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Ohlin, Andreas
Publications (10 of 20) Show all publications
Malmqvist, O., Ohlin, A., Ågren, J. & Jonsson, M. (2020). Seizures in newborn infants without hypoxic ischemic encephalopathy - antenatal and labor-related risk factors: a case-control study. The Journal of Maternal-Fetal & Neonatal Medicine, 33(5), 799-805
Open this publication in new window or tab >>Seizures in newborn infants without hypoxic ischemic encephalopathy - antenatal and labor-related risk factors: a case-control study
2020 (English)In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 33, no 5, p. 799-805Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To identify antepartum and intrapartum risk factors for neonatal seizures in the absence of hypoxic ischemic encephalopathy (HIE).

METHODS: Population-based case-control study. Of 98 484 births, 40 newborns at 34 gestational weeks or later had seizures within the first 7 days of life. Cases (n = 40) and controls (n = 160) were retrieved from the University hospitals of Örebro for 1994-2013 and Uppsala for 2003-2013. Demographics and characteristics of pregnancy, labor, delivery, and neonatal data were analyzed. Crude odds ratio (OR) and adjusted odds ratios (AOR) with 95% confidence intervals (CIs) for antenatal and intrapartum factors were calculated using logistic regression analysis. Main outcome measure was neonatal seizures within the first 7 days of life.

RESULTS: The incidence of neonatal seizures without HIE was 0.41/1000 live births. Antenatal risk factors for neonatal seizures were as follows: short maternal stature (AOR: 5.4; 1.8-16.5); previous caesarean section (AOR: 4.8; 1.5-15.0); and assisted fertilization (AOR: 6.8; 1.3-35.2). Intrapartum risk factors were as follows: induction of labor (AOR: 5.7; 1.8-17.7); preterm birth (AOR: 13.5; 3.7-48.9); and head circumference >37 cm (AOR: 6.9; 1.4-34.8).

CONCLUSIONS: Preterm birth was the strongest risk factor for neonatal seizures in the absence of HIE. The results also indicate that feto-pelvic disproportion is associated with the occurrence of seizures.

RATIONALE: Antepartum and intrapartum risk factors for newborn seizures in the absence of HIE were investigated in a case-control study. Out of 98 484 births at 34 gestational weeks or more, 40 newborns had seizures without HIE. All had a normal Apgar score although they later presented with seizures. Preterm birth was the strongest risk factor (OR: 13.5; 95% CI: 3.7-48.9). Our results also indicate that feto-pelvic disproportion is of importance. Furthermore, a history of prior caesarean was associated with seizures. This is the first study to assess obstetric risk factors for newborn seizures separate from those with seizures and concomitant HIE. The distinction is of importance due to different etiologies, treatments, and preventive strategies.

Place, publisher, year, edition, pages
Informa Healthcare, 2020
Keywords
Hypoxic ischemic encephalopathy, labor, neonatal seizures, preterm birth, risk factors
National Category
Obstetrics, Gynecology and Reproductive Medicine Pediatrics
Identifiers
urn:nbn:se:oru:diva-70004 (URN)10.1080/14767058.2018.1505853 (DOI)000505460100015 ()30373414 (PubMedID)2-s2.0-8505571785 (Scopus ID)
Available from: 2018-11-06 Created: 2018-11-06 Last updated: 2020-01-20Bibliographically approved
Pettersson, M., Olsson, E., Ohlin, A. & Eriksson, M. (2019). Neurophysiological and behavioral measures of pain during neonatal hip examination. Paediatric and Neonatal Pain, 1(1), 15-20
Open this publication in new window or tab >>Neurophysiological and behavioral measures of pain during neonatal hip examination
2019 (English)In: Paediatric and Neonatal Pain, ISSN 2637-3807, Vol. 1, no 1, p. 15-20Article in journal (Refereed) Published
Abstract [en]

Introduction: The aim of this study was to test the hypothesis that neonatal hip ex ‐amination causes pain in newborns. Pain assessment using instruments such as the Premature Infant Pain Profile‐Revised (PIPP‐R) scale is recommended, but recently physiological and neurophysiological measures, for example, near‐infrared spectros‐copy (NIRS) and galvanic skin response (GSR), have been used as well.

Methods: Heart auscultation and hip examination were performed, and the response of the newborn was registered by NIRS optodes, GSR electrodes, and a pulse oxime‐ter probe attached to the infant. The face of the newborn was filmed. Heart ausculta‐tion was used as a nonpainful reference.

