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Naumburg, Estelle
Publications (10 of 18) Show all publications
Irevall, T., Axelsson, I. & Naumburg, E. (2017). B12 deficiency is common in infants and is accompanied by serious neurological symptoms. Acta Paediatrica, 106(1), 101-104
Open this publication in new window or tab >>B12 deficiency is common in infants and is accompanied by serious neurological symptoms
2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 1, p. 101-104Article in journal (Refereed) Published
Abstract [en]

Aim: Adverse neurological symptoms have been linked to vitamin B12 deficiency in infants. This explorative study described the clinical presentation associated with vitamin B12 deficiency in this age group. Methods: The study comprised infants who were born between 2004 and 2012 and were tested for vitamin B12 levels after they were admitted to a hospital with neurological symptoms at less than one year of age. Vitamin B12 deficiency was defined as low cobalamin in serum and/or increased homocysteine and/or increased methylmalonate. It was diagnosed according to the applicable International Classification of Diseases, 10th revision, and recorded as vitamin B12 deficiency in the medical records. All information was retrieved from medical records and compared to symptomatic infants with normal levels. Results: Of the 121 infants tested, 35 had vitamin B12 deficiency and 86 had normal levels. Vitamin B12 deficiency was diagnosed at an average age of 1.7 months and was more common among boys. Seizures and apparent life-threatening events were the most common symptoms among infants with B12 deficiency compared to infants with normal levels. Conclusion: Vitamin B12 deficiency was more common in infants than we expected and presented with severe symptoms, such as seizures and apparent life-threatening events.

Keywords
Apparent life-threatening event, Infant nutrition, Neurological symptoms, Seizures, Vitamin B12 deficiency
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-130447 (URN)10.1111/apa.13625 (DOI)000390597700021 ()27736023 (PubMedID)
Available from: 2017-02-02 Created: 2017-01-20 Last updated: 2018-06-09Bibliographically approved
Tanghöj, G., Odermarsky, M., Naumburg, E. & Liuba, P. (2017). Early Complications After Percutaneous Closure of Atrial Septal Defect in Infants with Procedural Weight Less than 15 kg. Pediatric Cardiology, 38(2), 255-263
Open this publication in new window or tab >>Early Complications After Percutaneous Closure of Atrial Septal Defect in Infants with Procedural Weight Less than 15 kg
2017 (English)In: Pediatric Cardiology, ISSN 0172-0643, E-ISSN 1432-1971, Vol. 38, no 2, p. 255-263Article in journal (Refereed) Published
Abstract [en]

Atrial septal defect (ASD) is the most common congenital cardiac lesion accounting for 10-15% of all cardiac malformations. In the majority of cases, the secundum type of the ASD is closed percutaneously in the catheterization laboratory. Although transcatheter closure of ASD is considered safe and effective in pediatric patients, there are limited data regarding the efficacy and safety of device ASD closure in smaller infants. The aim of this study was to determine risk of complications within 72 h following device closure of ASD in children of body weight < 15 kg compared to larger children. Overall 252 children who underwent transcatheter closure of ASD at Children's Heart Centre in Lund, Sweden, between 1998 and 2015 were included. Data regarding demographics, comorbidity and complications occurring during and after device procedure until discharge were retrieved from the hospital's databases. Echocardiographic data were obtained from the digital and videotape recordings. Nearly half of the study cohort (n = 112; 44%) had a procedural weight < 15 (median 11.3) kg with a median procedural age of 2.02 years. Among this study group, 22 (9%) children had post-procedural in-hospital complications, of which 16 (7%) were considered as major and six (2%) considered as minor. No deaths occurred. There was no significant difference in of the occurrence of major or minor complications between the two groups (p = 0.32). Larger ASD was more often associated with minor complications, OR 1.37 (95% CI 0.99-1.89), which most often consisted of transient arrhythmias during or after the procedure. Percutaneous ASD device closure can be performed safely in low-weight infants with a risk of post-procedural in-hospital complications comparable to larger/older children. Nevertheless, careful considerations of the indications to device closure is needed, particularly in children with larger ASD, as recommended by the current international guidelines for ASD closure.

