Women In Norway Research Articles

Incidence, mortality and survival in malignant pleural mesothelioma before and after asbestos in Denmark, Finland, Norway and Sweden

BackgroundMalignant pleural mesothelioma (MPM) is a rare but fatal cancer, which is largely caused by exposure to asbestos. Reliable information about the incidence of MPM prior the influence of asbestos is lacking. The nationwide regional incidence trends for MPM remain poorly characterized. We use nationwide MPM data for Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE) to assess incidence, mortality and survival trends for MPM in these countries.MethodsWe use the NORDCAN database for the analyses: incidence data were available from 1943 in DK, 1953 in FI and NO and 1958 in SE, through 2016. Survival data were available from 1967 through 2016. World standard population was used in age standardization.ResultsThe lowest incidence that we recorded for MPM was 0.02/100,000 for NO women and 0.05/100,000 for FI men in 1953–57, marking the incidence before the influence of asbestos. The highest rate of 1.9/100,000 was recorded for DK in 1997. Female incidence was much lower than male incidence. In each country, the male incidence trend for MPM culminated, first in SE around 1990. The regional incidence trends matched with earlier asbestos-related industrial activity, shipbuilding in FI and SE, cement manufacturing and shipbuilding in DK and seafaring in NO. Relative 1-year survival increased from about 20 to 50% but 5-year survival remained at or below 10%.ConclusionIn the Nordic countries, the male incidence trends for MPM climaxed and started to decrease, indicating that the prevention of exposure was beneficial. Survival in MPM has improved for both sexes but long-term survival remains dismal.

Time and Friendship in the Corona Pandemic: Relationship-Making Between Middle-Class Migrant Women in Norway

The pandemic’s rupture in people’s lives was felt in a particular way among foreign-born middle-class women in Trondheim. In the situation of unexpected (im)mobility and anxieties related to the pandemic, the lack of close relationships in the local context, was significantly felt. Despite digital acceleration, that was witnessed with pandemic, it highlighted the centrality of local presence and physicality of relations. The pandemic created a situation in which women realised the importance of having friends in the local community to cope with the restrictions and triggered a necessity for the otherwise highly mobile individuals to establish new relationships and explore the local environment. In this article, I discuss the formation of such relationships and the role of social media platforms, more specifically the role of a local social media-based initiative for mobile women with diverse cultural backgrounds. I argue that ‘affective time’ of pandemic created temporalities for forming a community for sharing sufferings, security, and joyful distractions from the crisis. This article considers meaning and experiences of friendship under condition of uncertainty and how relationship-making shape migrant’s woman engagement with the present. I follow a methodology of friendship, developed by Tillmann-Healy (2003), as a useful tool to research friendship-making practices and specifically in times of crisis.

What women emphasise as important aspects of care in childbirth - an online survey.

To explore and describe what women who have given birthin Norway emphasise as important aspects of care during childbirth. The study is based on data from the Babies Born Better online survey, version 2. The maternity care system in Norway. Women who gave birth in Norway between 2013 and 2018. Descriptive statistics were used to describe sample characteristics and to compare data from the B3 survey with national data from the Medical Birth Registry of Norway. The open-ended questions were analysed with an inductive thematic analysis. Themes developed from two open-ended questions. The final sample included 8401 women. There were no obvious differences between the sample population and the national population with respect to maternal age, marital status, parity, mode of birth and place of birth, except for the proportion of planned home births. Four themes and one overarching theme were identified; Compassionate and Respectful Care, A Family Focus, Sense of Continuity and Consistency, and Sense of Security. Overarching theme: Coherence in Childbearing. Norwegian women across all birth settings emphasise maternity care that authentically focuses on both socio-cultural and psychological aspects of care, and physical and clinical factors. If the positive aspects of care identified in this study are adopted at all levels of the maternity care system and from all care providers, there is a high chance that most women will have a safe outcome, and a strong sense of coherence related to a positive birth and motherhood experience. Having a baby is a pivotal life changing experience and not just a clinical event, according to a survey of 8400 women in Norway. Positive birth and motherhood experiences depend on maternity staff who are both skilled and kind.

Interrelationships Among Fertility, Internal Migration,and Proximity to Nonresident Family:A Multilevel Multiprocess Analysis.