Results: The pain scores for hip examination were higher than for the heart ausculta‐tion. Near‐infrared spectroscopy showed a significant higher increase from baseline in oxygenated hemoglobin (HbO2) on both sides of the cortex at hip examination compared with at heart auscultation (P = .011 and P= .017). Mean PIPP‐R scores for the hip examination compared with heart auscultation increased from 3.0 to 8.1 (P = .000). The GSR analyses of hip examination compared with heart auscultation showed a significant increase in area under small peaks during the hip examination (P = .016), however, not when measured in peaks per second (P = .104). Interrater reliability was calculated for the NIRS interpretations, with an intraclass correlation coefficient (ICC) range of 0.93‐1.0 (P = .000).

Discussion: Pain in newborns can have negative consequences, and pain prevention and treatment are therefore important. We conclude that neonatal hip examinations are painful and that the pain should be treated, for example, with oral sweet solution. This is a change from present routines during neonatal hip examination and is hoped to lead to a change in national guidelines.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Neonatal hip examination, neonatal pain
National Category
Pediatrics Nursing
Research subject
Pediatrics; Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-76413 (URN)10.1002/pne2.12006 (DOI)
Available from: 2019-09-14 Created: 2019-09-14 Last updated: 2019-11-22Bibliographically approved
Pettersson, M., Olsson, E., Ohlin, A. & Eriksson, M. (2019). Neurophysiological and behavioural measures of pain during neonatal hip examination. In: : . Paper presented at Barnveckan, Örebro, Sweden, April 1-4, 2019.
Open this publication in new window or tab >>Neurophysiological and behavioural measures of pain during neonatal hip examination
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background

In Sweden, all newborns are examined before discharge from the maternity ward to rule out innate abnormalities. Parts of this procedure, such as the hip examination, appear to cause pain and discomfort. Pain in newborns can have both short- and long-term negative consequences and preventing and treating this pain is therefore an important part of medical care. There are several ways to recognize and assess pain in newborn infants. Scales such as the Premature Infant Pain Profile-Revised (PIPP-R) are recommended, but recently physiological and neurophysiological measures, e.g. Near-infrared spectroscopy (NIRS) and Galvanic Skin Response (GSR) have been suggested to have pain-assessing properties.

The aim of the study was to test the hypothesis that neonatal hip examination causes pain in newborns.

Methods

The infant was placed on an examination table and a video camera was placed so the face of the newborn was filmed. A pulse oximeter probe, NIRS optodes and GSR electrodes were attached to the infant. Heart auscultation was chosen to be used as a non-painful comparative to hip examination.

Results

The results showed higher pain scoring for the hip examination than for the heart auscultation. NIRS, showed a significant difference in HbO2 on both sides of cortex (p=0,011 and p=0,017). Mean PIPP-R went from 3.0 during the heart auscultation to 8.1 during the hip examination (p=0.000). GSR analyses showed significant increase in area under small peaks during the hip examination (p=0.016), however not when measured in peaks per second (p=0.104). Interrater reliability was calculated for the NIRS interpretations, with an ICC-range of 0.93-1.0 (p=0.000).

Conclusion

We conclude that neonatal hip examinations are painful and that the pain should be treated, e.g. with oral sweet solution. 

Keywords
Pain, newborn infants
National Category
Pediatrics Nursing
Research subject
Pediatrics; Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-73176 (URN)
Conference
Barnveckan, Örebro, Sweden, April 1-4, 2019
Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-04-17Bibliographically approved
Pettersson, M., Olsson, E., Ohlin, A. & Eriksson, M. (2019). Neurophysiological and behavioural measures of pain during neonatal hip examination. In: : . Paper presented at 12th International Symposium on Pediatric Pain (ISPP), Basel Switzerland, June 16-20, 2019.
Open this publication in new window or tab >>Neurophysiological and behavioural measures of pain during neonatal hip examination
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Introduction and Purpose: In Sweden, all newborns are examined before discharge from the maternity ward to rule out innate abnormalities. Parts of this procedure, such as the hip examination, appear to cause pain and discomfort. Pain in newborns can have both short- and long-term negative consequences and preventing and treating this pain is therefore an important part of medical care. There are several ways to recognize and assess pain in newborn infants. Scales such as the Premature Infant Pain Profile-Revised (PIPP-R) are recommended, but recently physiological and neurophysiological measures, e.g. Near-in-frared spectroscopy (NIRS) and Galvanic Skin Response (GSR) have been suggested as superior pain measuring methods. The aim of the study was to test the hypothesis that neonatal hip examination causes pain in newborns.

