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OBJECTIVES. This study investigated the influence of psychosocial stress, maternal schooling, social support, psychological well-being, alcohol, and smoking on intrauterine growth retardation and premature delivery. METHODS. At a Copenhagen university hospital, 2432 pregnant women completed a questionnaire on general health, psychosocial stressors, and sociodemographic characteristics. RESULTS. In 212 cases (8.7%) the women delivered prematurely. Preterm delivery as associated with psychosocial stress (adjusted odds ratio [OR]=1.14 for each 1-point increase on the psychosocial stressor 5-point scale and 1.92 for the whole scale) and poor school education (adjusted OR=2.62 for 7-9 years of schooling, 1.91 for 10 years, and 1.0 for 11-13 years). In 152 cases (6.3%), infants had a birthweight below the 10th percentile. Intrauterine growth retardation was associated with smoking, daily drinking, school education, and social network variables. In a multiple logistic regression model, intrauterine growth retardation was associated with smoking habits (adjusted OR=2.40 for 0-9 cigarettes daily, 2.68 for 10-15 daily, and 2.88 for more than 15 daily). CONCLUSIONS. Psychosocial stressors and limited duration of schooling appeared to influence preterm delivery. Smoking habits influenced intrauterine growth retardation.

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To determine if the use of oxygen in the delivery room influences subsequent global cerebral blood flow (CBF), 70 infants of gestational age of less than 33 completed weeks were randomly assigned to receive room air (group 1) or 80% oxygen (group II) during the initial stabilisation at birth. In group I supplemental oxygen was administered on clinical indications, when required. After being admitted to the neonatal intensive care unit all infants were treated according to our normal practice. At a postnatal age of 2 hours CBF was measured by xenon clearance. Seventy four per cent of the infants in group I were successfully stabilised without the need for supplemental oxygen. CBF was significantly higher in group I than in group II (CBF median (interquartile range): 159 (13.6-21-9) v 12-2 (10-7-13.8) ml/100 glminute). Differences in oxygen exposure seemed to be the only explanation for the differences in CBF. No differences in short term outcome were found between the Inhalation of 100% oxygen reduces global cerebral blood flow (CBF) in newborn infants.1 2 However, the duration of vasoconstriction following hyperoxaemia in the neonatal period remains unclear. The sensitivity to hyperoxaemia seems to decrease with maturity, and the effect may be prolonged in the immature brain.3 In newborn kittens the large arteries of the retina were severely constricted for several minutes by exposure to 80% oxygen.4 At normalisation of P02, a similarly long lasting decrease in CBF velocity induced by a threefold increase in Po2 was demonstrated in preterm infants; CBF velocity normalised along with Po2 in term infants.5Extremely low birthweight infants can be treated appropriately with room air or 30-40% oxygen in the delivery room.6 Routine use of 80-100% oxygen during the initial stabilisation at birth, as often recommended,7 may therefore produce hyperoxaemia in some infants.Greisen8 and Pryds et al 9 showed that CBF in newbom preterm infants is low compared with these values in older children and adults. These results have recently been confirmed by other authors.'0 The infants described by Greisen and Pryds were treated with 100% oxygen at birth. We therefore hypothesised that low CBF values might be caused by an extremely prolonged cerebral vasoconstriction following a few minutes of hyperoxaemia caused by routine use of oxygen shortly after birth. To test this, we conducted a randomised, controlled trial in which premature infants were assigned to receive room air or 80% oxygen during the initial stabilisation in the delivery room. Two hours after birth we measured CBF, and in an attempt to test for any systemic effect of hyperoxaemia, we also tested cardiac left ventricular output (LVO), mean arterial blood pressure (MABP), and heart rate at the same time.Method Enrolment criteria were a gestational age of <33 completed weeks and no known severe malformations. Women with incipient preterm delivery (gestational age of <33 weeks) were informed about the study and random allocation was delayed until immediately bef...

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Telephone-based advisory support was very effective in prolonging breastfeeding in obese mothers who often terminate the breastfeeding of their infants prematurely. A longer duration of breastfeeding may decrease risk of noncommunicable diseases in these infants. This trial was registered at clinicaltrials.gov as NCT01235663.

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