Category Archives: Reproductive Health and Childbirth

Fertility, contraception, abortion, in vitro fertilisation, pregnancy, mammary gland development, menstruation and menopause, breast feeding, antenatal care, childbirth and complications of newborns

Unveiling connections between preeclampsia and cardiovascular disease

Women with preeclampsia have up to eight times higher risk of later developing cardiovascular disease. CEMIR’s research group on Inflammation and Genetics in Pregnancy studies how the development of preeclampsia and cardiovascular disease are connected.

ISSHP

Liv Cecilie Vestrheim Thomsen (left) and Lobke Gierman.

The group has recently unveiled inflammatory mechanisms in the placenta and identified an important role for fetal trophoblasts. They have also identified a gene variant that is protective for both preeclampsia and cardiovascular disease.

This research was recently presented at the International Society for the Study of Hypertension in Pregnancy (ISSHP), a conference about research and treatment of hypersensitive diseases during pregnancy, primarily preeclampsia and gestational hypertension.

Researcher Liv Cecilie Vestrheim Thomsen received the prize for best poster and Post.doc. Lobke Gierman received third place in the category best oral presentation.

Article in Placenta:   Toll-like receptor profiling of seven trophoblast cell lines warrants caution for translation to primary trophoblasts

 

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Could Trophoblasts be the Immune Cells of Pregnancy?

Line TangeråsGuro StødleBlogger: Guro Stødle and Line Tangerås
PhD students, CEMIR

 

In the human body, infections (caused by bacteria or virus) and tissue injury may set off an inflammatory response, in which immune cells, blood vessels, proteins and other mediators work together to eliminate the threat and repair the damage.

Gravid magePregnancy is a delicate setting where the mother and fetus must adapt properly to each other to coexist, and an inflammatory response can disturb this delicate balance and cause complications. This is seen in preeclampsia, a potentially severe inflammatory pregnancy disorder threatening both the mother and fetus.

In preeclampsia, inflammation in the placenta contributes to poor placental development, later leading to systemic inflammation in the mother, manifesting as high blood pressure and protein in the mother’s urine.

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Six weeks of data collection in Sri Lanka’s hill country tea plantations

Bloggers: Jennifer J. Infanti (Department of Public Health and General Practice, NTNU), Ragnhild Lund (Department of Geography, NTNU) and Kumudu Wijewardene (Department of Community Medicine, University of Sri Jayawardenepura, Sri Lanka)

 

Tea plantation near Ella, Sri Lanka

Tea plantation near Ella, Sri Lanka (Photo: Jennifer Infanti)

Sri lanka is one of the world’s largest exporters of tea. The origins of the tea plantations date back to the mid-1800s when the country was under British rule.

During this era, the British tea planters brought low-caste, primarily Tamil-speaking labourers from villages in South India to Sri Lanka to work in the plantations. For most of their history in Sri Lanka, the plantation workers were not recognised as citizens of Sri Lanka and therefore had few entitlements or rights in the country. They could not vote, own land, access government health services, open bank accounts, or secure employment outside the tea plantations.

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Global Health Day 2014: Health challenges in low income countries

Health challenges in low income countries is the theme of this years’ Global Health Day. The is seminar organised by The Faculty of Medicine at NTNU,  Sør-Trøndelag University College and St. Olavs University Hospital.

Konsultasjon Sør-Afrika

The seminar will take place on 21 October in Øya helsehus (Aud. 1), and focus on:

  • Health care systems in low income countries
  • Violence against women

 Speakers

Professor Staffan Bergström, Karolinska Institute. Specialist in Obstetrics and Gynecology.
Staffan Bergström has experiences from several African countries on how to save mothers and newborns in places where there is a shortage of doctors. He points to the importance of health workers without medical training. It is they who are the backbone of health care system in low income countries.

