Ida Kathrine Gravensteen

• Gravensteen, Ida Kathrine; Ekeberg, Øivind; Thiblin, Ingemar; Helweg-Larsen, Karin; Hem, Erlend & Rogde, Sidsel [Show all 7 contributors for this article] (2019). Psychoactive substances in natural and unnatural deaths in Norway and Sweden - A study on victims of suicide and accidents compared with natural deaths in psychiatric patients. BMC Psychiatry. 19:33, p. 1–9. doi: 10.1186/s12888-019-2015-9. Full text in Research Archive Show summary

  Background The extent of post-mortem detection of specific psychoactive drugs may differ between countries, and may greatly influence the national death register’s classification of manner and cause of death. The main objective of the present study was to analyse the magnitude and pattern of post-mortem detection of various psychoactive substances by the manner of death (suicide, accidental, undetermined and natural death with a psychiatric diagnosis) in Norway and Sweden. Methods The Cause of Death Registers in Norway and Sweden provided data on 600 deaths in 2008 from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of death and 200 as natural deaths in individuals with a diagnosis of mental disorder as the underlying cause of death. We examined death certificates and forensic reports including toxicological analyses. Results The detection of psychoactive substances was commonly reported in suicides (66 and 74% in Norway and Sweden respectively), accidents (85 and 66%), undetermined manner of deaths (80% in the Swedish dataset) and in natural deaths with a psychiatric diagnosis (50 and 53%). Ethanol was the most commonly reported substance in the three manners of death, except from opioids being more common in accidental deaths in the Norwegian dataset. In cases of suicide by poisoning, benzodiazepines and z-drugs were the most common substances in both countries. Heroin or morphine was the most commonly reported substance in cases of accidental death by poisoning in the Norwegian dataset, while other opioids dominated the Swedish dataset. Anti-depressants were found in 22% of the suicide cases in the Norwegian dataset and in 29% of suicide cases in the Swedish dataset. Conclusions Psychoactive substances were detected in 66 and 74% of suicides and in 85 and 66% of accidental deaths in the Norwegian and Swedish datasets, respectively. Apart from a higher detection rate of heroin in deaths by accident in Norway than in Sweden, the pattern of detected psychoactive substances was similar in the two countries. Assessment of a suicidal motive may be hampered by the common use of psychoactive substances in suicide victims.

• Gravensteen, Ida Kathrine; Jacobsen, Eva-Marie; Sandset, Per Morten; Helgadóttir, Linda Björk; Rådestad, Ingela & Sandvik, Leiv [Show all 7 contributors for this article] (2018). Anxiety, depression and relationship satisfaction in the pregnancy following stillbirth and after the birth of a live-born baby: A prospective study. BMC Pregnancy and Childbirth. 18(41). doi: 10.1186/s12884-018-1666-8. Full text in Research Archive Show summary

  Background Experiencing a stillbirth can be a potent stressor for psychological distress in the subsequent pregnancy and possibly after the subsequent birth. The impact on women’s relationship with her partner in the subsequent pregnancy and postpartum remains uncertain. The objectives of the study were 1) To investigate the prevalence of anxiety and depression in the pregnancy following stillbirth and assess gestational age at stillbirth and inter-pregnancy interval as individual risk factors. 2) To assess the course of anxiety, depression and satisfaction with partner relationship up to 3 years after the birth of a live-born baby following stillbirth. Methods This study is based on data from the Norwegian Mother and Child Cohort Study, a population-based pregnancy cohort. The sample included 901 pregnant women: 174 pregnant after a stillbirth, 362 pregnant after a live birth and 365 previously nulliparous. Anxiety and depression were assessed by short-form subscales of the Hopkins Symptoms Checklist, and relationship satisfaction was assessed by the Relationship Satisfaction Scale. These outcomes were measured in the third trimester of pregnancy and 6, 18 and 36 months postpartum. Logistic regression models were applied to study the impact of previous stillbirth on depression and anxiety in the third trimester of the subsequent pregnancy and to investigate gestational age and inter-pregnancy interval as potential risk factors. Results Women pregnant after stillbirth had a higher prevalence of anxiety (22.5%) and depression (19.7%) compared with women with a previous live birth (adjusted odds ratio (aOR) 5.47, 95% confidence interval (CI) 2.90–10.32 and aOR 1.91, 95% CI 1.11–3.27) and previously nulliparous women (aOR 4.97, 95% CI 2.68–9.24 and aOR 1.91, 95% CI 1.08–3.36). Gestational age at stillbirth (> 30 weeks) and inter-pregnancy interval <  12 months were not associated with depression and/or anxiety. Anxiety and depression decreased six to 18 months after the birth of a live-born baby, but increased again 36 months postpartum. Relationship satisfaction did not differ between groups. Conclusion Women who have experienced stillbirth face a significantly greater risk of anxiety and depression in the subsequent pregnancy compared with women with a previous live birth and previously nulliparous women.

