Evaluation of Medicine and Health (EVALMEDHELSE) 2023-2024
Gynecology and pediatrics
This group conducts research within gynaecology/obstetrics and paediatrics.
Research group's organization
The thematic research group comprises 15 healthcare workers and researchers from Ålesund Hospital, HMR, dedicated to research in gynecology/obstetrics and pediatrics from 2012 to 2022. Many members hold both clinical and part-time academic positions. Beate Horsberg Eriksen, appointed by the HMR research department, leads the group, balancing roles as a clinical pediatrician, Associate Professor at NTNU, and part of the research and innovation section. Other members include clinical gynecologists/obstetricians, nurses, physicists, and midwives with academic affiliations.
Several members, without a PhD or academic position, actively engage in research, contributing to national studies. The group expects future growth and expansion, involving associated members with clinical positions or starting academic careers. Ongoing projects include a clinical fellow in pediatrics, a gynecologist/obstetrician pursuing a PhD, and members developing future research protocols. The group is actively involved in supervision, including both head and co-supervision, and contributes to medical student education in HMR.
Research group's strategy
During the evaluation period (2012-22), the thematic research group in gynecology/obstetrics and pediatrics aligns with two key strategic documents: the regional "Strategy for Research in Helse Midt-Norge 2016-2020" and the local adaptation "FIUK-plan 2018-2022." The overarching goal is to internally foster competitive research, strengthening clinical practice and patient treatment. The group is committed to the following six strategic focus points:
1) Research culture: Integrate research in the clinic and increase the number of researchers
2) High quality research: Increase the research competence in HMR
3) Establish research groups
4) Research collaboration: locally, regionally, nationally and internationally
5) Increased user participation in research
6) Sufficient financial resources.
Adde L, Brown A, van den Broeck C, DeCoen K, Eriksen BH, Fjørtoft T, et al. In-Motion-App for remote General Movement Assessment: a multi-site observational study. BMJ Open. 2021;11(3):e042147.
Bjellmo S, Andersen GL, Hjelle S, Klungsøyr K, Krebs L, Lydersen S, et al. Does caesarean delivery in the first pregnancy increase the risk for adverse outcome in the second? A registry-based cohort study on first and second singleton births in Norway. BMJ Open. 2020;10(8):e037717.
Bjellmo S, Hjelle S, Krebs L, Magnussen E, Vik T. Adherence to guidelines and suboptimal practice in term breech delivery with perinatal death- a population-based case-control study in Norway. BMC Pregnancy Childbirth. 2019;19(1):330.
de Boode WP, van der Lee R, Horsberg Eriksen B, Nestaas E, Dempsey E, Singh Y, et al. The role of Neonatologist Performed Echocardiography in the assessment and management of neonatal shock. Pediatr Res. 2018;84(Suppl 1):57-67.
Daae AS, Wigen MS, Fadnes S, Løvstakken L, Støylen A. Intraventricular Vector Flow Imaging with Blood Speckle Tracking in Adults: Feasibility, Normal Physiology and Mechanisms in Healthy Volunteers. Ultrasound Med Biol. 2021;47(12):3501-13.
Eika F, Nag T, Jåtun BM, Ytredal H. [A boy in his teens with weight loss, thirst and reduced consciousness]. Tidsskr Nor Laegeforen. 2019;139(5).
Ekelöf K, Sæther E, Santesson A, Wilander M, Patriksson K, Hesselman S, et al. A hybrid type I, multi-center randomized controlled trial to study the implementation of a method for Sustained cord circulation And VEntilation (the SAVE-method) of late preterm and term neonates: a study protocol. BMC Pregnancy Childbirth. 2022;22(1):593.
Grønseth IM, Nag T, Roland PH. [I.M. Grønseth and co-workers respond]. Tidsskr Nor Laegeforen. 2019;139(7).
Grønseth IM, Nag T, Roland PH. [No increase in inhaled corticosteroids in asthma exacerbation]. Tidsskr Nor Laegeforen. 2019;139(4).
Hagen IH, Iversen VC, Nesset E, Orner R, Svindseth MF. Parental satisfaction with neonatal intensive care units: a quantitative cross-sectional study. BMC Health Serv Res. 2019;19(1):37.
Hagen IH, Svindseth MF, Nesset E, Orner R, Iversen VC. Validation of the Neonatal Satisfaction Survey (NSS-8) in six Norwegian neonatal intensive care units: a quantitative cross-sectional study. BMC Health Serv Res. 2018;18(1):222.
