Maternal, Fetal, and Neonatal Research Group

Conception-implantation and later development – A longitudinal study from preconception to early childhood: how conception, implantation and fetal growth velocity determine pregnancy duration and child development, and how parental and environmental factors modify these elements for a lifecourse.

Main content

Life-style diseases, such as cardiovascular diseases, diabetes, and obesity are growing into a global epidemic, and therefore a prioritized agenda for the World Health Organization. Recently, it has become increasingly evident that the life courses of health and disease are already conditioned during fetal development. Maternal health and nutrition during the peri-conception period are presumed to influence pregnancy development and the later health of the child. Providing evidence of how maternal body composition, sleep and physical activity influences intrauterine development will constitute the foundation for advocating specific and simple advice on lifestyle that can condition a healthier lifecourse both for the expected child, and the life of the mother.

CONIMPREG is a composite research program that began in 2014. The goal is to follow 370 women (and their partners) from before pregnancy until birth. With follow-up of the children at the age of 5 years. 

Before conception, physical activity and sleep are measured, nutrition assessed, body proportion and composition measured, and specimens are collected from blood, saliva, hair, and nail. Some of the assessments are repeated thrice during pregnancy and at birth when placental biopsies, cord blood, cord biopsy, neonatal saliva, hair, and nail are added. Ovulation and implantation are monitored by daily urine samples until positive pregnancy test. Fetal development is monitored during pregnancy using ultrasound biometry and circulation assessment.

In addition to provide physical and nutritional information from the parents, the vitamin status and mono-carbon metabolites are followed, with a genome-wide assessment including epigenetics, xenobiotics and proteomic analysis of urine after conception. 

The Conimpreg project collaborates with the Bergen Sleep and Chronobiology Network at the Department of Global Public Health and Primary Care

Photo:

Conimpreg

Lenker 

Alexander Vietheer

Bergen Sleep and Chronobiology Network- Conimpreg

In Norway 20% of women will experience an assisted delivery with either forceps or vacuum. Forceps causes more maternal trauma, but is more likely to result in a successful delivery. However, delivery by vacuum is not so successful. It may be less traumatic for the mother but more so for the baby. The latest technology gives us the possibility to detect occult birth injuries to the pelvic floor. The pelvic floor is a group of muscle and fibrous tissue responsible for supporting the bladder, rectum and vagina.

The Bergen Birth study aims to identify the incidence of pelvic floor injury by comparing operative and spontaneous vaginal deliveries. Maternal and neonatal risk factors will be investigated and women followed up 1 year post-partum.

Tilknyttede personer 

Sindre Grindheim

Ph.d.-kandidat, Stipendiat/Overlege

Klinisk institutt 2

sindre.grindheim@student.uib.no

Elham Baghestan

Førsteamanuensis

Klinisk institutt 2

elham.baghestan@uib.no

Preterm birth is considered a leading indicator of health in a global context, and is the most frequent cause of neonatal death and the second most frequent cause of child mortality before the age of five. It is complex and poorly mapped, and effective and safe preventive treatment is not available. As frokm 2014 treatment with vaginal progesterone tablets is recommended according to Norwegian guidelines for increased risk of spontaneous preterm birth, but evidence for effect on subgroups is sparse and long-term follow-up of both the mother and child is lacking. By combining data from several Norwegian quality registers (Medical Birth Register, Legemiddelregisteret, Norwegian Patient Register), the project will evaluate the effect the treatment has had on the various groups at risk of preterm birth. Furthermore, through sibling files and follow-up of the children, the risk of increased morbidity and mortality in mother and child in both the short and long term as a result of exposure to progesterone during pregnancy will be mapped.

Lenker 

Anders Einum

Tilknyttede personer 

Nils-Halvdan Morken

Professor

Department of Clinical Science

nils-halvdan.morken@uib.no
 

Outcome measure: Recurrent postpartum bleeding - over generations and between siblings and other relatives.

