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Naumburg, Estelle
Publications (10 of 26) Show all publications
Tanghöj, G., Liuba, P., Sjöberg, G. & Naumburg, E. (2020). Predictors of the Need for an Atrial Septal Defect Closure at Very Young Age. Frontiers in Cardiovascular Medicine, 6, Article ID 185.
Open this publication in new window or tab >>Predictors of the Need for an Atrial Septal Defect Closure at Very Young Age
2020 (English)In: Frontiers in Cardiovascular Medicine, ISSN 1539-4565, E-ISSN 2296-701X, Vol. 6, article id 185Article in journal (Refereed) Published
Abstract [en]

An asymptomatic Atrial Septal Defect (ASD) is often closed at the age of 3-5 years using a transcatheter or surgical technique. Symptomatic ASD or ASD associated with pulmonary hypertension (PHT) may require earlier closure, particularly in combination with other non-cardiac risk factors for PHT, but the indications for early closure and the potential risk for complications are largely unknown. The aim of this study was to assess risk factors for needing ASD closure during the first and second years of life. This case-control study included all children treated with surgical or percutaneous ASD closure between 2000 and 2014 at two out of three pediatric heart centers in Sweden. "Cases" were children with ASD closure at <= 1 or <= 2 years of age. Clinical data were retrieved from medical journals and national registries. Overall, 413 children were included. Of these, 131 (32%) were <= 2 years, and 50 (12%) were <= 1 year. Risk factors associated with a <= 2 years ASD closure were preterm birth, OR = 2.4 (95% CI: 1.5-3.9); additional chromosomal abnormalities, OR = 3.4 (95% CI: 1.8-6.5); pulmonary hypertension, OR = 5.8 (95% CI: 2.6-12.6); and additional congenital heart defects, OR = 2.6 (95% CI: 1.7-4.1). These risk associations remained after adjustments for confounding factors, such as need for neonatal respiratory support, neonatal pulmonary diseases, neonatal sepsis, additional congenital heart defects (CHD) and chromosomal abnormalities. ASD size:body weight ratio of 2.0, as well as a ratio of 0.8 (upper and lower limit of the ASD size:body weight ratios), was associated with increased risk of an early ASD closure. Risk factors such as very premature birth, very low birth weight, congenital, and chromosomal abnormalities, neonatal pulmonary disease and need for ventilation support, as well as pulmonary hypertension, were associated with very early (<1 year of age) ASD closure. Several independent neonatal risk factors were associated with an increased risk of early ASD closure at 2 and at 1 year of age. An ASD size:body weight ratio is a poor predictor for indications for ASD closure.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2020
Keywords
atrial septal defect, ASD, follow-up studies, heart septal defect, atrial, pediatric cardiology, pediatric thoracic surgery, septal device occlusion
National Category
Cardiac and Cardiovascular Systems Pediatrics
Identifiers
urn:nbn:se:umu:diva-168178 (URN)10.3389/fcvm.2019.00185 (DOI)000509238100001 ()31998753 (PubMedID)
Available from: 2020-03-17 Created: 2020-03-17 Last updated: 2020-03-17Bibliographically approved
Tanghöj, G., Liuba, P., Sjöberg, G., Rydberg, A. & Naumburg, E. (2019). Adverse events within 1 year after surgical and percutaneous closure of atrial septal defects in preterm children. Cardiology in the Young, 29(5), 626-636
Open this publication in new window or tab >>Adverse events within 1 year after surgical and percutaneous closure of atrial septal defects in preterm children
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2019 (English)In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 29, no 5, p. 626-636Article in journal (Refereed) Published
Abstract [en]

Introduction: Atrial septal defect is the third most common CHD. A hemodynamically significant atrial septal defect causes volume overload of the right side of the heart. Preterm children may suffer from both pulmonary and cardiac comorbidities, including altered myocardial function. The aim of this study was to compare the rate of adverse events following atrial septal defect closure in preterm- and term-born children.

