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  • 1.
    Andersson, Liselott
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Sundström-Poromaa, Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Bixo, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Bondestam, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Åström, Monica
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Point prevalence of psychiatric disorders during the second trimester of pregnancy: a population-based study.2003Inngår i: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, E-ISSN 1097-6868, Vol. 189, nr 1, s. 148-154Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: This study was undertaken to determine the point prevalence of psychiatric disorders during the second trimester of pregnancy in a population-based sample of pregnant women. STUDY DESIGN: Participants were 1795 consecutive pregnant women attending routine ultrasound screening at two obstetric clinics in Northern Sweden during 1 year. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used for evaluating. RESULTS: Overall, 1734 (96.6%) of the women filled in the PRIME-MD patient questionnaire. Psychiatric disorders were present in 14.1% of the women. Major depression was prevalent in 3.3% of patients and minor depression in 6.9% of patients. Anxiety disorders were encountered in 6.6% of patients. Women with psychiatric disorders displayed significantly more somatic symptoms and more pronounced fear of childbirth. Among diagnosed patients, only 5.5% had some form of treatment. CONCLUSION: The prevalence of mood and anxiety disorders in this unselected population of pregnant women was high and the majority of the women were found to be undiagnosed and untreated.

  • 2.
    Andersson, Liselott
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Sundström-Poromaa, Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Åström, Monica
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Bixo, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Depression and anxiety during pregnancy and six months postpartum: a follow-up study2006Inngår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, nr 8, s. 937-944Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: To investigate the relationship between antenatal and postpartum depression and anxiety and to explore associated maternal characteristics. METHODS: From a population-based sample of 1,555 women attending two obstetric clinics in Sweden, all women with an antenatal psychiatric diagnosis (n = 220) and a random selection of healthy women (n = 500) were contacted for a second assessment three to six months postpartum. The Primary Care Evaluation of Mental Disorders was used for evaluation on both occasions. RESULTS: Fewer cases of depressive and/or anxiety disorders were prevalent postpartum compared with the second trimester screening. Depression and/or anxiety were prevalent in 16.5% of postpartal women versus 29.2% of pregnant women. There was a significant shift from a majority of subthreshold diagnoses during pregnancy to full Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnoses during the postpartum period. A history of previous psychiatric disorder, living single, and obesity were significantly associated with a new-onset postpartum psychiatric disorder. The absence of a previous psychiatric disorder was significantly associated with a postpartum recovery of depression or anxiety. CONCLUSIONS: Depression and anxiety appear to be less common postpartum than during pregnancy.

  • 3.
    Andersson, Liselott
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi. Department of Obstetrics and Gynecology, Sunderby Hospital, Luleå, Sweden.
    Sundström-Poromaa, Inger
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Åström, Monica
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Bixo, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Implications of antenatal depression and anxiety for obstetric outcome2004Inngår i: Obstetrics and Gynecology, ISSN 0029-7844, E-ISSN 1873-233X, Vol. 104, nr 3, s. 467-476Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate the obstetric outcome and health care consumption during pregnancy, delivery, and the early postpartum period in an unselected population-based sample of pregnant women diagnosed with antenatal depressive and/or anxiety disorders, compared with healthy subjects. METHODS: Participants were 1,495 women attending 2 obstetric clinics in Northern Sweden. The Primary Care Evaluation of Mental Disorders was used to evaluate depressive and anxiety disorders in the second trimester of pregnancy. To assess demographic characteristics, obstetric outcome, and complications, the medical records of the included women were reviewed. RESULTS: Significant associations were found between depression and/or anxiety and increased nausea and vomiting, prolonged sick leave during pregnancy and increased number of visits to the obstetrician, specifically, visits related to fear of childbirth and those related to contractions. Planned cesarean delivery and epidural analgesia during labor were also significantly more common in women with antenatal depression and/or anxiety. CONCLUSION: There is an association between antenatal depressive and/or anxiety disorders and increased health care use (including cesarean deliveries) during pregnancy and delivery.