The influence of region of interest width in fetal 2D-speckle tracking echocardiography late in pregnancy. Omdal TR, Khan U, Ebbing C, Kessler J, Karlsen HO, Leirgul E, Matre K, Greve G. Int J Cardiovasc Imaging. 2021 Nov 3. doi: 10.1007/s10554-021-02455-1. PMID: 34734368

Recurrence of postpartum hemorrhage in relatives: A population-based cohort study. Lorentz Erland Linde, Cathrine Ebbing, Dag Moster, Jørg Kessler, Elham Baghestan, Mika Gissler, Svein Rasmussen. Acta Obstet Gynecol Scand 2021 Dec;100(12):2278-2284. Epub 2021 Oct 8. PMID: 34622946 DOI: 10.1111/aogs.14262

Pre-gestational diabetes: Maternal body mass index and gestational weight gain are associated with augmented umbilical venous flow, fetal liver perfusion, and thus birthweight.Lund A, Ebbing C, Rasmussen S, Qvigstad E, Kiserud T, Kessler J.PLoS One. 2021 Aug 16;16(8): e0256171. doi: 10.1371/journal.pone. 0256171. eCollection 2021. PMID: 34398922 

Risk factors for surgical site infection following cesarean delivery: A hospital-based case-control study. Kvalvik SA, Rasmussen S, Thornhill HF, Baghestan E. Acta Obstet Gynecol Scand. 2021 Dec;100(12):2167-2175. doi: 10.1111/aogs.14235. Epub 2021 Aug 6. PMID: 34309849

Sleep and physical activity from before conception to the end of pregnancy in healthy women: a longitudinal actigraphy study. Vietheer A, Kiserud T, Lie RT, Haaland ØA, Kessler J. Sleep Med. 2021 Jul;83:89-98. doi: 10.1016/j.sleep.2021.04.028. Epub 2021 Apr 28.PMID: 33991895 

Maeland, K. S., Morken, N. H., Schytt, E., Aasheim, V., & Nilsen, R. M. (2021). Placental abruption in immigrant women in Norway: A population-based study. Acta obstetricia et gynecologica Scandinavica, 100(4), 658–665. https://doi.org/10.1111/aogs.14067

Sorbye LM, Cnattingius S, Skjaerven R, Klungsoyr K, Wikström AK, Kvalvik LG, Morken NH. Interpregnancy weight change and recurrence of gestational diabetes mellitus: a population-based cohort study. BJOG. 2020; 127(13): 1608- 1616. 

Risk factors and recurrence of cause-specific postpartum hemorrhage: A population-based study. Linde LE, Rasmussen S, Moster D, Kessler J, Baghestan E, Gissler M, Ebbing C. PLoS One. 2022 Oct 14;17(10):e0275879. doi: 10.1371/journal.pone.0275879. eCollection 2022.PMID: 36240210 Free PMC article.

Recurrence of postpartum hemorrhage, maternal and paternal contribution and the effect of offspring birthweight and sex: a population-based cohort study. Linde LE, Ebbing C, Moster D, Kessler J, Baghestan E, Gissler M, Rasmussen S. Arch Gynecol Obstet. 2022 Nov;306(5):1807-1814. doi: 10.1007/s00404-021-06374-3. Epub 2022 Jan 9. PMID: 34999924 Free PMC article.

Effect of maternal sleep on embryonic development. Vietheer A, Kiserud T, Haaland ØA, Lie RT, Kessler J.Sci Rep. 2022 Oct 12;12(1):17099. doi: 10.1038/s41598-022-21516-6. PMID: 36224237 Free PMC article.

Use of antihistmanines before or during pregnancy and risk of early-onset pre-eclampsia in allergic women: a population-based cohort study. Sande AK, Torkildsen EA, Sande RK, Dalen I, Danielsson KC, Morken NH. BMJ Open. 2022 Oct 7;12(10):e061837. doi: 10.1136/bmjopen-2022-061837.PMID: 36207047 Free PMC article.

Quantitative user data from a chatbox developed for women with gestational Diabetes Mellitus: Observational study. Sagstad MH, Morken NH, Lund A, Dingsør LJ, Nilsen ABV, Sorbye LM. JMIR Form Res. 2022 Apr 18;6(4):e28091. doi: 10.2196/28091.PMID: 35436213 Free PMC article.

Basnet P, Skjaerven R, Sørbye LM, Morken NH, Klungsøyr K, Singh A, Mannseth J, Harmon Q, Kvalvik. Long-term cardiovascular mortality in women with twin pregnancies by lifetime reproductive history. Paediatr Perinat Epidemiol. 2022; 29. doi:10.1111/ppe.12928

Sima, YT, Skjærven R, Kvalvik, LG, Morken NH, Klungsøyr K, Sørbye LM. Cesarean delivery in Norwegian nulliparous women with singleton cephalic term births, 1967–2020: a population-based study. BMC Pregnancy Childbirth 22, 419 (2022). https://doi.org/10.1186/s12884-022-04755-3

