Targeted non-invasive prenatal testing (NIPT) tests for trisomies 21, 18 and 13 and sex chromosom... more Targeted non-invasive prenatal testing (NIPT) tests for trisomies 21, 18 and 13 and sex chromosome aneuploidies and could be an alternative to traditional karyotyping. The aim of this study was to determine the risk of missing other abnormal karyotypes of probable phenotypic significance by NIPT. This was a retrospective population-based analysis of all singleton pregnancies booked for combined first-trimester screening (cFTS) in Denmark over a 4-year period. Data concerning maternal demographics, cFTS and prenatal or postnatal karyotypes were collected from the Danish Fetal Medicine database. Karyotypes were classified according to whether the chromosomal anomaly would have been detected by NIPT and whether it was likely to affect phenotype. cFTS was completed in 193638 pregnancies. 10205 (5.3%) had cytogenetic or molecular analysis performed. Of these, 1122 (11.0%) had an abnormal karyotype, of which 262 (23.4%) would have been missed by NIPT, but would probably have been clinically significant. The prevalence of such 'atypical abnormal karyotypes' was increased in women above 45 years of age, in pregnancies with increased nuchal translucency (NT) thickness (≥ 3.5 mm), with abnormal levels of free β-human chorionic gonadotropin (<0.2 or ≥ 5.0 multiples of the median (MoM)) or pregnancy-associated plasma protein-A<0.2 MoM. One or more of these factors was present in 3% of women, and the prevalence of atypical abnormal karyotypes in this high-risk cohort was 1.6%. A significant proportion of karyotypic abnormalities will be missed by targeted NIPT. Women of advanced maternal age, or with increased fetal NT or abnormal biochemistry, have a higher risk of having a fetus affected by an atypical abnormal karyotype and need to be counseled accordingly when considering NIPT.
We studied the agreement between different measurements of gestational age, i.e. self-reported ge... more We studied the agreement between different measurements of gestational age, i.e. self-reported gestational age in the Danish National Birth Cohort Study, ultrasound-estimated gestational age from the medical records in one Danish county and gestational age from the Danish National Hospital Discharge Register. The ultrasound-estimated gestational length was based on the size of the biparietal diameter. The ultrasound-estimated gestational length was related to corrected and uncorrected last menstrual period estimates in the Danish National Cohort Study, and to the gestational length recorded in the Danish National Discharge Register. Non-parametric statistics were used in the analysis. The gestational ages estimated by ultrasound were 2-3 days shorter than gestational ages estimated by the other methods. The gestational ages recorded by the Discharge Register and the gestational ages based on corrected last menstrual period did not differ significantly. The self-reported gestational ...
The aim was to follow the development of the parameters of the distribution of age at menarche in... more The aim was to follow the development of the parameters of the distribution of age at menarche in Danish women in recent decades. The study is based on retrospective data from six different samples with a total of 42,784 women, born in the period 1923-1973. We report a renewed decline in the mean menarcheal age in a large Danish sample after a period with a halt in the trend towards an earlier age at menarche in many North European countries. We find a continuously declining mean menarcheal age in Denmark in women born in the years 1964-1973. In a sample of textile workers born in the years 1939-1968 (n = 12,605) we find a higher mean menarcheal age of one year. The results indicate that menarcheal age is still delayed in certain groups in Denmark. It can therefore be expected that the menarcheal age will fall even more in the future.
BJOG An International Journal of Obstetrics & Gynaecology
Objective To examine the timing of reaching developmental milestones in children born post-term.D... more Objective To examine the timing of reaching developmental milestones in children born post-term.DesignCohort study.SettingThe Danish National Birth Cohort: children born between 1997 and 2003.PopulationData were obtained from a cohort of 92 892 pregnancies participating in the first pregnancy interview. All singletons born in gestational weeks 39–45 were identified. The study was then restricted to children who participated in an interview at the age of approximately 18 months and had information on at least one developmental milestone. We excluded children of mothers with chronic diseases from the final analysis. The remaining study population constituted of 43 915 singletons (27 503 born at term; 16 412 born post-term).Methods Logistic regression was used to calculate odds ratios of late achievement of these developmental milestones, adjusted for potential confounding factors.Main outcome measuresAchieving developmental milestones at the time of interview or at a certain age.Resul...
