Ionizing radiation is applied in healthcare for diagnostics or cancer therapy in various human populations, including pediatric patients. To ensure children's stillness during radiological procedures, they are usually sedated/anesthetized with anesthetics, such as ketamine. Previous studies have shown that exposure to ketamine, ionizing radiation, or a combination of both during critical periods of brain development can result in cognitive impairment later in life.The purpose of the project is to investigate developmental neurotoxic effects of ketamine and low-dose ionizing radiation.Female NMRI-mice were exposed on postnatal day 10 to ketamine (7.5 mg/kg), low-dose ionizing radiation (200 mGy), or co-exposure. Then, gene expression patterns in hippocampusfor Jagged1, Hes5, Nrf2, Keap1, Bdnf and Grin2b were studied by qPCR.Two primers were designed for the mouse genes Cat, Sod2, Tia1 and G3bp1 respectively. Subsequently, efficiency of each primer was investigated using qPCR to generate a standard curve.The gene expression of Grin2b showed/displayed statistically significant downregulation in all exposed groups. No statistically significant change in the gene expression of Jagged-1, Hes5, Nrf2, Keap1 and Bdnf were observed.Due to appearance of secondary peaks, primers for Tia1:1, G3bp1:2 and Sod2:1 were excluded from the study. The efficiency of Cat1, Cat2, Sod2-2, Tia1-2 and G3bp1-1 did not meet the criteria (90–110%) for further work.Exposure to ketamine, low-dose ionizing radiation or a co-exposure may affect Grin2bexpression in children and consequently result in cognitive impairment. More studies are required to determine the underlying mechanism. Additional aspects to consider when designing primers should be implemented.

SAMMANFATTNING Bakgrund Kvinnlig könsstympning (Female Genital Mutilation, FGM) är en uråldrig tradition med starka band till kulturell och etnisk identitet. Mer än 200 miljoner kvinnor och flickor beräknas vara könsstympade och årligen riskerar cirka 3,9 miljoner ytterligare flickor att utsättas. Andelen kvinnor från länder där FGM är vanligt förekommande och som föder barn i Sverige har ökat i och med ökad invandring från dessa länder. FGM är internationellt betraktat som en kränkning av de mänskliga rättigheterna samt ett brott mot kvinnor och barns rättigheter. Syfte Att jämföra förekomsten och risken för perinatala komplikationer hos kvinnor med en diagnos av FGM med kvinnor utan denna diagnos som fött barn i Sverige mellan åren 2007 - 2017. Metod En populationsbaserad kohortstudie. Resultat Det huvudsakliga resultatet i denna studie är att barn födda av kvinnor med en FGM diagnos har en signifikant ökad risk för låg Apgar, födas lätta för tiden (SGA), drabbas av kramper, perinatal död inklusive intrauterin fosterdöd samt att födas överburna. Slutsats FGM är förknippat med ett flertal allvarliga perinatala komplikationer. Störst risk kunde ses mellan FGM och att födas lätt för tiden, födas överburen och intrauterin fosterdöd. Dessa samband var robusta oavsett vilket land kvinnan är född. Det går att dra slutsatsen att kvinnor med en FGM-diagnos och deras nyfödda barn tillhör en riskgrupp. Det är av stor vikt att arbeta preventivt för att skydda dessa kvinnor och barns hälsa. / ABSTRACT Background Female Genital Mutilation (FGM) is an ancient tradition with strong ties to cultural and ethnic identity. More than 200 million women and girls are estimated to be exposed, and about 3.9 million more girls are at risk each year. The proportion of women from countries where female genital mutilation is common, and which gives birth to children in Sweden has increased with an increased immigration. Female genital mutilation is internationally considered as a violation of human rights and a violation of women's and children's rights. Aim To compare the incidence and risk of perinatal complications among women with a diagnosis of FGM with women without this diagnosis who has given birth to a child in Sweden during the years 2007 - 2017. Method A population-based cohort study. Results The main result of this study is that children born of women with an FGM-diagnosis have a significantly increased risk of low apgar scores, being born Small for Gestational Age, convulsions, perinatal death and prolonged pregnancy could be observed. Conclusion FGM is associated with a number of serious perinatal complications. The greatest risk was seen between female genital mutilation and being born Small for Gestational Age, prolonged pregnancy and intrauterine fetal death. These relationships were robust regardless of which country the woman was born. It can be concluded that women with an FGM diagnosis and their newborn children belong to a risk group. It is very important to work preventively to protect these women and children's health.