Search

This review gives a summary of Danish preterm care, which has been defined by national adaptation of antenatal corticosteroids in the 1970ies and continuous positive airway pressure in the 1980ies. Today, preterm survival in Denmark is high, by international standards, but lower than in the neighbouring countries Sweden and Norway. The lack of a national neonatal quality database may offer an explanation to this. Starting in 2019, the Danish Newborn Quality Database reports complete population-based measures of newborn survival and health and may help improve standards of care in the future.

Meta-analyses indicate that prophylactic probiotics for preterm infants reduces mortality and necrotising enterocolitis significantly. Despite the robust evidence clinicians are reluctant to implement probiotics because the beneficial mechanism is not clearly understood and due to concerns about the safety, the long-term effects, and the optimal treatment regimen. Hence, only few countries and only two-thirds of the Danish neonatal departments use probiotics. Currently three large randomised trials on probiotics vs. placebo are ongoing and it is an ethical dilemma whether to proceed or terminate the trials.

We present a case study of a newborn girl with a reduced erythrocytic nicotinamide adenine dinucleotide (NADH)-dependent methaemoglobin reductase level. Within the first days of life she developed cyanosis due to a methaemoglobin level of 21%. The hyperoxia test was characteristic, with normal increases in blood oxygen tension, whereas the oxygen saturation remained constant at 92%. Over the next months the methaemoglobin level decreased to 10%, and the girl did well without treatment.

In a set of monochorionic-diamniotic twins with twin-to-twin transfusion syndrome, systemic hypertension and biventricular myocardial hypertrophy were found in the recipient. The infant developed mild respiratory distress. A partial exchange transfusion was performed because of polycytaemia. Blood pressure measurements revealed persistent systemic hypertension. Biventricular hypertrophy was demonstrated by echocardiography. Blood pressure normalised after treatment with Nifedipine and the cardiac hypertrophy subsided over the following weeks. A potential contributing mechanism is intrauterine shunting of high renin levels from the donor to the recipient through anastomoses in the placenta.

Introduction: Neonatal dehydration with hypernatraemia is a serious condition with risk of cerebral damage and death. Recent studies have reported a rising incidence., Materials and Methods: A retrospective study was conducted at Hvidovre Hospital over a 5-year period to identify term or near-term infants (>35 weeks of gestation) who were admitted with a weight-loss >10%. Infants admitted between the 3rd and the 14th day of life with a discharge diagnosis code indicating dehydration were also included., Results: During the period a total of 89 infants were admitted and 24 had hypernatraemia. The incidence increased from 2.1 to 4.9 (RR 2,5-p >0.0008). All infants were breastfed and only 3 had had supplementation prior to admission. The weight-loss ranged between 270 and 1100 grams (equivalent to 10.1-29.7% reduction in birth weight) while lethargy and jaundice were frequent symptoms. Cerebral complications occurred for 8 infants and 2 developed permanent brain damage., Conclusions: Breastfeeding should be encouraged but supplementation may be necessary for some infants. Infants born to primiparous women, infants heavy for gestational age and infants who do not thrive on day 4-5 appear to have a high risk. These infants could be identified by regular weighing and, if necessary, supplementation and follow-up should be instituted.