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Background. The Nordic countries are well-known high-incidence areas of ovarian cancer, but even within the Nordic countries, differences exist. Methods. Focus in this descriptive epidemiological study is to assess developments in incidence and mortality of ovarian cancer in Denmark 1978-2002 and to make a comparison with the development in the other Nordic countries. The results are based on data from the nationwide Danish Cancer Registry as well as the other Nordic Cancer Registries. Results. A total of 14 325 cases of ovarian cancer were registered from 1978 to 2002 in Denmark. In this period, the age-standardized incidence decreased slightly from 14.3 (1978-1982) to 13.3 per 100 000 woman-years (1998-2002). The histology-specific time trends showed a tendency towards more specified histological diagnoses. Iceland had the highest age-adjusted ovarian cancer incidence in the Nordic countries, whereas Denmark had the highest mortality rate. In the entire period, the Danish mortality rate declined from 10.8 (1978-1982) to 9.0 per 100 000 woman-years (1998-1999). Only 19% of ovarian cancers in Denmark from 1978 to 2002 were localized at the time of diagnosis, while 30% had distant metastases. Older women were more likely to have advanced disease at diagnosis. The Danish distribution of stage at diagnosis seems less favorable compared to results from other countries. Conclusions. The Danish incidence of ovarian cancer seemed to decrease slightly from 1978 to 2002. Even though the mortality rate of ovarian cancer also declined, Denmark had the highest mortality rate of ovarian cancer in the world. Part of it may be explained by a less-favorable distribution of stage at diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To study the effect of antenatal magnesium sulphate (MgSO4 ) on cerebral palsy (CP) in a manner that also provides adequate power for a linked trial sequential analysis.Design: Double-blind, randomised, placebo-controlled, multi-centre trial.Setting: Fourteen Danish obstetric departments.Population: In total, 560 pregnant women at risk for preterm delivery before 32 weeks of gestation were randomised from December 2011 to January 2018. Those women gave birth to 680 children.Methods: Women were randomised to receive either a loading dose of 5 g MgSO4 followed by 1 g/hour or a placebo in identical volumes. The children were followed up at a corrected age of 18 months or older with a review of their medical charts and with the Ages and Stages Questionnaire.Main Outcome Measure: The primary outcome measure was moderate to severe CP. Secondary outcomes included mortality, neonatal morbidity, blindness and mild CP.Results: The crude rates of moderate to severe CP in the MgSO4 group and the placebo group were 2.0% and 3.3%, respectively. The adjusted odds of moderate to severe CP were lower in the MgSO4 group than in the placebo group (odds ratio 0.61; 95% CI 0.23-1.65).Conclusions: Antenatal MgSO4 before 32 weeks of gestation decreases the likelihood of moderate to severe CP; these results are entirely consistent with other randomised evidence summarised in the linked trial sequential analysis.Tweetable Abstract: Antenatal magnesium sulphate may decrease the risk of moderate to severe cerebral palsy in children born before 32 weeks of gestation. [ABSTRACT FROM AUTHOR]

Objective: Congenital heart disease (CHD) is the most common type of congenital birth defect, but little is known about possible modifiable behavioral risk factors. The study aimed to assess whether intake of periconceptional or postconceptional multivitamin was associated with a decreased risk of CHD in the offspring., Study Design: The study population comprised 15,567 women from the Copenhagen Pregnancy Cohort with complete data on multivitamin intake before and during pregnancy, who gave birth to live-born singletons from October 2012 to October 2016. Main outcome measure was CHD defined according to the International Classification of Diseases (ICD), 10th revision. Cases of CHD were classified into five subgroups based on the clinical phenotype: 1) Conotruncal defects, 2) Left ventricular outflow tract obstruction, 3) Right ventricular outflow tract obstruction, 4) Septal defects, and 5) Other CHD. Multivariate logistic regression analyses were performed with adjustment for maternal age, chronic disease, assisted reproductive technology, smoking status, and alcohol consumption., Results: Of the 15,567 included women, 31.9 % reported a daily multivitamin intake in the periconceptional period, 53.7 % in the postconceptional period, and 14.4 % women did not report a daily multivitamin intake. The prevalence of CHD in the population was 0.7 % (n = 112). Periconceptional and postconceptional multivitamin intake was not associated with risk of overall CHD in offspring: Adjusted OR was 0.64 (95 % CI 0.36-1.13) and 0.77 (95 % CI 0.47-1.30), respectively., Conclusion: The current large cohort study did not show a preventive effect of multivitamin intake in the periconceptional or postconceptional period on the risk of CHD in the offspring., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Children born preterm have an increased risk of severe morbidity, e.g. cerebral palsy (CP), compared to children born at term. CP cannot be treated, which is why a prophylactic approach is essential, as argued in this review. Six randomised controlled trials (RCTs) have provided data on MgSO4 treatment as CP neuroprotection in preterm birth, including a new RCT from Denmark. Recently, an updated meta-analysis with trial sequential analysis detected a significant neuroprotective effect of MgSO4 treatment in preterm birth. There is now sufficient evidence, that MgSO4 treatment should be used as neuroprotection in preterm birth.

