Population-based study of the incidence of congenital hip dysplasia in preterm infants from the Survey of Neonates in Pomerania (SNiP)

Background

Some etiological factors involved in developmental dysplasia of the hip (DDH) occur in the last trimester of pregnancy, which could result in a decreased incidence of DDH in preterm infants. The aim of this study was to compare the incidence of DDH between preterm and term infants.

Methods

Ultrasound of the hip joint was performed in 2,534 term infants and 376 preterm infants within the population-based Survey of Neonates in Pomerania (SNiP) study.

Results

A total of 42 (1.66%) term infants had DDH (Graf type II c, 0.8%; type D, 0.3% left and 0.4% right; type III a, 0.2% left). Eighteen infants had bilateral findings. Hip dysplasia occurred more frequently in female neonates (32/1,182 vs. 10/1,302, p < 0.023; 95% CI 0.012–0.022, χ² test). A familial disposition for DDH was found in 169 (6.7%) term infants and 181 (7.1%) infants in the overall population. In preterm infants, dysplasia of the hip was found in only three late preterm infants with gestational age between 36 and 37 weeks (n = 97) and not in preterm infants <36 weeks gestational age (n = 279). Regression analysis revealed a narrowly significant association between gestational week of birth and DDH (relative risk = 1.17; 95% confidence interval 0.99–1.37; p = 0.065).

Conclusion

Our study suggests that preterm infants <36 weeks gestational age have a decreased risk of DDH.

The impact of socioeconomic factors on the efficiency of voluntary toxoplasmosis screening during pregnancy: a population-based study

BACKGROUND

Congenital toxoplasmosis is associated with severe complications. German state health insurance covers rubella, but not toxoplasmosis, immunity screening. We analysed the effect of socioeconomic factors on the efficiency of private toxoplasmosis screening during pregnancy.

METHODS

Toxoplasmosis and rubella screening data (n = 5402 mothers) were collected within the population-based Survey of Neonates in Pomerania (SNiP).

RESULTS

At the first-trimester screening, 34.4 % (88.1 %) of expecting mothers were immune to toxoplasmosis (rubella). Susceptibility for toxoplasmosis (rubella) was observed in 39.6 % (8.9 %) and 25.8 % (2.95 %) were not tested. Data on a 2(nd) screening were available in a subgroup of women with negative immunity showing less than 45 % participation rate. Active toxoplasmosis (no rubella) infection was observed in 0.3 % (n = 17) of pregnant women. A multiple logistic regression model (AIC = 719.67; AUC = 0.725) revealed that the likelihood of participating in a second toxoplasmosis screening increased among women with a good level of education and a steady partnership and decreased with paternal unemployment and the absence of breastfeeding. The highest probability of non-participation in toxoplasmosis screening was found among women with temporal burden and family responsibilities. A cost-benefit analysis showed that covering general screening for toxoplasmosis with health insurance saved costs.

CONCLUSION

Toxoplasmosis carried a substantial risk of infection during pregnancy. Although increased socioeconomic status was positively associated with the participation in toxoplasmosis screening, this was not the case when pregnant women had strong temporal burden and family responsibilities. This data supports the need for toxoplasmosis screening among pregnant women as a general healthcare benefit covered by insurance.

Ultrasound screening strategies for the diagnosis of congenital anomalies of the kidney and urinary tract

PURPOSE

Congenital anomalies of the kidneys and urinary tract (CAKUT) are among the most common anomalies in newborn infants, and may cause chronic renal disease in newborns. We investigated the sensitivity and specificity of different ultrasound-based screening strategies for CAKUT.

MATERIALS AND METHODS

Newborns (n = 4331) were analyzed for CAKUT in at least one ultrasound examination as a part of the Survey of Neonates in Pomerania (SNiP), a 7-year population-based study on neonates in Western Pomerania (Germany). Intrauterine ultrasound examinations were compared with early postnatal ultrasound findings (from days 3 - 7 of life) and pathological findings within the first 6 months of postnatal life.

RESULTS

Cases of CAKUT were detected in 309 (3.7 %) kidneys in one ultrasound examination at the following points of time at least: (i) prenatally in 56 newborns (18.2 %), (ii) 3 - 7 days postnatally in 201 newborns (65.2 %) and (iii) in 52 newborns (17 %) during the 6-month follow-up. The prevalence was significantly higher in male infants, and hydronephrosis was found to be the most frequent obstructive nephropathy (83.3 %). Significant co-morbidity was observed with CNS malformations. The diagnostic sensitivity was significantly higher in postnatal ultrasound screening (79.6 vs. 18.2 % prenatally), while the specificity was above 99 % at all time points.

CONCLUSION

This study demonstrates a high prevalence of CAKUT and demonstrates the importance of combined prenatal and postnatal ultrasound examinations for early CAKUT diagnosis.