  • 4.
    Andersson, Liselott
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Sundström-Poromaa, Inger
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Åström, Monica
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Bixo, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Neonatal outcome following maternal antenatal depression and anxiety: a population-based study.2004Inngår i: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 159, nr 9, s. 872-881Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to determine neonatal outcomes among women who had depressive and anxiety disorders during the second trimester of pregnancy in a population-based sample. Participants were 1,465 women and their neonates born at two obstetric clinics in Sweden. The inclusion period for the women was October 2, 2000-October 1, 2001. The Primary Care Evaluation of Mental Disorders (PRIME-MD) classification system was used to evaluate mental disorders in the second trimester of pregnancy. For assessment of demographic characteristics, birth statistics, and birth-related complications, the medical records of the included women and their offspring were reviewed after delivery. The study results revealed no differences in neonatal outcome between women with antenatal depressive disorders and/or anxiety disorders and healthy subjects. The authors conclude that neonatal outcome did not deteriorate despite the women's impaired mental health during pregnancy.

  • 5. Chen, Tianhui
    et al.
    Lukanova, Annekatrin
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Zeleniuch-Jacquotte, Anne
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Johansson, Robert
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Schock, Helena
    Lenner, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Wadell, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Toniolo, Paolo
    Lundin, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    IGF-I during primiparous pregnancy and maternal risk of breast cancer2010Inngår i: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 121, nr 1, s. 169-175Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Previously, we reported that insulin-like growth factor (IGF)-I during early pregnancy is positively associated with maternal risk of breast cancer. To further explore this association, we designed a new study limited to women who donated a blood sample during their first pregnancy ending with childbirth. A case-control study was nested within the Northern Sweden Maternity Cohort in which repository since 1975, serum specimens remaining after early pregnancy screening for infectious diseases had been preserved. Study subjects were selected among women who donated a blood sample during the full-term pregnancy that led to the birth of their first child. Two hundred and forty-four women with invasive breast cancer were eligible. Two controls, matching the index case for age and date at blood donation were selected (n = 453). IGF-I was measured in serum samples on an Immulite 2000 analyzer. Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals. A significant positive association of breast cancer with IGF-I was observed, with OR of 1.73 (95% CI: 1.14-2.63) for the top tertile, P < 0.009. Subgroup analyses did not indicate statistical heterogeneity of the association by ages at sampling and diagnosis or by lag time to cancer diagnosis, although somewhat stronger associations with risk were observed in women < or = age 25 at index pregnancy and for cases diagnosed within 15 years of blood donation. The results of the study add further evidence for an adverse effect of elevated IGF-I concentrations during early reproductive life on risk of breast cancer.

  • 6. Chen, Tianhui
    et al.
    Lundin, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Zeleniuch-Jacquotte, Anne
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Afanasyeva, Yelena
    Schock, Helena
    Johansson, Robert
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Lenner, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Wadell, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Toniolo, Paolo
    Lukanova, Annekatrin
    Maternal hormones during early pregnancy: a cross-sectional study2010Inngår i: Cancer Causes and Control, ISSN 0957-5243, E-ISSN 1573-7225, Vol. 21, nr 5, s. 719-727Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Little is known about correlates of first-trimester pregnancy hormones as in most studies maternal hormones have been measured later in gestation. We examined the associations of maternal characteristics and child sex with first-trimester maternal concentrations of four hormones implicated in breast cancer: human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP), insulin-like growth factor (IGF)-I, and IGF-II. METHODS: About 338 serum samples donated to the Northern Sweden Maternity Cohort (NSMC), 1975-2001, during the first trimester of uncomplicated pregnancies, were analyzed for the hormones of interest as a part of a case-control study. The associations of maternal characteristics and child sex with hormone concentrations were investigated by correlation, general linear regression, and multivariate regression models. RESULTS: In the first trimester, greater maternal age was inversely correlated with IGF-I and IGF-II. In comparison with women carrying their first child, already parous women had higher IGF-I but lower hCG. Greater maternal weight and smoking were inversely correlated with hCG. No differences in hormone levels by child sex were observed. CONCLUSIONS: Our analyses indicated that potentially modifiable maternal characteristics (maternal weight and smoking) influence first-trimester pregnancy maternal hormone concentrations.