• Gravensteen, Ida Kathrine; Jacobsen, Eva-Marie; Sandset, Per Morten; Helgadóttir, Linda Björk; Rådestad, Ingela & Sandvik, Leiv [Show all 7 contributors for this article] (2018). Healthcare utilisation, induced labour and caesarean section in the pregnancy after stillbirth: a prospective study. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328. 125(2), p. 202–210. doi: 10.1111/1471-0528.14750. Full text in Research Archive Show summary

  Objective To investigate healthcare utilisation, induced labour and caesarean section (CS) in the pregnancy after stillbirth and assess anxiety and dread of childbirth as mediators for these outcomes. Design Population-based pregnancy cohort study. Setting The Norwegian Mother and Child Cohort Study. Sample 901 pregnant women; 174 pregnant after stillbirth, 362 pregnant after live birth and 365 previously nulliparous. Methods Data from questionnaires answered in the second and third trimesters of pregnancy and information from the Medical Birth Registry of Norway. Main outcome measures Self-reported assessment of antenatal care, register-based assessment of onset and mode of delivery. Results Women with a previous stillbirth had more frequent antenatal visits (mean 10.0; 95% confidence interval [CI] 9.4 - 10.7) compared with women with a previous live birth (6.0; 5.8 - 6.2) and previously nulliparous women (6.3; 6.1 - 6.6). Induced labour and CS, elective and emergency, were also more prevalent in the stillbirth group. The adjusted odds ratio for elective CS was 2.5 (95% CI 1.3 – 5.0) compared with women with previous live birth and 3.7 (1.8 - 7.6) compared with previously nulliparous women. Anxiety was a minor mediator for the association between stillbirth and frequency of antenatal visits, while dread of childbirth was not a significant mediator for elective CS. Conclusions Women pregnant after stillbirth were more ample users of healthcare services and had more often induced labour and CS. The higher frequency of antenatal visits and elective CS could not be accounted for by anxiety or dread of childbirth. The file is under embargo until 2018-05-18

• Gravensteen, Ida Kathrine (2017). Kvinners livskvalitet og psykiske helse etter dødfødsel. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(19). doi: 10.4045/tidsskr.17.0788. Full text in Research Archive
• Gravensteen, Ida Kathrine; HELGADOTTIR, LINDA BJØRK; Jacobsen, Eva-Marie; Rådestad, Ingela; Sandset, Per Morten & Ekeberg, Øivind (2013). Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study. BMJ Open. 3(10). doi: 10.1136/bmjopen-2013-003323. Full text in Research Archive Show summary