Kolnes K, Jåtun BM. [K. Kolnes and B. M. Jåtun respond]. Tidsskr Nor Laegeforen. 2021;141(17).
Kolnes K, Jåtun BM. Zebra lines. Tidsskr Nor Laegeforen. 2021;141(2021-11).
Laine K, Yli BM, Cole V, Schwarz C, Kwee A, Ayres-de-Campos D, et al. European guidelines on perinatal care- Peripartum care Episiotomy. J Matern Fetal Neonatal Med. 2022;35(25):8797-802.
Langhammer A, Crowley S, Humerfelt S, Melbye H, Nag T, Svanes Ø. [Not Available]. Tidsskr Nor Laegeforen. 2018;138(13).
Levy PT, Tissot C, Horsberg Eriksen B, Nestaas E, Rogerson S, McNamara PJ, et al. Application of Neonatologist Performed Echocardiography in the Assessment and Management of Neonatal Heart Failure unrelated to Congenital Heart Disease. Pediatr Res. 2018;84(Suppl 1):78-88.
Mawad W, Løvstakken L, Fadnes S, Grønli T, Segers P, Mertens L, Nyrnes SA. Right Ventricular Flow Dynamics in Dilated Right Ventricles: Energy Loss Estimation Based on Blood Speckle Tracking Echocardiography-A Pilot Study in Children. Ultrasound Med Biol. 2021;47(6):1514-27.
Mynarek M, Bjellmo S, Lydersen S, Afset JE, Andersen GL, Vik T. Incidence of invasive Group B Streptococcal infection and the risk of infant death and cerebral palsy: a Norwegian Cohort Study. Pediatr Res. 2021;89(6):1541-8.
Mynarek M, Bjellmo S, Lydersen S, Afset JE, Andersen GL, Vik T. Correction: Incidence of invasive Group B Streptococcal infection and the risk of infant death and cerebral palsy: a Norwegian Cohort Study. Pediatr Res. 2022;92(2):612.
Mynarek M, Bjellmo S, Lydersen S, Strand KM, Afset JE, Andersen GL, Vik T. Prelabor rupture of membranes and the association with cerebral palsy in term born children: a national registry-based cohort study. BMC Pregnancy Childbirth. 2020;20(1):67.
Nyrnes SA, Fadnes S, Wigen MS, Mertens L, Lovstakken L. Blood Speckle-Tracking Based on High-Frame Rate Ultrasound Imaging in Pediatric Cardiology. J Am Soc Echocardiogr. 2020;33(4):493-503.e5.
Ohnstad MO, Stensvold HJ, Pripp AH, Tvedt CR, Jelsness-Jørgensen LP, Astrup H, et al. Predictors of extubation success: a population-based study of neonates below a gestational age of 26 weeks. BMJ Paediatr Open. 2022;6(1).
Perra O, Rankin J, Platt MJ, Sellier E, Arnaud C, De La Cruz J, et al. Decreasing cerebral palsy prevalence in multiple births in the modern era: a population cohort study of European data. Arch Dis Child Fetal Neonatal Ed. 2021;106(2):125-30.
Schei K, Avershina E, Øien T, Rudi K, Follestad T, Salamati S, Ødegård RA. Correction to: Early gut mycobiota and mother-offspring transfer. Microbiome. 2021;9(1):120.
Schei K, Simpson MR, Avershina E, Rudi K, Øien T, Júlíusson PB, et al. Early Gut Fungal and Bacterial Microbiota and Childhood Growth. Front Pediatr. 2020;8:572538.
Schei K, Simpson MR, Øien T, Salamati S, Rudi K, Ødegård RA. Allergy-related diseases and early gut fungal and bacterial microbiota abundances in children. Clin Transl Allergy. 2021;11(5):e12041.
Stubberud A, Ipsen M, Brevik MS, Nag T, Hjort MA. A boy of early school-age with a painful foot. Tidsskr Nor Laegeforen. 2022;142(8).
Sæther E, Gülpen FR, Jensen C, Myklebust T, Eriksen BH. Neonatal transitional support with intact umbilical cord in assisted vaginal deliveries: a quality-improvement cohort study. BMC Pregnancy Childbirth. 2020;20(1):496.