  • 7.
    Goicoela, Isabel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    San Sebastian, Miguel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Women's reproductive rights in the Amazon basin of Ecuador: Challenges for transforming policy into practicce2008Inngår i: Health and Human Rights: An International Journal, ISSN 1079-0969, E-ISSN 2150-4113, Vol. 10, nr 2, s. 91-103Artikkel i tidsskrift (Fagfellevurdert)
  • 8.
    Goicolea, Isabel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    San Sebastian, Miguel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Öhman, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Adolescent pregnancies and girls' sexual and reproductive rights in the Amazon Basin of Ecuador: an analysis of providers' and policy makers' discourses2010Inngår i: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 10, nr 12Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Adolescent pregnancies are a common phenomenon that can have both positive and negative consequences. The rights framework allows us to explore adolescent pregnancies not just as isolated events, but in relation to girls' sexual and reproductive freedom and their entitlement to a system of health protection that includes both health services and the so called social determinants of health. The aim of this study was to explore policy makers' and service providers' discourses concerning adolescent pregnancies, and discuss the consequences that those discourses have for the exercise of girls' sexual and reproductive rights' in the province of Orellana, located in the amazon basin of Ecuador.

    Methods: We held six focus-group discussions and eleven in-depth interviews with 41 Orellana's service providers and policy makers. Interviews were transcribed and analyzed using discourse analysis, specifically looking for interpretative repertoires.

    Results: Four interpretative repertoires emerged from the interviews. The first repertoire identified was "sex is not for fun" and reflected a moralistic construction of girls' sexual and reproductive health that emphasized abstinence, and sent contradictory messages regarding contraceptive use. The second repertoire -"gendered sexuality and parenthood"-constructed women as sexually uninterested and responsible mothers, while men were constructed as sexually driven and unreliable. The third repertoire was "professionalizing adolescent pregnancies" and lead to patronizing attitudes towards adolescents and disregard of the importance of non-medical expertise. The final repertoire -"idealization of traditional family"-constructed family as the proper space for the raising of adolescents while at the same time acknowledging that sexual abuse and violence within families was common.

    Conclusions: Providers' and policy makers' repertoires determined the areas that the array of sexual and reproductive health services should include, leaving out the ones more prone to cause conflict and opposition, such as gender equality, abortion provision and welfare services for pregnant adolescents. Moralistic attitudes and sexism were present - even if divergences were also found-, limiting services' capability to promote girls' sexual and reproductive health and rights.

  • 9.
    Goicolea, Isabel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Öhman, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Gender structures constraining girls’ agency: exploring pregnancy and motherhood among adolescent gilrs in Ecuador’s Amazon Basin2010Inngår i: Sexuality, Health and Society, ISSN 1984-6487, Vol. 5, s. 50-73Artikkel i tidsskrift (Fagfellevurdert)
  • 10.
    Goicolea, Isabel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Öhman, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Gender structures constraining girls' agency: exploring pregnancy and motherhood among adolescent girls in Ecuador's Amazon basinManuskript (Annet vitenskapelig)
  • 11.
    Goicolea, Isabel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Öhman, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    San Sebastian, Miguel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Risk factors for pregnancy among adolescent girls in Ecuador's Amazon basin: a case-control study2009Inngår i: Revista panamericana de salud pùblica, ISSN 1020-4989, E-ISSN 1680-5348, Vol. 26, nr 3, s. 221-228Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. To examine risk factors for pregnancy among adolescent girls in the Amazonbasin of Ecuador.Methods. A matched case-control study with cases and controls identified within a community-based demographic and health survey was conducted in Orellana, Ecuador, from Mayto November 2006. A questionnaire focused on socioeconomic status, family structure, education,reproductive health, and childhood-adolescent trauma was applied. Conditional logisticregression was used to adjust for potential confounders.Results. Respondents included 140 cases and 262 controls. Factors associated with increasedrisk of adolescent pregnancies through multivariate analysis were: sexual abuse duringchildhood-adolescence (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.08–8.68);early sexual debut (OR 8.51, 95% CI 1.12–64.90); experiencing periods without mother andfather (OR 10.67, 95% CI 2.67–42.63); and living in a very poor household (OR 15.23, 95%CI 1.43–162.45). Another two factors were statistically associated in the bivariate analysis:being married or in a consensual union (OR 44.34, 95% CI 17.85–142.16) and not being enrolledin school at the time of the interview (OR 6.31, 95% CI 3.70–11.27). For a subsampleof sexually initiated adolescents, “non-use of contraception during first sexual intercourse”was also found to be a risk factor (OR 4.30, 95% CI 1.33–13.90).Conclusion. The study found that early sexual debut, non-use of contraception during firstsexual intercourse, living in a very poor household, having suffered from sexual abuse duringchildhood-adolescence, and family disruption (living extended periods of life without both parents)were associated with adolescent pregnancy in Orellana.