Place, publisher, year, edition, pages
SPRINGER, 2017
Keywords
Atrial septal defect, Infant, Follow-up, Septal device, Post-interventional complications
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-133438 (URN)10.1007/s00246-016-1507-3 (DOI)000395096700007 ()27837301 (PubMedID)
Available from: 2017-04-19 Created: 2017-04-19 Last updated: 2018-06-09Bibliographically approved
Grut, V., Söderström, L. & Naumburg, E. (2017). National cohort study showed that infants with Down's syndrome faced a high risk of hospitalisation for the respiratory syncytial virus. Acta Paediatrica, 106(9), 1519-1524
Open this publication in new window or tab >>National cohort study showed that infants with Down's syndrome faced a high risk of hospitalisation for the respiratory syncytial virus
2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 9, p. 1519-1524Article in journal (Refereed) Published
Abstract [en]

Aim: The respiratory syncytial virus (RSV) is a leading cause of hospitalisation in infants. We investigated this risk in children with Down's syndrome under two years of age, adjusted for other known risk factors. Methods: This national, retrospective 1: 2 matched cohort study comprised all Swedish children born with Down's from 2006 to 2011, who were each randomly matched to two controls without Down's. Data on RSV hospitalisation and risk factors for RSV were obtained from national registers. The risk of RSV hospitalisation was assessed using multivariable Cox regression with pairwise stratification. Results: The study comprised 814 children with Down's and 1628 controls. We found that 82 children with Down's (10.1%) and 22 controls (1.4%) were hospitalised for RSV. The hazard ratio for children with Down's was 4.00 (95% confidence interval 1.58-10.13) for up to one year of age and 6.60 (95% CI: 2.83-15.38) for up to two years of age, adjusted for other risk factors. During the second year of life, RSV hospitalisation continued for children with Down's, while it was minimal for the controls. Conclusion: Children with Down's faced a high risk of RSV hospitalisation, which continued beyond the first year of age.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Down's syndrome, Hospital admission, National registers, Respiratory syncytial virus, Risk factors
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-139810 (URN)10.1111/apa.13937 (DOI)000409343900024 ()28556255 (PubMedID)
Available from: 2017-09-25 Created: 2017-09-25 Last updated: 2018-06-09Bibliographically approved
Naumburg, E., Soderstrom, L., Huber, D. & Axelsson, I. (2017). Risk Factors for Pulmonary Arterial Hypertension in Children and Young Adults. Pediatric Pulmonology, 52(5), 636-641
Open this publication in new window or tab >>Risk Factors for Pulmonary Arterial Hypertension in Children and Young Adults
2017 (English)In: Pediatric Pulmonology, ISSN 8755-6863, E-ISSN 1099-0496, Vol. 52, no 5, p. 636-641Article in journal (Refereed) Published
Abstract [en]

Objectives: Pulmonary hypertension (PH) has been linked to preterm birth explained by congenital heart defects and pulmonary diseases. Working hypothesis: Other factors may influence the risk of PH among adolescences and children born premature. Study design: This national registry-based study assess risk of PH following premature birth adjusted for known risk factors. Patient-subject selection and methodology: All cases born 1993-2010, identified by diagnostic codes applicable to PH and retrieved from the Swedish Registry of Congenital Heart Disease (N = 67). Six controls were randomly selected and matched to each case by year of birth and hospital by the Swedish Medical Birth Register (N = 402). Maternal and infant data related to preterm birth, pulmonary diseases, and congenital defects were retrieved. The association between preterm birth and pulmonary hypertension was calculated by conditional logistic regression taking into account potential confounding factors. Results: One third of the cases and seven percent of the controls were born preterm in our study. Preterm birth was associated with PH, OR = 8.46 (95% CI 2.97-24.10) (P < 0.0001) even after adjusting for confounding factors. Other factors, such as acute pulmonary diseases, congenital heart defects, congenital diaphragm herniation, and chromosomal disorders were also associated with PH in the multivariate analysis. Conclusions: Children and young adults born preterm are known to have an increased risk of PH, previously explained by congenital heart defects and pulmonary diseases. By adjusting for such factors, our study indicates that new factors may play a role in the risk of developing PH among children born preterm. 

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
bronchopulmonary dysplasia, chronic lung disease of the newborn, congenital diaphragm herniation, eterm birth, pulmonary hypertension
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-136205 (URN)10.1002/ppul.23633 (DOI)000400375600011 ()27801982 (PubMedID)
Available from: 2017-07-03 Created: 2017-07-03 Last updated: 2018-06-09Bibliographically approved
Granbom, E., Fernlund, E., Sunnegårdh, J., Lundell, B. & Naumburg, E. (2016). Respiratory tract infection and risk of hospitalization in children with congenital heart defects during season and off-season: a Swedish national study. Pediatric Cardiology, 37(6), 1098-1105
Open this publication in new window or tab >>Respiratory tract infection and risk of hospitalization in children with congenital heart defects during season and off-season: a Swedish national study
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2016 (English)In: Pediatric Cardiology, ISSN 0172-0643, E-ISSN 1432-1971, Vol. 37, no 6, p. 1098-1105Article in journal (Refereed) Published
Abstract [en]

