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BACKGROUND. Chlamydia trachomatis is the most common sexually transmitted pathogen in adults, which at delivery may be transmitted from mother to child and cause conjunctivitis and pneumonia. In the Netherlands, prenatal chlamydial screening and treatment of pregnant women is not routine practice. The contribution of C trachomatis to neonatal ophthalmic disease has not been studied in the Netherlands and remains unclear.

Objective: Preterm infants are at risk for intracranial haemorrhage with subsequent hydrocephalus. Post-haemorrhagic hydrocephalus is associated with poor outcome but little is know about the long-term outcome at school-age. Our aim was to determine the cognitive outcome in children with post-haemorrhagic hydrocephalus at school-age. Methods:We included infants treated at the NICU in Groningen with post-haemorrhagic hydrocephalus, born between 1996 and 2003. We reviewed the medical charts for neonatal characteristics and interventional surgery. We determined intelligence (WISC-III-NL), attention (Test of Everyday Attention in Children), and verbal memory (Auditory Verbal Learning Test). Results:We included 28 children (18 boys, 10 girls), median gestational age 29 weeks (range 25-40) and birth weight 1355 grams (880-3810). Seven children died in infancy. Eleven children of 21 survivors required surgical intervention. At follow-up (median age 11y, [6][7][8][9][10][11][12][13][14]), 2 children had severe cerebral palsy and were not able to perform cognitive testing. Median total IQ was 88 (59-110) with verbal IQ 88 (62-128) and performance IQ 88 (52-112). Attention scores were normal in 6 (>P15), subclinical (P5-P15) in 1, and abnormal (< P5) in 7 children. Verbal memory was normal in 13, subclinical in 2, and abnormal in 2 children. There was no difference in cognitive scores between children requiring intervention and not. Conclusion:Children with post-haemorrhagic hydrocephalus have approximately 0.8 SD lower scores on IQ than the norm population. Attention was affected in more than half of the children, verbal memory seemed less affected. Surgical intervention for hydrocephalus was not associated with cognitive outcome.

Previous studies suggest postnatal blood pressure in preterm infants to be decreased by chorioamnionitis and increased by antenatal steroids (AS). We examined the adjusted effects of both antenatal modulators on postnatal blood pressure (BP), with separate effects reported for histologic chorioamnionitis with or without fetal involvement and timing of AS. General characteristics, BP, and heart rate values during the first 72 h after birth were obtained from 271 infants with gestational age Յ32.0 wk. In unadjusted analyses, chorioamnionitis was associated with lower BP, most prominently so in infants with fetal involvement, without an effect on hypotension incidence. AS increased BP and decreased the incidence of hypotension when administered within 7 d before birth. In a multivariable mixed model analysis, the AS effect remained significant, whereas chorioamnionitis was not independently predictive of postnatal BP. Other variables associated with increased postnatal BP were gestational age and umbilical artery pH, whereas hemolysis, elevated liver enzymes, low platelets syndrome was associated with decreased BP.

Background Antenatal screening for HIV, syphilis and HBV has been successfully implemented in The Netherlands, but data on other STI among pregnant women or male partners are limited. Our objectives: (i) to assess the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) among pregnant women and male partners, (ii) to identify risk factors for these STI during pregnancy, and (iii) to identify adverse perinatal outcomes (APO) associated with STI. Methods Cross-sectional study. Pregnant women aged ≤ 30 years (n = 548) and male partners (n = 425) were included at 30 midwifery practices during 2012–2016. Participants provided a self-collected vaginal swab (women) or urine sample (men) and completed a questionnaire. Perinatal data were derived from pregnancy cards. APO was defined as premature rupture of membranes, preterm delivery, low birthweight, stillbirth, neonatal conjunctival and respiratory infections. Data were analysed by logistic regression. Results STI were present in 2.4% of pregnant women (CT 1.8%, NG 0.4%, TV 0.4%), and in 2.2% of male partners (CT 2.2%, NG 0.2%, TV 0%). Of young women (≤ 20 years), 12.5% had a CT infection. Prevalent STI during pregnancy was associated with female young age (≤ 20 years vs ≥ 21 years) (adjusted OR 6.52, CI 95%: 1.11–38.33), male non-Western vs Western background (aOR 9.34, CI 2.34–37.21), and female with ≥ 2 sex partners < 12 months vs 0–1 (aOR 9.88, CI 2.08–46.91). APO was not associated with STI, but was associated with female low education (aOR 3.36, CI 1.12–10.09), complications with previous newborn (aOR 10.49, CI 3.21–34.25 vs no complications) and short duration (0–4 years) of relationship (aOR 2.75, CI 1.41–5.39 vs ≥ 5 years). Small-for-gestational-age was not associated with STI, but was associated with female low education (aOR 7.81, 2.01–30.27), female non-Western background (aOR 4.41, 1.74–11.17), and both parents smoking during pregnancy (aOR 2.94, 1.01–8.84 vs both non-smoking). Conclusions Prevalence of STI was low among pregnant women and male partners in midwifery practices, except for CT among young women. The study could not confirm previously observed associations between STI and APO, which is probably due to low prevalence of STI, small study sample, and presumed treatment for STI.

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