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Domellöf, Magnus
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Publications (10 of 151) Show all publications
Norman, M., Hallberg, B., Abrahamsson, T., Bjorklund, L. J., Domellöf, M., Farooqi, A., . . . Håkansson, S. (2019). Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-2016. Journal of the American Medical Association (JAMA), 321(12), 1188-1199
Open this publication in new window or tab >>Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-2016
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2019 (English)In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 321, no 12, p. 1188-1199Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE: Since 2004-2007, national guidelines and recommendations have been developed for the management of extremely preterm births in Sweden. If and how more uniform management has affected infant survival is unknown.

OBJECTIV: To compare survival of extremely preterm infants born during 2004-2007 with survival of infants born during 2014-2016.

DESIGN, SETTING AND PARTICIPANTS: All births at 22-26weeks' gestational age (n = 2205) between April 1, 2004, and March 31, 2007, and between January 1, 2014, and December 31, 2016, in Sweden were studied. Prospective data collection was used during 2004-2007. Data were obtained from the Swedish pregnancy, medical birth, and neonatal quality registries during 2014-2016. EXPOSURES Delivery at 22-26 weeks' gestational age.

MAIN OUTCOMES AND MEASURES: The primary outcomewas infant survival to the age of 1 year. The secondary outcome was 1-year survival among live-born infants who did not have any major neonatal morbidity (specifically, without intraventricular hemorrhage grade 3-4, cystic periventricular leukomalacia, necrotizing enterocolitis, retinopathy of prematurity stage 3-5, or severe bronchopulmonary dysplasia).

RESULTS: During 2004-2007, 1009 births (3.3/1000 of all births) occurred at 22-26 weeks' gestational age compared with 1196 births (3.4/1000 of all births) during 2014-2016 (P =.61). One-year survival among live-born infants at 22-26 weeks' gestational age was significantly lower during 2004-2007 (497 of 705 infants [70%]) than during 2014-2016 (711 of 923 infants [77%]) (difference, -7%[95% CI, -11% to -2.2%], P =.003). One-year survival among live-born infants at 22-26 weeks' gestational age and without any major neonatal morbidity was significantly lower during 2004-2007 (226 of 705 infants [32%]) than during 2014-2016 (355 of 923 infants [38%]) (difference, -6%[95% CI, -11% to -1.7%], P =.008).

CONCLUSIONS AND RELEVANCE: Among live births at 22-26 weeks' gestational age in Sweden, 1-year survival improved between 2004-2007 and 2014-2016.

Place, publisher, year, edition, pages
Chicago: American Medical Association, 2019
National Category
Pediatrics Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-158749 (URN)10.1001/jama.2019.2021 (DOI)000463074900015 ()30912837 (PubMedID)
Available from: 2019-05-15 Created: 2019-05-15 Last updated: 2019-05-15Bibliographically approved
Lindberg, J., Norman, M., Westrup, B., Domellöf, M. & Berglund, S. K. (2019). Cardiometabolic risk factors in children born with marginally low birth weight: A longitudinal cohort study up to 7 years-of-age. PLoS ONE, 14(4), Article ID e0215866.
Open this publication in new window or tab >>Cardiometabolic risk factors in children born with marginally low birth weight: A longitudinal cohort study up to 7 years-of-age
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 4, article id e0215866Article in journal (Refereed) Published
Abstract [en]

