The Sydney Blood Bank Cohort consists of a blood donor and eight transfusion recipients who were infected before 1985 with a strain of human immunodeficiency virus type 1 (HIV-1) with a deletion in the region in which the nef gene and the long terminal repeat overlap. Two recipients have died since 1994, at 77 and 83 years of age, of causes unrelated to HIV infection; one other recipient, who had systemic lupus erythematosus, died in 1987 at 22 years of age of causes possibly related to HIV. We present longitudinal immunologic and virologic data on the six surviving members and one deceased member of this cohort through September 30, 1998.

Administrative or population health datasets (PHDS) are increasingly being used for research related to maternal and infant health. However, the accuracy and completeness of the information in the PHDS is important to ensure validity of the results of this research. To compile and review studies that validate the reporting of conditions and procedures related to pregnancy, childbirth, and newborns and provide a tool of reference for researchers. A systematic search was conducted of Medline and EMBASE databases to find studies that validated routinely collected datasets containing diagnoses and procedures related to pregnancy, childbirth, and newborns. To be included datasets had to be validated against a gold standard, such as review of medical records, maternal interview or survey, specialized register, or laboratory data. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and/or κ statistic for each diagnosis or procedure code were calculated. Forty-three validation studies were included. Under-enumeration was common, with the level of ascertainment increasing as time from diagnosis/procedure to birth decreased. Most conditions and procedures had high specificities indicating few false positives, and procedures were more accurately reported than diagnoses. Hospital discharge data were generally more accurate than birth data, however identifying cases from more than 1 dataset further increased ascertainment. This comprehensive collection of validation studies summarizing the quality of perinatal population data will be an invaluable resource to all researchers working with PHDS.

Exclusive breastfeeding for the first six months of an infant’s life has enormous potential to reduce mortality and morbidity. The older generation, particularly the infant’s grandmothers, play a central role in various aspects of pregnancy and child rearing decision-making within the family unit. This is particularly true in low- and middle-income countries where older women are seen as owners of traditional knowledge. Despite this, most health programs target the individual person most directly involved in the target behaviour – usually new mothers – without a commensurate understanding of who else influences those decisions. In this systematic review we aim to quantify the impact of the grandmother on influencing a mother’s breastfeeding practices. We conducted a systematic review using Web of Science, Scopus, and Medline databases using search terms for grandmother and breastfeeding. Eligible studies reported on the duration of exclusive breastfeeding and included estimates of effect of a grandmother’s influence including whether or not the grandmother lived with the infant’s family, the grandmother’s education, and the grandmother’s attitudes towards and prior experience with breastfeeding. We identified 568 articles and, after review, 13 articles were assessed as meeting the selection criteria. They were conducted in both developed and developing countries and included cross-sectional surveys, prospective cohort studies and one randomised controlled trial. Eight studies examined the effects of attitudes or experiences of older generations with respect to breastfeeding and five of the eight found a significant positive impact on breastfeeding when grandmothers of the infants had had their own breastfeeding experience or were positively inclined towards breastfeeding, resulting in effects of between 1.6 to 12.4 times more likely to exclusively breastfeed or refrain from introducing solid foods. A Chinese study however found that highly educated grandmothers were associated with decreased exclusive breastfeeding. The majority of the studies were assessed to be of weak or moderate quality. This review found evidence that demonstrates that grandmothers have the capacity to influence exclusive breastfeeding. Programs that seek to influence exclusive breastfeeding should include grandmothers in their interventions to achieve maximum impact.

OBJECTIVE: To identify potentially modifiable risk factors for late-pregnancy stillbirth. METHODS: This was a population-based matched case–control study of pregnant women at 32 weeks of gestation or greater booked into tertiary maternity hospitals in metropolitan Sydney between January 2006 and December 2011. The case group consisted of women with singleton pregnancies with antepartum fetal death in utero. Women in the control group were matched for booking hospital and expected delivery date with women in the case group. Data collection was performed using a semistructured interview and included validated questionnaires for specific risk factors. Adjusted odds ratios (ORs) were calculated for a priori-specified risk factors using conditional logistic regression. RESULTS: There were 103 women in the case group and 192 women in the control group. Mean gestation was 36 weeks. Supine sleeping was reported by 10 of 103 (9.7%) of women who experienced late-pregnancy stillbirth and by 4 of 192 (2.1%) of women in the control group (adjusted OR 6.26, 95% confidence interval [CI] 1.2–34). Women who experienced stillbirth were more likely to: have been followed during pregnancy for suspected fetal growth restriction, 11.7% compared with 1.6% (adjusted OR 5.5, 95% CI 1.36–22.5); not be in paid work, 25.2% compared with 9.4% (adjusted OR 2.9, 95% CI 1.1–7.6); and to have not received further education beyond high school, 41.7% compared with 25.5% (adjusted OR 1.9, 95% CI 1.1–3.5). None of the deaths to women who reported supine sleeping were classified as unexplained. CONCLUSION: This study suggests that supine sleep position may be an additional risk for late-pregnancy stillbirth in an already compromised fetus. The clinical management of suspected fetal growth restriction should be investigated further as a means of reducing late stillbirth. LEVEL OF EVIDENCE: II