“On the African continent only 5,000 doctors are educated annually. African countries are thus forced use health workers without medical training. They do a tremendous job, without having spent even a day at medical school. Simply training midwives in life saving skills can make a big difference” says Professor Bergström. He has had great influence internationally on the task-shifting debate. The last three years Bergström has worked in Tanzania with “Maternal Health Initiative

Dean Sylvia Kaaya, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, Tanzania.
Silvia Kaaya is professor of psychiatry. Her research interest is children and mental health. Professor Kaaya’s publications trades extensively to detect and treat mental illness and depression in different groups e.g pregnant women, children, youths and how HIV positivity affects mental health. Recently NTNU and MUHAS signed a MoU in research and student exchange.

Professor Charlotte Watts, London School of Hygiene and Tropical Medicine, UK.
In the mid-90s Charlotte Watts did her fieldwork in Zimbabwe. The findings from her study illustrates not only the extent to which violence against women is widespread throughout the world, but also that there is considerable variation in the levels of violence – both within the country as well as between countries. Although the causes of violence are complex, this suggests local variation and that there may be local conditions that affect the extent to which women are subjected to violence. A better understanding of the causes of this variation can be used to identify how to prevent future violence.

Programme and registration

Programme for Global Health Day 2014 (pdf)

The seminar, lunch and pizza are free. Please register for the seminar before 10 October 2014.

Target audience

The target group are persons engaged in research, teaching or clinical activities targeted towards developing countries as well as students in health sciences or medicine.

About the seminar

Global health research embodies research on health problems related to challenges that particularly affect people in low- and middle income countries. The Faculty of Medicine, NTNU, has increased its investment in global health, in close cooperation with St. Olavs University Hospital, Sør-Trøndelag University College (HiST), as well as partner institutions in low- and middle income countries. The seminar aims to increase cooperation, networking and further research activity while providing professional input and inspiration. The Research Council of Norway has given financial support to this seminar.

If you have any questions about the seminar, please contact Elin Yli Dvergsdal

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30 years of research on small-for-gestational-age and very-low-birth-weight children

boy reachingThirty years ago, the first research project on Small-for-gestation-age (SGA)was started at the Department of Public Health and General Practice at NTNU in Trondheim. At the same time, a separate Very-low-birth-weight (VLBW) children study was organized at the Department of Laboratory Medicine, Women’s and Children’s Health, NTNU.

As for the SGA study, a contract worth $ 686,000 that took effect on June 1, 1984 was the first of its kind between the Faculty of Medicine and an external funding agency. On behalf of the National Institute of Child Health and Human Development (NICHD) and in cooperation with Uppsala University and the University of Bergen, the faculty planned, organized and conducted a detailed study of mothers through pregnancy and at birth. A follow-up of selected children during their first year of life (1986-89) and again at 5 years of age (1991-94) was later funded by a second contract ($ 618,000).

A vast amount of data are now available from pregnancy and delivery, at birth and through the first to five years of life which can be analysed longitudinally and/or cross sectionally. In addition to clinical and other information regarding development, health, behaviour, aptitudes and skills an overwhelming amount of serum samples are stored in a modernised biobank. Serum samples were collected longitudinally throughout pregnancy and at birth and are available for research purposes. The study is still in progress with new results from later follow-up studies of the mothers and their offspring.

The VLBW study is chaired by  Professors Ann-Mari Brubakk and Jon Skranes, who have amongst others, followed up around 230 of the Scandinavian SGA study in Trondheim at 14-15 at 19-20 years of age. Comprehensive clinical data have been collected in addition to information about physical development, behaviour, mental qualities, aptitudes, education, and psychiatric disorders and symptoms. A cerebral MRI scan has been conducted on both occasions. An interdependent and interdisciplinary cooperation has been established between the SGA and VLBW studies. The young adults are currently being followed up at age 26 years

An international seminar will now be held to mark the first 30 Years of the NICHD Scandinavian Successive Small for Gestational Age (SGA) Births Study.
The seminar will span Monday 16 June and Tuesday 17 June 2014, is sponsored by the Faculty of Medicine, NTNU and organized by the Department of Public Health and General Practice.
Professor Geir W. Jacobsen has since 1998 been the Principal Investigator of the SGA study and will act as host.

