Pediatric and respiratory epidemiology – Catarina Almqvist Malmros' research group

We study causes, consequences and comorbidities for asthma and other diseases in childhood and adolescence. We combine national health data with experimental and clinical data, use advanced family and twin design, and have large national and international collaborations.

Photo of the members in Catarina Almqvist Malmros' research group

Our pediatric and respiratory epidemiology research group is multidisciplinary and members contribute with expertise in pediatrics, epidemiology, physiology, psychology, molecular genetics, biostatistics, public health and clinical trials. We have up-to date population-based health linkages, clinical cohorts, genetic data and infrastructure in place. We also have several international and national collaborators in academia and with the health care and authorities. 

Appeasing the wheezing

The overall purpose of our ongoing research project Appeasing the wheezing is to understand causes and consequences of respiratory and allergic disorders and its comorbidity to neuropsychiatric, affective, autoimmune and other inflammatory disorders, as well as how genetic and early environmental factors contribute to the associations.

This will be accomplished by combining the national health-, sociodemographic- and quality registers with questionnaire data and biomarkers in the Swedish Twin Registry using novel analytical methods and innovative study designs. More information can be found on our ongoing study page here

The twin study STOPPA

In the Swedish Twin study On Perinatal characteristics to Prevent Asthma, STOPPA, we study environmental and genetic factors as determinants for asthmatic disease.

Based on parental interview at 9 or 12 years in the Child and Adolescent Twin Study in Sweden (CATSS), we identified monozygotic (MZ) and dizygotic (DZ) same-sexed twin pairs with and without asthma. A cohort of 752 (376 twin pairs) 9- to 14-year-old twins and their parents were invited to participate in a clinical examination. More information on the STOPPA study can be found here

Born into Life

The purpose of Born into Life is to investigate how conditions before pregnancy, during fetal life and the first years of life affect growth and health later in life. By collecting information about genetic predispositions, environmental exposures and lifestyles, unique opportunities are provided to shed light on risk factors for diseases as a basis for preventive measures. 

The study participants in the Pregnancy Study were recruited from participants in the LifeGene study who became pregnant. The women were examined on two occasions during pregnancy (questionnaires, saliva, blood and stool samples) and in connection with childbirth. Their children were then recruited into the Birth Cohort, and examined (questionnaires, height and weight, blood sampling, stool and saliva) at 6, 12 and 24 months of age and at 5-6 years of follow-up when lung function testing was also performed. More information on Born into Life can be found here

MAESTRO and MAESTRO-CHILD

In the Maternal Asthma Events, STRess and Offspring, MAESTRO study, we are interested to understand the factors related to the health of mothers with and without asthma during their pregnancy, delivery and in the postpartum period.

In total 1693 women were recruited the MAESTRO-study in the years 2013-2019. Questionnaires and saliva samples were collected from the women in early pregnancy (pregnancy week 8-12), towards the end of the pregnancy (pregnancy week 28-32) and 6 months after delivery.  Data was collected from the women’s medical notes and the sonography results from the antenatal/midwife clinic and from delivery. We also measured lung function using spirometry in 250 study participants during and after their pregnancy. 

In the MAESTRO-CHILD study we are following up the children born to the mothers who participated in the MAESTRO study. More information on the MAESTRO and MAESTRO-CHILD studies can be found here.

MANTRA - Internet-delivered cognitive behaviour therapy for asthma-related anxiety

In the MANTRA studies, we investigate whether cognitive behavioral therapy (CBT) can be helpful in reducing anxiety and everyday obstacles related to asthma. The goal is to develop an effective internet-mediated CBT (Internet-CBT) that can give many people with asthma and anxiety access to good treatment. 

Recruitment is ongoing, more information (in Swedish) can be found here.

Publications

Selected publications

Funding

Funders

  • Treatment of rhinoconjunctivitis with allergen immunotherapy in children and adolescents - long-term effects, asthma onset and compliance
    Region Stockholm, ALF
  • Asthma in children, pregnant women and adults; anxiety, socio-economy and familial factors – and internet-based treatment
    The Swedish Heart Lung Foundation
  • Food Allergies and Stress in Parents and Children – Heredity and Environment
    Swedish Asthma and Allergy Association

Members and contact

Group leader

All members of the group

Visiting address

Nobels väg 12A; Stockholm, 17177

Appeasing the wheezing

This will be accomplished by combining questionnaire data and biomarkers in the Swedish Twin Registry with the national health-, sociodemographic- and quality registers using novel analytical methods and innovative study designs.

