Objective To evaluate the difference in 10-year neurocognitive outcomes among extremely low gestational age newborns without bacteremia or with suspected or confirmed late-onset bacteremia. Study design Neurocognitive function was evaluated at 10 years of age in 889 children born at <28 weeks of gestation and followed from birth. Definite (culture positive) late-onset bacteremia during postnatal weeks 2–4 was identified in 223 children and 129 had suspected bacteremia. Results Infants with the lowest gestational age and birth weight Z-score had the highest prevalence of definite and suspected late-onset bacteremia. When compared with peers with no or suspected bacteremia, infants with definite bacteremia performed worse on tests of general cognitive ability, language, academic achievement, and executive function, even when adjusting for potential confounders. Adjustment for low IQ attenuated associations between bacteremia and all dysfunctions at 10 years. Children who had suspected bacteremia did not differ appreciably from children who did not have any evidence of bacteremia. The motor domain was unaffected. Conclusions Extremely low gestational age newborns who had definite late bacteremia during postnatal weeks 2–4 are at heightened risk of neurocognitive limitations at 10 years of age.

The differentiation between mono- and dichorionic placentation in twin pregnancies is of clinical importance because of the significant difference in perinatal morbidity and mortality between the two, and the increased surveillance indicated in monochorionic gestations. Application of ultrasonography has enabled very precise prenatal determination of chorionicity. While this is best performed in the first trimester when accuracy approaches 100%, even in the third trimester, using a composite cascade of available sonographic features, accuracy has been reported to approach 97%. While two clearly separate placentae or discordant fetal gender conform to dichorionicity, in most twin pregnancies other features need to be assessed to determine chorionicity. The presence of the 'lambda' or the 'T' sign in the presence of a single placenta, best determined in the first trimester, is the most reliable indicator of chorionicity, with measurements of the inter-twin membrane thickness and counting of the membrane layers being less reliable. In this article, we review the sonographic features that help in the accurate depiction of chorionicity.

Objectives Evaluation of new mathematical formula (Femur 4) derived from a twin population to estimate fetal weight in twins using ultrasound. Comparison of Femur 4 is with conventional mathematical models.Design Retrospective analysis of ultrasonic measurements of 297 twin babies from 24 to 40 weeks of gestation who were born within 10 days of ultrasound examination.Setting Aberdeen Maternity Hospital.Methods With ultrasonic measurements obtained from twin babies, estimated fetal weight was calculated using the mathematical models of Campbell, Shepard and Hadlock. The calculations were repeated for the model of Femur 4. All models were compared against Femur 4. Conclusion Femur 4 requires measurements of femur length and abdominal circumference only, hence avoiding the need to obtain difficult head measurements which is a common problem in twins. It is a good model for estimation of fetal weight in twins. However, prediction of growth discordancy remains problematic. Results

Objectives-To examine elevated neonatal inflammatory and neurotrophic proteins from children born extremely preterm in relation to later childhood brain Magnetic Resonance Imaging volumes and cognition.Study design-We measured circulating inflammation-related proteins and neurotrophic proteins on postnatal days 1, 7, and 14 in 166 children at 10 years of age (73 males; 93 females). Top quartile levels on ≥2 days for ≥3 inflammation-related proteins and for ≥4 neurotrophic

Three quarters of children had normal intellect at age ten years; nearly 70% were free of neurodevelopmental impairment. Forty percent of children with impairments had multiple diagnoses.