Medisinsk fødselsregisters fødsel og senere vekst; noen observasjoner og refleksjoner fra hornet på veggen

Da «Medisinsk melding om fødsel» ble etablert 1. januar 1967, var dette en melderutine som representerte noe nytt ikke bare i et norsk, men også i et internasjonalt perspektiv. Bakgrunnen var thalidomid-katastrofen som hadde rystet verden noen år tidligere. Men man hadde fra begynnelsen også et ønske om å skaffe et kunnskapsbasert grunnlag for fremtidens obstetrikk, neonatalogi og habilitering. Initiativet ble tatt av Helsedirektoratet. I den opprinnelige planen skulle fødselsmeldingene bearbeides og analyseres i Statistisk sentralbyrå (SSB), men det ble tidlig klart at dette ville sprenge de rammene SSB vanligvis arbeidet innenfor. SSB hadde heller ikke den medisinske kompetansen som var en forutsetning for en fullverdig utnyttelse av de innsamlede data. På denne tiden arbeidet dr.med. Tor Bjerkedal som medisinsk statistisk konsulent/forsker I i SSB. Da han i 1969 tiltrådte sitt professorat ved Institutt for hygiene og sosialmedisin (IHS), Universitetet i Bergen (UiB), brakte han MFRs første årganger av fødselsmeldinger med seg. I en avtale med helsedirektør Karl Evang ble Bjerkedal gitt i oppdrag å opprette og drive et register basert på meldingene. I informasjonsteknologiens barndom representerte denne oppgaven en pionerinnsats. Meldeskjemaets data ble punchet på et 80 karakterers hullkort som ble prosessert i UiBs store sentrale regnemaskin. Arbeidet ble utført av en liten, men entusiastisk gruppe medarbeidere, i det alt vesentlige finansiert ved hjelp av lokale UiB-ressurser. I tillegg gikk Norges almenvitenskapelige forskningsråd de første årene inn med midler, dels fordi ITaspektene ble sett på som innovative, dels fordi man forsto at de innsamlede data ville få stor forskningsmessig verdi. MFR ble raskt operativt med et system for overvåking av medfødte misdannelser og andre uønskede svangerskapsutfall. For å sikre oppfølgning av barn med behov for spesielle medisinske hjelpetiltak ble det startet prøveprosjekter med elektronisk registrering av data fra helsestasjonenes 1-års og 4- årsundersøkelser samtidig som data fra vaksinasjonsprogrammet ble registrert, videreført i det nåværende SYSVAK. Etablering av alle driftsrutinene knyttet til MFR krevet omfattende innsats. Derfor ble den forskningsmessige utnyttelsen av de innsamlede data til å begynne med relativt beskjeden. Men etter hvert vokste det frem en omfattende vitenskapelig produksjon samtidig som antall ansatte økte; de første årene var 6-8 personer tilknyttet MFR mens i 2002 da MFR ble integrert som en avdeling i Folkehelseinstituttet var ca. 60 personer ansatt, herunder stipendiater. Virksomheten ved MFR kom til å bli avgjørende for at registerbasert epidemiologi ble et prioritert innsatsområde for Det medisinske fakultet ved UiB og for den videre etablering av helseregistre ved Folkehelseinstituttet i Bergen

Pregnancy outcome in women before and after cervical conisation: population based cohort study

Objectives To examine the consequences of cervical conisation in terms of adverse outcome in subsequent pregnancies

Employment Trends During Preschool Years Among Mothers of Term Singletons Born with Low Birth Weight

Children born at term with low birth weight (LBW) are regarded growth restricted and are at particular risk of adverse health outcomes requiring a high degree of parental participation in the day-to-day care. This study examined whether their increased risk of special health care needs compared to other children may influence mothers’ opportunities for participation in the labor market at different times after delivery. Data from 32,938 participants in the population-based Norwegian Mother and Child Cohort Study with singleton children born at term in 2004–2006 were linked to national registers in order to investigate the mothers’ employment status when their children were 1–3 years in 2007 and 4–6 years in 2010. Children weighing less than two standard deviations below the gender-specific mean were defined as LBW children. Although not significantly different from mothers of children in the normal weight range, mothers of LBW children had the overall highest level of non-employment when the children were 1–3 years. At child age 4–6 years on the other hand, LBW was associated with an increased risk of non-employment (RR 1.39: 95 % CI 1.11–1.75) also after adjustment for factors associated with employment in general. In accordance with employment trends in the general population, our findings show that while mothers of normal birth weight children re-enter the labor market as their children grow older, mothers of LBW children born at term participate to a lesser extent in paid employment and remain at levels similar to those of mothers with younger children. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited

Maternal Sick Leave Due to Psychiatric Disorders Following the Birth of a Child With Special Health Care Needs

Objective Child-related stress following the birth of a child with special health care needs (SHCN) can take a toll on parental health. This study examined how the risk of sick leave due to psychiatric disorders (PD) among mothers of children with SHCN compares with that of mothers of children without SHCN during early motherhood. Methods Responses from 58,532 mothers participating in the Norwegian Mother and Child Cohort Study were linked to national registries and monitored for physician-certified sick leave from the month of their child's first birthday until the month of their child's fourth birthday. Results As compared with mothers of children without SHCN, mothers of children with mild and moderate/severe care needs were at substantial risk of a long-term sick leave due to PD in general and due to depression more specifically. Conclusions Extensive childhood care needs are strongly associated with impaired mental health in maternal caregivers during early motherhoo

Maternal sick leave due to psychiatric disorders following the birth of a child with special health care needs

Objective: Child-related stress following the birth of a child with special health care needs (SHCN) can take a toll on parental health. This study examined how the risk of sick leave due to psychiatric disorders (PD) among mothers of children with SHCN compares with that of mothers of children without SHCN during early motherhood. Methods: Responses from 58,532 mothers participating in the Norwegian Mother and Child Cohort Study were linked to national registries and monitored for physician-certified sick leave from the month of their child's first birthday until the month of their child's fourth birthday. Results: As compared with mothers of children without SHCN, mothers of children with mild and moderate/severe care needs were at substantial risk of a long-term sick leave due to PD in general and due to depression more specifically.  Conclusions: Extensive childhood care needs are strongly associated with impaired mental health in maternal caregivers during early motherhoo

Setting research priorities to improve global newborn health and prevent stillbirths by 2025

Acknowledgements: The authors thank the expert group for their time and effort in this priority–setting exercise, and the contribution of anonymous reviewers to the final version of this report. We acknowledge inputs from Dr Diane Morof from Centers for Disease Control and Prevention, USA. Funding: This work was supported by Save the Children.Peer reviewedPublisher PD