Thaulow CM, Berild D, Blix HS, Brigtsen AK, Myklebust T, Eriksen BH. Can We Optimize Antibiotic Use in Norwegian Neonates? A Prospective Comparison Between a University Hospital and a District Hospital. Front Pediatr. 2019;7:440.
Thaulow CM, Berild D, Blix HS, Brigtsen AK, Myklebust T, Eriksen BH. Corrigendum: Can We Optimize Antibiotic Use in Norwegian Neonates? A Prospective Comparison Between a University Hospital and a District Hospital. Front Pediatr. 2022;10:862484.
Thaulow CM, Berild D, Eriksen BH, Myklebust T, Blix HS. Potential for More Rational Use of Antibiotics in Hospitalized Children in a Country With Low Resistance: Data From eight Point Prevalence Surveys. Pediatr Infect Dis J. 2019;38(4):384-9.
Thaulow CM, Blix HS, Eriksen BH, Ask I, Myklebust T, Berild D. Using a period incidence survey to compare antibiotic use in children between a university hospital and a district hospital in a country with low antimicrobial resistance: a prospective observational study. BMJ Open. 2019;9(5):e027836.
Thaulow CM, Blix HS, Nilsen RM, Eriksen BH, Wathne JS, Berild D, Harthug S. Antibiotic use in children before, during and after hospitalisation. Pharmacoepidemiol Drug Saf. 2022;31(7):749-57.
Thaulow CM, Harthug S, Nilsen RM, Eriksen BH, Wathne JS, Berild D, Blix HS. Are infants exposed to antimicrobials during the first 3 months of life at increased risk of recurrent use? An explorative data-linkage study. J Antimicrob Chemother. 2022;77(5):1468-75.
Vik T, Redline R, Nelson KB, Bjellmo S, Vogt C, Ng P, et al. The Placenta in Neonatal Encephalopathy: A Case-Control Study. J Pediatr. 2018;202:77-85.e3.
Wigen MS, Fadnes S, Rodriguez-Molares A, Bjastad T, Eriksen M, Stensath KH, et al. 4-D Intracardiac Ultrasound Vector Flow Imaging-Feasibility and Comparison to Phase-Contrast MRI. IEEE Trans Med Imaging. 2018;37(12):2619-29.
Project 1: PhD project Elisabeth Sæther "Extra-Uterine Placental Transfusion to Facilitate Physiology-Based Cord Clamping and Intact-Cord Stabilisation in Caesarean Sections" (The INTACT-study), HMR, NTNU (Klinforsk).
Objectives:
The overall aim of this project is to develop and disseminate knowledge, techniques and logistics needed for a universal provision of intact-cord stabilisation and physiology-based cord clamping during caesarean sections, independent of mobile resuscitation equipment and without compromising safety for mothers and infants.
Planned papers:
Study 1: Extra-uterine placental transfusion to facilitate intact cord stabilisation of term and near-term infants delivered by caesarean section: An intervention development study.
(Submitted Oct. 2023-under peer-review)
Study 2: Extra-uterine placental transfusion to facilitate physiology-based cord clamping for term and moderately preterm infant delivered by caesarean section – A feasibility study with historical control
Study 3: Newborn heart rate during extra uterine placental transfusion and intact-cord stabilisation in caesarean sections measured by dry-electrode ECG
Study Details | Intact-cord Stabilisation and Physiology-based Cord Clamping in Caesarean Sections | ClinicalTrials.gov
Project 2: SIMON-Study, "Stillbirth and Infant Mortality in Norway: A Population-Based Study", HMR/NTNU, Klinforsk.
The overall objective of this study:
- To assess temporal trends, timing, risk factors and aetiology of stillbirth in a complete population-based birth cohort in Norway between 2009 and 2021
- To assess temporal trends of infant mortality in Norway from 2009-2021; and the influence of regional, geographical and socioeconomic factors.
- Investigate causes of death within the first year of life in Norway from 2009 to 2021
Project 3: PhD project: "Potential Harms and Benefits of Planned Caesarean Dilivery of Fetuses in Breech Presentation at Term: An Observational Study from Norway" (2015-2020), Torstein Vik, Solveig Bjellmo.
The main aim of this thesis is to increase the knowledge of acute and late complications in children born vaginally in breech or by caesarean delivery (CD) in a population with low perinatal mortality, and to examine potential complications in subsequent pregnancies after a CD. This aim was addressed in three papers including the following research questions:
Paper I: Do singletons without congenital anomalies born vaginally at term have higher risk for stillbirth, neonatal mortality and cerebral palsy (CP) if they are born in breech than in cephalic presentation?