Parity violation constraints using cosmic microwave background polarization spectra from 2006 and 2007 observations by the QUaD polarimeter

We constrain parity-violating interactions to the surface of last scattering using spectra from the QUaD experiment's second and third seasons of observations by searching for a possible systematic rotation of the polarization directions of cosmic microwave background photons. We measure the rotation angle due to such a possible "cosmological birefringence" to be 0.55 degrees +/-0.82 degrees (random) +/-0.5 degrees (systematic) using QUaD's 100 and 150 GHz temperature-curl and gradient-curl spectra over the spectra over the multipole range 200<l<2000, consistent with null, and constrain Lorentz-violating interactions to <2 x 10;{-43} GeV (68% confidence limit). This is the best constraint to date on electrodynamic parity violation on cosmological scales.

Cosmology from MAXIMA-1, BOOMERANG, and COBE DMR cosmic microwave background observations

Recent results from BOOMERANG-98 and MAXIMA-1, taken together with COBE DMR, provide consistent and high signal-to-noise measurements of the cosmic microwave background power spectrum at spherical harmonic multipole bands over 2<l less similar to 800. Analysis of the combined data yields 68% (95%) confidence limits on the total density, Omega(tot) approximately 1.11+/-0.07 (+0.13)(-0.12), the baryon density, Omega(b)h(2) approximately 0.032(+0.005)(-0.004) (+0.009)(-0.008), and the scalar spectral tilt, n(s) approximately 1.01(+0.09)(-0.07) (+0.17)(-0.14). These data are consistent with inflationary initial conditions for structure formation. Taken together with other cosmological observations, they imply the existence of both nonbaryonic dark matter and dark energy in the Universe.

A Measurement of Omega from the North American Test Flight of Boomerang

We use the angular power spectrum of the cosmic microwave background, measured during the North American test flight of the Boomerang experiment, to constrain the geometry of the universe. Within the class of cold dark matter models, we find that the overall fractional energy density of the universe Omega is constrained to be 0.85</=Omega</=1.25 at the 68% confidence level. Combined with the COBE measurement, the data on degree scales from the Microwave Anisotropy Telescope in Chile, and the high-redshift supernovae data, we obtain new constraints on the fractional matter density and the cosmological constant.

Measurement of a Peak in the Cosmic Microwave Background Power Spectrum from the North American Test Flight of Boomerang

We describe a measurement of the angular power spectrum of anisotropies in the cosmic microwave background (CMB) at scales of 0&fdg;3 to 5 degrees from the North American test flight of the Boomerang experiment. Boomerang is a balloon-borne telescope with a bolometric receiver designed to map CMB anisotropies on a long-duration balloon flight. During a 6 hr test flight of a prototype system in 1997, we mapped more than 200 deg(2) at high Galactic latitudes in two bands centered at 90 and 150 GHz with a resolution of 26&arcmin; and 16&farcm;5 FWHM, respectively. Analysis of the maps gives a power spectrum with a peak at angular scales of 1 degrees with an amplitude 70 µK(CMB).

Composite infrared bolometers with Si3N4 micromesh absorbers

We report the design and performance of 300-mK composite bolometers that use micromesh absorbers and support structures patterned from thin films of low-stress silicon nitride. The small geometrical filling factor of the micromesh absorber provides 20x reduction in heat capacity and cosmic ray cross section relative to a solid absorber with no loss in IR-absorption efficiency. The support structure is mechanically robust and has a thermal conductance, G < 2 x 10(-11) W/K, which is four times smaller than previously achieved at 300 mK. The temperature rise of the bolometer is measured with a neutron transmutation doped germanium thermistor attached to the absorbing mesh. The dispersion in electrical and thermal parameters of a sample of 12 bolometers optimized for the Sunyaev-Zel'dovich Infrared Experiment is +/-7% in R (T), +/-5% in optical efficiency, and +/-4% in G.

Performance of a low-pass filter for far-infrared wavelengths

We describe a low-pass filter that provides high in-band transmittance and excellent rejection at ν > 100 cm(-1). The transmittance of the filter components was measured at liquid-helium temperatures from 10 to 10,000 cm(-1). The total transmittance is >50% for ν < 50 cm(-1) and is calculated to be <10(-9) for ν > 300 cm(-1). The filter was successfully used in a liquid-helium-cooled, rocketborne, far-infrared absolute photometer.

Emissivity measurements of reflective surfaces at near-millimeter wavelengths

We have developed an instrument for directly measuring the emissivity of reflective surfaces at near-millimeter wavelengths. The thermal emission of a test sample is compared with that of a reference surface, allowing the emissivity of the sample to be determined without heating. The emissivity of the reference surface is determined by one's heating the reference surface and measuring the increase in emission. The instrument has an absolute accuracy of Δε = 5 × 10(-4) and can reproducibly measure a difference in emissivity as small as Δε = 10(-4) between flat reflective samples. We have used the instrument to measure the emissivity of metal films evaporated on glass and carbon fiber-reinforced plastic composite surfaces. We measure an emissivity of (2.15 ± 0.4) × 10(-3) for gold evaporated on glass and (2.65 ± 0.5) × 10(-3) for aluminum evaporated on carbon fiber-reinforced plastic composite.