  Objectives: (1) To investigate the experiences of women with a previous stillbirth and their appraisal of the care they received at the hospital. (2) To assess the long-term level of post-traumatic stress symptoms (PTSS) in this group and identify risk factors for this outcome. Design: A retrospective study. Setting: Two university hospitals. Participants: The study population comprised 379 women with a verified diagnosis of stillbirth (=23 gestational weeks or birth weight =500 g) in a singleton or twin pregnancy 5–18 years previously. 101 women completed a comprehensive questionnaire in two parts. Primary and secondary outcome measures: The women's experiences and appraisal of the care provided by healthcare professionals before, during and after stillbirth. PTSS at follow-up was assessed using the Impact of Event Scale (IES). Results: The great majority saw (98%) and held (82%) their baby. Most women felt that healthcare professionals were supportive during the delivery (85.6%) and showed respect towards their baby (94.9%). The majority (91.1%) had received some form of short-term follow-up. One-third showed clinically significant long-term PTSS (IES?=?20). Independent risk factors were younger age (OR 6.60, 95% CI 1.99 to 21.83), induced abortion prior to stillbirth (OR 5.78, 95% CI 1.56 to 21.38) and higher parity (OR 3.46, 95% CI 1.19 to 10.07) at the time of stillbirth. Having held the baby (OR 0.17, 95% CI 0.05 to 0.56) was associated with less PTSS. Conclusions: The great majority saw and held their baby and were satisfied with the support from healthcare professionals. One in three women presented with a clinically significant level of PTSS 5–18 years after stillbirth. Having held the baby was protective, whereas prior induced abortion was a risk factor for a high level of PTSS.

• Heazell, Alexander E.P.; Leisher, Susannah; Cregan, Mairie; Flenady, Vicki; Frøen, Frederik & Gravensteen, Ida Kathrine [Show all 13 contributors for this article] (2013). Sharing experiences to improve bereavement support and clinical care after stillbirth: report of the 7th annual meeting of the international stillbirth alliance. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 92(3), p. 352–361. doi: 10.1111/aogs.12042. Full text in Research Archive
• Gravensteen, Ida Kathrine; HELGADOTTIR, LINDA BJØRK; Jacobsen, Eva-Marie; Sandset, Per Morten & Ekeberg, Øivind (2012). Long-term impact of intrauterine fetal death on quality of life and depression: a case-control study. BMC Pregnancy and Childbirth. 12(43). doi: 10.1186/1471-2393-12-43. Full text in Research Archive Show summary

  Background Intrauterine fetal death (IUFD) is a serious incidence that has been shown to impact mothers’ psychological well-being in the short-term. Long-term quality of life (QOL) and depression after IUFD is not known. This study aimed to determine the association between intrauterine fetal death and long-term QOL, well-being, and depression. Methods Analyses were performed on collected data among 106 women with a history of intrauterine fetal death (IUFD) and 262 women with live births, 5–18 years after the event. Univariable and multivariable linear and logistic regression models were used to quantify the association between previous fetal death and long-term QOL, well-being and depression. QOL was assessed using the QOL Index (QLI), symptoms of depression using the Center for Epidemiological Studies Depression Scale (CES-D), and subjective well-being using the General Health Questionnaire 20 (GHQ-20). Results More of the cases had characteristics associated with lower socioeconomic status and did not rate their health as good as did the controls. The QLI health and functioning subscale score was slightly but significantly lower in the cases than in the controls (22.3. vs 23.5, P = .023). The CES-D depressed affect subscale score (2.0 vs 1.0, P = 0.004) and the CES-D global score (7.4 vs 5.0, P = .017) were higher in the cases. Subjective well-being did not differ between groups (20.6 vs 19.4, P = .094). After adjusting for demographic and health-related variables, IUFD was not associated with global QOL (P = .674), subjective well-being (P = .700), or global depression score (adjusted odds ratio = 0.77, 95% confidence interval 0.37–1.57). Conclusions Women with previous IUFD, of which the majority have received short-term interventions, share the same level of long-term QOL, well-being and global depression as women with live births only, when adjusted for possible confounders. Trial registration The study was registered at http://www.clinicaltrials.gov , with registration number NCT 00856076.

