Units In Denmark Research Articles

Making Administrative Work Matter in Public Service Delivery: A Lens for Linking Practice with the Purpose of Office

Abstract Among the general public as well as in the scientific literature, administrative work is widely associated with heavy bureaucratic procedures that are disconnected from serving clients. Less is said and written about the importance of administrative work in delivering public service. Drawing on a relational theoretical approach and based on an ethnographic field study in two municipal child welfare units in Denmark (including 38 days of observations and 30 interviews), this study shows how administrative work plays three key functions in various accountability relations, and that these functions aid street-level bureaucrats in mastering the complexities of their work. The study offers a theoretical framework that delineates the functions of administrative work in complex street-level practice. By demonstrating how administrative work may contribute positively to fulfilling the purposes of street-level work, this study contributes to developing our understanding of administrative work as an invaluable part of street-level work and provides a more nuanced foundation for future studies on the virtues and issues of administrative work.

Labor outcomes in caseload midwifery compared with standard midwifery care: A cohort study.

Research has shown caseload midwifery to increase the chance of vaginal birth, but this may not be the case in settings with high vaginal birth rates in standard care. This study investigated the association between caseload midwifery and birth mode, labor interventions, and maternal and neonatal outcomes at a large obstetric unit in Denmark. Cohort study including medical records on live, singleton births fr om June 2018 until February 2022. Exposure was caseload midwifery care compared with standard midwifery care. The primary outcome was birth mode, and secondary outcomes were other outcomes of labor. Adjusted risk ratios (aRR) with 95% confidence intervals (CI) were estimated by log-binomial regression. Among 16,110 pregnancies, 3162 pregnancies (19.6%) received caseload midwifery care. Caseload midwifery was associated with fewer planned cesareans (aRR 0.63 [95% CI 0.54-0.74]) and emergency cesareans (aRR 0.86 [95% CI 0.75-0.95]). No differences in labor induction, use of epidural analgesia, oxytocin augmentation, or anal sphincter tears were observed. Caseload midwifery performed more amniotomies (aRR 1.14 [95% CI 1.02-1.27]) and tended to perform more episiotomies (aRR 1.19 [95% CI 0.96-1.48]). Postpartum hemorrhage (aRR 0.90 [95% CI 0.82-0.99]) and low Apgar score were less likely (aRR 0.54 [95% CI 0.37-0.77]), and early discharge more likely (aRR 1.22 [95% CI 1.17-1.28]) in caseload midwifery. In caseload midwifery care, a higher vaginal birth rate was observed with no increase in adverse outcomes, mainly due to a lower likelihood of planned cesarean. Also, fewer children were born with low Apgar scores.

High prevalence of erectile dysfunction in male patients with acute stroke was associated with age but not to modifiable cardiovascular risk factors

BackgroundErectile dysfunction (ED) and stroke share common risk factors, and symptoms of ED often precede the development of clinical cardiovascular disease (CVD). However, little is known about how ED is...

Probiotic supplementation and risk of necrotizing enterocolitis and mortality among extremely preterm infants—the Probiotics in Extreme Prematurity in Scandinavia (PEPS) trial: study protocol for a multicenter, double-blinded, placebo-controlled, and registry-based randomized controlled trial

BackgroundExtremely preterm infants, defined as those born before 28 weeks’ gestational age, are a very vulnerable patient group at high risk for adverse outcomes, such as necrotizing enterocolitis and death. Necrotizing enterocolitis is an inflammatory gastrointestinal disease with high incidence in this cohort and has severe implications on morbidity and mortality. Previous randomized controlled trials have shown reduced incidence of necrotizing enterocolitis among older preterm infants following probiotic supplementation. However, these trials were underpowered for extremely preterm infants, rendering evidence for probiotic supplementation in this population insufficient to date.MethodsThe Probiotics in Extreme Prematurity in Scandinavia (PEPS) trial is a multicenter, double-blinded, placebo-controlled and registry-based randomized controlled trial conducted among extremely preterm infants (n = 1620) born at six tertiary neonatal units in Sweden and four units in Denmark. Enrolled infants will be allocated to receive either probiotic supplementation with ProPrems® (Bifidobacterium infantis, Bifidobacterium lactis, and Streptococcus thermophilus) diluted in 3 mL breastmilk or placebo (0.5 g maltodextrin powder) diluted in 3 mL breastmilk per day until gestational week 34. The primary composite outcome is incidence of necrotizing enterocolitis and/or mortality. Secondary outcomes include incidence of late-onset sepsis, length of hospitalization, use of antibiotics, feeding tolerance, growth, and body composition at age of full-term and 3 months corrected age after hospital discharge.DiscussionCurrent recommendations for probiotic supplementation in Sweden and Denmark do not include extremely preterm infants due to lack of evidence in this population. However, this young subgroup is notably the most at risk for experiencing adverse outcomes. This trial aims to investigate the effects of probiotic supplementation on necrotizing enterocolitis, death, and other relevant outcomes to provide sufficiently powered, high-quality evidence to inform probiotic supplementation guidelines in this population. The results could have implications for clinical practice both in Sweden and Denmark and worldwide.Trial registration(Clinicaltrials.gov): NCT05604846

