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Biomedical subjects

C Stoltenberg

Publications and source records attributed to C Stoltenberg.

13 recordsLinked to original sources
PubMed2000

Cesarean section among immigrants in Norway.

OBJECTIVE: We studied prevalences and risk factors for cesarean section among different groups of immigrants from countries outside Western Europe and North America in comparison to ethnic Norwegians. METHODS: The study is population based using data from the Medical Birth Registry of Norway. A total of 553,491 live births during the period 1986-1995 were studied, including 17,891 births to immigrant mothers. RESULTS: The prevalences of cesarean section ranged from 10.1% among women from Vietnam to 25.8% in the group of Filipino origin. The use of abdominal delivery was also high in the groups from Sri Lanka/India (21.3%), Somalia/Eritrea/Ethiopia (20.5%) and Chile/Brazil (24.3%), while the frequency among women from Turkey/Morocco (12.6%) and Pakistan (13.2%) was approximately the same as among ethnic Norwegians (12.4%). Feto-pelvic disproportion, fetal distress and prolonged labor were the most important diagnoses associated with the high prevalences, but the significance of these diagnoses differed among the groups. Other unknown factors come into play, particularly among women from Somalia/Eritrea/Ethiopia and Chile/Brazil. CONCLUSION: There was substantial variation in the use of cesarean section among ethnic groups in Norway. The diagnoses feto-pelvic disproportion, fetal distress and prolonged labor may be confounded by a number of factors including maternal request for cesarean section and difficulties in handling the delivery. Further research is needed to explain the observed differences.

Adult↗
PubMed1999

Consanguinity and recurrence risk of birth defects: a population-based study.

Recurrence risks give insight into the causes of birth defects and are useful in genetic counseling. There are few population-based studies of recurrence of birth defects for subsequent sibs with consanguineous parents. The aim of this study was to estimate and compare the recurrence risk of birth defects for offspring of first cousins and nonconsanguineous parents. The study population consisted of all single births with a previous sib born in Norway between 1967 and 1995. Altogether 660,398 children had nonconsanguineous parents, and 3,583 had parents who were first cousins. For nonconsanguineous parents the risk of a birth defect for the subsequent sib was 15 per 1,000 births (95% confidence interval: 14.5-15.1) if the previous child did not have a birth defect and 33 (95% confidence interval: 30-37) if the previous child had a birth defect. For parents who were first cousins the risk of a birth defect for the subsequent sib was 36 per 1,000 (95% confidence interval: 30-42) if the previous child did not have a birth defect and 68 (95% confidence interval: 33-122) if the previous child had a birth defect. The risk of recurrence of birth defects is higher for subsequent sibs with first-cousin parents than for those with nonconsanguineous parents. This difference indicates the degree to which the increased homozygosity among offspring of consanguineous parents influences the risk of recurrence of birth defects.

Age Factors↗
PubMed1999

Consanguinity and recurrence risk of stillbirth and infant death.

OBJECTIVES: The aim of this study was to estimate the recurrence risk for stillbirth and infant death and compare results for offspring of first-cousin parents with results for offspring of unrelated parents. METHODS: The study population consisted of all single births with a previous sibling born in Norway between 1967 and 1994. Altogether, 629,888 births were to unrelated parents, and 3466 births were to parents who were first cousins. The risk of stillbirth and infant death was estimated for subsequent siblings contingent on parental consanguinity and survival of the previous sibling. RESULTS: For unrelated parents, the risk of early death (stillbirth plus infant death) for the subsequent sibling was 17 of 1000 if the previous child survived and 67 of 1000 if the previous child died before 1 year of age. For parents who were first cousins, the risk of early death for the subsequent sibling was 29 of 1000 if the previous child survived and 116 of 1000 if the previous child died. CONCLUSIONS: The risk of recurrence of stillbirth and infant death is higher for offspring of first-cousin parents compared with offspring of unrelated parents.

Adult↗
PubMed1998

Influence of consanguinity and maternal education on risk of stillbirth and infant death in Norway, 1967-1993.