  • 12.
    Hammarstedt, Meta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Jacobsson, Lars
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Lalos, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Views of midwives and gynecologists on legal abortion: a population-based study2005Inngår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 84, nr 1, s. 58-64Artikkel i tidsskrift (Fagfellevurdert)
  • 13.
    Hammarstedt, Meta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Lalos, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    A population-based study of Swedish gynecologists' experiences of working in abortion care.2006Inngår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, nr 2, s. 229-235Artikkel i tidsskrift (Fagfellevurdert)
  • 14.
    Hedlund, Malin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk immunologi.
    Stenqvist, Ann-Christin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk immunologi.
    Nagaeva, Olga
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk immunologi.
    Kjellberg, Lennart
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Baranov, Vladimir
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk immunologi.
    Mincheva-Nilsson, Lucia
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Klinisk immunologi.
    Human placenta expresses and secretes NKG2D ligands via exosomes that down-modulate the cognate receptor expression: evidence for immunosuppressive function2009Inngår i: Journal of Immunology, ISSN 0022-1767, E-ISSN 1550-6606, Vol. 183, nr 1, s. 340-351Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    During mammalian pregnancy maternal-fetal tolerance involves a number of immunosuppressive factors produced by placenta. Recently, placenta-derived exosomes have emerged as new immune regulators in the maternal immune tolerance. Exosomes are membrane nanovesicles with defined morphology, which are secreted from endosomal multivesicular bodies (MVB) upon fusion with the plasma membrane. Previously, we reported that the MHC class I chain-related (MIC) proteins A and B, human ligands of the activating NK cell receptor NKG2D, are expressed by placenta, sorted to MVB of syncytiotrophoblast and probably released via MIC-bearing exosomes. In this report, we show that the second family of human NKG2D ligands, the UL-16 binding proteins (ULBP), is also expressed by placenta. Importantly, this expression was not due to placental CMV infection. Immunoelectron microscopy disclosed that ULBP1-5 are produced and retained in MVB of the syncytiotrophoblast on microvesicles/exosomes. Using human placenta explant cultures and different assays, we demonstrate that exosomes bearing NKG2D ligands are released by human placenta. Isolated placental exosomes carried ULBP1-5 and MIC on their surface and induced down-regulation of the NKG2D receptor on NK, CD8(+), and gammadelta T cells, leading to reduction of their in vitro cytotoxicity without affecting the perforin-mediated lytic pathway. Release of placental NKG2D ligands via exosomes is an alternative mechanism for generation of bioactive soluble form of these ligands. These findings highlight a role for NKG2D ligand-bearing placental exosomes in the fetal immune escape and support the view of placenta as a unique immunosuppressive organ.

  • 15.
    Högberg, Ulf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Lynöe, Niels
    Centre for Bioethics, Karolinska Institutet, Stockholm, Sweden.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Cesarean by choice? Empirical study of public attitudes.2008Inngår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 87, nr 12, s. 1301-1308Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: This study examines public attitudes towards maternal requests for cesarean delivery and its association with health care and birth experiences. In addition, this study attempts to ascertain whether gender, age and residence influence these attitudes. DESIGN: Cross-sectional population survey with a postal questionnaire. SETTING: The counties of Stockholm and Vasterbotten in Sweden. POPULATION: Equal numbers of women and men between 20 and 80 years of age (n=2,000) by population size and gender distribution. METHODS: Descriptive statistics and content analysis. RESULTS: Of the 1,066 women (53%) who responded, two-thirds stated that a cesarean should be decided on for medical reasons and by a doctor. One-third considered that a woman, without persuasion, should decide herself about mode of delivery and should be free to choose a cesarean. These respondents used arguments such as women's rights, bodily integrity and childbirth fear. The results were associated with low trust in health care, women being young or middle aged, urban living and having no children. Low trust in health care was associated with experiences of insecurity, vulnerability and perceived maltreatment. CONCLUSION: Public norms towards women's own decision making on mode of delivery are associated with younger age, lower trust in health care and urban living. Antenatal care will encounter more parents asking for a cesarean and demanding that health professionals provide an ethically appropriate informed consent process. Considering the risk of violating young women's trust if not respecting her wish, it seems reasonable that making decisions whether or not to perform a cesarean is part of shared decision making.