Dysphagia and unintentional weight loss among older adults in a rehabilitation unit in Denmark

Dysphagia and unintentional weight loss among older adults in a rehabilitation unit in Denmark

315 Prehospital Blood Gas Analyses in Acute Patients treated by a Physician-manned Emergency Unit in Denmark

315 Prehospital Blood Gas Analyses in Acute Patients treated by a Physician-manned Emergency Unit in Denmark

Nordic survey showed wide variation in discharge practices for very preterm infants.

We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units. Medical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-text comments. We received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post-discharge home visits and video-consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay. Discharge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge.

Patient and family engagement in Danish intensive care units: A national survey.

Patient and family engagement in the intensive care unit increases the quality of care and patient safety. The aim of our study was to describe current practice and experiences of contemporary patient and family engagement in the intensive care unit at the individual level, the organizational level, and in the research process according to critical care nurses. We conducted a national qualitative survey of intensive care units in Denmark from 5th May-5th June 2021. Questionnaires were piloted and sent to intensive care nurse specialists and research nurses at 41 intensive care units, allowing one respondent per unit. All respondents were provided with written information about the study by email, and by activating the survey link, they accepted participation. Thirty-two nurses responded to the invitation, 24 completed and 8 partially completed the survey, yielding a response rate of 78%. At the individual level, 27 respondents stated that they involved patients and 25 said they involved family in daily treatment and care. At the organizational level, 28 intensive care units had an overall strategy or guideline for patient and family engagement, and 4 units had established a PFE panel. And, finally, 11 units engaged patients and families in the research process. Our survey suggested that patient and family engagement was implemented to some degree at the individual level, organizational level, and in the research process, but only 4 units had established a PFE panel at the organizational level, which is key to engagement. Patient engagement increases when patients are more awake, and family engagement increases when patients are unable to participate. Engagement increases when patient and family engagement panels are implemented.

Women and partners' experience of major postpartum haemorrhage: a qualitative study.

To examine women and their partners' experience of major postpartum haemorrhage (PPH). A qualitative interview study. Two Labour and Delivery Units in Denmark. Women who experienced major PPH (≥1 litre within 2hours after vaginal birth). Semi-structured interviews were conducted with 15 women and nine partners (nine joint interviews, six individual interviews). Interviews were analysed using thematic analysis. A qualitative description of women and their partners' experiences. Three major themes were identified. (1) 'From birth to emergency' included factors that increased concern in women and their partners, such as 'incomprehensible' medical terminology, a tense atmosphere, and alarm call. Transfer to the operating theatre was experienced as the most devastating part of major PPH. (2) 'Feeling safe during an emergency' described factors that supported the women and their partners' management of the situation such as brief explanations from a few healthcare professionals and reassurance that the healthcare professionals were in control of the situation. The pain was experienced as severe, but acceptable. (3) 'Family unity challenged' described how family bonding was supported by positioning the partner at the head of the bed and by keeping the baby on the woman's chest. Several factors such as small gestures from healthcare professionals and appropriate organisation of the PPH can make a difference to the woman and her partner's experience of major PPH. Particularly, efforts that support family bonding are greatly valued by women and their partners.

Vaccination timeliness of preterm infants hospitalised in a neonatal intensive care unit in Denmark.

