I earned my PhD in 2015 with a thesis named "Early life origins of asthma - genetic and environmental factors in twin and kin" at the Department of Medical Epidemiology and Biostatistics. My studies focused on potential risk factors during the period around pregnancy and subsequent childhood health.
After finishing my PhD studies I pursuied my clinical career as a medical doctor, and have now started my residency training in obstetrics and gynecology at Visby Lasarett, Gotland.
In parallell with clinical work I have continued doing research and I am now affiliated to Olof Stephansson's research group, at the Clinical Epidemiology Division. My projects will focus on the pregnancy and neonatal period and the association with adverse outcomes.
- MD, Karolinska Institutet, 2013
- PhD, Karolinska Institutet, 2015
- Resident in Obstetrics and Gynecology, Visby Lasarett, 2018
Description of research area for my PhD studies and included projects:
During the last decades there has been an upsurge of studies investigating how early life events or exposures may affect subsequent health outcomes of the child, such as childhood asthma. Much focus has been put into the idea of how our future may be programmed already in utero or during our first months in life.
By combining data from national health registers such as the National Patient Register, the Prescribed Drug Register and the Medical Birth Register, prospectively collected clinical material and questionnaire data, with twin- and family based designs, the studies included in my thesis aimed to disentangle familial genetic and environmental confounding from causal mechanisms leading to asthma. I have focused on the role of fetal growth and exposure to antibiotics, and the risk of developing asthma.
1. Fetal growth and asthma
We have previously investigated if birth weight, as a proxy for fetal growth in twins, affects the development of asthma in a cohort of 9-12 year old Swedish twins in CATSS. We found a significant association which was thought to be explained by unique individual factors and not due to confounding by familial factors shared by the twins.
We are currently investigating if fetal growth affects childhood lung function in a cohort of 9-14 year old twins clinically examined at several sites around Sweden in the STOPPA study.
2. Exposure and treatment of antibiotics and asthma
We have recently investigated the suggested association between exposure to antibioitcs in fetal life and in early childhood and asthma. Previous studies may have been confounded by shared genetic and environmental familial factors, by indication or reverse causation due to respiratory infections. By investigating this association in a family-based setting, comparing affected siblings with non-affected siblings, we aimed to further assess causality. We found that there was no association between antibiotic exposure in fetal or early life and childhood asthma. In summary, our study suggests that the association between antibiotics and asthma is caused by confounding factors shared within families, in addition to confounding by indication or reverse causation because of respiratory infections. The study was recently published in the BMJ and can be found here http://www.bmj.com/content/349/bmj.g6979.
3. Validation of asthma in national registers
A precise and accurate definition of asthma for register- and population-based studies has been lacking. We have previously collected medical records corresponding to prescription dates of asthma medications or to discharge dates with accompanying asthma diagnoses, identified from drug- and patient registers, from health care units all over Sweden. The information in the medical records was evaluated against pre-defined criteria of asthma and we found a high positive predictive value for asthma medication as a proxy for asthma/obstructive bronchitis. Moreover, the quality of asthma diagnoses for children in the patient register was considered to be high.