Introduction Low birth weight (LBW, <2500 g) may predict an increased risk of an adverse cardiometabolic profile later in life, but long-term effects in different populations and birth weight strata are still unclear. We explored laboratory markers of cardiometabolic risk in children born with marginally LBW (2000-2500 g). Methods This was a prospective longitudinal cohort study including 285 Swedish marginally LBW children and 95 normal birth weight (NBW, 2501-4500 g) controls. At 3.5 and 7 years of age, blood samples for glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), cholesterol, triglycerides, high-and low density lipoprotein (HDL and LDL), apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) were assessed and compared between the groups. Results No significant differences in levels of insulin, HOMA-IR, hs-CRP or blood lipids were observed between marginally LBW and NBW children. At 7 years there was a higher proportion of marginally LBW children with elevated levels of insulin, defined as above the 90th percentile of the control group (21% vs 8.6%, p = 0.038). This association was, however, confounded by maternal ethnicity. In marginally LBW children born small for gestational age (SGA), mean fasting glucose was significantly higher compared to controls (4.7 vs 4.5 mmol/L, p = 0.020). Conclusions There were no significant differences in insulin, insulin resistance, hs-CRP or blood lipids between the marginally LBW children and controls. The subgroup of marginally LBW children born SGA may present early signs of glucose imbalance already at school age.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-158951 (URN)10.1371/journal.pone.0215866 (DOI)000465019900056 ()31002705 (PubMedID)
Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-05-27Bibliographically approved
Klevebro, S., Westin, V., Stoltz Sjöström, E., Norman, M., Domellöf, M., Edstedt Bonamy, A.-K. & Hallberg, B. (2019). Early energy and protein intakes and associations with growth, BPD and ROP in extremely preterm infants. Clinical Nutrition, 38(3), 1289-1295
Open this publication in new window or tab >>Early energy and protein intakes and associations with growth, BPD and ROP in extremely preterm infants
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2019 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 38, no 3, p. 1289-1295Article in journal (Refereed) Published
Abstract [en]

Background & aim: Extremely preterm infants face substantial neonatal morbidity. Nutrition is important to promote optimal growth and organ development in order to reduce late neonatal complications. The aim of this study was to examine the associations of early nutritional intakes on growth and risks of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) in a high-risk population.

Methods: This population-based cohort study includes infants born before 27 0/7 weeks of gestational age without severe malformations and surviving ≥10 days. Intake of energy and protein on postnatal days 4–6 and association with weight standard deviation score (WSDS) from birth to day 7, as well as intakes of energy and protein on postnatal days 4–6 and 7 to 27, respectively, and association with composite outcome of death and BPD and separate outcomes of BPD and ROP were examined, and adjusted for potential confounders.

Results: The cohort comprised 296 infants with a median gestational age of 25 3/7 weeks. Expressed as daily intakes, every additional 10 kcal/kg/d of energy during days 4–6 was associated with 0.08 higher WSDS on day 7 (95% CI 0.06–0.11; p < 0.001). Between days 7 and 27, every 10 kcal/kg/d increase in energy intake was associated with a reduced risk of BPD of 9% (95% CI 1–16; p = 0.029) and any grade of ROP with a reduced risk of 6% (95% CI 2–9; p = 0.005) in multivariable models. This association was statistically significant in infants with ≤10 days of mechanical ventilation. In infants with >10 days of mechanical ventilation, a combined higher intake of energy and protein was associated with a reduced risk of BPD.

Conclusion: Early provision of energy and protein may reduce postnatal weight loss and risk of morbidity in extremely preterm infants.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Extremely preterm infant, Nutrition, Growth, Retinopathy of prematurity, Bronchopulmonary dysplasia
National Category
Pediatrics Nutrition and Dietetics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-147966 (URN)10.1016/j.clnu.2018.05.012 (DOI)000469891800037 ()29885776 (PubMedID)
Funder
Stockholm County Council
Available from: 2018-05-23 Created: 2018-05-23 Last updated: 2019-06-24Bibliographically approved
He, X., Parenti, M., Grip, T., Domellöf, M., Lonnerdal, B., Hernell, O., . . . Slupsky, C. M. (2019). Metabolic phenotype of breast-fed infants, and infants fed standard formula or bovine MFGM supplemented formula: a randomized controlled trial. Scientific Reports, 9, Article ID 339.
Open this publication in new window or tab >>Metabolic phenotype of breast-fed infants, and infants fed standard formula or bovine MFGM supplemented formula: a randomized controlled trial
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2019 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 339Article in journal (Refereed) Published
Abstract [en]