In Denmark, preterm infants are recommended to receive childhood vaccinations without correction for gestational age. This study aimed to describe the timeliness of the Danish Childhood Vaccination Program in preterm infants during the first 13months of life and to evaluate possible determinants of delay. This retrospective cohort study included preterm infants admitted to a level III neonatal intensive care unit between October 2019 and October 2020. Clinical data were retrieved from medical records and the Danish Vaccination Register. Timely vaccination was defined corresponding to chronological age of 3-, 5- and 12months, within a time interval of 30 days before to 29 days after the expected date. Analyses included 365 infants. Timely vaccination occurred in 91%, 83% and 67% of preterm infants for the first, second and third vaccination, respectively, and timeliness was highest if born before gestational age 28 weeks. Gestational age 28-31 + 6 weeks and delayed former vaccinations negatively influenced the timeliness of the following vaccinations. Most preterm infants received the first vaccination timely; however, timeliness decreased with each subsequent vaccination. Efforts to improve timeliness should focus on counselling healthcare personnel and parents to follow the recommendations for the first and the following vaccinations.

Healthcare providers’ perceptions and expectations of video-assisted debriefing of real-life obstetrical emergencies: a qualitative study from Denmark

ObjectivesVideo-assisted debriefing (VAD) of real-life obstetrical emergencies provides an opportunity to improve quality of care, but is rarely used in clinical practice. A barrier for implementation is the expected mental...

Hiding practices in employee-user innovation

Recent research has demonstrated that employees can develop novel solutions to work-process-related problems that they experience directly, but in order for organizations to benefit from this form of user innovation (“employee-user innovation”), employee-developed innovations need to diffuse within the innovator's organization. This paper challenges the prevalent assumption in studies of employee-user innovation that employee-users readily reveal and diffuse their innovations. Based on a grounded analysis of 117 innovations developed by rank-and-file workers that we identified during 32 months of ethnographic fieldwork in two police units and two military units in Denmark, we show that employee-users frequently invest considerable effort in actively hiding their innovations. We (i) identify four distinct hiding practices that employee-user innovators enact, (ii) demonstrate how decisions about whether and how to hide are based on interpretations of a range of material and organizational conditions, and (iii) show how these decisions negatively impact the employee-user innovation process by impeding not just use and diffusion, but also the development of innovations. Our findings carry implications for user innovation research, as well as for how we understand both covert innovation processes in organization and the relationship between bureaucratic organization and innovation.

Hospital admissions and need for mechanical ventilation in children with respiratory syncytial virus before and during the COVID-19 pandemic: a Danish nationwide cohort study

