were 65,913 adolescents born in 2001 living in Norway, of whom 10,223 were exempt from completing the declaration; declarations were therefore sent to 55,690 participants. We included 54,132 participants who completed the declaration (response rate 97.2%): 27,220 male and 26,912 female respondents. Results: We found that 18% of male and 28% of female respondents reported at least one clinically diagnosed disease, mental disorder or behavioural disorder. Among health condition where clinical diagnosis was not required, 19% of male and 37% of female respondents reported anxiety/depression affecting daily life and 10 versus 18% reported migraines/recurring headaches. The respondents probably represent the healthiest part of the total cohort of 17-year-old Norwegians because those who are exempt from completing the declaration are already considered unfit for military service. Conclusions: These data represent a rich resource for further research. Similar data exist for the birth cohorts in 1993–2003. We encourage further research that can help decision-makers identify areas of concern that should be targeted for interventions

Health at age 17 in Norwegian adolescents: Mental and physical status in the national cohort born in 2001

Aims: We present self-reported data on physical and mental health at age 17 years from 82% of Norwegians born in 2001. Methods: In Norway, the Armed Forces require that each resident who reaches the age of 17 years completes a self-administered declaration of health that is used for military selection. The declaration collects information on height and weight, various clinically diagnosed diseases, mental and behavioural disorders, and other health conditions where clinical diagnosis is not required. In 2018, there were 65,913 adolescents born in 2001 living in Norway, of whom 10,223 were exempt from completing the declaration; declarations were therefore sent to 55,690 participants. We included 54,132 participants who completed the declaration (response rate 97.2%): 27,220 male and 26,912 female respondents. Results: We found that 18% of male and 28% of female respondents reported at least one clinically diagnosed disease, mental disorder or behavioural disorder. Among health condition where clinical diagnosis was not required, 19% of male and 37% of female respondents reported anxiety/depression affecting daily life and 10 versus 18% reported migraines/recurring headaches. The respondents probably represent the healthiest part of the total cohort of 17-year-old Norwegians because those who are exempt from completing the declaration are already considered unfit for military service. Conclusions: These data represent a rich resource for further research. Similar data exist for the birth cohorts in 1993–2003. We encourage further research that can help decision-makers identify areas of concern that should be targeted for interventions

Bruk av spiral ved Helsestasjon for Ungdom i Bærum kommune

Helsedirektoratet har en målsetning om å redusere antall uønskede svangerskap og aborter i aldersgruppen 15-24 år. Denne aldersgruppen sammenfaller med målgruppen for Helsestasjon for ungdom og vil derfor være et naturlig innsatsområde. Etter gjennomgang av kunnskapsgrunnlaget fant vi at Helsedirektoratet anbefaler økt bruk av langtidsvirkende reversibel prevensjon (LARC) for å forebygge uønskede graviditeter, spesielt for målgruppen til Helsestasjon for ungdom. Dette er i tråd med evidensbasert forskning som viser at LARC har bedre effekt og kontinuasjonsrate sammenlignet med annen prevensjon. LARC er en fellesbetegnelse for p-stav og spiral. Ved Helsestasjon for ungdom (HFU) i Bærum har de ikke et tilbud for innsetting av spiral. Det må gjøres opplæring av personell, rutiner må utarbeides og det må anskaffes materiell for at dette skal kunne tilbys. Vi anbefaler at antall spiraler som settes inn registreres og dette vil være en prosessindikator for prosjektet. Prosjektet vil ledes av daglig leder ved HFU Bærum. Vi har utformet en plan for prosjektet basert på gjeldende anbefalinger og evidens i litteraturen, og vi mener at dette kvalitetsforbedringsprosjektet er både viktig og gjennomførbart