Strandberg, R.B., Iversen, M.M., Jenum, A.K., Sørbye, L.M., Vik, E.S., Schytt, E., Aasheim, V. and Nilsen, R.M. (2021), Gestational diabetes mellitus by maternal country of birth and length of residence in immigrant women in Norway. Diabet Med, 38: e14493. https://doi.org/10.1111/dme.14493

Histologic chorioamnionitis in extremely preterm births, microbiological findings and infant outcome. Budal EB, Bentsen MHL, Kessler J, Ebbing C, Lindemann PC, Haugen OH, Aukland SM, Eide GE, Halvorsen T, Collett K. J Matern Fetal Neonatal Med. 2023 Dec; 36(1): 2196599. doi: 10.1080/14767058.2023.2196599. PMID: 37031964 Free article.

Maternal physical activity affects yolk sac size and growth in early pregnancy, but girls and boys use different strategies. Alexander Vietheer, Torvid Kiserud, Cathrine Ebbing, Hemamaalini Rajkumar, Øystein Ariansen Haaland, Rolv Terje Lie, Roberto Romero & Jørg Kessler. Scientific reports volume 13, Article number: 20246 (2023

The relationship between cesarean delivery and fecundability: a population-based cohort study. Yeneabeba Tilahun Sima, Marie Christine Magnus, Liv Grimstvedt Kvalvik, Nils-Halvdan Morken, Kari Klungsøyr, Rolf Skjærven, Linn Marie Sørbye. Am J Obstet Gynecol 2023 Oct 18:S0002-9378(23)00759-7. doi: 10.1016/j.ajog.2023.10.029. PMID: 37863159. Online ahead of print. Free article.

Risk of adverse pregnancy outcomes in twin- and singleton-born women: An inter-genrational cohort study. Basnet P, Skjaerven R, Harmon QE, Sørbye LM, Morken NH, Singh A, Klungsøyr K, Kvalvik LG. BJOG. 2023 Oct 12. doi: 10.1111/1471-0528.17690. PMID: 37827857 Online ahead of print.

Lower levels of the neuroprotective tryptophan metabolite, kyrurenic acid, in users of the estrogen contraceptives. Bjørke-Monsen AL, Varsi K, Sakkestad ST, Ulvik A, Ebbing C, Ueland PM.Sci Rep. 2023 Sep 29;13(1):16370. doi: 10.1038/s41598-023-43196-6. PMID: 37773439 Free PMC article.

Paternal and maternal birthweight and offspring risk of macrosomia at term gestations: A nationwide population study. Rasmussen S, Carlsen EØ, Linde LE, Morken NH, Håberg SE, Ebbing C. Paediatr Perinat Epidemiol. 2023 Sep 2. doi: 10.1111/ppe.13005. PMID: 37658778. Online ahead of print.

Birthweight of the subsequent singelton pregnancy following a first tein or singleton pregnancy. Basnet P, Skjaerven R, Harmon QE, Wilcox AJ, Klungsøyr K, Sørbye LM, Morken NH, Kvalvik LG. Acta Obstet Gynecol Scand. 2023 Dec;102(12):1674-1681. doi: 10.1111/aogs.14644. Epub 2023 Aug 28.PMID: 37641452. Free PMC article.

Pregestational maternal risk factors for preterm and term preeclampsia: A population-based study. Sande AK, Dalen I, Torkildsen EA, Sande RK, Morken NH.Acta Obstet Gynecol Scand. 2023 Nov;102(11):1549-1557. doi: 10.1111/aogs.14642. Epub 2023 Jul 25. PMID: 37491773 Free PMC article.

Pregnancy complications in last pregnancy and mothers' long-term cardiovascular mortality: does the relation differ from that of complications in first pregnancy? A population based study. Seid AK, Morken NH, Klungsøyr K, Kvalvik LG, Sorbye LM, Vatten LJ, Skjærven R. BMC Womens Health. 2023 Jul 4;23(1):355. doi: 10.1186/s12905-023-02503-z. PMID: 37403040. Free PMC article.

Birth weight in consecutive pregnanies and maternal cardiovascular disease mortality among spontaneous and iatrogenic terms births: A population-based cohort study. Sima YT, Skjaerven R, Kvalvik LG, Morken NH, Klungsøyr K, Mannseth J, Sørbye LM.Am J Epidemiol. 2023 Aug 4;192(8):1326-1334. doi: 10.1093/aje/kwad075.PMID: 37249253. Free PMC article.