Respiratory tract infections (RTI) are common among young children, and congenital heart defect (CHD) is a risk factor for severe illness and hospitalization. This study aims to assess the relative risk of hospitalization due to RTI in winter and summer seasons for different types of CHD. All children born in Sweden and under the age of two, in 2006-2011, were included. Heart defects were grouped according to type. Hospitalization rates for respiratory syncytial virus (RSV) infection and RTI in general were retrieved from the national inpatient registry. The relative risk of hospitalization was calculated by comparing each subgroup to other types of CHD and otherwise healthy children. The relative risk of hospitalization was increased for all CHD subgroups, and there was a greater increase in risk in summer for the most severe CHD. This included RSV infection, as well as RTI in general. The risk of hospitalization due to RTI is greater for CHD children. Prophylactic treatment with palivizumab, given to prevent severe RSV illness, is only recommended during winter. We argue that information to healthcare staff and parents should include how the risk of severe infectious respiratory tract illnesses, RSV and others, is present all year round for children with CHD.

Place, publisher, year, edition, pages
New York: Springer, 2016
Keywords
Congenital heart defect (CHD), Immunoprophylaxis, Palivizumab, Respiratory syncytial virus, Respiratory tract infection
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-122827 (URN)10.1007/s00246-016-1397-4 (DOI)000381279300014 ()27090653 (PubMedID)
Available from: 2016-06-22 Created: 2016-06-22 Last updated: 2018-06-07Bibliographically approved
Edler, G., Axelsson, I., Barker, G. M., Lie, S. & Naumburg, E. (2016). Serious complications in male infant circumcisions in Scandinavia indicate that this always be performed as a hospital-based procedure. Acta Paediatrica, 105(7), 842-850
Open this publication in new window or tab >>Serious complications in male infant circumcisions in Scandinavia indicate that this always be performed as a hospital-based procedure
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2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 7, p. 842-850Article in journal (Refereed) Published
Abstract [en]

AIM: More than 7000 male circumcisions are performed in Scandinavia every year. Circumcision is regulated in different ways in Sweden and Denmark and Norway. This study reviewed and described factors associated with complications of circumcision in infant boys in Scandinavia over the last two decades and discussed how these complications could be avoided.

METHODS: Data on significant complications following circumcision on boys under the age of one in Scandinavia over the last 20 years were collected. Information was retrieved from testimonies of circumcisers, witnesses, medical records and verdicts. A systematic review was performed of fatal cases in the literature.

RESULTS: We found that 32 cases had been reported to the health authorities in the three countries, and we identified a total of 74 complications in these cases. These included four boys with severe bleeding and circulatory shock, which ended in the death of one boy. Other less serious complications may have occurred in other boys, but not been reported.

CONCLUSION: Complications following male circumcision in Scandinavia were relatively rare, but serious complications did occur. Based on the analyses of the severe cases, we argue that circumcision should only be performed at hospitals with 24-hour emergency departments. 

Keywords
Circulatory shock, Infant circumcision, Medical malpractice, Neonatal complications, Severe bleeding
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-122797 (URN)10.1111/apa.13402 (DOI)000378565100027 ()
Available from: 2016-06-22 Created: 2016-06-22 Last updated: 2018-06-07Bibliographically approved
Edler, G., Axelsson, I., Barker, G. M., Lie, S. & Naumburg, E. (2016). Säkerheten vid omskärelse av pojkar måste bli bättre. Läkartidningen, 113, Article ID D4CC.
Open this publication in new window or tab >>Säkerheten vid omskärelse av pojkar måste bli bättre
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2016 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, article id D4CCArticle in journal (Other (popular science, discussion, etc.)) Published
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-140353 (URN)27351390 (PubMedID)
Available from: 2017-10-06 Created: 2017-10-06 Last updated: 2018-06-09Bibliographically approved
Naumburg, E., Axelsson, I., Huber, D. & Soderstrom, L. (2015). Some neonatal risk factors for adult pulmonary arterial hypertension remain unknown. Acta Paediatrica, 104(11), 1104-1108
Open this publication in new window or tab >>Some neonatal risk factors for adult pulmonary arterial hypertension remain unknown
2015 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 11, p. 1104-1108Article in journal (Refereed) Published
Abstract [en]

AimPulmonary hypertension has been linked to premature birth, chronic lung disease, bronchopulmonary dysplasia and congenital heart disease. This national population-based registry study assessed the risk of adult pulmonary hypertension following premature birth, adjusted for known risk factors. MethodsWe focused on adults in the Swedish Pulmonary Arterial Hypertension Registry, who were born prematurely, and controls randomly selected from the Swedish medical birth register and matched to each case by birth year and delivery hospital. Information on perinatal factors was also retrieved from the medical birth register. Conditional multiple logistic regression was used to evaluate the association between premature birth and adult pulmonary hypertension, taking into account the potential confounding factors. ResultsThe study population comprised 427 adults born between 1973 and 1996, with 61 cases and 366 controls. Adult pulmonary hypertension was associated with premature birth, with an odds ratio of 3.08 and 95% confidence interval of 1.21-7.87. The association did not alter after adjusting for potential confounders. ConclusionBy adjusting for factors linked to adult pulmonary hypertension, namely congenital heart defects, pulmonary diseases and premature birth, we were able to show that other unknown factors may influence the risk for pulmonary hypertension among adults who were born premature.

