Neonatology
About 10% of all newborns in Sweden are treated in a neonatal unit. Thanks to modern neonatal intensive care, many severe conditions in newborns can be successfully treated and Sweden has an infant mortality rate which is among the lowest in the world. Many infants treated in the neonatal intensive care unit (NICU) are at high risk of malnutrition – this includes preterm infants, infants undergoing surgery, infants with cardiac malformations or neuromuscular disorders.
We are focusing on research related to nutrition in preterm infants, aiming to find interventions to improve the long term health of this high-risk group of patients. Furthermore, we have developed an advanced software tool, Nutrium, which has been shown to improve nutrition and growth of preterms in the NICU.
More than 1000 very preterm infants (< 32 weeks) are born every year in Sweden. They are at high risk of neurodevelopmental disabilities and mental illness throughout the lifespan.
A pilot study looking at neurofilament light as a biomarker of brain damage in term newborns with birth asphyxia launched in early 2021 and showed promising results. In January 2024 the follow-up study launched in collaboration with Uppsala and Gothenburg with the aim of testing whether NFL can be a clinically useful prognostic biomarker for long-term neurodevelopmental outcomes.
DROPROP is a randomized intervention, multi-center study to determine the effect of Dexamethasone eye drops against proliferative retinopathy of prematurity (ROP).
The Probiotics in Extreme Prematurity in Scandinavia (PEPS) trial started in 2023 and is an ongoing study in Sweden and Denmark. The study enrolls extremely premature infants born before 28 weeks’ gestational age and investigates whether probiotic supplementation reduces the risk of developing necrotizing enterocolitis (NEC) and neonatal mortality. Other important short- and long-term health outcomes will also be investigated over the duration of the study.
Using a multi-professional approach, we have developed a post-discharge “Intervention for Neurodevelopmental Support in Preterm Infants using Responsive parenting and E-health” (INSPIRE) aimed at improving neurodevelopment (cognitive, motor, feeding, language, socio-emotional) of very preterm infants by supporting responsive parenting behaviours. Parents of very preterm infants will be included in the program at hospital discharge and will receive the intervention in 16 sessions over a two-year period. A pilot study to evaluate efficiency has finished recruiting and a randomized clinical trial (n=176) started in autumn 2024. Families will be randomized to the INSPIRE program or standard care. Follow-up and assessment of children (and parents) across a range of crucial domains will be performed up to at least 2 years of age. The primary outcome is neurodevelopment at 2 years of age assessed using the Bayley Scales of Infant Development (BSID IV). The project will be the first in the world to use a digital e-health solution with video interaction to deliver a post-discharge parental support intervention to parents of very preterm infants, and will have great impact on future post discharge care for these vulnerable infants and families.
N4 Perinatology
The COPE study is a is a Swedish multicentre study aiming to increase understanding of how COVID-19 infection during pregnancy affects the mother, the birth, and the newborn baby. The goal is also to gain increased knowledge of how pregnant women and their partners experience expecting a baby and becoming parents during a pandemic. Increased knowledge of these factors will help maternal health clinics and obstetric clinics give better information, recommendations, and support to pregnant women and their partners during a pandemic. It will also contribute to greater monitoring, treatment, and follow-up in case of COVID-19 infection during pregnancy.
The OPTION study aims to investigate pregnant mothers, partners, midwifes and obstetricians experience of home induction including health related and economic aspects for both mother and child of home induction. This is a multicentre collaboration in Sweden, where most of the hospitals with a delivery ward participate.
The SUstained Cord Circulation at Emergency Cesarean Section (SUCCECS) multicenter study with a stepped wedge randomized cluster design will include 12 centers in five groups. Based on a large series of successful studies on delayed cord clamping the study aims to evaluate a new approach to resuscitation of non-breathing neonates born by Cesarean section. The hypothesis is that by keeping the cord circulation intact during resuscitation, the neonate will benefit from a larger circulatory volume, increased number of stem cells, red blood cells and oxygenation from the placenta
N4 Preterm
Preterm infants are at high risk of malnutrition, even in modern neonatal intensive care units. Very low birth weight infants (< 1500 g) are at high risk of general malnutrition (protein, energy, micronutrients). Late preterm infants and term infants with marginally low birth weight (2000-2500 g) have high risk of iron deficiency. Our research on preterm infants has resulted in improved clinical care.