Methods: The infant was placed on an examination table and a video camera was placed so the face of the newborn was filmed. A pulse oximeter probe, NIRS optodes and GSR electrodes were attached to the infant. Heart auscultation was chosen to be used as a non-painful comparative to hip examination.

Results: The results showed higher pain scoring for the hip examination than for the heart auscultation. NIRS, showed a significant difference in HbO2 on both sides of cortex (p=0,011 and p=0,017). Mean PIPP-R went from 3.0 during the heart auscultation to 8.1 during the hip examination (p=0.000). GSR analyses showed significant increase in area under small peaks during the hip examination (p=0.016), however not when measured in peaks per second (p=0.104). The interrater reliability for NIRS interpretations had an ICC-range of 0,93-1,0 (p<0,001). 

Conclusion: We conclude that neonatal hip examinations are painful and that the pain should be treated, e.g. with oral sweet solution.

Keywords
Pain, newborn infant, hip examination
National Category
Nursing Pediatrics
Identifiers
urn:nbn:se:oru:diva-74655 (URN)
Conference
12th International Symposium on Pediatric Pain (ISPP), Basel Switzerland, June 16-20, 2019
Available from: 2019-06-11 Created: 2019-06-11 Last updated: 2019-07-03Bibliographically approved
Pettersson, M., Olsson, E., Ohlin, A. & Eriksson, M. (2019). Neurophysiological and behavioural measures of pain during neonatal hip examination. In: : . Paper presented at RPA & RSOG 1st Joint Scientific Conference, Kigali, Rwanda, 11-13 September, 2019.
Open this publication in new window or tab >>Neurophysiological and behavioural measures of pain during neonatal hip examination
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: In Sweden, all newborns are examined before discharge from the maternity ward to rule out innate abnormalities. Parts of this procedure, such as the hip examination, appear to cause pain and discomfort. Pain in newborns can have both short- and long-term negative consequences and preventing and treating this pain is therefore an important part of medical care. There are several ways to recognize and assess pain in newborn infants. Scales such as the Premature Infant Pain Profile-Revised (PIPP-R) are recommended, but recently physiological and neurophysiological measures, e.g. Near-infrared spectroscopy (NIRS) and Galvanic Skin Response (GSR) have been suggested to have pain-assessing properties.

The aim of the study was to test the hypothesis that neonatal hip examination causes pain in newborns. 

Methods: The infant was placed on an examination table and a video camera was placed so the face of the newborn was filmed. A pulse oximeter probe, NIRS optodes and GSR electrodes were attached to the infant. Heart auscultation was chosen to be used as a non-painful comparative to hip examination. 

Results: The results showed higher pain scoring for the hip examination than for the heart auscultation. NIRS, showed a significant difference in HbO2 on both sides of cortex (p=0,011 and p=0,017). Mean PIPP-R went from 3.0 during the heart auscultation to 8.1 during the hip examination (p=0.000). GSR analyses showed significant increase in area under small peaks during the hip examination (p=0.016), however not when measured in peaks per second (p=0.104). Interrater reliability was calculated for the NIRS interpretations, with an ICC-range of 0.93-1.0 (p=0.000).

Conclusion: We conclude that neonatal hip examinations are painful and that the pain should be treated, e.g. with oral sweet solution. 

National Category
Pediatrics Nursing
Research subject
Pediatrics; Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-76414 (URN)
Conference
RPA & RSOG 1st Joint Scientific Conference, Kigali, Rwanda, 11-13 September, 2019
Available from: 2019-09-14 Created: 2019-09-14 Last updated: 2019-09-17Bibliographically approved
Eriksson, M., Pettersson, M., Olsson, E. & Ohlin, A. (2019). Neurophysiological and behavioural measures of pain during neonatal hip examination. In: : . Paper presented at Svenskt smärtforum, Malmö, Sweden, October 17-18, 2019.
Open this publication in new window or tab >>Neurophysiological and behavioural measures of pain during neonatal hip examination
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: In Sweden, all newborns are examined before discharge from the maternity ward to rule out innate abnormalities. Parts of this procedure, such as the hip examination, appear to cause pain and discomfort. Pain in newborns can have both short- and long-term negative consequences and preventing and treating pain is therefore an important part of medical care. There are several ways to recognize and assess pain in newborn infants. Scales such as the Premature Infant Pain Profile-Revised (PIPP-R) are recommended, but recently physiological and neurophysiological measures, e.g. Near-infrared spectroscopy (NIRS) and Galvanic Skin Response (GSR) have been suggested to have pain-assessing properties.