Project leader

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Catarina Almqvist Malmros

Professor/Senior Physician

Co-investigators

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Samuel Arthur Rhedin

Postdoctoral Studies
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Awad Smew

Affiliated to Research

Doctoral students

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Giulia Dallagiacoma

Affiliated to Research;Phd Student
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Hanna Karim

Phd Student

We also have strong collaborations with several researchers at KI, nationally and internationally and contribute with data towards a number of consortia such as the SHARE, PACE and HEALS. More information can be found at the principal investigator KI profile page

Collaborations: Finregistry and RSV Gold

If you have a project proposal or would like to collaborate, please contact Catarina Almqvist Malmros

Grants: Vetenskapsrådet, Hjärt-lungfonden, Astma- och Allergiförbundet, Åke Wiberg, Stiftelsen Samariten, Sällskapet Barnavård, KI Fonder, Region Stockholm and KID funding.

Media

Publications

Risk factors for multisystem inflammatory syndrome in children - A population-based cohort study of over 2 million children.
Rhedin S, Lundholm C, Horne A, Smew AI, Osvald EC, Haddadi A, Alfvén T, Kahn R, Król P, , Brew BH, Almqvist C
Lancet Reg Health Eur 2022 Aug;19():100443

Association of maternal snuff use and smoking with Sudden Infant Death Syndrome: a national register study.
Gunnerbeck A, Lundholm C, Rhedin S, Mitha A, Chen R, D'Onofrio BM, Almqvist C
Pediatr Res 2023 Aug;94(2):811-819

Mode of delivery and offspring atopic dermatitis in a Swedish nationwide study.
Mubanga M, Lundholm C, Rohlin ES, Rejnö G, Brew BK, Almqvist C
Pediatr Allergy Immunol 2023 Jan;34(1):e13904

Maternal depression or anxiety during pregnancy and offspring type 1 diabetes: a population-based family-design cohort study.
Smew AI, Lundholm C, Gong T, Sävendahl L, Lichtenstein P, Brew BK, Almqvist C
BMJ Open Diabetes Res Care 2023 Apr;11(2):

Maternal body mass index in pregnancy and offspring asthma and food allergy.
Mubanga M, Brew BH, Karim H, Curman P, Hedman A, Lundholm C, Almqvist C
Allergy 2023 Sep;78(9):2556-2558

Risk factors for severe respiratory syncytial virus infection during the first year of life: development and validation of a clinical prediction model.
Vartiainen P, Jukarainen S, Rhedin SA, Prinz A, Hartonen T, Vabalas A, Viippola E, Rodosthenous RS, Koskelainen S, Liu A, Lundholm C, Smew AI, Osvald EC, Helle E, Perola M, Almqvist C, Heinonen S, Ganna A
Lancet Digit Health 2023 Nov;5(11):e821-e830

Maternal mental health disorders and offspring asthma and allergic diseases: The role of child mental health.
Brew BK, Gong T, Ohlin E, Hedman AM, Larsson H, Curman P, Lundholm C, Almqvist C
Pediatr Allergy Immunol 2024 Feb;35(2):e14085

Comorbidity Between Inflammatory Bowel Disease and Asthma and Allergic Diseases: A Genetically Informed Study.
Gong T, Brew BK, Lundholm C, Smew AI, Harder A, Kuja-Halkola R, Ludvigsson JF, Lu Y, Almqvist C
Inflamm Bowel Dis 2024 Feb;():

Born into Life

Born into life is a longitudinal study before, during and in the first years of life. 

Background

The study participants in the Pregnancy Study were recruited from participants in the LifeGene study who became pregnant. The women were examined on two occasions during pregnancy (questionnaires, saliva, blood and stool samples) and in connection with childbirth. Some of the study participants in the Pregnancy Study also had partners who participated in the LifeGene study. Their children were then recruited into the Birth Cohort, and examined (questionnaires, height and weight, blood sampling, stool and saliva) at 6, 12 and 24 months of age and at 5-6 years of follow-up when lung function testing was also performed. Please read our cohort description of Born-into-Life and see flowchart below on occasions and biosamples collected.

We have now examined 107 women and their children with repeated measurements before, during and after pregnancy. We have also completed the data collection for the 5-6 year follow-up, and data is processed and samples are analyzed.