The incidence of respiratory syncytial virus (RSV) increased in several countries after the relaxation of COVID-19 restrictions. We aimed to investigate the age-related risk of RSV-associated hospital admissions and need for mechanical ventilation during the RSV resurgence in summer and autumn 2021 compared with the four RSV seasons preceding the COVID-19 pandemic. We also aimed to describe the clinical complications necessitating mechanical ventilation. This population-based cohort study included patients aged 0-17 years admitted to hospital with RSV in Denmark during the RSV resurgence in summer and autumn 2021, and the four pre-COVID-19 RSV seasons (2016-17, 2017-18, 2018-19, and 2019-20). We retrieved data on RSV-associated hospital admissions from the Danish National Patient Registry and demographic and clinical details of children who received mechanical ventilation through prospective real-time data collection in 2021-22 and retrospective data collection for the 2016-17 to 2019-20 RSV seasons from all eight paediatric and neonatal intensive care units in Denmark. Risk factors for severe RSV disease were as defined as age younger than 3 months or severe comorbidities. We calculated the risk of RSV-associated hospital admissions per 100 000 population in each RSV season from week 21 to week 20 of the following year. We also calculated the risk rate of receiving mechanical ventilation per 100 000 population and 1000 RSV-associated hospital admissions during each RSV season from week 21 to week 20 of the following year. We calculated risk ratios (RRs) for hospital admission and mechanical ventilation by dividing the risk rate of hospital admission and mechanical ventilation in 2021-22 by annual mean risk rates in the four pre-COVID-19 RSV epidemics (2016-17 to 2019-20). We compared RRs using Fisher's exact test. We compared complications leading to intubation between children with and without risk factors for severe RSV disease. The study is registered at ClinicalTrials.gov, NCT05186597. Among 310 423 Danish children aged younger than 5 years, the mean number of RSV-associated hospital admissions increased from 1477 (SD 226) in the 2016-17 to 2019-20 RSV seasons to 3000 in the 2021-22 RSV season (RR 2·0 [95% CI 1·9-2·1]). 54 children with RSV received mechanical ventilation in 2021-22 compared with 15-28 annually in the 2016-17 to 2019-20 RSV seasons (2·3 [1·6-3·3]). The highest increase in hospital admissions and need for mechanical ventilation occurred among children aged 24-59 months (4·1 [3·6-4·7] for hospital admission; 4·6 [1·7-12·6] for mechanical ventilation). Among children admitted to hospital, the risk of mechanical ventilation was similar in 2021-22 and the four pre-COVID-19 seasons (risk rate 14·3 per 1000 RSV-associated hospital admissions [95% CI 10·4-19·3] vs 12·9 [10·1-16·1]; RR 1·1 [95% CI 0·8-1·6]). Across all RSV seasons studied, among children younger than 3 months or those with severe comorbidities, respiratory failure due to bronchiolitis led to mechanical ventilation in 69 (79%) of 87 children. Of 46 children with no risk factors for severe RSV, 40 (87%) received mechanical ventilation due to additional complications, including neurological (n=16; 35%), cardiac (n=1; 2%), and pulmonary complications (n=23; 50%; eg, wheeze responsive to bronchodilator therapy, severe bacterial co-infections, and pneumothorax). In Denmark, RSV disease did not seem to be more severe for the individual child during the RSV resurgence in 2021 following relaxation of COVID-19 restrictions. However, hospital admissions were higher among older children, possibly due to a postponed first RSV infection or no recent reinfection. Older children without risk factors for severe RSV disease had atypical complications that led to intubation. If new RSV-preventive interventions for healthy infants delay first RSV infection, a higher number of older children might be admitted to hospital due to atypical clinical phenotypes, rather than classical bronchiolitis. National Ministry of Higher Education and Science and the Innovation Fund Denmark.

Identifying Nurses’ Perception of a Lighting Installation in a Newly Built Hospital

Prior to the installation of new integrative lighting systems, perceived experiences by nurses of the existing lighting were collected as a baseline study through interviews at two newly built hospital units in Denmark. This paper addresses the advantages and barriers that the current lighting application presents for the nurses’ work-practice. The study found that ten out of twelve of the interviewed staff at the Neurointensive Care Unit (neuro-ICU) and Postanesthesia Care Unit (PACU) prefer to work in relatively dark conditions. The interviews revealed how light and darkness are perceived as important to the staff for entraining the circadian rhythm of the patients; this was manifested in their working routines. An identification and description of nurses’ experience will guide and inform future implementation of integrative lighting systems at neuro-ICU and PACU to ensure patients’ sleep quality and recovery, improve visual comfort for the staff, enhance the degree of perceived usefulness of the lighting systems and facilitate technology acceptance. The study concludes that there is a need for implementing differentiated lighting design for the different units and contexts in the hospital, in contrast to a ‘one-size fits-all’ lighting implementation.

Venturing Inside the Body: Transformative Experiences of Pain, Anatomy and Age among Danish Patients Undergoing Awake Arthroscopic Surgery

ABSTRACT When patients who undergo awake arthroscopic surgery follow the surgery on a screen, medical image technologies enable a rare look inside one’s own body. Based on ethnographic fieldwork at an orthopedic surgery unit in Denmark, we investigate how patients experience their bodies during surgery. Patients see surgery as proof of their pain, experience an anatomical re-categorization, and contemplate the decay of the aging body. We argue that awake arthroscopic surgery constitutes a liminal setting transforming patients’ perceptions of their body and their sufferings. Furthermore, we discuss how awake arthroscopic surgery can be understood as a frame for producing new realities. It constitutes a particular way of seeing and understanding that highlights the seductiveness of the visual as an objective carrier of truth and reminds us to remain critical toward the power of certain frames of knowledge production in medical settings.

Influence of eating disorder psychopathology and general psychopathology on the risk of involuntary treatment in anorexia nervosa.

