Self-reported dyspareunia and outcome satisfaction after spontaneous second-degree tear compared to episiotomy: A register-based cohort study.

Introduction: Symptoms after second-degree tears and in particular episiotomies are common. Our aim was to investigate the prevalence and degree of dyspareunia and level of satisfaction with the outcome of the perineal repair after a spontaneous second-degree tear compared to an episiotomy. Further, we aimed to identify risk factors for dyspareunia and dissatisfaction with the outcome.

The association between pre-eclampsia and neonatal complications in relation to gestational age.

Aim: There has been limited research about the associations between pre-eclampsia and neonatal complications in relation to gestational age. This register-based study aimed to address that gap in our knowledge.

Methods: We used Swedish Medical Birth Register to carry out a population-based study on primiparas with singleton pregnancies from 1999 to 2017.

Neonatal outcomes of elective labor induction in low-risk term pregnancies.

The rate of labor induction has increased in recent years. The results of previously conducted studies examining associations between elective induction of labor (IOL) and neonatal outcomes have been contradictory. The aim of this study was to examine the intrinsic neonatal risks following IOL.

Freebirth, the only option for women who do not fit into common practice- A Swedish national interview study.

Objective: To explore women's experience of freebirth, as giving birth without the presence of a skilled healthcare professional such as a midwife.

Methods: Online semi-structured interviews with nine multiparous women in Sweden. A qualitative experiential approach, as described by Burnard, was followed for data analysis.

Long-term neurological morbidity among children delivered by vacuum extraction - a national cohort study.

Introduction: This is the first nationwide cohort study of vacuum extraction (VE) and long-term neurological morbidity. We hypothesized that VE per se, and not only complicated labor, can cause intracranial bleedings, which could further cause neurological long-term morbidity. The aim of this study was to investigate the risk of neonatal mortality, cerebral palsy (CP), and epilepsy among children delivered by VE in a long-term perspective.

Economic Evaluation of Elective Cesarean Section on Maternal Request Compared With Planned Vaginal Birth-Application to Swedish Setting Using National Registry Data.

Objectives: There is a lack of consensus around the definition of delivery by cesarean section (CS) on maternal request, and clinical practice varies across and within countries. Previous economic evaluations have focused on specific populations and selected complications. Our aim was to evaluate the cost-effectiveness of CS on maternal request compared with planned vaginal birth in a Swedish context, based on a systematic review of benefits and drawbacks and national registry data on costs.

Pregnancy, delivery, and neonatal outcomes among women with spinal cord injury in Sweden 1997-2015: A population-based cohort study.

Introduction: The aim of this study was to describe the rate of pregnancy in spinal cord injured women in Sweden as well as pregnancy, delivery, and neonatal outcomes.

Material And Methods: This study was based on data from the Swedish Medical Birth Register and the National Patient Register. The study population included women with spinal cord injury who gave birth in Sweden during the period 1997 to 2015.

Swedish guidelines for type 1 diabetes and pregnancy outcomes: A nationwide descriptive study of consensus and adherence.

Aims: Type 1 diabetes (DM1) during pregnancy and labor is associated with an increased risk of maternal and fetal complications. Evidence-based care is therefore provided in accordance with guidelines. In this study, we aimed to compare all the Swedish guidelines for DM1 during pregnancy and labor in terms of the variables emphasized in the national guidelines from the US and from England and Wales.

Paternal violent criminality and preterm birth: a Swedish national cohort study.

Background: Fathers may affect expectant mothers' daily living situations, which in turn might influence pregnancy outcomes. We investigated the association between paternal violent criminality and risk of preterm birth (≤36 weeks).

Methods: We conducted a register-based study with all live singleton births in the Swedish Medical Birth Register from 1992 to 2012, linked with records of paternal violent crime convictions from the National Crime Register from 1973 to 2012.

Rates of Extreme Neonatal Hyperbilirubinemia and Kernicterus in Children and Adherence to National Guidelines for Screening, Diagnosis, and Treatment in Sweden.

Importance: Neonatal hyperbilirubinemia can cause lifelong neurodevelopmental impairment (kernicterus) even in high-resource settings. A better understanding of the incidence and processes leading to kernicterus may help in the design of preventive measures.

Objectives: To determine incidence rates of hazardous hyperbilirubinemia and kernicterus among near-term to term newborns and to evaluate health care professional adherence to best practices.

Protracted vacuum extraction and neonatal intracranial hemorrhage among infants born at term: a nationwide case-control study.

Introduction: The association between vacuum extraction and intracranial hemorrhage has been debated. We sought to investigate the impact of protracted vacuum extraction on the risk for neonatal intracranial hemorrhage in term infants.

Material And Methods: This nationwide case-control study covered Swedish maternity wards from 1999 to 2013.

Risk of obstetric anal sphincter injury increases with maternal age irrespective of parity: a population-based register study.

Background: Obstetric anal sphincter injury (OASI) is a rare but serious outcome of vaginal birth. Based on concerns about the increasing number of women who commence childbearing later than previous generation, this study aimed at investigating age-related risk of OASI in women of different parity.

Methods: A population-based register study including 959,559 live singleton vaginal births recorded in the Swedish Medical Birth Register 1999 to 2011.

Vaginal breech delivery at term and neonatal morbidity and mortality - a population-based cohort study in Sweden.

Introduction: The routine to deliver almost all term breech cases by elective cesarean section (CS) has continued to be debated due to the risk of maternal and neonatal complications. The aims of the study were (1) to investigate if mode of delivery impacts on the risk of morbidity and mortality among term infants in breech presentation and (2) to compare the rates of severe neonatal complications and mortality in relation to presentation and mode of delivery.

