Effect of prenatal alcohol exposure on childhood academic outcomes: contrasting maternal and paternal associations in the ALSPAC study.

Background: The impact of low-to-moderate levels of alcohol consumption during pregnancy on child cognitive outcomes has been of recent concern. This study has tested the hypothesis that low-to-moderate maternal alcohol use in pregnancy is associated with lower school test scores at age 11 in the offspring via intrauterine mechanisms.

Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort study based in the South West of England.

Template-assisted electrohydrodynamic atomization of polycaprolactone for orthopedic patterning applications.

This paper presents the development of the novel deposition of biodegradable polycaprolactone (PCL) polymer patterns on a metallic substrate using a jet spraying technique, template-assisted electrohydrodynamic atomization (TAEA), at ambient temperature. The structure of patterns was controlled by systematically varying the polymer concentration (2-15 wt.%) and the flow rate (1-25 μl min(-1)).

Prenatal alcohol exposure and offspring cognition and school performance. A 'Mendelian randomization' natural experiment.

Background: There is substantial debate as to whether moderate alcohol use during pregnancy could have subtle but important effects on offspring, by impairing later cognitive function and thus school performance. The authors aimed to investigate the unconfounded effect of moderately increased prenatal alcohol exposure on cognitive/educational performance.

Methods: We used mother-offspring pairs participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) and performed both conventional observational analyses and Mendelian randomization using an ADH1B variant (rs1229984) associated with reduced alcohol consumption.

Modelling time to death or discharge in neonatal care: an application of competing risks.

Background: Understanding length of stay for babies in neonatal care is vital for planning services and for counselling parents. While previous work has focused on the length of stay of babies who survive to discharge, when investigating resource use within neonatal care, it is important to also incorporate information on those babies who die while in care. We present an analysis using competing risks methodology which allows the simultaneous modelling of babies who die in neonatal care and those who survive to discharge.

A randomized, observer-blinded immunogenicity trial of Cervarix(®) and Gardasil(®) Human Papillomavirus vaccines in 12-15 year old girls.

Background: The current generation of Human Papillomavirus (HPV) vaccines, Cervarix® and Gardasil®, exhibit a high degree of efficacy in clinical trials against the two high-risk (HR) genotypes represented in the vaccines (HPV16 and HPV18). High levels of neutralizing antibodies are elicited against the vaccine types, consistent with preclinical data showing that neutralizing antibodies can mediate type-specific protection in the absence of other immune effectors. The vaccines also confer protection against some closely related non-vaccine HR HPV types, although the vaccines appear to differ in their degree of cross-protection.

Effects of out-of-hours and winter admissions and number of patients per unit on mortality in pediatric intensive care.

Objective: To investigate the effect of out-of-hours and winter admissions, and unit size on risk adjusted mortality in pediatric intensive care.

Study Design: A national pediatric intensive care clinical audit provided data on over 86000 admissions to 29 pediatric intensive care units (2006-2011). Multivariate logistic regression modeled risk adjusted mortality prior to discharge with out-of-hours (night, weekend, public holiday) admissions, admissions per unit, winter admission, and potential confounders, overall and separately for emergency and planned admissions.

Neighbourhood deprivation and very preterm birth in an English and French cohort.

Background: Social factors affect the risk of very preterm birth and may affect subsequent outcomes in those born preterm. We assessed the influence of neighbourhood socio-economic characteristics on the risk and outcomes of singleton very preterm birth (<32 weeks of gestation) in two European regions with different health systems.

Methods: Live births (n=1118) from a population-based cohort of very preterm infants in 2003 in Trent (UK) and Ile-de-France (France) regions were geocoded to their neighbourhood census tracts.

Fraser syndrome: epidemiological study in a European population.

Fraser syndrome is a rare autosomal recessive disorder characterized by cryptophthalmos, cutaneous syndactyly, laryngeal, and urogenital malformations. We present a population-based epidemiological study using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network of birth defect registries. Between January 1990 and December 2008, we identified 26 cases of Fraser syndrome in the monitored population of 12,886,464 births (minimal estimated prevalence of 0.

Contemporary management and outcomes for infants born with oesophageal atresia.

Background: Reports on the management and outcome of rare conditions, such as oesophageal atresia, are frequently limited to case series reporting single-centre experience over many years. The aim of this study was to identify all infants born with oesophageal atresia in the UK and Ireland to describe current clinical practice and outcomes.

Methods: This was a prospective multicentre cohort study of all infants born with oesophageal atresia and/or tracheo-oesophageal fistula in 2008-2009 in the UK and Ireland to record current clinical management and early outcomes.

Light drinking in pregnancy and mid-childhood mental health and learning outcomes.

Objective: To investigate whether light drinking in pregnancy is associated with adverse child mental health and academic outcomes.

Design: Using data from the prospective, population-based Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated the associations between light drinking in pregnancy (<1 glass per week in the first trimester) and child mental health (using both parent and teacher rated Strengths and Difficulties Questionnaires (SDQs)) and academic outcomes based on Key Stage 2 examination results at age 11 years.

Participants: 11-year-old children from ALSPAC with parent (n=6587) and teacher (n=6393) completed SDQs and data from Key Stage 2 examination results (n=10 558).

Population-based estimates of in-unit survival for very preterm infants.