Past research has found that relations to nonresident family can influence individual fertility and migration behaviors separately. However, fertility and migration outcomes may also be interrelated, suggesting potential links across all three demographic processes. With this in mind, we track a cohort of women in Norway from age 18 to 31, recording the emergence of birth and migration events as well as their proximity to nonresident family networks (siblings and parents). Using a multilevel multiprocess statistical framework, with observations nested within women and equations for births, migrations, and proximity to nonresident family estimated simultaneously, our results support the notion that linked lives matter. Even in early adulthood, proximity to nonresident family has a positive effect on transitions to motherhood, whereas the presence of children (itself an outcome of past fertility) is associated with lower propensities to migrate. Mothers also have higher propensities to be living near family than women without children. The presence of local nonresident family reduces propensities for second and third migrations. However, after accounting for unobserved heterogeneity and selection, we observe a small positive effect of proximity to family on first migrations undertaken after age 18. Significant cross-process residual correlations exist across all three outcomes, suggesting that separately estimated model estimates may be vulnerable to bias emerging from unobserved sources of heterogeneity and selection. Our analysis therefore suggests that decisions about fertility, migration, and proximity to family are jointly determined and endogenous, and they should be analyzed simultaneously when possible.

Barriers and facilitators to the access to specialized female genital cutting healthcare services: Experiences of Somali and Sudanese women in Norway.

BackgroundGirls and women subjected to female genital cutting (FGC) risk experiencing obstetrical, gynecological, sexual, and psychological health problems. Therefore, Norway has established low-threshold specialized healthcare services where girls and women with FGC-related health problems can directly seek medical attention. Nevertheless, we lack data about access to these services, especially for non-maternity-related purposes. In this article, we explore experiences of seeking medical attention for health problems that are potentially FGC-related, aiming to identify factors that hinder or facilitate access to FGC-specialized services.MethodsWe conducted a qualitative study in three Norwegian cities employing semi-structured repeat interviews with 26 girls and women subjected to FGC, participant observation, and three validation focus group discussions with 17 additional participants. We thematically analyzed the data and approached access as a dynamic process of interactions between individuals and the healthcare system that lasts from an initial perception of need until reception of healthcare appropriate to that need.FindingsWe identified several barriers to healthcare, including 1) uncertainty about FGC as a cause of experienced health problems, 2) unfamiliarity with FGC-specialized services, 3) lack of assessment by general practitioners of FGC as a potential cause of health problems, and 4) negative interactions with healthcare providers. In contrast, factors facilitating healthcare included: 1) receiving information on FGC-related health problems and FGC-specialized services from a non-profit immigrant organization, 2) referral to gynecologists with good knowledge of FGC, and 3) positive interactions with healthcare providers.ConclusionAssessing whether FGC is the cause for experienced health problems requires diagnostic competency and should not be left entirely to the patients. We recommend that Norwegian policymakers acknowledge the central role of GPs in the clinical management of patients with FGC-related health problems and provide them with comprehensive training on FGC.

Hormonal contraceptive use in Norway, 2006-2020, by contraceptive type, age and county: A nationwide register-based study

Aim: Our aim was to study hormonal contraceptive use among women in Norway during 2006-2020 according to age groups and geography, including choice of contraceptive method, type of prescriber for long-acting reversible contraceptives, and prescriber’s adherence to the national health authority recommendations.Material and methods: We conducted a nationwide drug utilization study including all women aged 16-49 years in Norway during 2006-2020. The Norwegian Prescription Database (NorPD) includes detailed information about all dispensed prescription medications from Norwegian pharmacies to individuals in ambulatory care, including year of dispensing, patient’s year of birth and county of residence, and the prescriber’s profession.Results: This study shows a slight increase in overall use of hormonal contraceptives among 16-49-year-olds during 2006-2018, increasing from 36% of the population to 40%. Combined oral contraceptives (COCs) was the most commonly used hormonal contraceptive method in all age groups. The use of COCs decreased during the period and the decline was greatest in those below 25 years. From 2016 80% of all new users of COCs received the recommended COC containing levonorgestrel. Use of estrogen-free contraceptives, long-acting reversible contraceptives (LARCs) and gestagen pills, has increased. After 2014 the use of LARCs, especially subdermal implant, increased steeply among younger women. Oslo had the lowest proportion of users of hormonal contraceptives among teenagers and young adults during the whole period, while among 30-49-yearolds Oslo was more in line with the other counties.Conclusion: Combined oral contraceptives (COC) was the most used hormonal contraceptive method in all age groups. However, the use of COCs decreased during the period, especially in those < 25 years, where a corresponding increase in the use of LARC has taken place, mainly from 2014 onwards. Four out of five women who initiated COC received the recommended COC type and the steep increase in use of estrogen-free LARCs in recent years implies that Norwegian prescribers have high compliance with the recommendations from the health authorities.