Method: We performed a retrospective cohort study including children born in Sweden, who had a surgical or percutaneous atrial septal defect closure at the children’s hospitals in Lund and Stockholm, between 2000 and 2014, assessing time to the first event within 1 month or 1 year. We analysed differences in the number of and the time to events between the preterm and term cohort using the Kaplan–Meier survival curve, a generalised model applying zero-inflated Poisson distribution and Gary-Anderson’s method.

Results: Overall, 413 children were included in the study. Of these, 93 (22.5%) were born prematurely. The total number of adverse events was 178 (110 minor and 68 major). There was no difference between the cohorts in the number of events, whether within 1 month or within a year, between major (p = 0.69) and minor (p = 0.84) events or frequencies of multiple events (p = 0.92).

Conclusion: Despite earlier procedural age, larger atrial septal defects, and higher comorbidity than term children, preterm children appear to have comparable risk for complications during the first year after surgical or percutaneous closure.

Place, publisher, year, edition, pages
Cambridge University Press, 2019
Keywords
Child, atrial septal defect, percutaneous closure, surgical closure, complications
National Category
Cardiac and Cardiovascular Systems Pediatrics
Identifiers
urn:nbn:se:umu:diva-161607 (URN)10.1017/S1047951119000350 (DOI)000472634800012 ()31159892 (PubMedID)
Available from: 2019-07-12 Created: 2019-07-12 Last updated: 2019-07-12Bibliographically approved
Axelsson, I., Naumburg, E., Prietsch, S. O. M. & Zhang, L. (2019). Effects of inhaled corticosteroids on growth in children with persistent asthma: Impact of drug molecules and delivery devices - An overview of Cochrane reviews. Paediatric Respiratory Reviews, 32, 28-29
Open this publication in new window or tab >>Effects of inhaled corticosteroids on growth in children with persistent asthma: Impact of drug molecules and delivery devices - An overview of Cochrane reviews
2019 (English)In: Paediatric Respiratory Reviews, ISSN 1526-0542, E-ISSN 1526-0550, Vol. 32, p. 28-29Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-167034 (URN)10.1016/j.prrv.2019.09.007 (DOI)000503085800009 ()31732321 (PubMedID)
Available from: 2020-01-09 Created: 2020-01-09 Last updated: 2020-01-09Bibliographically approved
Naumburg, E. & Söderström, L. (2019). Increased risk of pulmonary hypertension following premature birth. BMC Pediatrics, 19(1), Article ID 288.
Open this publication in new window or tab >>Increased risk of pulmonary hypertension following premature birth
2019 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 19, no 1, article id 288Article in journal (Refereed) Published
Abstract [en]

Background: Pulmonary hypertension (PAH) among children and adults has been linked to premature birth, even after adjustments for known risk factors such as congenital heart disease and chronic lung disease. The aim of this population-based registry study was to assess the risk of PAH following exposure to premature birth and other factors in the decades when modern neonatal care was introduced and survival rates increased.

Methods: Data on pulmonary hypertension and perinatal factors were retrieved from population-based governmental and national quality registers. Cases were adults and children over five years of age with pulmonary hypertension born from 1973 to 2010 and individually matched to six controls by birth year and delivery hospital. Conditional multiple logistic regression was performed to assess the risk of pulmonary hypertension following premature birth and to adjust for known confounding factors for the total study population and for time of birth, grouped into five-year intervals.

Results: In total, 128 cases and 768 controls were included in the study group. Preterm birth was over three times more common among cases (21%) than among controls (6%). The overall adjusted risk of pulmonary hypertension was associated with premature birth, OR = 4.48 (95% CI; 2.10–9.53). Maternal hypertension, several neonatal risk factors and female gender were independently associated with PAH when potential confounders were taken into account. For each five-year period, the risk of PAH following premature birth increased several times for children born in the 2000s and later, OR = 17.08 (95% CI 5.60–52.14).

Conclusions: Preterm birth, along with other factors, significantly contributes to PAH. PAH following premature birth has increased over the last few decades. Our study indicates that new, yet unknown factors may play a role in the risk of preterm-born infants developing PAH later in life.

