Current studies

SAINT 

More than four out of 10 women end up with an operative intervention after induction of labor. First-time mothers in particular have a high risk of operative delivery (caesarean section or vacuum/forceps delivery) after induction of labor. The randomized controlled study SAINT - SAfe INduction of labor Trial - will investigate whether two drugs can reduce this proportion. The drugs that will be tested are intravenous butylscopolamine bromide (Buscopan®), which can facilitate dilation of the cervix, as well as oral bicarbonate, which can prevent the uterus from becoming exhausted and "acidic" during birth. These drugs are frequently used in maternity wards in Norway and in the rest of the world, but the knowledge base that this is an effective treatment is lacking. Very few have investigated whether these drugs can also be effective in women with labor induction. Almost every third birth in Norway is induced, and this is therefore an important study and the largest clinical intervention study ever planned to be carried out on women in labor in Norway. Pregnant women and those giving birth are an understudied group, and are often excluded from intervention studies due to uncertainty about negative effects on the fetus. The SAINT study follows in the footsteps of the Department of Obstetrics' BUSCLAB study (PI Michelsen), which examined the effect of Buscopan® on the duration of labor among women who show signs of slow progress in labor. The study will last five years and recruitment will take place at 10 large maternity wards in Norway. The study will also examine women's own birth experience after labor has been initiated, as an important patient-reported outcome measure. Another important sub-goal for the study is the establishment of a national consortium for clinical studies in obstetrics (NORBIRTH), with a view to future research on this patient group. 

STORK-Rikshospitalet 

The STORK cohort study focuses on nutritional, metabolic, neuroendocrine and vascular aspects of mother and child interaction with regard to fetal growth and development. The mother's metabolic status is mapped by examining, among other things overweight/obesity, endocrine and inflammatory parameters, as well as plasma levels of lipids and glucose. Several new sub-projects have been started using the STORK cohort. One concerns the follow-up of the children of women who had hyperlipidemia during pregnancy to see if it affects the child's risk profile for cardiovascular diseases. Project title: Effect of metabolically unfavorable phenotype during pregnancy on later risk markers for cardiovascular disease in children and young people. The study is underway. The second sub-project is a study of "Healthy and unhealthy obese" where we will look at different metabolic profiles in overweight/obese pregnant women in relation to pregnancy and childbirth complications. The basic idea is that it is not the excess weight in itself, but the metabolic and inflammatory changes that may come with the excess weight that are important in relation to disease risk/pregnancy complications. The third is follow-up of 300 women from the STORK cohort that has been carried out (post-STORK). Studies of connections between pregnancy physiology and pregnancy complications (such as gestational diabetes) and later increased risk for e.g. cardiovascular disease is ongoing. Data from the STORK project is part of a collaboration with projects from Trondheim, Kristiansand and Oslo to study risk factors for the development of gestational diabetes. 

The 4-vessel study

The placenta is the most important organ of pregnancy and controls both maternal physiology and fetal development. Human in vivo studies of placental functions have to a small extent been carried out due to significant methodological limitations. We have established a method ("The 4 vessel sampling method") which makes such investigations possible and which has laid the foundation for the STORK placenta project. The method makes it possible to study the transport of nutrients and oxygen from the mother across the placenta, and to calculate the consumption of energy and nutrients in the child before it is born. The group is the only one worldwide to have established this method so far. We have initially concentrated on glucose, lipids and amino acids, and the study is now being further developed with proteomics and metabolomics analyses. 

Placental proteins in healthy pregnancies and preeclampsia

"The 4 vessel sampling method" combined with measurement of 5000 proteins is used to identify proteins released from the placenta to the maternal and fetal circulation.  Such placenta-derived proteins may affect both maternal physiology and fetal and development. We are especially interested in proteins linked to the pathophysiology in preeclampsia, including proteins with a disruptive effect on endothelial cell function in the mother. In the event of disturbances in the endothelial function, high blood pressure develops in the mother, which in turn can have a negative effect on the function of the placenta and the development of the fetus. Furthermore, we are investigating potential biomarkers that can be measured in the maternal circulation to indicate placental function. Such biomarkers would aid the identification of risk pregnancies and enable interventions. Last, we are interested in proteins released into the fetal circulation that may unravel the placentas impact on fetal development. Such proteins may also have relevance in the treatment of very preterm born infants, as they miss the placental supply of proteins during the last trimester. 

PREBRAIN – The 4 vessel follow-up study

Women and children who participated in the STORK placenta study will be invited to participate in a follow-up study where we will focus on brain/cognitive function ("Placenta-brain axis") and cardio metabolic health ("Placenta-cardio") 10 years after pregnancy . We will collect blood samples, carry out cognitive tests and MRI scans of the children. The aim is to link data from pregnancy and the placenta to long-term health. 

SOFUS 

The SOFUS (Parents' experience of stress during ultrasound examinations during pregnancy) cohort study investigates psychological stress in parents-to-be who have been diagnosed with a fetal abnormality and relates this to a control group. We measure psychometric and endocrine variables in the pregnant woman and circulatory conditions in the fetus with Doppler ultrasound. In collaboration with the Department of Psychology at the University of Oslo, a follow-up study of children and parents is carried out. 

Stork-3 and the IUGR food study 

The fetus's liver is central to energy and nutrient metabolism in the fetus as well. The aim of this study is to study how the blood flow from the placenta is distributed to the fetus's liver and heart (ductus venosus) and brain at different stages of fetal life and in relation to the mother's nutritional intake. The study has been extended to a cohort with fetal growth retardation. In addition, a blinded randomized study is being carried out, looking at the effect of food intake versus fasting in a population with normal pregnancies. 

PreventADALL 

PreventADALL ('Preventing Atopic Dermatitis and ALLergy in children') is a multinational population-based prospective intervention study that will investigate the effect of 'skin care' and early introduction of food allergens in infants. Inclusion takes place in two rounds; in week 18 of pregnancy and then at birth. The inclusion was completed in 2017. Our research group is involved in ultrasound examinations of fetal growth in general with a particular focus on the growth and circulation of fetal lungs. 

Consequences of hysterectomy and oophorectomy 

The group has close collaboration with Sørlandet Hospital, and has over time worked with health after gynecological surgery. This is now being continued with three PhD students and a postdoc (Nora Johansen) at Sørlandet Hospital, with research group leader Michelsen involved in project management and supervision.