Pseudoxanthoma elasticum (PXE) is a rare inherited systemic disorder characterized by progressive... more Pseudoxanthoma elasticum (PXE) is a rare inherited systemic disorder characterized by progressive calcification in the elastic tissue. Information about pregnancy in women with PXE is sparse. We report of a 36-year-old Caucasian woman, diagnosed with PXE, with a dichorionic diamniotic twin pregnancy, whose antenatal ultrasound scans showed a hyperechogenic placenta due to calcification. The calcification was confirmed on post-partum placental histology. Both twins, delivered via caesarean section due to maternal bleeding at 27 weeks of gestation suffered from intraventricular haemorrhage.
Studies suggest that children born very preterm have a high risk of developmental coordination di... more Studies suggest that children born very preterm have a high risk of developmental coordination disorder (DCD). We examined the relation between the larger spectrum of gestational age at birth and the risk of DCD. We used the 7-year follow-up data from 22898 singletons in the Danish National Birth Cohort. We calculated a total score from the Developmental Coordination Disorder Questionnaire (DCDQ), incorporated in the 7-year follow-up, and defined children with a score of 46 or below as having probable DCD. Information on gestational age was obtained from the Medical Birth Register. Gestational age at birth was inversely associated with the risk of DCD; a decline in gestational age by a week was associated with a 19% [95% confidence interval 14%, 25%] increased risk of DCD screening positive among children delivered before 40 weeks. No significant increased risk of DCD was seen for children born post-term. Our data indicate that short gestational age at birth in a range up to ges...
We report a renewed decline in mean menarcheal age in a large Danish sample after a period with a... more We report a renewed decline in mean menarcheal age in a large Danish sample after a period with a halt in the trend towards earlier age at menarche in many North European countries. In our study based on retrospective data from six different samples constituting 42784 women, we find a continuously declining mean menarcheal age in Denmark among women born in the years 1964-1973. In a sample of textile workers born in the years 1939-1968 (n = 12605) we find a 1 year higher mean menarcheal age. This indicates that menarcheal age is still delayed in certain groups in Denmark. This leaves the possibility that the menarcheal age could fall even further in the future.
American Journal of Obstetrics and Gynecology, 2004
The purpose of this study was to test a possible genetic component to prolonged gestation. The ge... more The purpose of this study was to test a possible genetic component to prolonged gestation. The gestational duration of single, first pregnancies by both female and male twins was obtained by linking the Danish Twin Registry, The Danish Civil Registration System, and the Danish Medical Birth Register. A total of 2588 same-sex twin pairs of whom both cotwins became parents during 1978 to 1996 were identified. The concordance rate for female twin pairs for a gestation of > or =41 weeks and > or =42 weeks was higher for monozygotic twin pairs than for dizygotic twin pairs, which indicates genetic effects. Biometric modeling suggested that genetic factors account for 23% to 30% of the liability to prolonged gestation. The difference in concordance rate between monozygotic and dizygotic male twin pairs was small, and the best fitting model indicated no genetic factors. Maternal genes influence prolonged gestation. However, a substantial paternal genetic influence through the fetus was not found.