Keywords
Bronchopulmonary dysplasia, Lung disease, Preterm birth, Pulmonary hypertension
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-165212 (URN)10.1186/s12887-019-1665-6 (DOI)000481770500002 ()31421674 (PubMedID)2-s2.0-85070941509 (Scopus ID)
Available from: 2019-11-15 Created: 2019-11-15 Last updated: 2019-11-15Bibliographically approved
Axelsson, I., Naumburg, E., Prietsch, S. O. M. & Zhang, L. (2019). Inhaled corticosteroids in children with persistent asthma: effects of different drugs and delivery devices on growth. Cochrane Database of Systematic Reviews (6), Article ID CD010126.
Open this publication in new window or tab >>Inhaled corticosteroids in children with persistent asthma: effects of different drugs and delivery devices on growth
2019 (English)In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 6, article id CD010126Article, review/survey (Refereed) Published
Abstract [en]

Background: Inhaled corticosteroids (ICS) are the most effective treatment for children with persistent asthma. Although treatment with ICS is generally considered to be safe in children, the potential adverse effects of these drugs on growth remains a matter of concern for parents and physicians.

Objectives: To assess the impact of different inhaled corticosteroid drugs and delivery devices on the linear growth of children with persistent asthma.

Search methods: We searched the Cochrane Airways Trials Register, which is derived from systematic searches of bibliographic databases including CENTRAL, MEDLINE, Embase, CINAHL, AMED and PsycINFO. We handsearched respiratory journals and meeting abstracts. We also conducted a search of ClinicalTrials.gov and manufacturers' clinical trial databases, or contacted the manufacturer, to search for potential relevant unpublished studies. The literature search was initially conducted in September 2014, and updated in November 2015, September 2018, and April 2019.

Selection criteria: We selected parallel‐group randomized controlled trials of at least three months' duration. To be included, trials had to compare linear growth between different inhaled corticosteroid molecules at equivalent doses, delivered by the same type of device, or between different devices used to deliver the same inhaled corticosteroid molecule at the same dose, in children up to 18 years of age with persistent asthma.

Data collection and analysis: At least two review authors independently selected studies and assessed risk of bias in included studies. The data were extracted by one author and checked by another. The primary outcome was linear growth velocity. We conducted meta‐analyses using Review Manager 5.3 software. We used mean differences (MDs) and 95% confidence intervals (CIs ) as the metrics for treatment effects, and the random‐effects model for meta‐analyses. We did not perform planned subgroup analyses due to there being too few included trials.

Main results: We included six randomized trials involving 1199 children aged from 4 to 12 years (per‐protocol population: 1008), with mild‐to‐moderate persistent asthma. Two trials were from single hospitals, and the remaining four trials were multicentre studies. The duration of trials varied from six to 20 months.

One trial with 23 participants compared fluticasone with beclomethasone, and showed that fluticasone given at an equivalent dose was associated with a significant greater linear growth velocity (MD 0.81 cm/year, 95% CI 0.46 to 1.16, low certainty evidence). Three trials compared fluticasone with budesonide. Fluticasone given at an equivalent dose had a less suppressive effect than budesonide on growth, as measured by change in height over a period from 20 weeks to 12 months (MD 0.97 cm, 95% CI 0.62 to 1.32; 2 trials, 359 participants; moderate certainty evidence). However, we observed no significant difference in linear growth velocity between fluticasone and budesonide at equivalent doses (MD 0.39 cm/year, 95% CI ‐0.94 to 1.73; 2 trials, 236 participants; very low certainty evidence).

Two trials compared inhalation devices. One trial with 212 participants revealed a comparable linear growth velocity between beclomethasone administered via hydrofluoroalkane‐metered dose inhaler (HFA‐MDI) and beclomethasone administered via chlorofluorocarbon‐metered dose inhaler (CFC‐MDI) at an equivalent dose (MD ‐0.44 cm/year, 95% CI ‐1.00 to 0.12; low certainty evidence). Another trial with 229 participants showed a small but statistically significant greater increase in height over a period of six months in favour of budesonide via Easyhaler, compared to budesonide given at the same dose via Turbuhaler (MD 0.37 cm, 95% CI 0.12 to 0.62; low certainty evidence).