Long-term cardiovascular mortality in women with twin pregnancies by lifetime reproductive history. Basnet P, Skjaerven R, Sørbye LM, Morken NH, Klungsøyr K, Singh A, Mannseth J, Harmon QE, Kvalvik LG. Paediatr Perinat Epidemiol. 2023 Jan;37(1):19-27. doi: 10.1111/ppe.12928. Epub 2022 Sep 29.PMID: 36173007. Free PMC article.

Association of placental and umbilical cord characteristics with cerebral palsy: national chort study. Ebbing C, Rasmussen S, Kessler J, Moster D. Ultrasound Obstet Gynecol. 2023 Feb;61(2):224-230. doi: 10.1002/uog.26047.PMID: 36722428 Free PMC article.

Njolsta PR, Feenstra B, Freathy RM. et al. Regulation of placental growth is a complex interplay of maternal and fetal genomes. NATURE GENETICS. 2023 Oct 5. https://doi.org/10.1038/s41588-023-01520-w

Mæland, K. S., Morken, N. H., Schytt, E., Aasheim, V., & Nilsen, R. M. (2023). Risk of Subsequent Preeclampsia by Maternal Country of Birth: A Norwegian Population-Based Study. International journal of environmental research and public health, 20(5), 4109. https://doi.org/10.3390/ijerph20054109

Baalman, J.H., Bergholt, T., Betran Lazaga, A.P., Dumont, A., Frusca, T., Greene, R., Kacerauskiene, J., Kessler, J., Keane, D., Kempe, P., Ladfors, L., Louwen, F., Hassan, L., Lucovnik, M., Maso, G., Piccoli, M., Roda, O.P., Robson, M., Smárason, A.K., Torloni, M.R. and Ugwumadu, A. (2024), Prospective Structured Perinatal Audit and the Ten Group Classification System: Essential for understanding and improving childbirth. Aust N Z J Obstet Gynaecol. https://doi.org/10.1111/ajo.13893

Einum A, Harmon QE, Sørbye LM, Nilsen RM, Morken NH. Associations between term cesarean delivery in the first pregnancy and second-pregnancy preterm delivery. Acta Obstet Gynecol Scand. 2024 Oct 24. https://doi.org/10.1111/aogs.14996.

Nilsen, R. M., Strandberg, R. B., Yaya, Y., Fismen, A. S., Macsali, F., Morken, N. H., Gómez Real, F., Schytt, E., Vik, E. S., & Sørbye, L. M. (2024). Pre-pregnancy obesity among immigrant and non-immigrant women in Norway: Prevalence, trends, and subgroup variations. Acta obstetricia et gynecologica Scandinavica, 103(10), 2081–2091. https://doi.org/10.1111/aogs.14923

Mæland, K. S., Morken, N. H., Schytt, E., Aasheim, V., & Nilsen, R. M. (2024). Associations between non-registered ultrasound examination in pregnancy and adverse perinatal outcomes in immigrant and non-immigrant women: a Norwegian population-based study 1999-2016. Scandinavian journal of public health, 14034948241274596. https://doi.org/10.1177/14034948241274596

Jauniaux E, Ebbing C, Oyelese Y, Maymon R, Prefumo F, Bhide A. European association of perinatal medicine (EAPM) position statement: Screening, diagnosis and management of congenital anomalies of the umbilical cord. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2024 Jul 1;298:61-5. https://doi.org/10.1016/j.ejogrb.2024.04.044

Mørch J, Kolnes EH, Greve G, Omdal TR, Ebbing C, Kessler J, Khan U. Increasing region of interest width reduces neonatal circumferential strain. Echocardiography. 2024 Jul;41(7):e15873. https://doi.org/10.1111/echo.15873

Moen IH, Johnsen SL, Karlsen HO, Stokke AM, Rasmussen S, Ebbing C. The routine prenatal ultrasound scan should be more comprehensive. Tidsskrift for Den norske legeforening. 2024 Mar 19. https://doi.org/10.4045/tidsskr.24.0042

Rasmussen S, Ebbing C, Baghestan E, Linde LE. Shoulder dystocia by severity in families: A nationwide population study. Acta Obstetricia et Gynecologica Scandinavica. 2024 Jan 7. https://doi.org/10.1111/aogs.14766

Einum A, Sørbye LM, Nilsen RM, Ebbing C, Morken NH. Unveiling sex bias and adverse neonatal outcomes in ultrasound estimation of gestational age: A population-based cohort study. Paediatr Perinat Epidemiol. 2024; 38: 34-42. https://doi.org/10.1111/ppe.13029