Tokolyse Godkendt på Sandbjerg 2011 Arbejdsgruppens medlemmer: Annette Wind Olesen, Jens Svare, A... more Tokolyse Godkendt på Sandbjerg 2011 Arbejdsgruppens medlemmer: Annette Wind Olesen, Jens Svare, Anders Atke, Niels Uldbjerg, Charlotte Kjaergaard. Denne guideline er baseret på tokolyse guidelines fra Afgraensning af emnet: Obstetrisk kode BKHG (Behandling med vehaemmende midler). Denne guideline behandler Idiopatiske praeterme veer o Tokolytika – monoterapi (Opdatering af (Atke et al., 2007)) o Sekventiel behandling – second line drug, som anvendes, hvis ikke first line drug har tilstraekkelig effekt eller uacceptable bivirkninger (Nyt) o Kombinationsbehandling – samtidig anvendelse af flere tokolytika (Nyt) o Vedligeholdelsesbehandling ud over 48 timer (Nyt) o Flerfoldgraviditet (Opdatering af (Atke et al., 2007)) o GA < 28 +0 (opdatering af (Atke et al., 2007)) Tokolyse ved ekstern vending ved saedepraesentation (Nyt) Hyperakut tokolyse ved obstetriske komplikationer (Nyt) Denne guideline behandler ikke 1) Antibiotisk behandling ved truende praeterm fødsel (Ertberg et al., 201...
Resumé af guideline Definition af små biometrier i 1. trimester ● Diskrepans på 8 dage eller dero... more Resumé af guideline Definition af små biometrier i 1. trimester ● Diskrepans på 8 dage eller derover i gestationsalderen fastsat ved sidste menstruation og CRL, forudsat at den gravide har en sikker menstruationsanamnese. evidensgrad D IV ● Diskrepans på 8 dage eller derover i gestationsalderen fastsat ved tidligere ultralydsskanning / positiv graviditetstest / transferdate eller CRL. Evidensgrad D IV Definition af små biometrier i 2. trimester ● HC og/eller AC < 3. percentil for gestationsalderen fastsat ved CRL i første trimester. Evidensgrad B II-III Årsager til små biometrier ● Små biometrier kan vaere udtryk for patologi, men kan også vaere udtryk for normal fysiologisk variation, Evidensgrad III-IV . Sammenhaeng med perinatal mortalitet og morbiditet ● Små biometrier i første og andet trimester giver øget risiko for abort, kromosomanomalier, malformationer, IUGR, spontan praeterm fødsel, lav fødselsvaegt og peri/neonatal død. Evidensgrad B II-III ● Det anbefales at gravidit...
Targeted non-invasive prenatal testing (NIPT) tests for trisomies 21, 18 and 13 and sex chromosom... more Targeted non-invasive prenatal testing (NIPT) tests for trisomies 21, 18 and 13 and sex chromosome aneuploidies and could be an alternative to traditional karyotyping. The aim of this study was to determine the risk of missing other abnormal karyotypes of probable phenotypic significance by NIPT. This was a retrospective population-based analysis of all singleton pregnancies booked for combined first-trimester screening (cFTS) in Denmark over a 4-year period. Data concerning maternal demographics, cFTS and prenatal or postnatal karyotypes were collected from the Danish Fetal Medicine database. Karyotypes were classified according to whether the chromosomal anomaly would have been detected by NIPT and whether it was likely to affect phenotype. cFTS was completed in 193638 pregnancies. 10205 (5.3%) had cytogenetic or molecular analysis performed. Of these, 1122 (11.0%) had an abnormal karyotype, of which 262 (23.4%) would have been missed by NIPT, but would probably have been clinically significant. The prevalence of such &#39;atypical abnormal karyotypes&#39; was increased in women above 45 years of age, in pregnancies with increased nuchal translucency (NT) thickness (≥ 3.5 mm), with abnormal levels of free β-human chorionic gonadotropin (&lt;0.2 or ≥ 5.0 multiples of the median (MoM)) or pregnancy-associated plasma protein-A&lt;0.2 MoM. One or more of these factors was present in 3% of women, and the prevalence of atypical abnormal karyotypes in this high-risk cohort was 1.6%. A significant proportion of karyotypic abnormalities will be missed by targeted NIPT. Women of advanced maternal age, or with increased fetal NT or abnormal biochemistry, have a higher risk of having a fetus affected by an atypical abnormal karyotype and need to be counseled accordingly when considering NIPT.