Silicon-gap Fabry-Perot filter for far-infrared wavelengths

We developed a far-infrared Fabry-Perot filter constructed from a single silicon substrate. The limiting resolving power caused by beam divergence of a silicon-gap Fabry-Perot filter is approximately 10 times higher than that of a vacuum-gap Fabry-Perot filter because of the large index of refraction of silicon. The filter thus permits compact, high-throughput optical systems. Metal mesh patterns microlithographed on each face provide enhanced, wavelength-dependent face reflectivity. We tested the performance of filters with metal mesh patterns consisting of inductive crosses and capacitive squares. A Fabry-Perot filter developed for a rocketborne astrophysics experiment with a capacitive square metal mesh pattern achieves a resolving power of λ/Δλ(FWHM) =160 at λ= 158 µm, with a peak transmittance of 37% over an active aperture of 6.9 mm for an ƒ/3.8 optical beam at 15° incidence. The absorptivity of a 240-µm thick silicon substrate patterned with capacitive metal mesh is A ≲ 1% per pass, including loss in both the silicon and the metal mesh.

Cooled baffle system for spaceborne infrared telescopes

We report the design and testing of a compact system of baffles for cooled infrared telescopes. The baffle system consists of a reflecting forebaffle and a black aftbaffle and provides a high level of rejection of emission from off-axis sources. The forebaffle reflects radiation incident at angles greater than 40° off axis out of the telescope, thereby reducing the aperture heat load. The black aftbaffle absorbs radiation scattered or diffracted by the forebaffle, as well as radiation from sources within 40° off axis. We describe ground-based measurements at λ = 0.9 µm of the baffle system at ambient temperature and rocketborne measurements at far-infrared wavelengths of the baffle system at ~3 K. The effective emissivity of the cooled forebaffle was measured to be 7 × 10(-3). The system has been successfully used in rocketborne measurements of the diffuse infrared background and will be used in the Infrared Telescope in Space.

Bolometric detectors: optimization for differential radiometers

A differential radiometer can be constructed by placing two matched bolometric detectors in an ac bridge, thus producing a signal that is proportional to the difference in power incident on the two detectors. In conditions of large and time-varying common-mode radiative load, the common-mode response resulting from imperfectly matched detectors can limit the stability of the difference signal. For semiconductor thermistor bolometers we find that the bridge can always be trimmed to null the common-mode response for a given instantaneous value of the radiative load. However, subsequent changes in the commonmode radiative load change the operating point of the detectors, giving rise to a second-order common-mode response. This response can be minimized by increasing the electrical-power dissipation in the detectors at the cost of sensitivity. For the case that we are analyzing, and for mismatches in detector parameters that are typical of randomly paired detectors, common-mode rejection ratios in excess of 10(3) can be achieved under 20% changes in radiative load.

Design and construction of high-sensitivity, infrared bolometers for operation at 300 mK

The design and construction of 300-mK composite bolometers developed for millimeter-wave astronomical observations are described. Graphite fibers are used as the electrical leads for the thermistor to reduce the thermal conductance and heat capacity associated with the leads. A mechanical suspension made of Nylon fibers odes the required thermal conductance. Electrical noise equivalent powers below 1 x 10(-16) W/ radicalHz have been achieved for detectors with thermal time constants of 11 ms. The detectors were installed in a millimeter-wave photometer and used to perform observations of the cosmic microwave background from a balloonborne platform. The flight performance was consistent with the measured laboratory properties.

Submillimeter wave low pass filters made of glass beads

We have fabricated low pass filters made of spherical glass beads embedded in polyethylene and measured the transmittance at room temperature and 1.3 K as a function of the diameter and the filling factor of the glass beads. The cutoff frequency is a function of the bead diameter. Compared with the transmittance of thin glass plates or Fluorogold filters, these filters have a sharper cutoff due to the effect of scattering by the spherical beads. This effect becomes prominent at low temperature, because of the decrease in the absorption coefficient of glass itself. The glass bead filters have very low transmittance above the cutoff frequency. One of the filters we fabricated has a transmittance of <5 x 10(-4) between 50 and 1000 cm(-1).

Horn antenna with low sidelobe response for observations of diffuse celestial radiation

A horn antenna with low sidelobe response has been fabricated for a rocket-borne observation of the diffuse brightness of the sky at submillimeter wavelengths. The antenna consists of a Winston concentrator which defines the field of view and a flared baffle which minimizes diffraction. The sidelobe response for lambda = 337 microm was measured to be <10(-9) at an angle of 70 degrees from the optical axis. Calculations are reported which illustrate the contributions of diffraction and scattering to the sidelobe response.

Rocket-borne submillimeter radiometer

We report the performance of a rocket-borne absolute radiometer which was designed to measure the diffuse brightness of the sky in six passbands between 100 microm and 1 mm. The radiometer consisted of a horn antenna and a photometer, both of which were cooled to 1.2 K by liquid (4)He. The performance of the instrument was satisfactory, but no astrophysical data were obtained during the flight because a lid covering the horn antenna failed to pen. Another flight of a similar apparatus is planned for 1986.