Formula-fed (FF) infants exhibit a different metabolic profile than breast-fed (BF) infants. Two potential mechanisms are the higher protein level in formula compared with breast milk and the removal of the milk fat and associated milk fat globule membranes (MFGM) during production of infant formula. To determine whether MFGM may impact metabolism, formula-fed infants were randomly assigned to receive either an MFGM isolate-supplemented experimental formula (EF) or a standard formula (SF) from 2 until 6 months and compared with a BF reference group. Infants consuming EF had higher levels of fatty acid oxidation products compared to infants consuming SF. Although the protein level in the study formula was approximately 12 g/L (lower than most commercial formulas), a metabolic difference between FF and BF remained such that FF infants had higher levels of amino acid catabolism by-products and a low efficiency of amino acid clearance (preference for protein metabolism). BF infants had higher levels of fatty acid oxidation products (preference for fat metabolism). These unique, energy substrate-driven metabolic outcomes did not persist after diet was shifted to weaning foods and appeared to be disrupted by complementary feeding. Our results suggest that MFGM may have a role in directing infant metabolism.

Place, publisher, year, edition, pages
Nature Publishing Group, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-156312 (URN)10.1038/s41598-018-36292-5 (DOI)000456392400020 ()30674917 (PubMedID)
Available from: 2019-02-21 Created: 2019-02-21 Last updated: 2019-02-21Bibliographically approved
Zamir, I., Stoltz Sjöström, E., Edstedt Bonamy, A.-K., Mohlkert, L.-A., Norman, M. & Domellöf, M. (2019). Postnatal nutritional intakes and hyperglycemia as determinants of blood pressure at 6.5 years of age in children born extremely preterm. Pediatric Research, 86(1), 115-121
Open this publication in new window or tab >>Postnatal nutritional intakes and hyperglycemia as determinants of blood pressure at 6.5 years of age in children born extremely preterm
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2019 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 86, no 1, p. 115-121Article in journal (Refereed) Published
Abstract [en]

Background: Adverse developmental programming by early-life exposures might account for higher blood pressure (BP) in children born extremely preterm. We assessed associations between nutrition, growth and hyperglycemia early in infancy, and BP at 6.5 years of age in children born extremely preterm.

Methods: Data regarding perinatal exposures including nutrition, growth and glycemia status were collected from the Extremely Preterm Infants in Sweden Study (EXPRESS), a population-based cohort including infants born <27 gestational weeks during 2004–2007. BP measurements were performed at 6.5 years of age in a sub-cohort of 171 children (35% of the surviving children).

Results: Higher mean daily protein intake (+1 g/kg/day) during postnatal weeks 1–8 was associated with 0.40 (±0.18) SD higher diastolic BP. Higher mean daily carbohydrate intake (+1 g/kg/day) during the same period was associated with 0.18 (±0.05) and 0.14 (±0.04) SD higher systolic and diastolic BP, respectively. No associations were found between infant growth (weight, length) and later BP. Hyperglycemia and its duration during postnatal weeks 1–4 were associated primarily with higher diastolic BP z-scores.

Conclusions: These findings emphasize the importance of modifiable early-life exposures, such as nutrition and hyperglycemia, in determining long-term outcomes in children born extremely preterm.