We studied the agreement between different measurements of gestational age, i.e. self-reported ge... more We studied the agreement between different measurements of gestational age, i.e. self-reported gestational age in the Danish National Birth Cohort Study, ultrasound-estimated gestational age from the medical records in one Danish county and gestational age from the Danish National Hospital Discharge Register. The ultrasound-estimated gestational length was based on the size of the biparietal diameter. The ultrasound-estimated gestational length was related to corrected and uncorrected last menstrual period estimates in the Danish National Cohort Study, and to the gestational length recorded in the Danish National Discharge Register. Non-parametric statistics were used in the analysis. The gestational ages estimated by ultrasound were 2-3 days shorter than gestational ages estimated by the other methods. The gestational ages recorded by the Discharge Register and the gestational ages based on corrected last menstrual period did not differ significantly. The self-reported gestational ...
The aim was to follow the development of the parameters of the distribution of age at menarche in... more The aim was to follow the development of the parameters of the distribution of age at menarche in Danish women in recent decades. The study is based on retrospective data from six different samples with a total of 42,784 women, born in the period 1923-1973. We report a renewed decline in the mean menarcheal age in a large Danish sample after a period with a halt in the trend towards an earlier age at menarche in many North European countries. We find a continuously declining mean menarcheal age in Denmark in women born in the years 1964-1973. In a sample of textile workers born in the years 1939-1968 (n = 12,605) we find a higher mean menarcheal age of one year. The results indicate that menarcheal age is still delayed in certain groups in Denmark. It can therefore be expected that the menarcheal age will fall even more in the future.
BJOG An International Journal of Obstetrics & Gynaecology
Objective To examine the timing of reaching developmental milestones in children born post-term.D... more Objective To examine the timing of reaching developmental milestones in children born post-term.DesignCohort study.SettingThe Danish National Birth Cohort: children born between 1997 and 2003.PopulationData were obtained from a cohort of 92 892 pregnancies participating in the first pregnancy interview. All singletons born in gestational weeks 39–45 were identified. The study was then restricted to children who participated in an interview at the age of approximately 18 months and had information on at least one developmental milestone. We excluded children of mothers with chronic diseases from the final analysis. The remaining study population constituted of 43 915 singletons (27 503 born at term; 16 412 born post-term).Methods Logistic regression was used to calculate odds ratios of late achievement of these developmental milestones, adjusted for potential confounding factors.Main outcome measuresAchieving developmental milestones at the time of interview or at a certain age.Resul...
Pseudoxanthoma elasticum (PXE) is a rare inherited systemic disorder characterized by progressive... more Pseudoxanthoma elasticum (PXE) is a rare inherited systemic disorder characterized by progressive calcification in the elastic tissue. Information about pregnancy in women with PXE is sparse. We report of a 36-year-old Caucasian woman, diagnosed with PXE, with a dichorionic diamniotic twin pregnancy, whose antenatal ultrasound scans showed a hyperechogenic placenta due to calcification. The calcification was confirmed on post-partum placental histology. Both twins, delivered via caesarean section due to maternal bleeding at 27 weeks of gestation suffered from intraventricular haemorrhage.
Studies suggest that children born very preterm have a high risk of developmental coordination di... more Studies suggest that children born very preterm have a high risk of developmental coordination disorder (DCD). We examined the relation between the larger spectrum of gestational age at birth and the risk of DCD. We used the 7-year follow-up data from 22898 singletons in the Danish National Birth Cohort. We calculated a total score from the Developmental Coordination Disorder Questionnaire (DCDQ), incorporated in the 7-year follow-up, and defined children with a score of 46 or below as having probable DCD. Information on gestational age was obtained from the Medical Birth Register. Gestational age at birth was inversely associated with the risk of DCD; a decline in gestational age by a week was associated with a 19% [95% confidence interval 14%, 25%] increased risk of DCD screening positive among children delivered before 40 weeks. No significant increased risk of DCD was seen for children born post-term. Our data indicate that short gestational age at birth in a range up to ges...