We explored associations between clinical factors, including eating disorder psychopathology and more general psychopathology, and involuntary treatment in patients with anorexia nervosa. Our intention was to inform identification of patients at risk of involuntary treatment. This was a retrospective cohort study combining clinical data from a specialized eating disorder hospital unit in Denmark with nationwide Danish register-based data. A sequential methodology yielding two samples (212 and 278 patients, respectively) was adopted. Descriptive statistics and regression analyses were used to explore associations between involuntary treatment and clinical factors including previous involuntary treatment, patient cooperation, and symptom-level psychopathology (Eating Disorder Inventory-2 (EDI-2) and Symptom Checklist-90-Revised (SCL-90-R)). Somatization (SCL-90-R) (OR = 2.60, 95% CI 1.16-5.81) and phobic anxiety (SCL-90-R) (OR = 0.43, 95% CI 0.19-0.97) were positively and negatively, respectively, associated with the likelihood of involuntary treatment. Furthermore, somatization (HR = 1.77, 95% CI 1.05-2.99), previous involuntary treatment (HR = 5.0, 95% CI 2.68-9.32), and neutral (HR = 2.92, 95% CI 1.20-7.13) or poor (HR = 3.97, 95% CI 1.49-10.59) patient cooperation were associated with decreased time to involuntary treatment. Eating disorder psychopathology measured by the EDI-2 was not significantly associated with involuntary treatment. Clinical questionnaires of psychopathology appear to capture specific domains relevant to involuntary treatment. Poor patient cooperation and previous involuntary treatment being associated with shorter time to involuntary treatment raise important clinical issues requiring attention. Novel approaches to acute anorexia nervosa care along with unbiased evaluation upon readmission could mitigate the cycle of repeat admissions with involuntary treatment. Level III, cohort study.

Conditions and strategies to meet the challenges imposed by the COVID-19-related visiting restrictions in the intensive care unit: A Scandinavian cross-sectional study

ObjectivesTo examine conditions and strategies to meet the challenges imposed by the coronavirus disease 2019 (COVID-19)-related visiting restrictions in Scandinavian intensive care units. Research methodology/designA cross-sectional survey. SettingAdult intensive care units in Denmark, Norway and Sweden. Main outcome measuresLikert scale responses and free-text comments within six areas: capacity and staffing, visiting policies and access to the unit, information and conferences with relatives, written information, children as relatives and follow-up initiatives. ResultsThe overall response rate was 53% (74/140 participating units). All intensive care units had planned for capacity extensions; the majority ranging between 11 and 30 extra beds. From March–June 2020, units had a mean maximum of 9.4 COVID-19 patients simultaneously. Allowing restricted visiting was more common in Denmark (52%) and Norway (61%) than in Sweden where visiting was mostly denied except for dying patients (68%), due to a particular increased number of COVID-19 patients. The restrictions forced nurses to compromise on their usual standards of family care. Numerous models for maintaining contact between relatives and patients were described. ConclusionVisitation restrictions compromised the quality of family care and entailed dilemmas for healthcare professionals but also spurred initiatives to developing new ways of providing family care.

Ellen and the little one: A critical phenomenology of potentiality in life with dementia

In this article, we outline a critical phenomenology of potentiality as it emerges in life with dementia. Foregrounding the sources of everyday creativity that are part of life with dementia, we propose a critical counter-argument to that of dementia as a form of living death. Our ethnographic vantage point is an episode we encountered during fieldwork at a dementia unit in Denmark. Here, one of the residents of the unit, Ellen, is interrupted in her ways of inhabiting the world by an intimate encounter with a polymorphous creature she calls ‘the Little One’. We argue that this interruption is an ontological event that ushers in new meaningful possibilities for Ellen and the Little One—and for Ellen’s relatives, caregivers, and several other residents—to co-inhabit the world. In critical dialogue with recent theoretical developments in the anthropology of cognitive disability and the ontological turn, we develop a differential social ontology capable of tracing how such interruptions characterize everyday life at the unit—and how various ways of responding to the potentiality of interruptions form responsive communities of care that cross often profound differences between people and between humans and non-humans, such as Ellen and the Little One. We conclude by briefly sketching some implications of these arguments for the care ethics that underlie institutional practices of dementia care.

