The authors' findings show that allogeneic fetal MSC can engraft and differentiate into bone in a human fetus even when the recipient is immunocompetent and HLA-incompatible.

Aims: To determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotising enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage ≥ 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusions: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted. Background and aims: Autism spectrum disorders (ASDs) are disorders of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. Previous studies investigating neonatal factors and ASDs have produced inconsistent results. We performed confirmatory analyses concerning various neonatal complications and a later diagnosis with ASDs, and infantile autism, specifically. Methods: A Danish population based cohort study, including all children born in Denmark from 1994, through 2002, a total of 604,140 children. Diagnoses of neonatal complications were retrieved from the Danish National Hospital Register. Children diagnosed with ASDs were identified using the Danish Psychiatric Central Register. Data was analyzed using Cox proportional hazards regression. Results: A total of 4,145 children were diagnosed with ASDs, of which 1,493 had infantile autism. We found an increased risk of ASDs after exposure to a variety of neonatal complications; respiratory distress: adjusted hazard ratio (HR)=1.24 [95% confidence interval (CI): 1.02-1.51], intracranial bleeding, cerebral edema or seizures: HR=1.94 [95% CI: 1.12-3.36], neonatal hypoglycemia: HR=1.46

E arly-onset and late-onset preeclampsia differs somewhat in their aggressiveness, placentation, and risk of fetal growth retardation and probably should be considered as 2 different entities. Evidence suggests that the relationship between vascular endothelial growth factor A (VEGF-A), placental growth factor (PlGF), and their common receptor, soluble fms-like tyrosine kinase 1 (sFlt1) is important for controlling vasculogenesis, angiogenesis, and placental development during pregnancy. sFlt1 inhibits angiogenic activity by binding to and inactivating the proangiogenic factors VEGF-A and PlGF. Low levels of free VEGF-A and PlGF and elevated levels of sFlt1 precede the onset of clinical signs of preeclampsia by several weeks. This cross-sectional study was designed to estimate whether these changes were more pronounced in earlyonset versus late-onset preeclampsia.Preeclampsia was defined with the standard criteria. Early-onset preeclamptic women had the condition diagnosed at 24-32 weeks of gestation and who were delivered prematurely because of preeclampsia. Those with lateonset preeclampsia had the condition diagnosed at Z35week gestation. The 3 control groups included nonpregnant women being seen in a reproduction center for infertility who later became pregnant and delivered successfully (nonpregnant control), healthy women at 24 to 32 weeks of gestation (early controls), and healthy women delivering at 36 to 42 weeks of gestation (late controls). Only women with single pregnancies were included. Antihypertensive treatment was given in both groups with preeclampsia if the systolic and diastolic blood pressure rose above 170 or 110 mm Hg, respectively. Blood samples were analyzed for sFlt1, PlGF, and VEGF-A by enzymelinked immunosorbent assay kits. Comparisons between early controls and late controls were to early-onset and late-onset groups, respectively.Study groups were similar in maternal age and parity was similar between the pregnant groups. Gestation length was 13 days shorter for delivery for the late-onset preeclampsia group than for their controls. Body mass index was higher in the early-onset preeclamptic women compared with early controls. All women had normal blood pressure in the first trimester, but those who later had earlyonset preeclampsia had a mean initial diastolic pressure of 77 mm Hg compared with 69 mm Hg for their controls. Nonpregnant control women, late controls, early controls, early-onset, and late-onset preeclamptic women had sFlt1 levels of 48 pg/mL, 7827 pg/mL, 886 pg/mL, 37,700 pg/mL, and 26,106 pg/mL, respectively. The relative increase, compared with the respective control group, was 43 times greater in women with early-onset and 3 times greater than in women with late-onset preeclampsia. Median plasma levels of PGIF for the same groups, respectively, were 110 pg/mL, 221 pg/mL, 577 pg/mL, 27 pg/mL, and 48 pg/mL. Women in the early-onset group who had a small for gestational age infant had PGIF levels of 8.2 pg/ mL compared with 61 pg/mL for early-onset preeclampsia group with...

Both early- and late-onset preeclampsia are associated with altered plasma levels of sFlt1 and PlGF. The alterations are more pronounced in early-onset rather than in late-onset disease.

Objective To investigate whether there is a difference in occurrence of electrocardiogram changes suggestive of myocardial ischaemia between two different doses of oxytocin.Design Double-blind randomised controlled trial Setting University hospital in Sweden.Population A total of 103 healthy women undergoing elective caesarean section under spinal anaesthesia.Methods The participants were randomised to 5 or 10 units of oxytocin, given as an intravenous bolus. A Holter monitor was used to record electrocardiograms and non invasive blood pressure and heart rate (HR) was monitored. A blood sample was obtained 12-hour postoperatively.Main outcome measures Depression of the ST segment. Secondary outcomes: symptoms, Troponon I levels, mean arterial pressure (MAP), HR and blood loss.Results There was a significant difference in occurrence of ST depressions associated with oxytocin administration, 4 (7.7%) with 5 and 11 (21.6%) with 10 units, P < 0.05. The absolute risk reduction was 13.9% (95% confidence interval, 0.5-27.3). Decrease of mean MAP from baseline to 2 minutes differed, being 9 mmHg in the 5 unit group and 17 mmHg in the 10 unit group (P < 0.01). The increase in mean HR did not differ. Troponin I levels were increased in four subjects (3.9%). There were no differences in occurrence of symptoms, Troponin I levels, or estimated blood loss.Conclusion ST depressions were associated with oxytocin administration significantly more often in subjects receiving 10 units compared with 5 units. Interventions to prevent hypotension during caesarean section may reduce the occurrence of ST depressions on electrocardiograms.