Aim: The aim of the study was to test the hypothesis that neonatal hip examination causes pain in newborns. 

Method: The infant was placed on an examination table and a video camera was placed so the face of the newborn was filmed. A pulse oximeter probe, NIRS optodes and GSR electrodes were attached to the infant. Heart auscultation was chosen to be used as a non-painful comparative to hip examination.

Results: The results showed higher pain scoring for the hip examination than for the heart auscultation. NIRS, showed a significant difference in HbO2 on both sides of cortex. Mean PIPP-R went from 3.0 during the heart auscultation to 8.1 during the hip examination. GSR analyses showed significant increase in area under small peaks during the hip examination. 

Conclusion: We conclude that neonatal hip examinations are painful and that the pain should be treated, e.g. with oral sweet solution. 

Keywords
Pain, newborn infants, hip examination
National Category
Pediatrics Anesthesiology and Intensive Care
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-77277 (URN)
Conference
Svenskt smärtforum, Malmö, Sweden, October 17-18, 2019
Available from: 2019-10-14 Created: 2019-10-14 Last updated: 2019-10-21Bibliographically approved
Olsson, E., Pettersson, M., Eriksson, M. & Ohlin, A. (2019). Oral sweet solution to prevent pain during neonatal hip examination: a randomized controlled trial. Acta Paediatrica, 108(4), 626-629
Open this publication in new window or tab >>Oral sweet solution to prevent pain during neonatal hip examination: a randomized controlled trial
2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 4, p. 626-629Article in journal (Refereed) Published
Abstract [en]

Aim: To determine if oral glucose can have a pain relieving effect during routine hip exams in newborn infants.

Methods: In this randomized controlled study 100 newborn infants undergoing the routine physical examination including the potentially painful hip exam were included between March 2016 and April 2017. 50 infants were randomized to water (control) and 50 to oral glucose (intervention) before their examination. Pain was assessed using crying time, Astrid Lindgren and Lund Children's Hospital Pain and Stress Assessment Scale (ALPS‐Neo) and Visual analogue scale (VAS).

Results:  Total crying time (p=0.06), crying time during the hip examination (p=0.028), ALPS‐Neo (p=0.004) and VAS (p=0.006) (when assessed by the physician) were all significantly decreased in the group of infants receiving glucose. VAS assessment made by the parents did not reach statistical significance (p=0.127).

Conclusion:  Oral glucose given before the examination has a pain relieving effect during the hip exam in healthy newborn infants.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2019
Keywords
Hip examination, newborn, oral glucose, pain
National Category
Pediatrics Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-69112 (URN)10.1111/apa.14588 (DOI)000461014600008 ()30246505 (PubMedID)2-s2.0-85054926490 (Scopus ID)
Note

Funding Agency:

Research Committee of Region Örebro County 

Available from: 2018-09-29 Created: 2018-09-29 Last updated: 2019-06-19Bibliographically approved
Olsson, E., Pettersson, M., Eriksson, M. & Ohlin, A. (2018). Glukos som smärtlindring vid neonatal höftledsundersökning: En randomiserad kontrollerad studie. In: : . Paper presented at Barnveckan 2018, Västerås, 23-26 April, 2018.
Open this publication in new window or tab >>Glukos som smärtlindring vid neonatal höftledsundersökning: En randomiserad kontrollerad studie
2018 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
Keywords
Smärta, nyfödda barn
National Category
Health Sciences Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:oru:diva-66883 (URN)
Conference
Barnveckan 2018, Västerås, 23-26 April, 2018
Available from: 2018-05-05 Created: 2018-05-05 Last updated: 2018-05-18Bibliographically approved
Björkman, L., Hagberg, J., Schollin, J. & Ohlin, A. (2017). Can the use of isopropanol impregnated caps cause alcohol leakage into intravenous lines?. In: : . Paper presented at Pediatric Academic Societies (PAS) 2017 Meeting, San Francisco, CA, USA, May 6-9, 2017.
Open this publication in new window or tab >>Can the use of isopropanol impregnated caps cause alcohol leakage into intravenous lines?
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-67263 (URN)
Conference
Pediatric Academic Societies (PAS) 2017 Meeting, San Francisco, CA, USA, May 6-9, 2017
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2018-09-06Bibliographically approved
Serenius, F., Ewald, U., Farooqi, A., Fellman, V., Hafström, M., Hellgren, K., . . . Källén, K. (2016). Neurodevelopmental Outcomes Among Extremely Preterm Infants 6.5 Years After Active Perinatal Care in Sweden. JAMA pediatrics, 170(10), 954-963
Open this publication in new window or tab >>Neurodevelopmental Outcomes Among Extremely Preterm Infants 6.5 Years After Active Perinatal Care in Sweden
Show others...
2016 (English)In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 170, no 10, p. 954-963Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE: Active perinatal care increases the rate of survival of extremely preterm infants, but there are concerns that improved survival might increase the rate of disabled survivors.