Place, publisher, year, edition, pages
Nature Publishing Group, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-155795 (URN)10.1038/s41390-019-0341-8 (DOI)000472723400021 ()30776793 (PubMedID)
Funder
Swedish Research Council, 2016-02095Swedish Heart Lung Foundation, 20090380Swedish Heart Lung Foundation, 20100457Västerbotten County CouncilStockholm County CouncilRegion Skåne
Available from: 2019-01-28 Created: 2019-01-28 Last updated: 2019-07-25Bibliographically approved
Späth, C., Zamir, I., Stoltz Sjöström, E. & Domellöf, M. (2019). Use of concentrated parenteral nutrition solutions is associated with improved nutrient intakes and postnatal growth in very low-birth-weight infants. JPEN - Journal of Parenteral and Enteral Nutrition
Open this publication in new window or tab >>Use of concentrated parenteral nutrition solutions is associated with improved nutrient intakes and postnatal growth in very low-birth-weight infants
2019 (English)In: JPEN - Journal of Parenteral and Enteral Nutrition, ISSN 0148-6071, E-ISSN 1941-2444Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Evidence showing the beneficial effects of enhanced parenteral nutrition (PN) to very low-birth-weight (VLBW,<1500 g) infants is accumulating. However, PN composition and its impact on growth outcomes are questioned. This study aimed to investigate the associations between administration of a concentrated PN regime and intakes of energy and macronutrients as well as postnatal growth in VLBW infants. 

Methods: We compared 2 cohorts of VLBW infants born before (n = 74) and after (n =44) a concentrated PN regime was introduced into clinical use. Daily nutrition and fluid intake during the first 28 postnatal days and all available growth measurements during hospitalization were retrospectively collected from clinical charts. 

Results: Infants who received concentrated PN compared with original PN had higher parenteral intakes of energy (56 vs 45 kcal/kg/d, P < 0.001), protein (2.6 vs 2.2 g/kg/d, P = 0.008), and fat (1.5 vs 0.7 g/kg/d, P < 0.001) during the first postnatal week. Changes in standard deviation scores for weight and length from birth to postnatal day 28 were more positive in the concentrated PN group (mean [95% CI]; weight change: –0.77 [–1.02 to –0.52] vs –1.29 [–1.33 to –1.05], P = 0.005; length change: –1.01 [–1.36 to –0.65] vs –1.60 [–1.95 to –1.25], P = 0.025). There were no significant differences in fluid intake and infant morbidity between the groups. 

Conclusion: Our results suggest that concentrated PN is useful and seems to be safe for improving early nutrition and growth in VLBW infants.

National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-148009 (URN)10.1002/jpen.1522 (DOI)
Available from: 2018-05-24 Created: 2018-05-24 Last updated: 2019-03-06
Challis, P., Larsson, L., Stoltz Sjöström, E., Serenius, F., Domellöf, M. & Elfvin, A. (2019). Validation of the diagnosis of necrotising enterocolitis in a Swedish population-based observational study. Acta Paediatrica, 108(5), 835-841
Open this publication in new window or tab >>Validation of the diagnosis of necrotising enterocolitis in a Swedish population-based observational study
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 5, p. 835-841Article in journal (Refereed) Published
Abstract [en]

Aim: The definition of necrotising enterocolitis (NEC) is based on clinical and radiological signs that can be difficult to interpret. The aim of the present study was to validate the incidence of NEC in the Extremely Preterm Infants in Sweden Study (EXPRESS)

Methods: The EXPRESS study consisted of all 707 infants born before 27 + 0 gestational weeks during the years 2004–2007 in Sweden. Of these infants, 38 were recorded as having NEC of Bell stage II or higher. Hospital records were obtained for these infants. Furthermore, to identify missed cases, all infants with a sudden reduction of enteral nutrition, in the EXPRESS study were identified (n = 71). Hospital records for these infants were obtained. Thus, 108 hospital records were obtained and scored independently by two neonatologists for NEC.

Results: Of 38 NEC cases in the EXPRESS study, 26 were classified as NEC after validation. Four cases not recorded in the EXPRESS study were found. The incidence of NEC decreased from 6.3% to 4.3%.

Conclusion: Validation of the incidence of NEC revealed over- and underestimation of NEC in the EXPRESS study despite carefully collected data. Similar problems may occur in other national data sets or quality registers.

