Carolyn Cesta

Carolyn Cesta

Assistant Professor
Visiting address: Maria Aspmans gata 30A, 17164 Solna
Postal address: K2 Medicin, Solna, K2 KEP Kieler H, 171 77 Stockholm

About me

  • I am a pharmacoepidemiologist with a research focus on generating high-quality evidence on the benefits and consequences of medication use during pregnancy for both the mother and child. My work aims to leverage the strengths of the Swedish population-based registers in Nordic and International collaborative studies. I have been a researcher at the Centre for Pharmacoepidemiology [1] at Karolinska Institutet since 2017 and lead the Reproduction research area [2]. Currently, I am the chair of the Nordic Pharmacoepidemiological Network executive committee [3]. 

    Education
    2013-2017 PhD, Medical Sciences, Epidemiology, Karolinska Institutet, Sweden
    2007-2009 MSc, Medical Sciences, Physiology&Pharmacology, McMaster University, Canada
    2001-2006 BSc, Biology and Pharmacology, McMaster University, Canada

    Postdoctoral research
    2020-2022 Postdoctoral fellow, Harvard T.H. Chan School of Public Health, Boston, USA
    2017-2020 Postdoctoral research, Centre for Pharmacoepidemiology, Karolinska Institutet, Sweden

    [1] https://ki.se/en/meds/centre-for-pharmacoepidemiology
    [2] https://ki.se/en/meds/reproduction
    [3] https://www.norpen.org/

Research

  • My primary research field is within reproductive pharmacoepidemiology, with my largest focus on the benefits and consequences of medication use in pregnancy for the health of the mother and child. Much of my work is conducted in collaboration with Nordic and international researchers within the NorPreSS/InPreSS consortium.[1] Current projects include studying the utilization and safety of medications used to treat type 2 diabetes, bipolar disorder, depression and anxiety, epilepsy, and sleeping problems in pregnant women.

    I am the main supervisor for two doctoral students with research projects in this field:
    ·Felix Wittström 
    ·Silvia Segovia Chacón

    As well as two postdoctoral researchers:

    ·Awad Smew 

    ·Essi Heinonen 

    My secondary interests include how psychiatric health influences reproductive health and vice versa, and in particular, the role of androgens in the etiology of mood disorders. I address these topics through studies on the comorbidity of psychiatric illness in women and their children with polycystic ovary syndrome, in collaboration with researchers at KI.[2]

    Additionally, I am co-PI of UppStART – the "Uppsala-Stockholm Assisted Reproductive Techniques study", a prospective cohort study of couples who underwent infertility treatment in the greater Stockholm and Uppsala municipalities in 2011-2013. 

    My research is, or has been, funded by:
    ·Marie Skłodowska-Curie Actions Global Fellowship, European Commission, Horizon 2020
    ·Stiftelsen Söderström-Königska Sjukhemmet

    ·Karolinska Institutet Research Foundation Grants

    ·Swedish Research Council for Health, Working Life and Welfare (FORTE)

    ·Swedish Research Council (Vetenskapsrådet)


    [1] PMID: 38079178, 37343541, 36477338, 32870289, 39680408

    [2] PMID: 31792459, 33441551, 30857571, 27513883, 40036632

Teaching

  • I have over 300 hours of teaching including supervision, lecturing, and seminar leading at bachelor, masters, and doctoral level at KI:
    ·2014–2022, Group leader, Medical Program, Scientific Development and Scientific Methodology courses
    ·2017-2021, Seminar leader, Research School for Clinicians in Epidemiology
    ·2019, 2020, Seminar leader and examiner, Global Masters Programme in Global Health
    ·2019, Teaching assistant and examiner, Register-based research: Pharmacoepidemiology - drug use and safety
    ·2019, 2021, 2023, Lecturer, Basic Pharmacoepidemiology in a Global Context
    ·2019, 2021, 2022, 2024, Lecturer, Epidemiology I: Introduction to Epidemiology

    I am the course director for the new KI doctoral course: K2F6033 Pharmacoepidemiology: Drug Exposure Definitions and Study Design Approaches in Register-Based Data held for the first time in VT2025.

    Additionally, I have supervised 4 students for their Term 8 Degree Project in Medicine, Medical Programme, and 3 students for their Degree Project in the Masters Programme in Public Health Sciences - Epidemiology.

Selected publications

Articles

All other publications

Grants

  • Swedish Research Council
    1 January 2025 - 31 December 2028
    Semaglutide and other GLP-1 receptor agonists (GLP-1 RA) have revolutionized the treatment of type 2 diabetes and obesity and their use in Sweden and globally has increased dramatically since 2020. Women are more likely to be overweight or obese which is associated with infertility and adverse pregnancy outcomes. GLP-1 RA may be an effective tool to lose weight before pregnancy and while it is advised that they are discontinued two months prior to conception, up to 50% of pregnancies are unplanned. Unintended GLP-1 RA exposure in early pregnancy is a real possibility and it is unknown if they increase the risk of malformations in infants. Additionally, even if GLP-1 RA are discontinued as recommended, there is a chance of excessive weight gain in pregnancy which is associated with adverse pregnancy outcomes, such as gestational diabetes.This project aims to fill this knowledge gap through observational studies using a common protocol in data from Swedish population health registers and from other Nordic and international collaborators. First, utilization patterns and characteristics of women using GLP-1 RA will be described. Then the risk for adverse pregnancy outcomes will be compared between exposed and unexposed pregnancies from women with similar body mass index. High quality evidence will be generated in a timely manner to help avoid unnecessary harm. Results may also provide reassurance to those who can benefit from these new pharmacotherapies.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2022 - 31 December 2024
  • InPreSS – International Pregnancy Safety Study
    Marie Skłodowska-Curie Actions Global Fellowship, , European Commission, Horizon 2020
    1 September 2020 - 4 March 2023

Employments

  • Assistant Professor, Department of Medicine, Karolinska Institutet, 2023-2029

Degrees and Education

  • Docent, Karolinska Institutet, 2024
  • Degree Of Doctor Of Philosophy, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 2017

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