The program can be found on http://www.ntnu.no/ism/sgaseminar
More information on the SGA studies can be found on http://www.ntnu.no/ism/forskning/sga

For participation, please contact: Guri.Helmersen@ntnu.no

 

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Prize for PCOS-research

Blogger: Elisabeth DarjElisabeth Darj

 

The Gemzell prize at Uppsala University has this year been awarded to Eszter Vanky, researcher at NTNU.

Eszter Vanky, associate professor at the Department of Laboratory Medicine, Children’s and Women’s Healt, received this honor at Uppsala University 20. march 2014 and gave the prestigious “Gemzell lecture of the year”.

Eszter Vanky was nominated for her research in endocrinology, on women with polycystic ovary syndrome (PCOS) and gave a very and interesting lecture at Uppsala University with the title; “PCOS i blant frustrerende, alltid spennande” (PCOS sometimes frustrating, always interesting) . She described for the audience diagnose, pregnancy complications for PCOS-women and treatment in a pedagogic and inspiring way.

Carl Axel Gemzell was an internationally respected Swedish gynecologist and endocrinologist (1910-2007). Gemzell worked in Sweden and USA and contributed significantly to the treatment with gonadotropins to infertile women. He purified protein hormones from pituitaries and introduced stimulation of the ovaries. This was the beginning of assisted human reproduction. He developed several hormone tests, and one of his students developed the modern pregnancy test.

Eszter Vanky

Eszter Vanky receives prize for her research on PCOS

Skilled international researchers has since 1977 been nominated to the Gemzell prize. Only once before has a Norwegian researcher been awarded the Gemzell prize and held the “Gemzell lecturer of the year”. This was Arne Sunde in 2009, also from NTNU.

Eszter Vanky has previously received Norwegian prizes for her research.

 

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Filed under Metabolic and Endocrine, NTNUmedicine, Reproductive Health and Childbirth, Research

Is pre-eclampsia a risk factor for cerebral palsy

portrettbilde

Kristin Melheim

Medical research student Kristin Melheim and her supervisor Professor of Paediatrics Torstein Vik have examined whether pre-eclampsia is a risk factor for cerebral palsy.
In this short video they explain the study

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Improving antenatal care for pregnant women experiencing domestic violence

Blogger: Jennifer J. Infanti Jennifer Infanti

 

 

 

The Faculty of Medicine at NTNU is delighted to welcome four doctors/researchers from Nepal to Trondheim between January 15th and 17th. The visiting delegates are members of an international collaboration of researchers investigating strategies to improve antenatal care for pregnant women experiencing domestic violence in Nepal and Sri Lanka. This research team is led by Professor Berit Schei of The Department of Public Health and General Practice and funded by the Research Council of Norway under its GLOBVAC programme.

Domestic violence is a profound global health problem.

Visit from Nepal

At the Obstetrics & Gynaecology Department at St. Olavs Hospital. From left to right, the people are: Dr. Rajendra Koju, Dr. Sunil Kumar Joshi, Dr. Chanda Karki, Dr. Meena Thapa. (Photo: Jennifer Infanti)

The guests from Nepal include Dr. Chanda Karki, Professor in the Department of Obstetrics and Gynaecology and Principal (Dean) of Kathmandu Medical College and Teaching Hospital (KMC); Dr. Meena Thapa, Associate Professor of Obstretics and Gynaecology at KMC; Dr. Sunil Kumar Joshi, Associate Professor in the Medical Education Department at KMC; and Dr. Rajendra Koju, medical doctor at Dhulikhel Hospital and Associate Dean of the Kathmandu University School of Medical Sciences.

Domestic violence is a profound global health problem, posing significant risks for the physical, sexual and psychological health and well-being of women and children in particular. Domestic violence crosses all geographic, economic and cultural barriers and borders. Despite the significant risks of domestic violence for poor health, rigorously conducted research on the interventions, services and policies that work best to prevent and respond to domestic violence is limited.