Keywords
Bells staging, Extremely premature infants, Necrotising enterocolitis, Validation
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-155463 (URN)10.1111/apa.14585 (DOI)000465091200009 ()30238614 (PubMedID)2-s2.0-85054621996 (Scopus ID)
Funder
Swedish Research Council, 2016-02095
Available from: 2019-01-16 Created: 2019-01-16 Last updated: 2019-05-27Bibliographically approved
Berglund, S. K., Chmielewska, A., Starnberg, J., Westrup, B., Hägglöf, B., Norman, M. & Domellöf, M. (2018). Effects of iron supplementation of low-birth-weight infants on cognition and behavior at 7 years: a randomized controlled trial. Pediatric Research, 83, 111-118
Open this publication in new window or tab >>Effects of iron supplementation of low-birth-weight infants on cognition and behavior at 7 years: a randomized controlled trial
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2018 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 83, p. 111-118Article in journal (Refereed) Published
Abstract [en]

Background Low-birth-weight infants (LBW) are at an increased risk of iron deficiency that has been associated with impaired neurodevelopment. We hypothesized that iron supplementation of LBW infants improves cognitive scores and reduces behavioral problems until school age.

Methods We randomized 285 marginally LBW (2,000-2,500 g) infants to receive 0, 1, or 2 mg/kg/day of iron supplements from 6 weeks to 6 months of age. At 7 years of age, 205 participants were assessed regarding cognition using Wechsler Intelligence Scale for Children (WISC-IV) and behavior using the parental questionnaires Child Behavior Checklist (CBCL) and Five to Fifteen (FTF).

Results There were no significant differences between the intervention groups in WISC-IV or FTF. However, the CBCL scores for externalizing problems were significantly different, in favor of supplemented children (P=0.045). When combining the supplemented groups, they had significantly lower scores for externalizing behavior compared with placebo (median (interquartile range): 44 [34;51] vs. 48.5 [41;56] P=0.013), and their risk ratio (95% confidence interval) for a total behavioral score above the cutoff for clinical problems was 0.31 (0.09-1.0), P=0.054.

Conclusion Lower scores of externalizing behavior in supplemented children support our previous findings at 3 years, and suggest that iron supplementation may have long-lasting effects on behavioral functions.

Place, publisher, year, edition, pages
New York: Nature Publishing Group, 2018
Keywords
weeks gestational age, children born, late preterm, deficiency anemia, brain, growth, childhood, disorder, outcomes, risk
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-145099 (URN)10.1038/pr.2017.235 (DOI)000426175900019 ()28953856 (PubMedID)
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-11-13Bibliographically approved
Mihatsch, W. A., Braegger, C., Bronsky, J., Cai, W., Campoy, C., Carnielli, V., . . . Yan, W. (2018). ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition. Clinical Nutrition, 37(6), 2303-2305
Open this publication in new window or tab >>ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition
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2018 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 37, no 6, p. 2303-2305Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Nutrition and Dietetics Pediatrics
Identifiers
urn:nbn:se:umu:diva-155227 (URN)10.1016/j.clnu.2018.05.029 (DOI)000454376500001 ()30471662 (PubMedID)
Note

Part: B

Available from: 2019-01-14 Created: 2019-01-14 Last updated: 2019-05-08Bibliographically approved
van Goudoever, J. B., Carnielli, V., Darmaun, D., de Pipaon, M. S., Braegger, C., Bronsky, J., . . . Weihui, Y. (2018). ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Amino acids. Clinical Nutrition, 37(6), 2315-2323
Open this publication in new window or tab >>ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Amino acids
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2018 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 37, no 6, p. 2315-2323Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
parenteral nutrition, amino acids, requirements, toxicity, deficiency
National Category
Pediatrics Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-158681 (URN)10.1016/j.clnu.2018.06.945 (DOI)000454376500004 ()30100107 (PubMedID)
Note

Part: B

Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-05-08Bibliographically approved
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