ReproEpi - Registrybased reproductive epidemiology
In our work we study the relation between adverse pregnancy complications and long-term morbidity and mortality of the mother and the father, with emphasis on the occurrence of cardiovascular diseases, diabetes, and reproductive related cancers. Unlike most other researchers we study long-term health in relation to an individual's complete reproductive history, utilizing high-quality family structured data from Norwegian Health Registries.
For a long time infant health has been studied in relation to adverse pregnancy complications such as preeclampsia, gestational diabetes, and preterm birth. Such adverse pregnancy complications cause increased infant morbidity and mortality. During the last two decades there has been an increased interest in the association between adverse pregnancy complications and long-term maternal health. Cross-sectional observational studies have shown that mothers with adverse pregnancy complications such as preeclampsia, preterm delivery, or intrauterine growth restriction have increased morbidity and mortality, and die at younger ages. Thus, there is emerging evidence that adverse pregnancy complications may be important predictors – and perhaps even determinants – for maternal development of chronic diseases later in life.
In addition to adverse pregnacy complications we focus on the effects of parity on morbidity and mortality of parents. As shown by Grundy and Kravdal women with no children or only one child have increased long-term mortality compared with women having two or more children. Thus, parity is important itself when studying the long term health women and men.
Our motivation for focusing on future maternal and paternal health is the clear potential for preventing chronic diseases in the long term. For example, women with pregnancy complications such as preeclampsia or placental abruption could be targeted for preventative measures or additional monitoring for the development of cardiovascular disease. We think our work may alter our understanding of long-term consequences of adverse pregnancy complications on health, and may lead to a better understanding of the importance of parity in itself when studying long term survival.
The Medical Birth Registry of Norway
The Medical Birth Registry of Norway comprises data on all births in Norway from 1967 onwards.
The Registry was organized in the wake of the thalidomide catastrophe that caused more than 10 000 cases of limb reduction deformities throughout the world. The particular aim was epidemiological surveillance of birth defects and other perinatal health problems in order to detect, as soon as possible, any future increase in rates. (1)
Through the years, longitudinal research has been given high priority. In particular defining the sibship rather than the single birth as the unit of analysis has been productive. In this research, the clinical high risk group 'grand multi-parity' has turned out to be a misnomer. The high risk, observed in cross sectional studies, is caused by heterogeneity due to the fact that many high parity mothers have lost previous infants and thus carry a high risk. Multiparous mothers with no previous loss carry a very low risk. Sibship studies of sudden infant death syndrome have established a much lower recurrence risk than those observed in previous studies by other groups who were unable, due to lack of data, to employ the sibship method. By using the sibship method, evidence is obtained that environmental factors play an important role in the etiology of birth defects; as expected the recurrence rate is reduced if the mother has a new partner, but even more so if the same couple moves to another municipality. (2)
Research track student
Forskerlinjestudent Thomas Nymo Skogvold <Thomas.Skogvold@student.uib.no>