  • 16.
    Kero, Anneli
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi. Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lalos, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Home abortion - experiences of male involvement2010Inngår i: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 15, nr 4, s. 264-270Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To gain knowledge about the male partner's experience of being present during an induced home abortion. METHODS: Twenty-three couples, whose male partner had been present when the woman aborted at home, were interviewed one to two weeks post-abortion. RESULTS: Each of the men supported his partner in her decision to have a home abortion, as this gave him the possibility of being near and of caring for her needs on the expulsion day. All the men were present and all their partners confirmed that they had been supportive. Half the men had been anxious prior to the expulsion, but most considered that their experiences during the expulsion had been 'easier than expected' and their dominant feeling was one of relief. CONCLUSIONS: Abortion is an important life event. When taking place at home, it increases the possibility for the couple to share the experience. Sharing an abortion may have a positive impact on those men who lack a sense of responsibility regarding reproductive issues, such as contraceptive use. This could facilitate society's efforts to involve men as a target group in this field. Designing an abortion policy that caters for the needs of both partners is a challenge.

  • 17.
    Kero, Anneli
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lalos, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Home abortion implies radical changes for women2009Inngår i: The European journal of contraception and reproductive health care, ISSN 1362-5187, Vol. 14, nr 5, s. 324-333Artikkel i tidsskrift (Fagfellevurdert)
  • 18.
    Kero, Anneli
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lalos, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Why shouldn't one report on women's positive feelings with regard to abortion?2010Inngår i: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 15, nr 2, s. 150-151Artikkel i tidsskrift (Annet vitenskapelig)
  • 19.
    Lindström, Meta
    et al.
    Umeå universitet, Medicinsk fakultet, Klinisk vetenskap, Obstetrik och gynekologi.
    Jacobsson, Lars
    Umeå universitet, Medicinsk fakultet, Klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinsk fakultet, Klinisk vetenskap, Obstetrik och gynekologi.
    Lalos, Ann
    Umeå universitet, Medicinsk fakultet, Klinisk vetenskap, Obstetrik och gynekologi.
    Midwives' experiences of encountering women seeking an abortion.2007Inngår i: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 28, nr 4, s. 231-237Artikkel i tidsskrift (Fagfellevurdert)
  • 20.
    Lindström, Meta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Dahlgren, Lars
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Lalos, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Experiences of working with induced abortion: focus group discussions with gynaecologists and midwives/nurses2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 3, s. 542-548Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:  While there exists an extensive amount of research regarding the medical aspects of abortion, there is a great lack of studies investigating staff's views and experiences of working in abortion services.

    Aims:  To elucidate gynaecologists' and midwives'/nurses' experiences, perceptions and interactions working in abortion services, their experiences of medical abortions and abortions performed at the woman's home. An additional aim was to illustrate gynaecologists', midwives' and nurses' visions of their future professional roles within the abortion services.

    Method:  Three focus group discussions within each profession were carried out in 1-hour sessions with a total of 25 gynaecologists and 15 midwives/nurses from three different hospitals.

    Results:  The content analysis reflected that gynaecologists and midwives/nurses had no doubts about participating in abortions despite the fact that they had experienced complex and difficult situations, such as repeat and late-term abortions. They experienced their work as paradoxical and frustrating but also as challenging and rewarding. However, they were rarely offered ongoing guidance and continuously professional development education. For gynaecologists, as well as midwives/nurses, their experiences and perceptions were strongly linked to the concurrent development of abortion methods. The interaction between the professions was found to be based on great trust in each other's skills.

    Conclusions:  In order to promote women's health, gynaecologists' and midwives'/nurses' need for a forum for reflection and ongoing guidance should be acted on. With a higher number of abortions done medically and a higher proportion of home abortions, midwives/nurses will get increased, responsibilities in the abortion services in the future.

  • 21.
    Lukanova, Annekatrin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Toniolo, Paolo
    Zeleniuch-Jacquotte, Anne
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Arslan, Alan A
    Afanasyeva, Yelena
    Johansson, Robert
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Lenner, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi. null.
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning. null.
    Wadell, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi. null.
    Lundin, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi. null.
    Insulin-like growth factor I in pregnancy and maternal risk of breast cancer2006Inngår i: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 15, nr 12, s. 2489-2493Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The role of insulin-like growth factor (IGF)-I in breast cancer remains controversial, despite numerous reports on the association of the hormone with breast cancer or high-risk mammographic densities. We hypothesized that exposure to elevated IGF-I during early pregnancy, a period characterized by intense cell proliferation in the breasts and in the presence of high concentrations of sex steroids, will be associated with increased maternal risk to develop a breast malignancy.