Methods: This population-based cohort study used data from the Swedish Medical Birth Register.

Neonatal complications among 596 infants delivered by vacuum extraction (in relation to characteristics of the extraction).

Objective: To investigate the association between complicated vacuum extraction (VE) deliveries and neonatal complications.

Methods: Observational study including data on the management of 596 consecutive VE-deliveries at 6 different birth clinics in Sweden in 2013. We used logistic regression to examine the association between a complicated VE and: extracranial bleeding, severe neonatal complication (intracranial hemorrhage and/or asphyxia/low Apgar score and/or convulsions, and/or encephalopathy), and brachial plexus injury.

Risk of labor dystocia increases with maternal age irrespective of parity: a population-based register study.

Introduction: Advanced maternal age is associated with labor dystocia (LD) in nulliparous women. This study investigates the age-related risk of LD in first, second and third births.

Material And Methods: All live singleton cephalic births at term (≥ 37 gestational weeks) recorded in the Swedish Medical Birth Register from 1999 to 2011, except elective cesarean sections and fourth births and more, in total 998 675 pregnancies, were included in the study.

Vacuum extraction in fetal macrosomia and risk of neonatal complications: a population-based cohort study.

Introduction: High birthweight is associated with complicated childbirth. The aim of the present study was to investigate the association between birthweight, mode of delivery, and neonatal complications among infants born at term with a birthweight ≥3000 g.

Material And Methods: This population-based cohort study used data from the Swedish Medical Birth Register from 1999 to 2012, including 1 030 775 births at >36 completed weeks.

Obstetric management in vacuum-extraction deliveries.

Objective: The aim of this observational study was to describe the obstetric management in vacuum extraction (VE) deliveries and to compare these findings to instructions in clinical guidelines on VE.

Methods: In 2013, detailed data on management of 600 VE cases were consecutively collected from six different delivery units in Sweden. Each unit also contributed their own clinical VE guideline.

Fathers' experiences of a vacuum extraction delivery - a qualitative study.

Objective: To explore fathers' experiences of a birth by vacuum extraction (VE).

Method: A qualitative interview study with 10 fathers analysed with qualitative content analysis.

Findings: The theme 'affected but helpless' refers to the father's role changing when childbirth terminates with a VE.

Risk factors for anal sphincter tears in vacuum-assisted delivery.

Objective: The aim of the present study was to describe the prevalence of anal sphincter tears (AST) in relation to obstetric management and technique during vacuum extraction deliveries (VE) (re: indications, the station of the fetal head at application of the cup, number of tractions, the length for the extraction, cup detachments, pain relief, episiotomy, fetal presentation, and experience of the operator) as well as maternal and infant anthropometrics.

Methods: Descriptive study. Data on six hundred vacuum extraction deliveries were consecutively collected from six different delivery units in Sweden.

Induced Labor in Sweden, 1999-2012: A Population-Based Cohort Study.

Background: Previous studies show contradictory results about the impact of induced labor on the cesarean delivery rate and few studies have investigated the risk of vacuum extraction subsequent to induced labor. The aims of the present study were to describe the rate of induced labor in Sweden from 1999 to 2012, and to assess the risk of unplanned cesarean delivery and vacuum extraction after induced labor in relation to medical complications and length of gestation.

Methods: A register-based cohort study was conducted, including 1,078,536 women with spontaneous or induced onset of labor who gave birth by noninstrumental vaginal delivery, unplanned cesarean delivery, or vacuum extraction in gestational week 37 + 0 to 41 + 6.

Predicting Nonhemolytic Neonatal Hyperbilirubinemia.

Background: Before hospital discharge, newborn infants should be assessed for the risk of excessive hyperbilirubinemia. We determined maternal and obstetric risk factors for hyperbilirubinemia in infants born at term (gestational age ≥37 weeks) to form an individualized risk assessment tool for clinical use.

Methods: This was a population-based study with data from the Swedish Medical Birth Register from 1999 to 2012, including 1,261,948 singleton infants.

Risk factors for failed vacuum extraction and associated complications in term newborn infants: a population-based cohort study.

Objective: The aims of the present study were to investigate risk factors for failed vacuum extraction (VE), and to compare neonatal complications among infants delivered by failed VE with those delivered by successful VE.

Methods: Population-based study including all women (and their newborn infants) with singleton pregnancy who gave birth at term by failed VE (n = 4747) or successful VE (n = 83 671) in Sweden between 1999 and 2010. Failed VE was defined as VE followed by an emergency cesarean section (ECS), forceps, or both forceps and ECS.

Low Apgar score, neonatal encephalopathy and epidural analgesia during labour: a Swedish registry-based study.

Background: Maternal intrapartum fever (MF) is associated with neonatal sequelae, and women in labour who receive epidural analgesia (EA) are more likely to develop hyperthermia. The aims of this study were to investigate if EA and/or a diagnosis of MF were associated to adverse neonatal outcomes at a population level.

Methods: Population-based register study with data from the Swedish Birth Register and the Swedish National Patient Register, including all nulliparae (n=294,329) with singleton pregnancies who gave birth at term in Sweden 1999-2008.

Preterm birth by vacuum extraction and neonatal outcome: a population-based cohort study.

Background: Very few studies have investigated the neonatal outcomes after vacuum extraction delivery (VE) in the preterm period and the results of these studies are inconclusive. The objective of this study was to describe the use of VE for preterm delivery in Sweden and to compare rates of neonatal complications after preterm delivery by VE to those found after cesarean section during labor (CS) or unassisted vaginal delivery (VD).

Methods: Data was obtained from Swedish national registers.