Aim-To audit the prevalence of retinopathy of prematurity (ROP) in a level 2 status neonatal unit. Methods-Data were collected prospectively over 9 years from September 1989 to September 1998. Preterm infants were examined according to the Royal College of Ophthalmologists' guidelines and retinopathy graded following the International Classification of ROP. ROP 3-5 was analysed using logistic regression in relation to time, and to gestational age and birth weight. Results-383 babies were examined. Mean gestational age fell over the 9 year period (p=0.051) as did mean birth weight (p<0.001). There was a decrease in the number of infants with ROP grades 3-5 over the 9 years (p=0.045 and, when adjusted for gestational age and birth weight, the decrease in ROP 3-5 was significant (p=0.03). Conclusions-This study found a significant reduction in the incidence of ROP during the 9 years of the study period, despite a decrease in mean gestational age of and birth weight. The reduced incidence of ROP is attributed to improvements in ventilation techniques and overall care of the neonate, in particular the use of prenatal steroids and surfactant. (Br J Ophthalmol 2001;85:933-935) Recent advances in neonatal care have improved the survival rates for premature infants

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Objective Reasons for first trimester noninvasive prenatal screening (NIPS) test failure in obese women remain elusive. As dilution from maternal sources may be explanatory, we determined the relationship between obesity, fetal fraction (FF), and total cell‐free DNA (cfDNA) using our NIPS platform. Methods We assessed differences in first trimester (≤14 weeks) FF, indeterminate rate, and total cfDNA between obese (n = 518) and normal‐weight women (n = 237) after exclusion of confounders (anticoagulation, autoimmunity, aneuploidy) and controlling for covariates. Results Fetal fraction was lower, and the indeterminate rate higher, in obese compared to controls (9.2% ± 4.4 vs. 12.5% ± 4.5, p < 0.001 and 8.4 vs. 1.7%, p < 0.001, respectively), but total cfDNA was not different (92.0 vs. 82.1 pg/µl, p = 0.10). For each week, the FF remained lower in obese women (all p < 0.01) but did not increase across the first trimester for either group. Obesity increased the likelihood of indeterminate result (OR 6.1, 95% CI 2.5, 14.8; p < 0.001) and maternal body mass index correlated with FF (β −0.27, 95% CI −0.3, −0.22; p < 0.001), but not with total cfDNA (β 0.49, 95% CI −0.55, 1.53; p = 0.3). Conclusions First trimester obese women have persistently low FF and higher indeterminate rates, without differences in total cfDNA, suggesting placental‐specific mechanisms versus dilution from maternal sources as a potential etiology.

Objective-To determine the prevalence of HIV among pregnant women, in particular those whose behaviour or that of their partners put them at "low risk" of infection.Design-Voluntary named or anonymous HIV testing of pregnant women during 21 months (November 1988 to July 1990).Subjects and setting-All women who planned to continue their pregnancy and attended clinics serving the antenatal populations of Edinburgh and Dundee. All women admitted for termination of pregnancy to gynaecology wards serving the pregnant populations ofDundee and outlying rural areas.Main outcome measures-Period prevalence of HIV antibody positivity.Results-91% of antenatal clinic attenders and 97% of women having termination of pregnancy agreed to HIV testing on a named or anonymous basis. HIV period prevalences for antenatal clinic attenders and women having termination of pregnancy tested in Dundee were 0-13% and 0 85% respectively, and for antenatal clinic attenders tested in Edinburgh 0-26%. For those at "low risk" rates for antenatal clinic attenders and women having termination of pregnancy in Dundee were 0-11% and 0-13%, and for antenatal clinic attenders in Edinburgh 0-02%. In Dundee HIV prevalence among women having a termination of pregnancy (0.85%) was significantly greater than that among antenatal clinic attenders (0-13%).Conclusions-HIV infection is undoubtedly occurring among women at "low risk," and it is clear that a policy ofselective testing ofthose at only "high risk" is inadequate for pregnant women living in areas of high prevalence such as Edinburgh and Dundee. Moreover, when studying pregnant populations in such areas there is the need to include those having a termination of pregnancy.

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