Paper II: In paper II we addressed three study questions:
1) Was the management of breech deliveries associated with intrapartum or neonatal death more likely to deviate from the Norwegian guidelines for breech delivery compared with control breech deliveries where the infant survived?
2) Was suboptimal clinical management more common in breech deliveries when the offspring died than in deliveries when the offspring survived?
3) Might neonatal death have been prevented had the offspring been delivered by planned CD?
Paper III: Do infants in subsequent pregnancies, following a previous CD, have higher risk for perinatal mortality and CP compared with infants of subsequent pregnancies following a previous vaginal delivery? And are placental complications, uterine rupture, being small for gestational age (SGA) and preterm birth more common in deliveries following a previous CD
In this thesis, data was retrieved from the Medical Birth Registry of Norway (MBRN) and combined with data from the Cerebral Palsy Registry of Norway (CPRN). In addition, in Paper II, a perinatal audit was performed with thorough reviews of medical records from 1999-2015 of the women who lost their child, either intrapartum or in the neonatal period, born at term in breech and without congenital anomalies recorded in the MBRN. These births were compared with control deliveries – children born at term in breech that survived.
In our first study assessing the risk for cerebral palsy in children born in breech at term, the study did not show increased risk for cerebral palsy in children born as singleton in breech compared to children born in cephalic, when congenital anomalies were excluded. However, when we compared singletons born in breech with singletons born in cephalic presentation, we found a small but significantly increased risk of intrapartum or neonatal death. In the perinatal audit, all the in-hospital births were in line with Norwegian guidelines for breech delivery. However, antenatal care and/or management of the deliveries was more often assessed suboptimal in the case group than in the controls.
In our third study assessing the risk for CD in subsequent pregnancy, independent of fetal presentation, the study found a small associated risk of stillbirth, perinatal mortality and cerebral palsy among infants born after the mother had previously had a CD compared with children born after the mother had previously had a vaginal delivery (VD). Mothers with a previous CD had an increased risk of placental complications and uterine rupture, and their fetuses had an increased risk of being small for gestational age (SGA) and being born prematurely.
In Norway, with its very good maternity care and one of the lowest perinatal mortalities in the world, it is important to emphasize that the absolute risk for death intrapartum or in the neonatal period is very low, also when born vaginally in breech. Rising concerns regarding complications in later pregnancies and the future health of children born by planned CD compared with VD must also be weighed against this very low absolute risk of death. Keeping these factors in mind, our studies conclude that vaginal delivery may still be offered to women with a fetus in breech presentation, provided competent obstetric care and strict criteria for selection of vaginal delivery.
Project 4: PhD project Kristian Sørensen "High Fram Rate Echocardiography for Advanced Evaluation of Cardiac Function". NTNU, HMR, St. Olavs Hospital, Hospital for Sick Children in Toronto. Researcher Solveig Fadnes, Professor Siri Ann Nyrnes, PhD Candidate Kristian Sørensen.
Overall objective:
Validation and clinical verification of novel parameters of systolic and diastolic cardiac function based on high frame rate ultrasound. The long-term goal is improved functional assessment of cardiac disease in children through clinical application of these novel parameters.
The project has three main research questions:
1 Validation, feasibility:
Validate blood-speckle tracking-derived intraventricular pressure difference in early diastole. Investigate the feasibility and robustness of high frame rate ultrasound-derived quantitative parameters of left ventricular systolic and diastolic function in children.
2 Advanced evaluation of cardiac function in children:
Describe novel quantitative parameters of left ventricular systolic and diastolic function and diastolic suction in a cohort of healthy children. Investigate transitional functional hemodynamics in healthy newborns.
3 Clinical applications: Investigate the ability to detect and quantitate left ventricular diastolic dysfunction in children with cardiomyopathies and univentricular hearts.
Website UL-gruppa, NTNU: https:/www.ntnu.edu/isb/ultrasound
Project 5: Christian Thaulow PhD project "Antibiotic Use in a Cohort of Norwegian Children and Neonates Before, During and After Hospitalisation" (2016-2022) HMR, University of Bergen.
