Improved exclusive breastfeeding rates in preterm infants after a neonatal nurse training program focusing on six breastfeeding-supportive clinical practices.

BackgroundEarly breast milk expression, prolonged skin-to-skin contact, rooming-in, use of test-weighing and minimizing use of pacifiers are positively associated with exclusive breastfeeding of preterm infants, whereas use of nipple shields is negatively associated.AimTo test whether a training program for neonatal nurses with a focus on these six breastfeeding-supportive clinical practices affects the rate of preterm infants exclusively breastfed at discharge to home, the postmenstrual age at establishment of exclusive breastfeeding, and maternal self-reported use of the practice in the neonatal intensive care unit, the.MethodsA quasi-experimental multi-centre intervention study from 2016-2019 including a control group of 420 preterm mother-infant dyads, an intervention with a training program for neonatal nurses and implementation of weekly breastfeeding meetings for neonatal nurses, and an intervention group of 494 preterm mother-infant dyads.ResultsSignificantly more preterm infants in the intervention group were exclusively breastfed at discharge to home (66.6%) than in the control group (58.1%) p = 0.008. There was no significant difference in postmenstrual age at establishment of exclusive breastfeeding between control and intervention group (37.5 vs.37.8 weeks, p = 0.073). Compared to the control group the number of infants continuing daily skin-to-skin contact after incubator care increased (83.2% vs. 88.3%, p = 0.035), infants using a nipple shield decreased (61.8% vs. 54.2%, p = 0.029), and the number of mothers initiating breast milk expression before six hours post-partum increased (32.6% vs. 42.4%, p = 0.007). There was a significant correlation between percentage of neonatal nurses participating in the breastfeeding training program and changes in exclusive breastfeeding rates (Pearson Correlation 0.638, p = 0.047).ConclusionExclusive breastfeeding rates in preterm infants and maternal self-reported use of breastfeeding-supportive practices increased by training neonatal nurses in the six clinical practices. It is important to include all nurses in the breastfeeding training program to ensure positive effect on exclusive breastfeeding rates

Parental Rheumatoid Arthritis, Child Mortality and Case Fatality:A Nationwide Cohort Study

OBJECTIVE: We have reported increased long term morbidity in children of parents with rheumatoid arthritis (RA). Here we assess child mortality and case fatality in the same cohort. METHODS: All singletons born in Denmark from 1977 to 2008 were identified through linkage of Danish National registries. Cox proportional hazard model was used to calculate hazard ratios (HR’s) of death from all causes among children exposed to parental RA, compared to unexposed children. Risk of death after infection or respiratory diseases was also assessed for children below the age of 5 years. RESULTS: 1,917,723 new-borns were followed for an average of 16 years. Of these 13,556 were exposed to maternal RA and 6,330 to paternal RA. Overall mortality rates in children exposed to maternal or paternal RA did not differ from unexposed children: HR 0.98 [95% CI 0.84, 1.15] and 1.08 [95% CI 0.86, 1.36] and neither did the risk of death below the ages of 5 years, 3 years, or 1 year. Below the age of 5 years, 6,106 children of parents with RA were diagnosed with respiratory diseases and 3,320 with infectious diseases. Case fatalities in children with these diseases were not significantly higher than those for unexposed children: HR 1.11 [95% CI 0.74–1.66] and 0.84 [95% CI 0.52–1.35], respectively. CONCLUSION: Children of parents with RA had similar mortality as other children, also after diagnoses of respiratory or infectious diseases

Effects of a midwife-coordinated maternity care intervention (Chropreg) vs. standard care in pregnant women with chronic medical conditions:Results from a randomized controlled trial