Visit from Nepal

The four guests from Nepal are standing or sitting from left to right as follows: Dr. Sunil Kumar Joshi (standing), Dr. Chanda Karki, Dr. Rajendra Koju, Dr. Meena Thapa. (Photo: Jennifer Infanti).

In addition, addressing such a widespread public health challenge requires cooperative actions and solutions which bridge many sectors of society – for example, governments, non-profit organisations, researchers, and health care. Professor Schei’s project strengthens the formal partnership of NTNU and Kathmandu University to advance such a cross-cultural exchange of skills, knowledge and experiences to tackle domestic violence.

The visiting doctors/researchers from Nepal will have the opportunity to meet with some of Trondheim’s service providers for victims of domestic violence during their stay, including the Sexual Assault Care Centre team at St. Olavs Hospital, staff at the Trondheim Crisis Centre, and victim support officers and investigators at the police station. In addition, they will be sharing their experiences in obstetrics and public health in Nepal at various meetings and seminars at St. Olavs hospital and NTNU.

Visit from Nepal

Dr. Chanda Karki is speaking at the podium. (Photo: Jennifer Infanri)

Importantly for the research project, the visit will allow time to further develop two PhD proposals – the funding from the Norwegian Research Council for this project will allow two students from Nepal to complete PhD degrees at NTNU over the next three years. The doctoral projects aim to develop culturally and contextually sensitive screening tools to identify pregnant women experiencing domestic violence in antenatal care settings in the Kathmandu area of Nepal. In addition, the PhD students will each develop training and education interventions to support health care professionals in their work with victims of domestic violence. The goal of the interventions is to improve the safety of pregnant women by either reducing the recurrence of abuse or mitigating its impact and consequences.

Professor Schei’s study aligns with the strategic efforts of the Faculty of Medicine at NTNU and St. Olavs Hospital to build competency in the field of global health. The Faculty will benefit from the skills and knowledge of health care practitioners from other countries. With Norway’s population becoming increasingly multicultural, this will help us prepare for patients coming to the hospitals from diverse cultural and ethnic backgrounds, contributing to a more culturally responsive health care system.

 

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Global health in Trondheim

Blogger: Elisabeth DarjElisabeth Darj

 

 

 

On the first of September I started my work as the first professor in Global Health at NTNU and I have now been asked to present myself. I’m most honored to have this job opportunity and it has been two intense, interesting and exciting months. My office is at Department of Public Health and General Practice.

I am a Swedish obstetrician and gynecologist and have been working clinically for many years. Simultaneously I have always been engaged in education and research. While employed at Uppsala University in Sweden I have taught medical students, midwives, nurses and biomedical assistants among others.

My research profile is in obstetrics and gynecology, but for more than ten years I have focused on reproductive health in low income countries, mainly in East-Africa, where I have supervised PhD and Master’s students. I have conducted research in women’s health from different angles: maternal health and mortality, support in the post-partum period, abortions, violence against women and children, adolescents’ reproductive health, infectious diseases, such as STI/HIV and health systems. I am now involved in a project at NTNU on violence against women in Nepal and Sri Lanka, and have applied for funds for other projects with others.

Mother and child participating in a research project  in rural Tanzania. (Photo: Elisabeth Darj)

Mother and child in Tanzania

Global health is defined as health issues that transcend national boundaries and call for research and actions to improve health for all, irrespective of where we live. “Collaborative international research and action for promoting health for all”. As health is influenced by politics, society, culture and the environment, solutions to health problems not only reside within health systems, but also elsewhere. I have already met a lot of people in Trondheim with strong interests in global health who are engaged in different research projects in various faculties. In the medical faculty there are well-established cooperations and projects in Nepal, Sierra Leone, Malawi and South-Africa. I recently lectured to a large group of medical students and almost all of them had been travelling outside Europe. They showed knowledge and great interest in global health and in solutions to challenging issues. So I think it is timely that the medical faculty has now decided that Global Health shall be included in all education.A new two-year international Master’s program in global health will be developed, which is exciting and challenging, and I’m sure it will benefit research and education.