Keywords
Brochopulmonary dysplasia, Chronic lung disease, Premature birth, Pulmonary Hypertension, Risk ctors
National Category
Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-111757 (URN)10.1111/apa.13205 (DOI)000363866200023 ()26346500 (PubMedID)2-s2.0-84945162469 (Scopus ID)
Available from: 2015-11-25 Created: 2015-11-23 Last updated: 2018-06-07Bibliographically approved
Granbom, E., Fernlund, E., Sunnegårdh, J., Lundell, B. & Naumburg, E. (2014). Evaluating national guidelines for the prophylactic treatment of respiratory syncytial virus in children with congenital heart disease. Acta Paediatrica, 103(8), 840-845
Open this publication in new window or tab >>Evaluating national guidelines for the prophylactic treatment of respiratory syncytial virus in children with congenital heart disease
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2014 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 8, p. 840-845Article in journal (Refereed) Published
Abstract [en]

Aim: This is the first study to evaluate compliance with the 2003 Swedish national guidelines for prophylactic treatment of respiratory syncytial virus (RSV) in children with congenital heart disease (CHD). We estimated the relative risk (RR) of children with CHD being hospitalised with a RSV infection, studied the extent to which RSV prophylactic treatment with palivizumab corresponded to the guidelines and determined the morbidity of children with CHD who developed RSV infection despite prophylaxis. Methods: This national observational study comprised prospectively registered data on 219 children with CHD treated with palivizumab, medical records on RSV cases and information on hospitalisation rates of children with CHD and RSV infection. Results: The calculated RR of children with CHD being hospitalised with RSV infection was 2.06 (950/0 Cl 1.6-2.6; p < 0.0001) compared with children without CHD. Approximately half of the patients (49%) born before the RSV season and 25% born during the RSV season did not start treatment as recommended by the guidelines. Conclusion: Having CHD increased the rate and estimated RR of children being hospitalised with RSV infection. The guidelines were not followed for about half of the children born before a RSV season and a quarter of the children born during a RSV season and need updating.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014
Keywords
Congenital heart disease, Palivizumab, Prophylaxis, Respiratory syncytial virus, Swedish national guidelines
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-92644 (URN)10.1111/apa.12658 (DOI)000339986800009 ()
Available from: 2014-09-17 Created: 2014-09-01 Last updated: 2018-06-07Bibliographically approved
Naumburg, E., Strömberg, B. & Kieler, H. (2012). Prenatal characteristics of infants with a neuronal migration disorder: a national-based study. International Journal of Pediatrics, 1-5, Article ID 541892.
Open this publication in new window or tab >>Prenatal characteristics of infants with a neuronal migration disorder: a national-based study
2012 (English)In: International Journal of Pediatrics, ISSN 1687-9740, E-ISSN 1687-9759, p. 1-5, article id 541892Article in journal (Refereed) Published
Abstract [en]

The development of the central nervous system is complex and includes dorsal and ventral induction, neuronal proliferation, and neuronal migration, organization, and myelination. Migration occurs in humans in early fetal life. Pathogenesis of malformations of the central nervous system includes both genetic and environmental factors. Few epidemiological studies have addressed the impact of prenatal exposures. All infants born alive and included in the Swedish Medical Birth Register 1980-1999 were included in the study. By linkage to the Patient Register, 820 children with a diagnosis related to a neuronal migration abnormality were identified. Through copies of referrals for computer tomography or magnetic resonance imaging of the brain, the diagnosis was confirmed in 17 children. Median age of the mothers was 29 years. At the start of pregnancy, four out of 17 women smoked. Almost half of the women had a body mass index that is low or in the lower range of average. All infants were born at term with normal birth weights. Thirteen infants had one or more concomitant diseases or malformations. Two infants were born with rubella syndrome. The impact of low maternal body mass index and congenital infections on neuronal migration disorders in infants should be addressed in future studies.

Keywords
formula-feeding, human milk, infant nutrition
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-118653 (URN)10.1155/2012/541892 (DOI)22548087 (PubMedID)
Available from: 2016-03-29 Created: 2016-03-29 Last updated: 2018-06-07Bibliographically approved

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