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• Einevoll, Gaute & Gravensteen, Ida Kathrine (2025). #106: Om rettsmedisin - med Ida Gravensteen. Full text in Research Archive
• Gravensteen, Ida Kathrine & Stray-Pedersen, Arne (2025). Gi oss en egen spesialitet! Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145(4). doi: 10.4045/tidsskr.25.0013. Full text in Research Archive
• Jemterud, Torkild; Dietrichs, Erik Sveberg; Delsett, Lene Liebe; Bøckman, Petter; Gravensteen, Ida Kathrine & Storehaug, Ida Torkjellsdatter [Show all 7 contributors for this article] (2025). Blir du frisk raskere uten paracet? - Abels tårn - NRK Radio. [Radio]. NRK P2. Full text in Research Archive Show summary

  Sammen med et ekspertpanel gir Torkild Jemterud deg svar på alt du ikke visste du lurte på.

• Anell, Ingrid; Jemterud, Torkild; Gravensteen, Ida Kathrine & Sandtorv, Alexander Harald (2023). Abels Tårn Hvorfor sier norske leger: "drikk vann". [Radio]. Voksenopplæringa i Oslo. Full text in Research Archive
• Vereide, Emilie Hernes; Wahl, Andreas & Gravensteen, Ida Kathrine (2023). Jøss #99 - Å splitte tommelen, blø fra alle kroppsoppninger, og påstå at potetgull ikke er potetgull. Full text in Research Archive
• Vereide, Emilie Hernes; Gravensteen, Ida Kathrine & Wahl, Andreas (2023). Jøss #101 - Slaveopprør på seks bein, knapp for å føde og verdens verste eksperiment. Full text in Research Archive
• Jemterud, Torkild; Skogvoll, Vidar; Røyne, Anja; Eriksen, Anita; Gravensteen, Ida Kathrine & Ellingsen-Dalskau, Kristian (2023). Abels tårn - Abels Påskemix - Hvorfor liker vi surt godteri, sånn rent evolusjonært? [Radio]. P2. Full text in Research Archive
• Gravensteen, Ida Kathrine & Rogde, Sidsel (2022). Sudden Death Due to Cervical Necrotizing Soft Tissue Infection. American Journal of Forensic Medicine and Pathology. ISSN 0195-7910. 43(3), p. E26–E27. doi: 10.1097/PAF.0000000000000780. Full text in Research Archive
• Engebretsen, Solveig; Raklev, Are; Gravensteen, Ida Kathrine & Jemterud, Torkild (2021). Abels tårn. [Radio]. NRK. Full text in Research Archive
• Gravensteen, Ida Kathrine (2018). Author's reply re: Healthcare utilisation, induced labour and caesarean section in the pregnancy after stillbirth: a prospective study. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328. 125(1), p. 92–92. doi: 10.1111/1471-0528.14787. Full text in Research Archive
• Bøckman, Petter; Bergsaker, Anne Schad; Gravensteen, Ida Kathrine & Jemterud, Torkild (2018). Abelels tårn. [Radio]. Ekko, NRK P2. Full text in Research Archive
• Jemterud, Torkild; Gravensteen, Ida Kathrine; Løvvik, Ole Martin & Gadmar, Tone Charlotte (2017). Abels Tårn, NRK Radio: "Er popcorn junkfoodens svar på norsk gass? [Radio]. Ekko, NRK P2. Full text in Research Archive
• Graff, Ingvild Eide; Ellingsen, Christian Lycke; Gravensteen, Ida Kathrine; Johansen, Ingrid Hjulstad; Kirkhorn, Kari & Lexander, Hågen Vatshelle [Show all 11 contributors for this article] (2025). Utredning av hvordan mørketall ved selvmord kan reduseres. Folkehelseinstituttet. ISSN 9788284064970. Full text in Research Archive Show summary