Why research related to pregnancy?

We know that conditions before, during fetal life and in the first years of life affect growth, ill health and diseases later in life. Previous research studies have shown that factors in both heredity and the environment are involved in the reason why some children and young people develop, for example, asthma and allergies. However, it is still not clear how these factors interact at an early stage.

Collaboration

We welcome researchers to new and innovative collaborations on research issues using data from the Born-into-Life cohort.

Flowchart of the study

Contact

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Catarina Almqvist Malmros

Professor/Senior Physician
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Anna Hedman

Senior Research Specialist;Lecturer

Publications

Biological age is increased by stress and restored upon recovery.
Poganik JR, Zhang B, Baht GS, Tyshkovskiy A, Deik A, Kerepesi C, Yim SH, Lu AT, Haghani A, Gong T, Hedman AM, Andolf E, Pershagen G, Almqvist C, Clish CB, Horvath S, White JP, Gladyshev VN
Cell Metab 2023 May;35(5):807-820.e5

Ambient air pollution and inflammation-related proteins during early childhood.
He S, Klevebro S, Baldanzi G, Pershagen G, Lundberg B, Eneroth K, Hedman AM, Andolf E, Almqvist C, Bottai M, Melén E, Gruzieva O
Environ Res 2022 Dec;215(Pt 2):114364

Development of gut microbiota during the first 2 years of life.
Wernroth ML, Peura S, Hedman AM, Hetty S, Vicenzi S, Kennedy B, Fall K, Svennblad B, Andolf E, Pershagen G, Theorell-Haglöw J, Nguyen D, Sayols-Baixeras S, Dekkers KF, Bertilsson S, Almqvist C, Dicksved J, Fall T
Sci Rep 2022 May;12(1):9080

Association of Maternal DNA Methylation and Offspring Birthweight.
Kheirkhah Rahimabad P, Arshad SH, Holloway JW, Mukherjee N, Hedman A, Gruzieva O, Andolf E, Kere J, Pershagen G, Almqvist C, Jiang Y, Chen S, Karmaus W
Reprod Sci 2021 Jan;28(1):218-227

DNA methylation differences at birth after conception through ART.
Tobi EW, Almqvist C, Hedman A, Andolf E, Holte J, Olofsson JI, Wramsby H, Wramsby M, Pershagen G, Heijmans BT, Iliadou AN
Hum Reprod 2021 Jan;36(1):248-259

Antibodies against Phosphorylcholine and Malondialdehyde during the First Two Years of Life.
Thiagarajan D, Lundström SL, Pershagen G, Almqvist Malmros C, Andolf E, Hedman A, et al
J Immunol 2020 Oct;205(8):2109-2116

Longitudinal plasma inflammatory proteome profiling during pregnancy in the Born into Life study.
Hedman AM, Lundholm C, Andolf E, Pershagen G, Fall T, Almqvist C
Sci Rep 2020 10;10(1):17819

Paternal DNA Methylation May Be Associated With Gestational Age at Birth.
Luo R, Mukherjee N, Chen S, Jiang Y, Arshad SH, Holloway JW, Hedman A, Gruzieva O, Andolf E, Pershagen G, Almqvist C, Karmaus WJ
Epigenet Insights 2020 ;13():2516865720930701

DNA Methylation Trajectories During Pregnancy.
Gruzieva O, Merid SK, Chen S, Mukherjee N, Hedman AM, Almqvist C, et al
Epigenet Insights 2019 ;12():2516865719867090

Oral Microbiota Development in Early Childhood.
Kennedy B, Peura S, Hammar U, Vicenzi S, Hedman A, Almqvist C, et al
Sci Rep 2019 12;9(1):19025

Reference Intervals for Fecal Calprotectin in Pregnant Women Using a Particle Enhanced Turbidimetric Assay.
Fall T, Hedman A, Pershagen G, Andolf E, Almqvist C, Helmersson-Karlqvist J, Larsson A
Clin Lab 2019 Jul;65(7):

Normal values for calprotectin in stool samples of infants from the population-based longitudinal born into life study.
Peura S, Fall T, Almqvist C, Andolf E, Hedman A, Pershagen G, et al
Scand. J. Clin. Lab. Invest. ;78(1-2):120-124

Allergen-specific IgE over time in women before, during and after pregnancy.
Hedman AM, Lundholm C, Scheynius A, Alm J, Andolf E, Pershagen G, et al
Allergy 2019 Mar;74(3):625-628