Authors' conclusions: This review suggests that the drug molecule and delivery device may impact the effect size of ICS on growth in children with persistent asthma. Fluticasone at an equivalent dose seems to inhibit growth less than beclomethasone and budesonide. Easyhaler is likely to have less adverse effect on growth than Turbuhaler when used for delivery of budesonide. However, the evidence from this systematic review of head‐to‐head trials is not certain enough to inform the selection of inhaled corticosteroid or inhalation device for the treatment of children with persistent asthma. Further studies are needed, and pragmatic trials and real‐life observational studies seem more attractive and feasible.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-161751 (URN)10.1002/14651858.CD010126.pub2 (DOI)000473340700008 ()31194879 (PubMedID)
Available from: 2019-07-25 Created: 2019-07-25 Last updated: 2019-07-25Bibliographically approved
Lennelöv, E., Irewall, T., Naumburg, E., Lindberg, A. & Stenfors, N. (2019). Prevalence of asthma and respiratory symptoms among cross-country skiers in early adolescence. Paper presented at European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.. European Respiratory Journal, 54
Open this publication in new window or tab >>Prevalence of asthma and respiratory symptoms among cross-country skiers in early adolescence
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sheffield: European Respiratory Society Journals, 2019
Keywords
Asthma, Physical activity, Adolescents
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168154 (URN)10.1183/13993003.congress-2019.PA942 (DOI)000507372408033 ()
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.
Note

Supplement: 63. Meeting Abstract: PA942.

Available from: 2020-03-18 Created: 2020-03-18 Last updated: 2020-03-18Bibliographically approved
Naumburg, E., Rane, A., Halvorsen, T., Glosli, H., Henriksen, T. B., Haraldsson, A., . . . Lepola, P. (2019). Tardy development of safe medicines for children: a Nordic network offers new platform to reduce this inequity. Acta Paediatrica, 108(6), 992-993
Open this publication in new window or tab >>Tardy development of safe medicines for children: a Nordic network offers new platform to reduce this inequity
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 6, p. 992-993Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-159590 (URN)10.1111/apa.14775 (DOI)000467867900004 ()30844088 (PubMedID)
Available from: 2019-06-18 Created: 2019-06-18 Last updated: 2019-06-18Bibliographically approved
Lennelöv, E., Irewall, T., Naumburg, E., Lindberg, A. & Stenfors, N. (2019). The Prevalence of Asthma and Respiratory Symptoms among Cross-Country Skiers in Early Adolescence. Canadian Respiratory Journal, 2019, Article ID 1514353.
Open this publication in new window or tab >>The Prevalence of Asthma and Respiratory Symptoms among Cross-Country Skiers in Early Adolescence
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2019 (English)In: Canadian Respiratory Journal, ISSN 1916-7245, Vol. 2019, article id 1514353Article in journal (Refereed) Published
Abstract [en]

Objective: To determine the prevalence of asthma and respiratory symptoms among Swedish cross-country skiers in early adolescence in comparison to a population-based reference group of similar ages.

Methods: A postal questionnaire on asthma, asthma medication, allergy, respiratory symptoms, and physical activity was distributed to Swedish competitive cross-country skiers aged 12–15 years (n = 331) and a population-based reference group (n = 1000). The level of asthma control was measured by the Asthma Control Test.

Results: The response rate was 27% (n = 87) among skiers and 29% (n = 292) in the reference group. The prevalence of self-reported asthma (physician-diagnosed asthma and use of asthma medication in the last 12 months) and the prevalence of reported wheezing during the last 12 months were 23% and 25%, respectively, among skiers, which were significantly higher than the values reported in the reference group (12% and 14%). Skiers exercised more hours/week than the reference group. Among adolescents with self-reported asthma, neither the usage of asthma medications nor the level of asthma control according to the Asthma Control Test differed between skiers and the reference group.

Conclusions: Adolescent competitive cross-country skiers have an increased prevalence of respiratory symptoms and asthma compared to nonskiers.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-165207 (URN)10.1155/2019/1514353 (DOI)000493514500001 ()31636769 (PubMedID)2-s2.0-85072988852 (Scopus ID)
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-28Bibliographically approved
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
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