    Methods: The Northern Sweden Maternity Cohort is an ongoing prospective study, collecting blood samples from first-trimester-pregnant women since 1975 as part of screening for infectious diseases. A case-control study (212 cases and 369 controls) was nested among Northern Sweden Maternity Cohort members who delivered singleton babies. RIA was used to measure IGF-I and IGF-II levels. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI).

    Results: Breast cancer risk increased with increasing IGF-I (top tertile OR, 1.7; 95% CI, 1.1-2.7). The association was stronger among the primiparous (OR, 2.2; 95% CI, 1.1-4.4) than in the nonprimiparous women (OR, 1.4; 95% CI, 0.7-2.8). Upper-tertile risks seemed to decrease within the <28-, 28 to 33, and >33-year groups of age at sampling, from 2.5 (0.9-7.6) to 2.1 (0.9-5.0) and 1.2 (0.5-2.5), respectively. There was no association of breast cancer with first-trimester-pregnancy IGF-II.

    Conclusions: The study offers further evidence that IGF-I is important in breast cancer. Our findings suggest that the adverse effect of IGF-I on the breast may be stronger before the remodeling of the gland induced by a first pregnancy.

  • 22.
    Lundin, Eva
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Dossus, Laure
    Clendenen, Tess
    Krogh, Vittorio
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Sieri, Sabina
    Arslan, Alan
    Lenner, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Berrino, Franco
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Zeleniuch-Jacquotte, Anne
    Toniolo, Paolo
    Lukanova, Annekatrin
    C-reactive protein and ovarian cancer: a prospective study nested in three cohorts (Sweden, USA, Italy).2009Inngår i: Cancer Causes and Control, ISSN 0957-5243, E-ISSN 1573-7225, Vol. 20, nr 7, s. 1151-1159Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Inflammatory processes may influence the risk of epithelial ovarian cancer, but available epidemiological evidence is limited and indirect. Circulating C-reactive protein (CRP), a sensitive marker of inflammation, may serve as a direct biological marker of an underlying association. METHODS: The association between ovarian cancer risk and pre-diagnostic circulating CRP was tested in a case-control study nested within three prospective cohorts from Sweden, USA, and Italy. The study included 237 cases and 427 individually matched controls. CRP was measured in stored blood samples by high-sensitivity immunoturbidimetric assay. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by conditional logistic regression. RESULTS: Overall, CRP was not related to risk of ovarian cancer. However, a marked increase in risk was observed for CRP concentrations >10 mg/l: OR (95% CI) 4.4 (1.8-10.9), which remained significant after limiting analyses to cases diagnosed more than two or five years after blood donation (OR 3.0 (1.2-8.0) and 3.6 (1.0-13.2), respectively). Risk of mucinous tumors increased with high CRP, but the number of cases in this analysis was small. CONCLUSION: Study results offer additional support to the concept that chronic inflammation plays a role in epithelial ovarian cancer.

  • 23.
    Nordin, Steven
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Broman, Daniel A
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Olofsson, Jonas K
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    A longitudinal descriptive study of self-reported abnormal smell and taste perception in pregnant women2004Inngår i: Chemical Senses, ISSN 0379-864X, E-ISSN 1464-3553, Vol. 29, nr 5, s. 391-402Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Self-reported abnormal sensitivity, qualitative distortions and phantom sensations with respect to smell and taste was assessed with a longitudinal design, based on questions referring to gestational weeks 13–16 and 31–34 of pregnancy in comparison with 9–12 weeks post partum and with non-pregnant women with corresponding time durations and intervals. The results show that abnormal smell and/or taste perception was reported by 76% of the pregnant women, typically believed to be caused by their pregnancy. Increased smell sensitivity was found to be very common at the early stage of pregnancy (67% of all pregnant respondents) and occasionally accompanied by qualitative smell distortions (17%) and phantom smells (14%). The smell abnormalities were less common at the late pregnancy stage and almost absent post partum. Abnormal taste sensitivity was fairly commonly reported (26%), often described as increased bitter sensitivity and decreased salt sensitivity. These results, suggesting that abnormal smell and/or taste perception is experienced by a large majority of pregnant women, imply that further research is needed to understand to what extent these chemosensory changes may underlie food aversions and craving with implications for food intake during pregnancy.