To analyze the influence of consanguinity and maternal education on stillbirth and infant death for children born in Norway between 1967 and 1993, the authors studied 7,274 children of ethnic Pakistani origin and 1,431,055 children of Norwegian ethnic origin. Of these children, 31.0% of the Pakistani children and 0.1% of the Norwegian children had parents who were first cousins. Consanguinity increased the relative risk of stillbirth (odds ratio (OR) = 1.3, 95% confidence interval (CI) 1.0-1.6) and infant death (OR = 2.4, 95% CI 2.0-3.0), after adjustment for maternal education, maternal age, parity, and year of birth. In 1985-1993, 29% (95% CI 13-45) of stillbirths and infant deaths among the Pakistani group were attributable to consanguinity. In the Norwegian group, 17% (95% CI 13-21) of the deaths were attributable to factors associated with low maternal education, while in the Pakistani group, the corresponding estimate was nonsignificant. The risks of stillbirth and infant death were similar for children with non-consanguineous parents in both populations. This is an important observation considering the differences in socioeconomic status between the two groups. The authors conclude that consanguinity influenced stillbirth and infant death independent of maternal education, and that a large proportion of deaths could be attributed to consanguinity in the Pakistani group due to high frequencies of consanguinity.

Consanguinity↗
PubMed1997

Birth defects and parental consanguinity in Norway.

The study compares frequencies of birth defects between immigrant groups and the rest of the Norwegian population in Norway and estimates the influence of consanguinity and socioeconomic factors on these frequencies. The authors studied all 1.56 million births in Norway from 1967 to 1993. Of these, 7,494 children had two Pakistani parents, 84,688 had one Norwegian and one immigrant parent, and 25,891 had two immigrant parents from countries other than Pakistan. The risk of birth defects relative to the Norwegian group was 0.98 (95% confidence interval 0.92-1.03) in the group with one foreign and one Norwegian parent, 1.39 (95% confidence interval 1.22-1.60) in the group with two Pakistani parents, and 1.04 (95% confidence interval 0.95-1.14) in the group with two parents from other foreign countries; 0.1% of the Norwegian and 30.1% of the Pakistani children had parents who were first cousins. There was no difference in risk between children of nonconsanguineous Pakistani parents and the other groups. The relative risk of birth defects among children whose parents were first cousins was about 2 in all groups. Among the Pakistani, 28% of all birth defects could be attributed to consanguinity. Low paternal educational level was associated with a slightly increased risk in the Norwegian group, while independent effects of parental educational levels were not found in any other groups.

Confidence Intervals↗
PubMed1996

Ethnicity and use of obstetrical analgesia: do Pakistani women receive inadequate pain relief in labour?

OBJECTIVE: To study whether the use of analgesic treatment in labour is influenced by ethnicity. DESIGN: A cross-sectional study of hospital patients. Setting; the two municipal hospitals, Ullevål and Aker, in Oslo, Norway. Subjects; a total of 137 obstetrical patients, 67 Pakistani women and 70 Norwegian women. Main outcome measure; use of analgesics in labour. RESULTS: 30% of the Pakistani and 9% of the Norwegian women received no analgesia in labour. Pethidine injection was the preferred analgesic administered to Pakistani women. Women of Pakistani origin received epidural infusion or nitrous oxide and oxygen gas less frequently than Norwegian women. They also received fewer combinations of other analgesic methods. When adjusted for the mothers' age, parity and duration of delivery, Pakistani origin was the only significant predictor for receiving no analgesia in labour. CONCLUSION: Women of Pakistani origin were more than three times as likely not to receive analgesia in labour as Norwegian women. The health services offered to Pakistani women in labour were different from those offered to Norwegian women. These results indicate that women of Pakistani origin may be offered insufficient obstetrical analgesia, or that Norwegian women received unnecessary pain relief in labour.

Adult↗
PubMed1995

Children with low birth weight and low gestational age in Oslo, Norway: immigration is not the cause of increasing proportions.

STUDY OBJECTIVE: To determine the influence of children born to immigrant mothers on the total proportions of low birth weight and preterm deliveries in Oslo and to explain the increases in the proportions of children with low birth weight and low gestational age since 1980-1982. DESIGN: This was a cross sectional study based on Norwegian Medical Birth Registry data and information on mothers' country of birth from the Central Bureau of Statistics. SETTING: Oslo, Norway 1968-91. POPULATION: All births in Oslo between 1968 and 1991 (n = 146 133). MAIN RESULTS: The observed increased proportion of children with low birth weight and low gestational age born after 1980-82 is not the result of an increased proportion of children born to immigrant women. Caesarean section rates have increased dramatically and the higher proportions of children with low birth weight and gestational age may be explained by this. CONCLUSION: Wide use of caesarean section probably results in more children of low birth weight and low gestational age as an iatrogenic effect. The trend in the proportion of children with low birth weight and low gestational age is not correlated to perinatal mortality after 1982. Using proportions of low birth weight and gestational age as indicators of a nation's child health status may therefore be misleading in countries with high rates of caesarean section.