The overall aim of this project was to develop an understanding of main aspects of antibiotic use pattern in Norwegian hospitalised children and neonates; both during hospitalisation, and before and after hospitalisation. Thereby, we aimed to find focus areas for paediatric antibiotic stewardship and to increase the understanding of the connection between hospital and ambulatory antibiotic consumption
Project 6: Beate Horsberg Eriksen PhD project "Myocardial Function in Infants During Postnatal Transition and with Further Maturation: A Longitudinal Echocardiographic Study in Preterm and Term Infants" (2011-2016), NTNU, HMR.
Three papers published:
Myocardial function in premature infants: a longitudinal observational study.
Eriksen BH, Nestaas E, Hole T, Liestøl K, Støylen A, Fugelseth D.BMJ Open. 2013 Mar 25;3(3):e002441. doi: 10.1136/bmjopen-2012-002441.PMID: 23533215
Myocardial function in premature infants: a longitudinal observational study - PubMed (nih.gov)
Longitudinal assessment of atrioventricular annulus excursion by grey-scale m-mode and colour tissue Doppler imaging in premature infants.
Eriksen BH, Nestaas E, Hole T, Liestøl K, Støylen A, Fugelseth D.Early Hum Dev. 2013 Dec;89(12):977-82. doi: 10.1016/j.earlhumdev.2013.09.006. Epub 2013 Sep 27.PMID: 24080390
Myocardial function in term and preterm infants. Influence of heart size, gestational age and postnatal maturation.
Eriksen BH, Nestaas E, Hole T, Liestøl K, Støylen A, Fugelseth D.Early Hum Dev. 2014 Jul;90(7):359-64. doi: 10.1016/j.earlhumdev.2014.04.010. Epub 2014 Apr 30.PMID: 24794303
Project 7: "The Norwegian Antibiotics for Pneumonia in Children (NAPiC) study" PI Håvard Skjerven Oslo University Hospital, PI Torbjørn Nag, HMR.
Phase IV randomized placebo controlled trial (RCT).
The overall objective of the study is to determine if antibiotic therapy is beneficial in children with pneumonia who do not have a highly suspicious bacterial infection, such as in lobar pneumonia.
Secondary objective is to determine whether antibiotic use influence the microbial flora, including antibiotic resistance, in the airways in the short or medium long term.
Antibiotika ved lungebetennelse hos barn - Oslo universitetssykehus HF (oslo-universitetssykehus.no)
Project 8: "Antibiotics, Microbiology and Immunology in Children with Chronic wet Cough – the AMIC study" Knut Øymar, Stavanger University Hospital, PI Ålesund Torbjørn Nag
Website in Norwegian: Antibiotika, mikrobiologi og immunologi hos barn med kronisk våt hoste - Helse Stavanger HF (helse-stavanger.no)
Project 9: "Airway Project 2 (AP2) - A Prospective Cohort Study on Children's RTI in Central Norway" CAIR-group St. Olavs University Hospital, PI Ålesund Torbjørn Nag
Objective: to secure the clinical research infrastructure to establish a new prospective, observational cohort study in the Central Norway Regional Health Authority (HMN) that includes clinical data from children admitted with RTI and controls. Both our short-term and long-term research aims are highly clinically relevant (specified below). For AP2, the added value includes development and use of the new eHealth system Helseplattformen (HP) in HMN, improved biobanking with more longitudinal samples for virus excretion and translational research, population-based controls, quality of life and lung function assessments.
Luftveisinfeksjoner hos barn - Institutt for klinisk og molekylær medisin - NTNU
Project 10: "In-Motion App for Remote General Movement Assessment" Lars Adde, NTNU, PI in HMR Beate Forsberg Eriksen.
Use of in-Motion App for remote general movement assessment in the Central Norway Regional Health Authority.
NB! The Cristin links redirect to the Norwegian version of the page. In order to read the information in English, click "English" in the upper right corner of the Cristin page.
Members with a doctorate degree
Beate Horsberg Eriksen (Cristin, NTNU)
Solveig Bjellmo (Cristin, NTNU)
Kasper Schei (NTNU)
Solveig Fadnes (Cristin, NTNU)
Inger Hilde Hagen (Cristin, NTNU)
Kristian Lied Wollen (Cristin)
PhD candidates
Kristian Sørensen (Cristin, NTNU)
Elisabeth Sæther (Cristin)
Sophie Bowe (ResearchGate)
Members without a doctorate degree
Torbjørn Nag (Cristin)
Bjørn Magne Jåtun (Cristin)