Furthermore, we wish to increase collaboration with other faculties, institutions, HiST and other actors. At the moment, we are updating the global health program that already exists for medical students. Two weeks ago there was the annual Global Health Day, held for the fourth year, and showing a growing interest in the topic with, now almost 200 participants. There were many stimulating presentations during the day, focusing on two main themes; our technological and educational possibilities from Norway to influence the health situations in low-and middle income countries, and opportunities to meet other researchers and teachers.

NTNU’s vision «Knowledge for a better world» and the medical faculty’s vision «Health for a better world» is comprehensive and relevant to the global world we live in, in Trondheim and elsewhere. Last but not least, I would like to thank all for the warm reception I have received in my new inspiring job.

 

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Can computer games help memory skills?

Blogger: Kristine Hermansen GrunewaldtKristine-Hermansen-Grunewal

Preterm children often have a reduced working memory capacity, which makes it more difficult to learn new things and overcome everyday challenges. But what if playin gcomputer games could improve their working memory?

Our research group at NTNU and St. Olavs Hospital decided to explore whether a computer-based training programme could help a group of severely premature nursery school children with a birth weight of below 1500 grams with their memory and even other cognitive skills.

dataspill1

Computer games improved children’s working memory. (Photo:  Screen dump Cogmed©)

After 5 weeks of training, the children achieved better results on tests focusing on their working memory. They also got better scores for other cognitive skills that are essential for their ability to learn, memorise and pay attention at school.

After 5 weeks of training, the children achieved better results on tests focusing on their working memory.

Premature children are more likely to develop neurological disorders than children born at term. Moreover, they often have reduced concentration skills and working memory capacity compared to children born on or after their due date.

These are all skills we need to be able to learn, plan and solve problems in everyday life. Problems with these skills can therefore have serious consequences fo the child, both socially and in terms of learning disorders and accomplishments at school, which in turn can have negative consequences that last well into adulthood.

Recent studies show that our working memory can be improved through training, and a computer-based training programme developed at Karolinska Institutet in Stockholm has previously shown promising results on children with ADHD and teenagers who were prematurely born with a very low birth weight.

Recent studies show that our working memory can be improved through training.

Our study included 20 preschool children aged 5 to 6 years with a birth weight of below 1500 grams (3.3 pounds). The children used the programme to train at home for 10 to 15 minutes per day, 5 days a week for a total of 5 weeks.

The programme is set up like a computer game where the children visit an amusement park with 7 different rotating exercises (Image 1). The child sees an  image on the computer screen showing a few dots of wool with friendly faces appearing in a specific order (Image 2). Afterwards, the child has to remember the sequences and click on the same dots of wool in the correct order.

dataspill2

Dots of wool with friendly faces enjoy the swimming pool. (Photo: Screen dump Cogmed©)

The programme is designed to increase the difficulty as the child gets better and is able to correctly remember several sequences in a row.

All the children took a series of neuropsychological tests before and after their training. Parents also responded to questions about their children’s adaptive function, anxiety and symptoms of attention disorders, both before and after the training.

After the training, the premature preschool children showed an improvement in results on both prepared and non-prepared working memory tests. They also displayed a clear, positive effect in terms of auditory/phonological attention – which is important for language skills that, in turn, are important in learning and developing reading and maths skills – as well as in visual and verbal memory. 

This appears to show that training the working memory can have an effect on other cognitive functions as well..

Our study was performed on a relatively small number of children, which means that larger studies must be performed before we can give specific recommendations for working memory training in preschool for severely premature children.

Nevertheless, our results are a good indicator that introducing a computer-based working memory programme at preschool age may help preterm children with a birth weight of below 1500 grams. This training can possibly reduce cognitive problems, which could affect future education and working life.

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