  Ekspertgruppen har evaluert dagens praksis for hvordan informasjon om dødsårsak og dødsmåte blir formidlet til Dødsårsaksregisteret (DÅR) etter en persons død. Dette inkluderer opplysninger fra dødsmeldingen, dialog med lege, og fra obduksjonsrapport når det er aktuelt. Målet for ekspertgruppen har vært å identifisere og vurdere tiltak som kan bedre forekomsttallene for selvmord. Gruppens mandat har vært å foreslå endringer i dagens system slik at kvaliteten på informasjon om selvmord bedres, og at graden av mørketallene når det gjelder antall selvmord i Norge, kan reduseres. Dette er en del av arbeidet med å forebygge selvmord og er i tråd med regjeringens handlingsplan for 2020-2025. Overgangen fra dødsmelding på papir til digital dødsmelding startet i 2018, og fra 01.01.2022 ble det obligatorisk for leger å melde inn dødsfall elektronisk. I løpet av 2022 kom 98 % av dødsmeldingene digitalt inn til DÅR. Dette ga raskere tilgang til opplysninger om dødsårsak, bedre lesbarhet og tryggere lagring av data. Det virker som om dette systemet fungerer godt, og det rapporteres ikke om tekniske vanskeligheter fra leger som benytter systemene. Dødsmeldingen sendes automatisk til relevante myndigheter. Det er likevel en utfordring at det for de fleste leger går lang tid mellom hver gang de fyller ut en dødsmelding, og at de svært sjeldent er i befatning med selvmord. Ved dødsfall utenfor institusjon har legen ofte lite informasjon tilgjengelig i vurderingen av dødsårsak og dødsmåte. Det er derfor en risiko for at dødsfallet kodes feil. Hvert år publiseres statistikk over dødsårsaker, inkludert selvmord, fra året før. Det er flere feilkilder ved innmelding av et dødsfall som kan påvirke forekomsttallene av selvmord. Dødsmeldinger kan være dårlig eller mangelfullt utfylt, slik at det ikke kommer frem at det er et selvmord. Legen kan oppgi en feil, men plausibel dødsårsak på dødsmeldingen, eller det kan være oppgitt korrekt skadediagnose, men feil dødsmåte. Noen ganger benyttes koder for dødsårsak og dødsmåte som gir lite informasjon om den underliggende dødsårsaken. I Norge er omtrent 29 % av dødsfallene kodet med en slik lite informativ kode (såkalt skrotkode), og det er sannsynlig at en del av mørketallene for selvmord befinner seg blant disse skrotkodene. Ekspertgruppen har derfor foreslått tiltak som gruppen mener vil bedre kvaliteten på kodene for dødsårsak og dødsmåte i Norge, og dermed bidra til å ta ned mørketallene ved selvmord. Ekspertgruppens ti foreslåtte tiltak for å ta ned mørketallene ved selvmord er: • Automatisk involvering av fastlege når en dødsmelding er sendt inn til DÅR • Elektronisk kommunikasjon mellom DÅR og fastlegen når DÅR skal innhente tilleggsopplysninger • Inkludering av unaturlige dødsfall og rusrelaterte dødsfall i en lignende prosess som for dødsfall i veitrafikken (2020) • Betydelig økning i kapasitet og kompetanse i de rettspatologiske fagmiljøene • Gjennomføring av et forsknings- og utviklingsprosjekt for å undersøke andelen selvmord blant eldre • Forbedring av det digitale skjemaet for dødsmeldingen • Honorering for arbeid med dødsmelding, innhenting av tilleggsopplysninger, og rekvirering av obduksjon (HELFO sats) • Arrangering av årlige møter mellom rettsmedisinere, andre leger og kodere i DÅR • Påminnelse til rettspatologiavdelingene om å sette rettsmedisinsk kommisjon og DÅR som kopimottakere når de oppretter sak • Revurdering av finansieringsordningen for obduksjoner Ekspertgruppen har også anbefalt ytterligere syv tiltak, og har vurdert ni tiltak som er omtalt, men som gruppen ikke anbefaler. Ekspertgruppen anbefaler ikke at det igangsettes en utredning av coroner eller medical examiner ordning etter modell fra England i denne omgang. Ekspertgruppen oppfordrer til at tiltakene iverksettes noenlunde samlet dersom det er mulig. Det vil lette evalueringen av om tiltakene samlet sett har virket.

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