The proportion of childbearing women with pre-existing chronic medical conditions (CMC) is rising. In a randomized controlled trial, we aimed to evaluate the effects of a midwife-coordinated maternity care intervention (ChroPreg) in pregnant women with CMC. The intervention consisted of three main components: (1) Midwife-coordinated and individualized care, (2) Additional ante-and postpartum consultations, and (3) Specialized known midwives. The primary outcome was the total length of hospital stay (LOS). Secondary outcomes were patient-reported outcomes measuring psychological well-being and satisfaction with maternity care, health utilization, and maternal and infant outcomes. A total of 362 women were randomized to the ChroPreg intervention (n = 131) or Standard Care (n = 131). No differences in LOS were found between groups (median 3.0 days, ChroPreg group 0.1% lower LOS, 95% CI −7.8 to 7%, p = 0.97). Women in the ChroPreg group reported being more satisfied with maternity care measured by the Pregnancy and Childbirth Questionnaire (PCQ) compared with the Standard Care group (mean PCQ 104.5 vs. 98.2, mean difference 6.3, 95% CI 3.0–10.0, p < 0.0001). In conclusion, the ChroPreg intervention did not reduce LOS. However, women in the ChroPreg group were more satisfied with maternity care

Psychological well-being and worries among pregnant women in the first trimester during the early phase of the COVID-19 pandemic in Denmark compared with a historical group:A hospital-based cross-sectional study

INTRODUCTION: A pandemic may negatively influence psychological well‐being in the individual. We aimed to assess the potential influence of the first national lockdown in Denmark (March to June 2020) due to the COVID‐19 pandemic on psychological well‐being and the content and degree of worries among pregnant women in early pregnancy. MATERIAL AND METHODS: In this hospital‐based cross‐sectional study based on self‐reported data we compared psychological well‐being and worries among women who were pregnant during the first phase of the pandemic (COVID‐19 group) (n = 685), with women who were pregnant the year before (Historical group) (n = 787). Psychological well‐being was measured by the five‐item World Health Organization Well‐being Index (WHO‐5), using a score ≤50 as indicator of reduced psychological well‐being. Differences in WHO‐5 mean scores and in the prevalence of women with score ≤50 were assessed using general linear and log‐binomial regression analyses. The Cambridge Worry Scale was used to measure the content and degree of major worries. To detect differences between groups, Pearson’s Chi‐square test was used. RESULTS: We found no differences in mean WHO‐5 score between groups (mean difference) 0.1 (95% CI −1.5 to 1.6) or in the prevalence of women with WHO‐5 score ≤50 (prevalence ratio 1.04, 95% CI 0.83–1.29) in adjusted analyses. A larger proportion of women in the COVID‐19 group reported major worries about Relationship with husband/partner compared with the Historical group (3% [n = 19] vs 1% [n = 6], p = 0.04), and 9.2% in the COVID‐19 group worried about the possible negative influence of the COVID‐19 restrictions. CONCLUSIONS: Our findings indicate that national restrictions due to the COVID‐19 pandemic did not influence the psychological well‐being or the content and degree of major worries among pregnant women. However, a larger proportion of women in the COVID‐19 group reported major worries concerning Relationship with husband/partner compared with the Historical group and 9.2% in the COVID‐19 group worried about the possible negative influence of the COVID‐19 restrictions

Search for new resonances decaying to a WW or ZZ boson and a Higgs boson in the ℓ+ℓ−bbˉ\ell^+ \ell^- b\bar b, ℓνbbˉ\ell \nu b\bar b, and ννˉbbˉ\nu\bar{\nu} b\bar b channels with pppp collisions at s=13\sqrt s = 13 TeV with the ATLAS detector

See paper for full list of authors, 18 pages (plus author list + cover pages: 36 pages total), 13 figures, 1 table. Submitted to PLB. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/EXOT-2015-18/International audienceA search is presented for new resonances decaying to a $W$ or $Z$ boson and a Higgs boson in the $\ell^+ \ell^- b\bar b$, $\ell\nu b\bar b$, and $\nu\bar{\nu} b\bar b$ channels in $pp$ collisions at $\sqrt s = 13$ TeV with the ATLAS detector at the Large Hadron Collider using a total integrated luminosity of 3.2 fb$^{-1}$. The search is conducted by looking for a localized excess in the $WH$/$ZH$ invariant or transverse mass distribution. No significant excess is observed, and the results are interpreted in terms of constraints on a simplified model based on a phenomenological Lagrangian of heavy vector triplets