Introduction: The aim of this study was to assess the association between multivitamin intake during pregnancy and the risk of preterm birth and very preterm birth., Methods: The study population comprised 15,629 women from the Copenhagen Pregnancy Cohort with data on pregnancy multivitamin intake during their first trimester who gave birth to singletons from October 2012 to October 2016. Data on pregnancy multivitamin intake were linked to the Medical Birth Registry to identify the birth outcome. The main outcome measures were preterm birth before 37 weeks of gestation and very preterm birth before 32 weeks of gestation., Results: Among the included women, 85.6% had taken daily pregnancy multivitamins during their first trimester. We found no evidence that pregnancy multivitamin intake during the first trimester was associated with a decreased risk of preterm birth (adjusted odds ratio (OR) = 1.01; 95% confidence interval (CI): 0.77-1.33) or very preterm birth (adjusted OR = 1.06; 95% CI: 0.63-1.77). Stratification for BMI into lesser-than 25 kg/m2 and ≥ 25 kg/m2 did not alter these findings., Conclusions: Pregnancy multivitamin intake during the first trimester was not associated with a decreased risk of preterm birth or very preterm birth among women in a high-income population., Funding: none., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Importance: Administration-to-birth intervals of antenatal corticosteroids (ANS) vary. The significance of this variation is unclear. Specifically, to our knowledge, the shortest effective administration-to-birth interval is unknown., Objective: To explore the associations between ANS administration-to-birth interval and survival and morbidity among very preterm infants., Design, Setting, and Participants: The Effective Perinatal Intensive Care in Europe (EPICE) study, a population-based prospective cohort study, gathered data from 19 regions in 11 European countries in 2011 and 2012 on 4594 singleton infants with gestational ages between 24 and 31 weeks, without severe anomalies and unexposed to repeated courses of ANS. Data were analyzed November 2016., Exposure: Time from first injection of ANS to delivery in hours and days., Main Outcomes and Measures: Three outcomes were studied: in-hospital mortality; a composite of mortality or severe neonatal morbidity, defined as an intraventricular hemorrhage grade of 3 or greater, cystic periventricular leukomalacia, surgical necrotizing enterocolitis, or stage 3 or greater retinopathy of prematurity; and severe neonatal brain injury, defined as an intraventricular hemorrhage grade of 3 or greater or cystic periventricular leukomalacia., Results: Of the 4594 infants included in the cohort, 2496 infants (54.3%) were boys, and the mean (SD) gestational age was 28.5 (2.2) weeks and mean (SD) birth weight was 1213 (400) g. Mortality for the 662 infants (14.4%) unexposed to ANS was 20.6% (136 of 661). Administration of ANS was associated with an immediate and rapid decline in mortality, reaching a plateau with more than 50% risk reduction after an administration-to-birth interval of 18 to 36 hours. A similar pattern for timing was seen for the composite mortality or morbidity outcome, whereas a significant risk reduction of severe neonatal brain injury was associated with longer administration-to-birth intervals (greater than 48 hours). For all outcomes, the risk reduction associated with ANS was transient, with increasing mortality and risk for severe neonatal brain injury associated with administration-to-birth intervals exceeding 1 week. Under the assumption of a causal relationship between timing of ANS and mortality, a simulation of ANS administered 3 hours before delivery to infants who did not receive ANS showed that their estimated decline in mortality would be 26%., Conclusions and Relevance: Antenatal corticosteroids may be effective even if given only hours before delivery. Therefore, the infants of pregnant women at risk of imminent preterm delivery may benefit from its use.

Competing Interests: Conflict of Interest: No conflict of interests.

Introduction: Ovarian cancer (OC) registrations in the Danish Cancer Registry (CR) and the Danish Pathology Data Bank (PDB) 1978-99 were compared in order to assess the possibility of identifying OC cases from another data source than the CR., Material and Methods: A total of 13,320 OC were identified in the CR/PDB and comparisons of the registrations were performed., Results: The frequency of cases registered in both registries increased during 1978-99. Agreement in registration of histological subtypes in the two registries was found in 82% of the cases. Diagnosis among the rest was most often consistent; however, a more specific diagnosis was often found in one or the other registry. The frequency of women only registered with OC in the CR decreased from 81% to 35%, as the number of women with no diagnoses at all in the PDB declined from 1978 to 1997, whereafter it stabilised, primarily because all pathology departments now reported data to the PDB. In 1997-99, 29% of OC registered in the CR with a histologically verified OC diagnosis was still not registered with cancer in the ovaries in the PDB. Most of these, however, could be identified in the PDB with diagnoses consistent with metastases from OC. In total, 749 OC were not registered in the CR, though explanations for their missing registrations could be found in most cases., Conclusion: Data from the PDB may not be useful in complete identification of ovarian cancer cases for research purposes. However, it is a good supplement to data from the CR.