An 11-year nationwide registry-linkage study of opioid maintenance treatment in pregnancy in Norway

Aim: We aimed to describe opioid maintenance treatment (OMT) to pregnant women in Norway and study thebackground characteristics of the pregnant women compared to the general population of pregnant women andto a previous clinical cohort study of OMT in pregnancy.Methods: Population-based cohort study with linked data from the Norwegian Medical Birth Registry, theNorwegian Prescription Database, the Norwegian Patient Registry, and Statistics Norway. The study populationconsisted of women giving birth between 2005-2015 in Norway. We defined OMT pregnancies as pregnancieswhere the woman was dispensed OMT medications (methadone, buprenorphine, or buprenorphine/naloxone) at least once during pregnancy.Results: The study population consisted of 420,808 women with 645,440 pregnancies ending in a live birth inNorway in 2005-2015 (the general pregnant population). Of these, 261 women (0.6‰) had altogether 306OMT pregnancies. The mean number of pregnancies was 28 OMT pregnancies per year and quite stable duringthe study period. Women with OMT pregnancies were older, smoked tobacco more frequently, had lowereducation, and fewer of them had a partner, compared to the general population of pregnant women. In mostpregnancies, the women were treated with buprenorphine (n=183 (59.8%)), while in 120 (39.2%) pregnancies,the woman received methadone. From 2008, buprenorphine replaced methadone as the most frequently useddrug. In only 38 (12.4%) pregnancies, OMT treatment was initiated in pregnancy. In 201 (66%) pregnancies,the woman used OMT medications in all trimesters. For these women, the mean amount of dispensed drug was3.4 DDD/day (85 mg/day) in pregnancy for methadone and 1.9 DDD/day (15.2 mg/day) for buprenorphine.Conclusion: The number of OMT pregnancies per year has been low and stable in the period 2005-2015.Following Norwegian recommendations, there has been a shift from treatment with methadone towardsbuprenorphine. The women receiving OMT during pregnancy had more risk factors for adverse outcomes thanthe general pregnant population but were quite similar to the previous clinical cohort.

Effect of a community-based intervention to increase participation in cervical cancer screening among Pakistani and Somali women in Norway

BackgroundNorway implemented a regular cervical cancer screening program based on triennial screening in 1995, recommending participation of all women between 25 and 69 years of age. Somali and Pakistani women have the lowest participation in cervical cancer screening in Norway. This study evaluates the effect of a community-based intervention aimed at increasing participation in the screening program among women from these two groups.MethodsThe intervention consisted of an oral 20–25 min presentation in Urdu and Somali on cervical cancer and screening and practical information on how to make an appointment and payment for the test. The participants were invited to pose questions related to the topic after the presentation. This study was carried out in four geographical areas surrounding the capital Oslo between February and October 2017, among women aged 25–69 years from Pakistan and Somalia. We recruited women in the intervention group directly from different community institutions, households, and religious sites. Women from Pakistan and Somalia residing in Oslo were the controls. The absolute intervention effect was measured as difference in absolute proportion of women screened and estimated as the interaction between time and group allocation in a generalized estimation equation model with binomial distribution and identity link function.ResultsThe percentage of women screened in the intervention group increased, from 46 to 51%. The corresponding increase in proportion in the control group was from 44 to 45.5%. After adjustment for potential confounders the intervention group showed a significant larger increase in participation in the screening program as compared to the control group with an absolute difference in change in proportion screened of 0.03 (95% CI; 0.02- 0.06).ConclusionsOur findings suggest that theory-based, culturally and linguistically sensitive educational interventions can raise awareness and motivate immigrant women to participate in cervical cancer screening program. In addition, approaching health professionals as well as immigrant women, might improve participation even more.Trial registrationNCT03155581. Retrospectively registered, on 16 May 2017.