Mapping and describing natural terroir units in Denmark

A natural terroir unit is a tract of land whose natural characteristics form a unique assemblage of factors (soil, terrain and climate) which together impart specific high-quality characteristics to an agricultural product. In order to map and describe Danish natural terroir units, we built on previous efforts to quantitatively map and describe Danish natural terroir units based on soil, terrain, climatic and historical crop yield data. Our work consists of four stages: (1) The OSACA algorithm was applied to define soil centroids and measure taxonomic distance between soil profiles and soil centroids based on a Danish soil spectral library; (2) nine Danish terron classes were established by fuzzy c-means clustering based on soil, terrain and climate information; (3) a Danish terron map was generated by Cubist regression tree models and the uncertainty of this map was assessed by a terron membership map; (4) Danish natural terroir units were described by linking historical crop yield data to the terron map. The results suggested that the OSACA algorithm and Vis-NIR spectral data could be used as an efficient tool to facilitate terron identification. The terron predictions also showed that the addition of terrain and climatic predictors improved the previously created Danish terron map. The description of Danish natural terroir units showed that seven natural terroir units could be an optimal number for Denmark for specific crop types. Further investigations are needed that link more agricultural yield data to this terron map in order to describe natural terroir units for different agricultural products. The methods developed in this study could be tested in other countries to facilitate sustainable soil management and minimize environmental risks.

High-Dose Vitamin D Supplementation in Pregnancy and Neurodevelopment in Childhood

Observational studies have reported an association between high maternal vitamin D levels and improved neurodevelopment in offspring, but no randomized clinical trial (RCT) has investigated these observations. To determine whether high-dose vitamin D supplementation during pregnancy improves offspring neurodevelopment from birth to age 6 years. This prespecified secondary analysis of a double-blinded, placebo-controlled RCT of high-dose vitamin D3 supplementation vs standard dose during the third trimester of pregnancy was conducted in the unselected prospective mother-child birth cohort at a single-center research unit in Denmark as part of the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC-2010). Participants included pregnant women; women with vitamin D intake greater than 600 IU/d or an endocrine, heart, or kidney disorder, and those who did not speak Danish fluently were excluded. Neurodevelopmental assessments for offspring of these women were performed at ages 0 to 6 years. Children born prematurely (gestational week <37), with low birth weight (<2500 g), or with a neurological disease affecting neurodevelopment were excluded. Data were analyzed from August 2019 to February 2020. High-dose (ie, 2800 IU/d) vs standard dose (ie, 400 IU/d) vitamin D3 supplementation from pregnancy week 24 until 1 week after birth. The primary outcome of interest was cognitive development assessed at 2.5 years using the Bayley Scales of Infant and Toddler Development. Other neurodevelopmental outcomes included age of motor milestone achievement (Denver Developmental Index and World Health Organization milestone registration), language development (MacArthur-Bates Communicative Development Inventories), general neurodevelopment at age 3 years (Ages and Stages Questionnaire), and emotional and behavioral problems at age 6 years (Strengths and Difficulties Questionnaire). Among 623 women randomized, 315 were randomized to high-dose vitamin D3 and 308 were randomized to standard dose placebo. A total of 551 children were evaluated from birth to age 6 years, (282 [51.2%] boys; 528 [95.8%] White), with 277 children in the high-dose vitamin D3 group and 274 children in the standard dose group. There was no effect of the high-dose compared with standard dose of vitamin D3 supplementation during pregnancy on offspring achievement of motor milestones (β = 0.08 [95% CI, -0.26 to 0.43]; P = .64), cognitive development (score difference: 0.34 [95% CI, -1.32 to 1.99]; P = .70), general neurodevelopment (median [IQR] communication score: 50 [50-55] vs 50 [50-55]; P = .62), or emotional and behavioral problems (odds ratio, 0.76 [95% CI, 0.53 to 1.09]; P = .14). There was no effect on language development expressed by the word production at 1 year (median [IQR], 2 [0-6] words vs 3 [1-6] words; P = .16), although a decreased word production was apparent at 2 years in children in the high-dose vitamin D3 group (median [IQR], 232 [113-346] words vs 253 [149-382.5] words; P = .02). In this prespecified secondary analysis of an RCT, maternal high-dose vitamin D3 supplementation during the third trimester of pregnancy did not improve neurodevelopmental outcomes in the offspring during the first 6 years of life. These findings contribute essential information clarifying the effects of prenatal exposure to vitamin D on neurodevelopment in childhood. ClinicalTrials.gov Identifier: NCT00856947.