Background: Estimates of the probability of survival of very preterm infants admitted to NICU care are vital for counseling parents, informing care, and planning services. In 1999, easy-to-use charts of survival according to gestation, birth weight, and gender were published in the United Kingdom. These charts are widely used in clinical care and for benchmarking survival, and they form the core of the Clinical Risk Index for Babies II score.

Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies).

Objective: To determine survival and neonatal morbidity for babies born between 22 and 26 weeks' gestation in England during 2006, and to evaluate changes in outcome since 1995 for babies born between 22 and 25 weeks' gestation.

Design: Prospective national cohort studies.

Setting: Maternity and neonatal units in England.

Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies.

Objective: To determine outcomes at age 3 years in babies born before 27 completed weeks' gestation in 2006, and to evaluate changes in outcome since 1995 for babies born between 22 and 25 weeks' gestation.

Design: Prospective national cohort studies, EPICure and EPICure 2.

Setting: Hospital and home based evaluations, England.

Fetal alcohol exposure and IQ at age 8: evidence from a population-based birth-cohort study.

Background: Observational studies have generated conflicting evidence on the effects of moderate maternal alcohol consumption during pregnancy on offspring cognition mainly reflecting problems of confounding. Among mothers who drink during pregnancy fetal alcohol exposure is influenced not only by mother's intake but also by genetic variants carried by both the mother and the fetus. Associations between children's cognitive function and both maternal and child genotype at these loci can shed light on the effects of maternal alcohol consumption on offspring cognitive development.

Antenatal management and outcomes of gastroschisis in the U.K.

Background: The birth prevalence of gastroschisis is increasing worldwide, yet little evidence exists concerning the optimal monitoring strategies after diagnosis. The aim of this study was to describe the U.K.

The association between orthodontic treatment with removal of premolars and the angulation of developing mandibular third molars over time.

Objective: To assess changes in mandibular third molar angulation during orthodontic treatment in subjects having either first or second premolars or neither removed.

Materials And Methods: In a retrospective study approved by the institutional review board, right and left mandibular third molar angulations were compared to the vertical axis of adjacent second molars before and at the end of orthodontic treatment. The sample included 25 subjects with first premolars removed, 25 subjects with second premolars removed, and 24 subjects with no premolars removed.

Progressive visual and hearing loss secondary to neurosyphilis.

Purpose: There is a rising incidence of syphilis in economically advanced countries. Early diagnosis can spare the patient devastating vision and hearing loss, as well as other significant morbidity. Ocular presentations of neurosyphilis are varied and numerous, requiring syphilis to be considered in many clinical situations, even if a negative medical history is reported.

Epidemiology of small intestinal atresia in Europe: a register-based study.

Background: The epidemiology of congenital small intestinal atresia (SIA) has not been well studied. This study describes the presence of additional anomalies, pregnancy outcomes, total prevalence and association with maternal age in SIA cases in Europe.

Methods: Cases of SIA delivered during January 1990 to December 2006 notified to 20 EUROCAT registers formed the population-based case series.

Recent decrease in the prevalence of congenital heart defects in Europe.

Objectives: To examine trends in the prevalence of congenital heart defects (CHDs) in Europe and to compare these trends with the recent decrease in the prevalence of CHDs in Canada (Quebec) that was attributed to the policy of mandatory folic acid fortification.

Study Design: We used data for the period 1990-2007 for 47 508 cases of CHD not associated with a chromosomal anomaly from 29 population-based European Surveillance of Congenital Anomalies registries in 16 countries covering 7.3 million births.

The role of maternal nutrition in the aetiology of gastroschisis: an incident case-control study.

Background: Gastroschisis, a congenital anomaly involving a defect in the fetal abdominal wall, has increased in prevalence in many countries, but the aetiology is uncertain. We tested the hypothesis that high maternal alcohol consumption and poor diet in the first trimester are risk factors in a case-control study in the UK (1 July 2007 to 28 February 2010).

Methods: Gastroschisis cases and three controls per case (matched for maternal age) were identified at 18- to 20-week routine anomaly screening ultrasound scan (USS).

Socioeconomic inequalities in the rate of stillbirths by cause: a population-based study.

Objective: To assess time trends in socioeconomic inequalities in overall and cause-specific stillbirth rates in England.

Design: Population-based retrospective study.

Setting: England.

Comparing regional infant death rates: the influence of preterm births <24 weeks of gestation.

Objective: To investigate regional variation in the registration of preterm births <24 weeks of gestation and the impact on infant death rates for English Primary Care Trusts (PCTs).

Design: Cohort study.

Setting: England.

Babies born at the threshold of viability: changes in survival and workload over 20 years.

Objective: To assess the care given to the babies born at the threshold of viability over the last 20 years using regional and national data.

Design: Population-based retrospective study.

Setting: Former 'Trent' health region.

An investigation into the reporting and management of late terminations of pregnancy (between 22 +0 and 26 +6 weeks of gestation) within NHS Hospitals in England in 2006: the EPICure preterm cohort study.

Objective: To review all late terminations of pregnancy, between 22(+0) and 26(+6) weeks of gestation, collected as part of the EPICure2 study.

Design: Prospective cohort study.

Setting: All National Health Service (NHS) hospitals providing perinatal services for extremely preterm infants.