A qualitative exploration of interactions with natural environments among immigrant women in Norway

ABSTRACT The role of nature in potentially improving people’s health – including immigrant women, who are particularly prone to health challenges – has been highlighted. Success in this public health arena requires an adequate understanding of the target group’s current practices and preferences. However, knowledge in this field is lacking, and is nearly non-existent in the Norwegian context. The present study therefore aims to explore practices regarding interactions with nature among immigrant women in Norway. Data were gathered through individual interviews with 14 immigrant women from Iran (2), Poland (2), Palestine, Afghanistan, Congo, Kenya, Thailand, Russia, Portugal, Latvia, Colombia, and Bulgaria. The qualitative content analysis revealed a relatively comprehensive and mixed use of natural environments, which took place in three distinct types of locales: 1) local natural environments, e.g. neighboring wooded areas, sites by the water, playing fields, and school yards; 2) domestic natural environments, e.g. indoor and garden plants; and 3) distant natural environments, e.g. mountains and fjords requiring driving and often overnight visit. Nature outings often included passive recreational pursuits, such as eating a meal and enjoying the scenery, with a few close friends or family members. Walking emerged as a common local nature-based physical activity. Study findings also portray a complex ‘image of nature’ among the women, reflecting their valuing of both more managed and more pristine nature. Findings therefore suggest that future public health practices targeting immigrant women may apply a broad definition of ‘interaction with nature’, incorporating various geographical locales as well as types of nature.

Occupational physical activity and longevity in working men and women in Norway: a prospective cohort study

Studies suggest that high occupational physical activity increases mortality risk. However, it is unclear whether this association is causal or can be explained by a complex network of socioeconomic and behavioural factors. We aimed to examine the association between occupational physical activity and longevity, taking a complex network of confounding variables into account. In this prospective cohort study, we linked data from Norwegian population-based health examination surveys, covering all parts of Norway with data from the National Population and Housing Censuses and the Norwegian Cause of Death Registry. 437 378 participants (aged 18-65 years; 48·7% men) self-reported occupational physical activity (mutually exclusive groups: sedentary, walking, walking and lifting, and heavy labour) and were followed up from study entry (between February, 1974, and November, 2002) to death or end of follow-up on Dec 31, 2018, whichever came first. We estimated differences in survival time (death from all causes, cardiovascular disease, and cancer) between occupational physical activity categories using flexible parametric survival models adjusted for confounding factors. During a median of 28 years (IQR 25-31) from study entry to the end of follow-up, 74 203 (17·0%) of the participants died (all-cause mortality), of which 20 111 (27·1%) of the deaths were due to cardiovascular disease and 29 886 (40·3%) were due to cancer. Crude modelling indicated shorter mean survival times among men in physically active occupations than in those with sedentary occupations. However, this finding was reversed following adjustment for confounding factors (birth cohort, education, income, ethnicity, prevalent cardiovascular disease, smoking, leisure-time physical activity, body-mass index), with estimates suggesting that men in occupations characterised by walking, walking and lifting, and heavy labour had life expectancies equivalent to 0·4 (95% CI -0·1 to 1·0), 0·8 (0·3 to 1·3), and 1·7 (1·2 to 2·3) years longer, respectively, than men in the sedentary referent category. Results for mortality from cardiovascular disease and cancer showed a similar pattern. No clear differences in survival times were observed between occupational physical activity groups in women. Our results suggest that moderate to high occupational physical activity contributes to longevity in men. However, occupational physical activity does not seem to affect longevity in women. These results might inform future physical activity guidelines for public health. The Norwegian Research Council (grant number 249932/F20).

Generalized joint hypermobility and risk of pelvic girdle pain in pregnancy: does body mass index matter?