  • 24.
    Nordin, Steven
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Broman, Daniel
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Bringlöv, Eva
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Intolerance to ambient odors at an early stage of pregnancy2007Inngår i: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 48, nr 4, s. 339-343Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Adverse reactions to ambient odorous and pungent substances in daily activities among pregnant women who are half-way through pregnancy, and changes in odor perception at predominantly an early stage of pregnancy motivated the present study of odor intolerance at an early pregnancy stage. Ninety-five women averaging gestational week 11 and 102 non-pregnant women were compared with the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR). General environmental intolerance was assessed with items from the Noise Sensitivity Scale that are analogous to the CSS-SHR (“NSS-SHR”). Pregnant women were found to have higher scores on the CSS-SHR, but not on the “NSS-SHR”. This suggests an odor intolerance that affects pregnant women's daily activities, which appears not to be due to a general environmental intolerance. The effect size of pregnancy on CSS-SHR score is larger in the present study of early pregnancy than in the previous study of women half-way through pregnancy.

  • 25.
    Nordin, Steven
    et al.
    Umeå universitet, Samhällsvetenskaplig fakultet, Psykologi.
    Broman, Daniel
    Umeå universitet, Samhällsvetenskaplig fakultet, Psykologi.
    Wulff, Marianne
    Umeå universitet, Medicinsk fakultet, Klinisk vetenskap, Obstetrik och gynekologi.
    Environmental odor intolerance in pregnant women2005Inngår i: Physiology and Behavior, ISSN 0031-9384, E-ISSN 1873-507X, Vol. 84, nr 2, s. 175-179Artikkel i tidsskrift (Fagfellevurdert)
  • 26.
    N-Wihlbäck, Anna-Carin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    [Basic investigation of infertility]2004Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, nr 45, s. 3525-3529Artikkel i tidsskrift (Fagfellevurdert)
  • 27.
    Olofsson, Jonas
    et al.
    Umeå universitet, Samhällsvetenskaplig fakultet, Psykologi.
    Broman, Daniel
    Umeå universitet, Samhällsvetenskaplig fakultet, Psykologi.
    Wulff, Marianne
    Umeå universitet, Medicinsk fakultet, Klinisk vetenskap, Obstetrik och gynekologi.
    Martinkauppi, Martin
    Umeå universitet, Samhällsvetenskaplig fakultet, Psykologi.
    Nordin, Steven
    Umeå universitet, Samhällsvetenskaplig fakultet, Psykologi.
    Olfactory and chemosomatosensory function in pregnant women assessed with event-related potentials2005Inngår i: Physiology and Behavior, ISSN 0031-9384, E-ISSN 1873-507X, Vol. 86, nr 1-2, s. 252-257Artikkel i tidsskrift (Fagfellevurdert)
  • 28. Toniolo, Paolo
    et al.
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Chen, Tianhui
    Johansson, Robert
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Schock, Helena
    Lenner, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Lehtinen, Matti
    Kaaks, Rudolf
    Wadell, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Zeleniuch-Jacquotte, Anne
    Lundin, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Lukanova, Annekatrin
    Human chorionic gonadotropin in pregnancy and maternal risk of breast cancer2010Inngår i: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 70, nr 17, s. 6779-6786Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Full-term pregnancies are associated with long-term reductions in maternal risk of breast cancer, but the biological determinants of the protection are unknown. Experimental observations suggest that human chorionic gonadotropin (hCG), a major hormone of pregnancy, could play a role in this association. A case-control study (242 cases and 450 controls) nested within the Northern Sweden Maternity Cohort included women who had donated a blood sample during the first trimester of a first full-term pregnancy. Total hCG was determined on Immulite 2000 analyzer. Odds ratios (OR) and 95% confidence intervals (CI) were estimated through conditional logistic regression. Maternal breast cancer risk decreased with increasing hCG (upper tertile OR, 0.67; CI, 0.46-0.99), especially for pregnancies before age 25 (upper tertile OR, 0.41; CI, 0.21-0.80). The association diverged according to age at diagnosis: risk was reduced after age 40 (upper tertile OR, 0.60; CI, 0.39-0.91) and seemed to increase before age 40 (upper tertile OR, 1.78; CI, 0.72-4.38). Risk was reduced among those diagnosed 10 years or longer after blood draw (upper tertile OR, 0.60; CI, 0.40-0.90), but not so among those diagnosed within 10 years (upper tertile OR, 4.33; CI, 0.86-21.7). These observations suggest that the association between pregnancy hCG and subsequent maternal risk of breast cancer is modified by age at diagnosis. Although the hormone seems to be a determinant of the reduced risk around or after age 50, it might not confer protection against, or it could even increase the risk of, cancers diagnosed in the years immediately following pregnancy.