Asia↗
PubMed1995

Diet and vitamin D status among pregnant Pakistani women in Oslo.

OBJECTIVES: In the present study the diet and the nutritional status of pregnant Pakistani immigrant women have been compared with a group of Norwegian women. DESIGN: A cross-sectional survey of women in the 18th week of pregnancy. SETTING: Women referred to routine ultrasound examination at Aker and Ullevål Hospitals in Norway. SUBJECTS: All (58) healthy women of Pakistani origin referred from October of 1991 to January of 1992 were included, of whom 38 (66%) participated. Forty-five Norwegian women were randomly included in the same period and 38 (84%) of these women participated. RESULTS: The serum levels of 25-hydroxyvitamin D3 were significantly lower in the Pakistanis compared with the Norwegians (median 19 nmol/l vs 55 nmol/l, P < 0.001) and 83% of the Pakistani women had 25-hydroxyvitamin D3 levels below the reference value (< 30 nmol/l). The Pakistanis had higher levels of serum parathyroid hormone (median 2.6 vs 1.6 pmol/l, P < 0.001). The Pakistanis also had a lower dietary intake of vitamin D than that of the Norwegians (median 2.2 vs 3.3 micrograms/day, P < 0.05), and a lower total intake, including supplements (median 2.9 vs 7.0 micrograms/day, P < 0.001). Among the Pakistanis a correlation was found between the dietary intake of margarine, the main source of vitamin D in the diet, and the concentration of 25-hydroxyvitamin D3 in serum, r = 0.48 (P = 0.01). In general, the Pakistanis avoided any direct sunshine exposure, and no relation between outdoor activity and serum level of 25-hydroxyvitamin D3 was found. The Pakistani women had a lower intake of calcium than the Norwegians (median 793 vs 1134 mg/day, P < 0.001). CONCLUSION: This study has shown that Pakistani women living in Oslo are at great risk of developing vitamin D deficiency during pregnancy. The main reasons for this are avoidance of sun exposure, a low dietary intake of vitamin D, and no or little use of supplementation.

Adult↗
PubMedDate not supplied

Complaints and complications in pregnancy: a study of ethnic Norwegian and ethnic Pakistani women in Oslo.

OBJECTIVES: To describe the pattern of complaints and complications in pregnancy among ethnic Norwegian and ethnic Pakistani women in Oslo in order to modify antenatal care services. DESIGN: A cross-sectional study of hospital patients conducted in community hospitals in Oslo, Norway. A total of 137 obstetrical patients, 66 ethnic Pakistani and 71 ethnic Norwegian women were included in the study. Medical complications and subjective reported physical complaints during pregnancy were the main outcome measures. RESULTS: Among the ethnic Pakistani women complications were more common and the risks were higher for gestational diabetes [crude odds ratio (OR) = 5.6, 95% confidence interval (CI) = 1.5-20.5), intrauterine growth retardation (crude OR = 5.0, 95% CI = 1.4-18.8), hyperemesis gravidarum (crude OR = 3.7, 95% CI = 1.1-12.2) and anaemia (crude OR = 10.2, 95% CI = 3.3-31.4). The frequency of congenital malformations (p = 0.048, OR not calculated) were also higher. Among the ethnic Norwegian women the frequency of subjective reported physical complaints were more common and the risks were higher for pelvic girdle pain (crude OR = 0.4, 95% CI = 0.2-0.8) and exhaustion (crude OR = 0.2, 95% CI = 0.04-0.1). Infections such as hepatitis and tuberculosis only occurred in the Pakistani study group. CONCLUSION: This study indicates that health personnel delivering antenatal care to women of Pakistani origin need to be watchful for the following conditions: gestational diabetes, hyperemesis gravidarum, early diagnosis of the type of anaemia, fetal malformations and infections like hepatitis and tuberculosis. In addition, a correct diagnosis of intrauterine growth retardation is important. Among ethnic Norwegian women pelvic girdle pain and exhaustion were common complaints.

Adult↗