ABSTRACT Background: Women with generalized joint hypermobility may be at increased risk of pregnancy-related pelvic girdle pain, but evidence is inconclusive. Objectives: In this prospective cohort study of 283 pregnant women in Norway, we aimed to study the association of generalized joint mobility with pelvic girdle pain, and to evaluate if pre-pregnancy body mass index was a modifier of the association. Methods: Generalized joint hypermobility was defined as a score of ≥5/9 positive tests on the Beighton score measured in early pregnancy. Primary outcome was evening pain intensity in gestation week 30, measured by a 100 mm visual analogue scale. We applied linear regression analyses to estimate age-adjusted unstandardized beta coefficients. Results: Evening pain intensity was similar among women with Beighton score ≥ 5/9 and women with Beighton score < 5/9 (age-adjusted mean difference 2.8 mm; 95% CI: −9.2 to 14.9 mm). Women with Beighton score ≥ 5/9 and pre-pregnancy body mass index ≥ 25 kg/m2, reported higher evening pain than women with Beighton score < 5/9 and pre-pregnancy body mass index <25 kg/m2 (age-adjusted mean difference 28.7 mm; 95% CI: 14.3–43.1 mm). Conclusions: Overall, evening pain intensity was similar among pregnant women with and without generalized joint hypermobility. However, women with a combination of generalized joint hypermobility and body mass index ≥25 kg/m2 reported higher evening pain compared to women with normal joint mobility and body mass index <25 kg/m2, suggesting that body mass index may modify the association. The estimates could be imprecise due to the small study sample, and our findings should be interpreted with caution.

Preventable fractions of cancer incidence attributable to 7-years weight gain in the Norwegian Women and Cancer (NOWAC) study

There is a lack of tangible measures for directed public health action to halt the increase in weight and cancer. We estimated the fraction and preventable cases of all and major body fatness-related cancers attributable to 7-years weight gain (≥ 2 kg). We assessed validated self-reported anthropometrics from 44,114 women aged 34–49 years at the enrolment in 1991–1992 and from a second questionnaire in 1998, with follow-up through December 31, 2015. Over 18 years, 3216 body fatness-related cancers and 2041 deaths were reported. Nearly 70% of women experienced weight gain and the average weight change was 4 kg. We observed a substantial proportional impact of weight gain on pancreatic cancer with a population attributable fraction (PAF) of 41.8% (95% CI 8.1–63.1) and a high absolute impact on postmenopausal breast cancer with 4403 preventable cases (95% CI 1064–7299) and a PAF of 16.8% (95% CI 4.1–27.8), and colorectal cancer with 3857 preventable cases (95% CI 1313–5990) and a PAF of 22.6% (95% CI 7.7–35.1). Avoiding weight gain over seven years in middle adulthood could have prevented a considerable proportion of the cancer burden and thousands of cancer cases in women in Norway.

Experiences and perceptions of body weight among Turkish immigrant women in Norway

PurposeThe purpose of this study is to explore beliefs and experiences of Turkish immigrant women in Norway related to body weight, nutrition and exercise practices.Design/methodology/approachThis study has a qualitative research design. Ten semi-structured interviews and a focus group were conducted with a purposive sample of Turkish immigrant women residing in Oslo, Norway. Themes were identified in the transcripts using systematic text condensation.FindingsParticipants viewed Turkish women as more commonly overweight or obese compared to Norwegian women. Weight was discussed openly among Turkish women and a preference to lose weight, both as individuals and among community members more broadly, also emerged. For participants, this represented a generational shift. Participants identified their barriers to weight loss, including norms around socialization and food in their community and exercise and eating practices during the long Nordic winter.Practical implicationsParticipants expressed a tension between concern about health impacts of overweight and obesity and the desire to uphold cultural practices around food. Weight-related health-care initiatives for Turkish immigrant women can take into account such experiences shaped by their interaction with multiple cultures.Originality/valueParticipants emphasized that perspectives about weight in their Turkish immigrant community were influenced by the transition toward thin weight ideals in Turkey. Self-image regarding weight was also situated within the context of being immigrants in Norway.