Limited association between markers of stress during pregnancy and fetal growth in 'Born into Life', a new prospective birth cohort.
Smew AI, Hedman AM, Chiesa F, Ullemar V, Andolf E, Pershagen G, et al
Acta Paediatr. 2018 Jun;107(6):1003-1010

MAESTRO - Maternal Asthma Events, STRess and Offspring

In total 1693 women were recruited the MAESTRO-study in the years 2013-2019. Questionnaires and saliva samples were collected from the women in early pregnancy (pregnancy week 8-12), towards the end of the pregnancy (pregnancy week 28-32) and 6 months after delivery.  Data was collected from the women’s medical notes and the sonography results from the antenatal/midwife clinic and from delivery. We also measured lung function using spirometry in 250 study participants during and after their pregnancy. More information can be found in our recent publications.

In the MAESTRO-CHILD study we are following up the children born to the mothers who participated in the MAESTRO-study.

Background and aims

Asthma is one of the most common chronic respiratory diseases in children and adults and is also prevalent among pregnant women. Knowledge surrounding how asthma impacts the pregnancy and offspring is lacking. Some studies suggest that stress during pregnancy effects pregnancy and delivery outcomes and increases the risk that the child develops asthma. The knowledge gained from this research is pivotal to allow for prevention. The aim with the MAESTRO-study is to understand how mothers with different levels of stress and asthma influences their pregnancy and delivery.  These women are then compared with women without asthma. We are interested to understand factors which contribute to the development of asthma, amount of asthma medication used during the pregnancy and if there is an association between stress levels and other factors in the environment.

Asthma in the mother and other factors during pregnancy and delivery (diet, infections, anxiety and environmental factors) can also be associated with the development of common diseases in the child. We are interested to study these factors and follow the woman during her pregnancy and the subsequent offspring and family after delivery and into childhood.

MAESTRO-study – data collection is complete. Analyses are ongoing and articles will be published in due course.

MAESTRO-CHILD 3-year follow up.

The children in the MAESTRO-CHILD study were recruited by contacting the mothers who had participated in the MAESTRO study. Parents/guardians who wanted their child to participate in the study received a questionnaire when the child was 3 years old. The parents were asked to answer questions regarding the child´s health since birth including breastfeeding, diet and environmental factors as well as which infections the children had had and which, if any, of the common childhood diseases the children had developed. We also asked questions regarding background factors in the parents and in the family (for example parental education).  Parents/guardians were asked for written consent for their child to be part of the study and to link the collected data to our national health registers.

Those parents/guardians who chose for their children to participate in the MAESTRO-CHILD study also received a test kit in the post for saliva samples which parents/guardians collected from their children and sent back to us. The saliva samples were tested for cortisol levels which is a measure of stress. In total we recruited 550 children to the MAESTRO-CHILD 3 year follow up.

MAESTRO-CHILD 8-year follow-up

We are now planning an 8 year follow-up of the children. The parents/guardians and children who participated in the 3 year follow-up will receive a questionnaire. They will be asked to answer questions on the child’s health since the 3 year follow-up, infections, diet and environmental factors as well as which if any of the common childhood diseases the children have developed. 

Those who choose to continue to participate in the study will again receive a test kit in the post for saliva samples which parents/guardians will collect from their children and send back to us. The saliva sample will be tested for cortisol levels which is a measure of stress. We will also ask a number of children to come for a health check-up where we will measure length, weight, lung function and take blood and faecal samples.

Contact information

Postal address
MEB/ MAESTRO
Karolinska Institutet
Box 281
17177 Stockholm

Contact persons

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Catarina Almqvist Malmros

Professor, project leader
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Hanna Karim

Phd Student
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Samuel Arthur Rhedin

Postdoctoral Studies
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Aki Tuuliainen

System Developer

Publications from the MAESTRO-study

Maternal asthma and early fetal growth, the MAESTRO study.
Rejnö G, Lundholm C, Saltvedt S, Larsson K, Almqvist C
Clin Exp Allergy 2021 07;51(7):883-891

Associations Between Maternal Distress, Cortisol Levels, and Perinatal Outcomes.
Lundholm C, Rejnö G, Brew B, Smew AI, Saltvedt S, Almqvist C
Psychosom Med 2022 04;84(3):288-296