OBJECTIVE: To determine the neurodevelopmental outcomes of a national cohort of children 6.5 years of age who had been born extremely preterm (<27 weeks' gestational age) in Sweden.

DESIGN, SETTING, AND PARTICIPANTS: Population-based prospective cohort study of consecutively born extremely preterm infants. All of these infants were born in Sweden during the period from April 1, 2004, to March 31, 2007. Of 707 live-born extremely preterm infants, 486 (68.7%) survived to 6.5 years of age. These children were assessed and compared with matched controls who had been born at term. Comparison estimates were adjusted for demographic differences. Assessments ended in February 2014, and analysis started thereafter.

MAIN OUTCOMES AND MEASURES: Cognitive ability was measured with the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV), and the mean (SD) scores of the children who had been born extremely preterm were compared with those of the controls. Clinical examinations and parental questionnaires were used for diagnosis of cerebral palsy, hearing and vision impairments, and cognition for the children who were not assessed with the WISC-IV.

RESULTS: Of 486 eligible infants who were born extremely preterm, 441 (90.7%) were assessed at 6.5 years of age (59 by medical record review only) alongside 371 controls. The adjusted mean (SD) full-scale WISC-IV score was 14.2 (95% CI, 12.1-16.3) points lower for children who had been born extremely preterm than for controls. Cognitive disability was moderate for 18.8% of extremely preterm children and 2.2% of controls (P < .001), and it was severe for 11.1% of extremely preterm children and 0.3% of controls (P < .001). Cerebral palsy was observed in 9.5% of extremely preterm children and 0.0% of controls (P < .001), blindness was observed in 2.0% of extremely preterm children and 0.0% of controls (P < .001), and hearing impairment was observed in 2.1% of extremely preterm children and 0.5% of controls (P = .07). Overall, 36.1%(95% CI, 31.7%-40.6%) of extremely preterm children had no disability, 30.4%(95% CI 26.3%-34.8%) had mild disability, 20.2%(95% CI, 16.6%-24.2%) had moderate disability, and 13.4%(95% CI, 10.5%-16.9%) had severe disability. For extremely preterm children, moderate or severe overall disability decreased with gestational age at birth (adjusted odds ratio per week, 0.65 [95% CI, 0.54-0.79]; P < .001) and increased from 26.6% to 33.5%(P = .01) for children assessed both at 2.5 and 6.5 years.

CONCLUSIONS AND RELEVANCE: Of the 441 extremely preterm infants who had received active perinatal care, 293 (66.4%) had no or mild disability at 6.5 years; of the 371 controls, 11 (3.0%) had moderate or severe disability. Disability rates at 6.5 years increased relative to the rates at 2.5 years. Results are relevant for health care professionals and planners, and for clinicians counseling families facing extremely preterm births.

Place, publisher, year, edition, pages
Chicago: American Medical Association, 2016
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:oru:diva-53512 (URN)10.1001/jamapediatrics.2016.1210 (DOI)000385643000014 ()27479919 (PubMedID)
Funder
Swedish Research Council, 2006-3858 2009-4250
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council RFR-10324

Research Council in the South-East Region of Sweden

Swedish government

University of Umeå

Västerbotten County Council

Stockholm County Council

Karolinska Institute

Lilla Barnets Fond

Evy and Gunnar Sandberg Foundation

Birgit and Håkan Ohlsson Foundation

Available from: 2016-11-15 Created: 2016-11-15 Last updated: 2018-09-04Bibliographically approved
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