  • 29.
    Wulff, Marianne
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Reproductive hazards in an industrial setting: an epidemiological assessment1996Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background: As more women of childbearing age engage in the workforceand a lot of new chemicals are available, a growing interest of diagnosing andpreventing reproductive disorders due to occupational and environmentalexposure has occurred. The source location of this thesis is the Rönnskärcopper smelter which is situated in the north of Sweden, in the municipality of Skellefteå. Emissions from the smelter, which have diminished during theperiod 1975-1990 include sulphur dioxide and heavy metals, especially lead,arsenic, cadmium, copper, mercury and zinc. Reproductive studies from the1970s in and around the smelter reported increased risks of spontaneousabortions, malformations and lower birth weight. The aim of this thesis wasto perform a broad and long-term epidemiological assessment of adversereproductive outcome in and around the smelter and to determine if theexposed population suffered from reproductive disturbances during the recentdecades.

    Subjects and methods: The study involve two main sources of data. Onewas a retrospective cohort formed through record linkage of populationregisters, the medical birth register (1961-90), the register of congenitalmalformations (1973-90) and the cancer register (1961-90). As another source,information on reproductive history, life-style and work related factors wasobtained from a questionnaire study in 1992. An exposed population wasdefined as smelter workers and their children, and also neighbours to thesmelter and their children.

    Results: In the register study, compared to the reference population, nooverall significant increased risk of malformations, childhood cancer, low birthweight or perinatal death was found in the exposed group. In thequestionnaire study, regarding infertility, no environmental effects were found.Also, no increased risk of a prolonged waiting time to pregnancy or increasedrisk of spontaneous abortions were associated with occupational or environmentalfactors.

    Conclusion: With the lack of a high statistical power in mind, due to smallsample sizes in some of the studies, the summary of our findings includingseveral outcomes, different epidemiological study designs and studies coveringa long period of time gives no evidence for any increased risk of reproductivehazards due to occupational or environmental exposure.

  • 30.
    Wulff, Marianne
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Högberg, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Stenlund, Hans
    Occupational and environmental risks of spontaneous abortions around a smelter.2002Inngår i: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 41, nr 2, s. 131-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We found no increase of spontaneous abortion associated to smelter work or to living close to the smelter which could be a result of radically reduced emissions.

  • 31.
    Wulff, Marianne
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Lalos, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Coitus-dependent and coitus-independent contraceptive methods in women and men2002Inngår i: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 7, nr 2, s. 114-120Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To study the use of contraceptives in Sweden. Methods: Analysis of the population-based survey 'Sex in Sweden. On the Swedish sexual life 1996'. The survey was analyzed in relation to socio-demographic, lifestyle, sexual and behavioral characteristics as well as attitudes to, and evaluation of, personal experiences. The data included 2810 men and women between 18 and 74 years of age. The results were compared with a similar survey carried out in 1967. Results: During the 30-year period between the 1967 and 1996 surveys, condom use more than halved and use of oral contraceptives increased by 6 percentage points. The decline in the use of condoms did not occur among teenagers but among all other age groups in both men and women. In 1996 the majority (72%) used a reliable contraceptive method, but 29% did not. Coitus-dependent methods were more frequently used by men and women who were below the age of 21, smoked, used alcohol simultaneously with coitus, had casual partners, were more highly educated, were breastfeeding, had coitus less frequently and among those who were most satisfied with their sexual life and their partner relationship. Conclusion: In order to increase the use of more reliable contraceptive methods, three crucial factors should be focused on in counselling and media campaigns: gender, age and the use of coitus-dependent/coitus-independent methods.

  • 32.
    Wulff, Marianne
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Lalos, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    The condom in relation to prevention of sexually transmitted infections and as a contraceptive method in Sweden.2004Inngår i: Eur J Contracept Reprod Health Care, ISSN 1362-5187, Vol. 9, nr 2, s. 69-77Artikkel i tidsskrift (Fagfellevurdert)
1 - 32 of 32
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