Arshad, N., Skjærven, R., Klungsøyr, K., Sørbye, L.M., Kvalvik, L.G. and Morken, N.-H. (2025), Pregnancy-Associated Maternal Mortality Within One Year After Childbirth: Population-Based Cohort Study. BJOG, 132: 365-374. https://doi.org/10.1111/1471-0528.17985

Basnet P,  Skjærven R,  Harmon QE,  Sørbye LM,  Morken N-H,  Singh A, et al.  Risk of adverse pregnancy outcomes in twin- and singleton-born women: An inter-generational cohort study. BJOG.  2024; 131(6): 750–758. https://doi.org/10.1111/1471-0528.17690

Sima YT, Magnus MC, Kvalvik LG, Morken NH, Klungsøyr K, Skjærven R, Sørbye LM. The relationship between cesarean delivery and fecundability: a population-based cohort study. Am J Obstet Gynecol. 2024 Jun;230(6):667.e1-667.e21. https://doi.org/10.1016/j.ajog.2023.10.029 

Ebbing C, Salvesen KÅB, Sitras V, Tiller H. New treatment for alloimmunisation in pregnancy. Tidsskr Nor Laegeforen. 2025 Jan 2;145(1). English, Norwegian. doi: 10.4045/tidsskr.24.0611. PMID: 39835861.

Grindheim S, Rasmussen S, Iversen JK, Kessler J, Baghestan E. Influence of instrument choice on fear of childbirth after assisted vaginal delivery: A secondary analysis of the Bergen birth study. Acta Obstet Gynecol Scand. 2025 Mar 12. doi: 10.1111/aogs.15097.

Letter: Grindheim, S., Rasmussen, S., Iversen, J.K., Kessler, J. and Baghestan, E. (2025), Instrument selection in assisted vaginal delivery, when spontaneous vaginal delivery is no longer an option. Acta Obstet Gynecol Scand. https://doi.org/10.1111/aogs.15133

Ebbing C, Halmoy A, Rasmussen S, Mauland KK, Kessler J, Moster D. Umbilical cord length and neurodevelopmental disorders, a national cohort study. PLoS One. 2025 Apr 23;20(4):e0322444. doi: 10.1371/journal.pone.0322444. PMID: 40267150; PMCID: PMC12017576.

Khan U, Omdal TR, Ebbing C, Kessler J, Leirgul E, Greve G. The Effect of Smoothing and Drift Compensation on Fetal Strain. Ultrasound Med Biol. 2025 Apr 19:S0301-5629(25)00093-6. doi: 10.1016/j.ultrasmedbio.2025.03.014. Epub ahead of print. PMID: 40254520.

Nordtvedt, E., Kessler, J., Ebbing, C. et al. Placental and cerebral circulation in fetuses of mothers with polycystic ovary syndrome and the effect of Metformin exposure. BMC Pregnancy Childbirth 25, 749 (2025). https://doi.org/10.1186/s12884-025-07866-9

Grindheim S, Iversen JK, Hill S, Macsali F, Baghestan E, Skagseth R, Kessler J. Reverse Løvset maneuver for shoulder dystocia. Am J Obstet Gynecol. 2025 Jul 8:S0002-9378(25)00472-7. doi: 10.1016/j.ajog.2025.07.012. Epub ahead of print. PMID: 40639780.

2025 Anders Einum: Primum non nocere: Prevention of preterm birth in Norway"

2024 Alexander Vietheer: Human embryonic development: Effects of physical activity and sleep in physiological pregnancies

2023 Anne Kvie Sande: Early-onset preeclampsia in the balance of Immunology and Pregnancy: Risk factors, the Role of Allergy, and potential protection by Antihistamine use

2022 Lorentz Linde: Postpartum hemorrhage in families

2019 Agnethe Lund: Maternal diabetes mellitus and fetal venous liver flow —a longitudinal study

2019 Linn Marie Sørbye: Maternal weight, weight change and perinatal outcomes: Can physical activity and gestational weight gain modify the risk?

2018 Julie Sletten: Circadian rhythms of the fetal heart rate and heart rate variation in low-risk and pre-gestational diabetic pregnancies. Studies on long-term antenatal cardiotocographic recordings.

2016 Henriette Odland Karlsen: Maternal influence on fetal size and use of longitudinal fetal surveillance in predicting adverse perinatal outcomes.