Physical activity in pregnancy: a Norwegian-Swedish mother-child birth cohort study

BACKGROUNDPhysical activity during pregnancy is important for maternal and offspring health. Optimal conditions during pregnancy may help reduce the burden of noncommunicable diseases. National and international guidelines recommend at least 150 minutes of physical activity of at least moderate intensity per week. To optimize physical activity in pregnant women, it is important to identify factors associated with higher levels of physical activity.OBJECTIVEThis study aimed to explore types and levels of physical activity in midpregnancy in Norway and Sweden and to identify factors associated with higher levels of physical activity.MATERIALS AND METHODSFrom the population-based mother-child cohort Preventing Atopic Dermatitis and Allergies in Children study recruiting 2697 women in Norway and Sweden from 2014 to 2016, we included 2349 women who answered an electronic questionnaire at enrollment in midpregnancy. Women were asked about regular physical activity in the last 2 weeks of pregnancy and afterward for types and levels of physical activity in pregnancy and before pregnancy and socioeconomic status, lifestyle, and maternal health. Logistic regression analyses were used to identify factors associated with higher levels of physical activity in pregnancy, defined as >30 minutes per session of ≥2 times per week of moderate- or high-intensity brisk walking, strength training, jogging, and bicycling.RESULTSNo regular physical activity during the last 2 weeks before answering the questionnaire at midpregnancy was reported by 689 women (29%). In this study, 1787 women (76%) reported weekly strolling during pregnancy. Regular physical activity at least twice weekly in the first half of pregnancy was reported as brisk walking by 839 women (36%), bicycling by 361 women (15%), strength training by 322 women (14%), and other activities by <10% of women. Among the 1430 women with regular moderate- or high-intensity physical activity, the estimated median duration per week was 120 minutes. Higher physical activity levels were achieved in 553 women (23.5%) by brisk walking, 287 women (12.2%) by strength training, 263 women (11.2%) by bicycling, and 114 women (4.9%) by jogging. Higher physical activity levels were positively associated with regular physical activity before pregnancy, dog ownership, and atopic dermatitis and negatively associated with higher body mass index, study location in Østfold, previous pregnancy or pregnancies, non-Nordic origin, suburban living, and sick leave.CONCLUSIONAt midpregnancy, 29% of women were inactive, and less than 50% of women had at least 2 hours of moderate-intensity physical activity weekly. Awareness of physical activity in pregnancy should be discussed at pregnancy follow-up visits, particularly among women with higher body mass index, sick leave, previous pregnancy or pregnancies, and non-Nordic origin.

Placental abruption in immigrant women in Norway: A population-based study.

Placental abruption is a serious complication in pregnancy. Its incidence varies across countries, but the information of how placental abruption varies in immigrant populations is limited. The aims of this study were to estimate the incidence of placental abruption in immigrant women compared with non-immigrants by maternal country and region of birth, reason for immigration, and length of residence. We conducted a nationwide population-based study using data from the Medical Birth Registry of Norway and Statistics Norway (1990-2016). The study sample included 1558174 pregnancies, in which immigrant women accounted for 245887 pregnancies and 1312287 pregnancies were to non-immigrants. Crude and adjusted odds ratios with 95% CI for placental abruption in immigrant women compared with non-immigrants were estimated by logistic regression with robust standard error estimations (accounting for within-mother clustering). Adjustment variables included year of birth, maternal age, parity, multiple pregnancies, chronic hypertension, and level of education. The incidence of placental abruption decreased during the study period for both immigrants (from 0.68% to 0.44%) and non-immigrants (from 0.80% to 0.34%). Immigrant women from sub-Saharan Africa had an adjusted odds ratio of 1.35 (95% CI 1.15-1.58) compared with non-immigrants for placental abruption, whereas immigrant women from Ethiopia had an adjusted odds ratio of 2.39 (95% CI 1.67-3.41). We found a small variation in placental abruption incidence by other countries or regions of birth, length of residence, and reason for immigration. Immigrant women from sub-Saharan Africa, especially Ethiopia, have increased odds for placental abruption when giving birth in Norway. Reason for immigration and length of residence had little impact on the incidence of placental abruption.

Prevalence of Antibodies Against SARS-CoV-2 Among Pregnant Women in Norway During the Period December 2019 Through December 2020

Prevalence of Antibodies Against SARS-CoV-2 Among Pregnant Women in Norway During the Period December 2019 Through December 2020

Trisomy 21 - incidence, diagnostics and pregnancy terminations 1999-2018.