We report a renewed decline in mean menarcheal age in a large Danish sample after a period with a... more We report a renewed decline in mean menarcheal age in a large Danish sample after a period with a halt in the trend towards earlier age at menarche in many North European countries. In our study based on retrospective data from six different samples constituting 42784 women, we find a continuously declining mean menarcheal age in Denmark among women born in the years 1964-1973. In a sample of textile workers born in the years 1939-1968 (n = 12605) we find a 1 year higher mean menarcheal age. This indicates that menarcheal age is still delayed in certain groups in Denmark. This leaves the possibility that the menarcheal age could fall even further in the future.
American Journal of Obstetrics and Gynecology, 2004
The purpose of this study was to test a possible genetic component to prolonged gestation. The ge... more The purpose of this study was to test a possible genetic component to prolonged gestation. The gestational duration of single, first pregnancies by both female and male twins was obtained by linking the Danish Twin Registry, The Danish Civil Registration System, and the Danish Medical Birth Register. A total of 2588 same-sex twin pairs of whom both cotwins became parents during 1978 to 1996 were identified. The concordance rate for female twin pairs for a gestation of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =41 weeks and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =42 weeks was higher for monozygotic twin pairs than for dizygotic twin pairs, which indicates genetic effects. Biometric modeling suggested that genetic factors account for 23% to 30% of the liability to prolonged gestation. The difference in concordance rate between monozygotic and dizygotic male twin pairs was small, and the best fitting model indicated no genetic factors. Maternal genes influence prolonged gestation. However, a substantial paternal genetic influence through the fetus was not found.
Tokolyse Godkendt på Sandbjerg 2011 Arbejdsgruppens medlemmer: Annette Wind Olesen, Jens Svare, A... more Tokolyse Godkendt på Sandbjerg 2011 Arbejdsgruppens medlemmer: Annette Wind Olesen, Jens Svare, Anders Atke, Niels Uldbjerg, Charlotte Kjaergaard. Denne guideline er baseret på tokolyse guidelines fra Afgraensning af emnet: Obstetrisk kode BKHG (Behandling med vehaemmende midler). Denne guideline behandler Idiopatiske praeterme veer o Tokolytika – monoterapi (Opdatering af (Atke et al., 2007)) o Sekventiel behandling – second line drug, som anvendes, hvis ikke first line drug har tilstraekkelig effekt eller uacceptable bivirkninger (Nyt) o Kombinationsbehandling – samtidig anvendelse af flere tokolytika (Nyt) o Vedligeholdelsesbehandling ud over 48 timer (Nyt) o Flerfoldgraviditet (Opdatering af (Atke et al., 2007)) o GA < 28 +0 (opdatering af (Atke et al., 2007)) Tokolyse ved ekstern vending ved saedepraesentation (Nyt) Hyperakut tokolyse ved obstetriske komplikationer (Nyt) Denne guideline behandler ikke 1) Antibiotisk behandling ved truende praeterm fødsel (Ertberg et al., 201...
Resumé af guideline Definition af små biometrier i 1. trimester ● Diskrepans på 8 dage eller dero... more Resumé af guideline Definition af små biometrier i 1. trimester ● Diskrepans på 8 dage eller derover i gestationsalderen fastsat ved sidste menstruation og CRL, forudsat at den gravide har en sikker menstruationsanamnese. evidensgrad D IV ● Diskrepans på 8 dage eller derover i gestationsalderen fastsat ved tidligere ultralydsskanning / positiv graviditetstest / transferdate eller CRL. Evidensgrad D IV Definition af små biometrier i 2. trimester ● HC og/eller AC < 3. percentil for gestationsalderen fastsat ved CRL i første trimester. Evidensgrad B II-III Årsager til små biometrier ● Små biometrier kan vaere udtryk for patologi, men kan også vaere udtryk for normal fysiologisk variation, Evidensgrad III-IV . Sammenhaeng med perinatal mortalitet og morbiditet ● Små biometrier i første og andet trimester giver øget risiko for abort, kromosomanomalier, malformationer, IUGR, spontan praeterm fødsel, lav fødselsvaegt og peri/neonatal død. Evidensgrad B II-III ● Det anbefales at gravidit...
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