Copenhagen Baby Heart Study: a population study of newborns with prenatal inclusion.

Congenital heart diseases (CHDs) are reported in 0.8% of newborns. Numerous factors influence cardiovascular development and CHD prevalence, and possibly also development of cardiovascular disease later in life. However, known factors explain the probable etiology in only a fraction of patients. Past large-scale population-based studies have made invaluable contributions to the understanding of cardiac disease, but none recruited participants prenatally and focused on the neonatal period. The Copenhagen Baby Heart Study (CBHS) is a population-based study of the prevalence, spectrum, and prognosis of structural and functional cardiac abnormalities. The CBHS will also establish normal values for neonatal cardiac parameters and biomarkers, and study prenatal and early childhood factors potentially affecting later cardiovascular disease risk. The CBHS is an ongoing multicenter, prospective study recruiting from second trimester pregnancy (gestational weeks 18-20) (expected n = 25,000). Information on parents, pregnancy, and delivery are collected. After birth, umbilical cord blood is collected for biochemical analysis, DNA purification, and biobank storage. An echocardiographic examination, electrocardiography, and post-ductal pulse oximetry are performed shortly after birth. Infants diagnosed with significant CHD are referred to a specialist or admitted to hospital, depending on CHD severity. CBHS participants will be followed prospectively as part of specific research projects or regular clinical follow-up for CHD. CBHS design and methodology are described. The CBHS aims to identify new mechanisms underlying cardiovascular disease development and new targets for prevention, early detection, and management of CHD and other cardiac diseases presenting at birth or developing later in life.

Unannounced in situ simulation of obstetric emergencies: staff perceptions and organisational impact.

AIM: To describe how unannounced in situ simulation (ISS) was perceived by healthcare professionals before and after its implementation, and to describe the organisational impact of ISS. STUDY DESIGN: Ten unannounced ISS involving all staff were scheduled March-August 2007. Questionnaire surveys on staff perceptions were conducted before (2003-2006) and after (2007-2008) implementation of unannounced ISS. Information from the debriefing sessions following each ISS constituted a proxy measure of the organisational impact of the ISS. RESULTS: Five out of ten of the unannounced ISS scheduled were conducted. Twenty-three members of the staff at work on a scheduled day for ISS were randomly selected to participate. Questionnaires before implementation revealed that 137/196 (70%) of staff members agreed or strongly agreed that ISS was a good idea and 52/199 (26%) thought it likely to be stressful and unpleasant. Questionnaires completed after implementation showed significantly more staff members, 135/153 (89%), thought ISS was a good idea. A significantly higher amount of staff members 50/153 (33%) found it to be stressful and unpleasant, and among midwives, 15/59 (25%) were anxious about ISS, whereas none of the obstetricians reported this. Information obtained through debriefing sessions generated learning points. CONCLUSIONS: The number of staff members with a positive perception of multiprofessional unannounced ISS increased after implementation; however, one-third considered ISS to be stressful and unpleasant and midwives more frequently so. The specific perception of ISS by each healthcare profession should be taken into account when planning ISS. The information from the debriefing sessions showed that implementation of ISS had an impact as it provided information required for organisational changes.

A case of well-established breastfeeding for a 61-year-old woman after menopause.

During recent years, an increasing number of women who have become pregnant after fertility treatment, including oocyte transplantation, have presented at obstetric departments. A number of these women want to breastfeed their children even though they are postmenopausal. However, whether this is possible has remained doubtful, and any possible special needs in establishing their breastfeeding are not described. The experience of establishing breastfeeding in a postmenopausal woman aged 61 years is reported.

Low prevalence of long-term breastfeeding among women with type 2 diabetes.

OBJECTIVE: To investigate the prevalence of long-term breastfeeding among women with type 2 diabetes compared to women with type 1 diabetes and to identify predictors of long-term breastfeeding for women with pre-gestational diabetes. METHODS: In total, 149 women with diabetes were interviewed about long-term breastfeeding, defined as any breastfeeding 4 months postpartum. RESULTS: Ninety-eight percent of the women aimed to breastfeed. At time of discharge, any breastfeeding was frequent for both groups of women (86% versus 93%, p = 0.17). However, 4 months postpartum, the 44 women with type 2 diabetes showed significantly lower prevalence of breastfeeding than the 105 women with type 1 diabetes (34% versus 61%, p < 0.01). Number of feedings in the first 24 h was an independent positive predictor, whereas pre-pregnancy body mass index (BMI) and smoking were independent negative predictors of long-term breastfeeding. CONCLUSION: The prevalence of long-term breastfeeding among women with type 2 diabetes was considerably lower than in women with type 1 diabetes. Number of feedings in the first 24 h was positive and BMI and smoking were negative predictors of long-term breastfeeding in women with pre-gestational diabetes.