We hypothesised that the examinations offered to pregnant women at fetal medicine centres differ from those offered to other pregnant women in Norway. We therefore wanted to investigate the incidence, prenatal diagnostics and pregnancy terminations in cases of trisomy 21. We also wanted to compare the figures from the National Center for Fetal Medicine, St Olav's Hospital, Trondheim University Hospital, with national figures for Norway. We analysed figures for the period 1999-2018retrospectively. National data were compared with an unselected population whose local hospital is St Olav's Hospital. National figures were retrieved from the Medical Birth Registry of Norway and local figures were from the quality registry at the National Center for Fetal Medicine. The national incidence of trisomy 21 was 0.20%, varying from 0.14% to 0.23%, and showed a significant increase over time (p < 0.01). The increasing incidence showed an association with increasing age in the women (p < 0.01). The incidence of live births was stable, even though the proportion of pregnancy terminations increased. In the local population, the incidence of trisomy 21 was 0.19%. A total of 68.2% of the local population were diagnosed prenatally, and 87.7% of these pregnant women terminated the pregnancy. There was a significantly higher proportion of pregnancy terminations in the local population than in the remainder of the national population (p < 0.01). The difference in the proportion of pregnancy terminations may be associated with variation in access to prenatal diagnostics.

Prenatal health of immigrant women in Norway - an exploratory literature review.

Immigrant women are a vulnerable group within Norwegian prenatal care and have an increased risk of adverse pregnancy outcomes. The purpose of this exploratory literature review was to compile an overview of the available knowledge on the prenatal health of immigrant women in Norway. The literature review covers 44peer-reviewed articles on the prenatal health of immigrant women in Norway. The articles reflect a variety of study designs and were published in the period 2000-2019. Searches were conducted in MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, Maternity & Infant Care Database and SveMed+. Frequently studied topics included gestational diabetes, obesity, hyperemesis gravidarum, preeclampsia and folate use. We found a considerable variation in the disease risk for different sub-groups of immigrants. Little research has been conducted on especially vulnerable immigrant groups, such as new arrivals, undocumented immigrants and refugees. We recommend that future studies consider using a qualitative research design that sheds light on the experiences of immigrant families, as well as intervention studies that test the effectiveness of measures for improving prenatal care.

Gestational diabetes mellitus by maternal country of birth and length of residence in immigrant women in Norway.

Immigrant women are at higher risk for gestational diabetes mellitus (GDM) than non-immigrant women. This study described the prevalence of GDM in immigrant women by maternal country of birth and examined the associations between immigrants' length of residence in Norway and GDM. This Norwegian national population-based study included 192,892 pregnancies to immigrant and 1,116,954 pregnancies to non-immigrant women giving birth during the period 1990-2013. Associations were reported as odds ratios (ORs) with 95% confidence intervals (CIs) using logistic regression models, adjusted for year of delivery, maternal age, marital status, health region, parity, education and income. The prevalence and adjusted OR [CI] for GDM were substantially higher in immigrant women from Bangladesh (7.4%, OR 8.38 [5.41, 12.97]), Sri Lanka (6.3%, OR 7.60 [6.71, 8.60]), Pakistan (4.3%, OR 5.47 [4.90, 6.11]), India (4.4%, OR 5.18 [4.30, 6.24]) and Morocco (4.3%, OR 4.35 [3.63, 5.20]) compared to non-immigrants (prevalence 0.8%). Overall, GDM prevalence increased from 1.3% (OR 1.25 [1.14, 1.36]) to 3.3% (OR 2.55 [2.39, 2.71]) after 9years of residence in immigrants compared to non-immigrant women. This association was particularly strong for women from South Asia. Gestational diabetes mellitus prevalence varied substantially between countries of maternal birth and was particularly high in immigrants from Asian countries. GDM appeared to increase with longer length of residence in certain immigrant groups.

Exploring Participation and Interaction in a Bottom-Up Health Promotion Program for Migrant Women in Norway.

In this article, we examine the participation and interactions of migrant women and experts who attended health parties. Based on data from participation observations and semi-structured interviews from participants of health parties, we examine how health parties may be considered an innovative bottom-up community program that could influence how migrant women focus, learn, and discuss health issues as well as interact with health care. Through a qualitative analysis, the article demonstrates two ways of organizing health parties and different approaches to the health expert role, and how this impacts the social setting and interactions of a health party. In the Norwegian setting, migrant women are considered by health authorities to be the most difficult group to reach due to cultural and language barriers. Health parties may represent an alternative for bridging these barriers and may create a useful context for active participation and learning about health for migrant women.