Do Neonatal Outcomes Differ Depending on the Cause of Preterm Birth? A Comparison between Spontaneous Birth and Iatrogenic Delivery for Preeclampsia

2009 ◽  
Vol 27 (02) ◽  
pp. 163-169 ◽  
Author(s):  
Jamie Bastek ◽  
Sindhu Srinivas ◽  
Mary Sammel ◽  
Michal Elovitz
Keyword(s):  
Preterm Birth ◽  
Neonatal Outcomes

Preterm Birth, Inflammation and Infection: New Alternative Strategies for their Prevention

2019 ◽  
Vol 20 (5) ◽  
pp. 354-365 ◽  
Author(s):  
Víctor M. Muñoz-Pérez ◽  
Mario I. Ortiz ◽  
Raquel Cariño-Cortés ◽  
Eduardo Fernández-Martínez ◽  
Leticia Rocha-Zavaleta ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Medicinal Plants ◽  
Low Income ◽  
Experimental Studies ◽  
Neonatal Outcomes ◽  
New Drugs ◽  
Alternative Strategies ◽  
Mortality And Morbidity ◽  
Therapeutic Benefits ◽  
Gynecology And Obstetrics

Background:Worldwide, the progress in reducing neonatal mortality has been very slow. The rate of preterm birth has increased over the last 20 years in low-income and middle-income countries. Its association with increased mortality and morbidity is based on experimental studies and neonatal outcomes from countries with socioeconomic differences, which have considered implementing alternative healthcare strategies to prevent and reduce preterm births.Methods:Currently, there is no widely effective strategy to prevent preterm birth. Pharmacological therapies are directed at inhibiting myometrial contractions to prolong parturition. Some drugs, medicinal plants and microorganisms possess myorelaxant, anti-inflammatory and immunomodulatory properties that have proved useful in preventing preterm birth associated with inflammation and infection.Results:This review focuses on the existing literature regarding the use of different drugs, medicinal plants, and microorganisms that show promising benefits for the prevention of preterm birth associated with inflammation and infection. New alternative strategies involving the use of PDE-4 inhibitors, medicinal plants and probiotics could have a great impact on improving prenatal and neonatal outcomes and give babies the best start in life, ensuring lifelong health benefits.Conclusion:Despite promising results from well-documented cases, only a small number of these alternative strategies have been studied in clinical trials. The development of new drugs and the use of medicinal plants and probiotics for the treatment and/or prevention of preterm birth is an area of growing interest due to their potential therapeutic benefits in the field of gynecology and obstetrics.

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

scholarly journals Metabolic-endocrine disruption due to preterm birth impacts growth, body composition, and neonatal outcome

2021 ◽  
Author(s):  
Lea Sophie Möllers ◽  
Efrah I. Yousuf ◽  
Constanze Hamatschek ◽  
Katherine M. Morrison ◽  
Michael Hermanussen ◽  
...  
Keyword(s):  
Body Composition ◽  
Preterm Birth ◽  
Postnatal Development ◽  
Endocrine Disruption ◽  
Fat Mass ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Endocrine Function ◽  
List Type ◽  
Term Infants

Abstract Despite optimized nutrition, preterm-born infants grow slowly and tend to over-accrete body fat. We hypothesize that the premature dissociation of the maternal–placental–fetal unit disrupts the maintenance of physiological endocrine function in the fetus, which has severe consequences for postnatal development. This review highlights the endocrine interactions of the maternal–placental–fetal unit and the early perinatal period in both preterm and term infants. We report on hormonal levels (including tissue, thyroid, adrenal, pancreatic, pituitary, and placental hormones) and nutritional supply and their impact on infant body composition. The data suggest that the premature dissociation of the maternal–placental–fetal unit leads to a clinical picture similar to panhypopituitarism. Further, we describe how the premature withdrawal of the maternal–placental unit, neonatal morbidities, and perinatal stress can cause differences in the levels of growth-promoting hormones, particularly insulin-like growth factors (IGF). In combination with the endocrine disruption that occurs following dissociation of the maternal–placental–fetal unit, the premature adaptation to the extrauterine environment leads to early and fast accretion of fat mass in an immature body. In addition, we report on interventional studies that have aimed to compensate for hormonal deficiencies in infants born preterm through IGF therapy, resulting in improved neonatal morbidity and growth. Impact Preterm birth prematurely dissociates the maternal–placental–fetal unit and disrupts the metabolic-endocrine maintenance of the immature fetus with serious consequences for growth, body composition, and neonatal outcomes. The preterm metabolic-endocrine disruption induces symptoms resembling anterior pituitary failure (panhypopituitarism) with low levels of IGF-1, excessive postnatal fat mass accretion, poor longitudinal growth, and failure to thrive. Appropriate gestational age-adapted nutrition alone seems insufficient for the achievement of optimal growth of preterm infants. Preliminary results from interventional studies show promising effects of early IGF-1 supplementation on postnatal development and neonatal outcomes.

scholarly journals G555 The maternal and neonatal microbiota correlates of preterm birth and adverse neonatal outcomes

2020 ◽  
Author(s):  
R Adam ◽  
M Temmerman ◽  
R Ochieng ◽  
M Carvahlo ◽  
P Okiro ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Neonatal Outcomes ◽  
Adverse Neonatal Outcomes

scholarly journals Country of first birth and neonatal outcomes in migrant and Norwegian-born parous women in Norway: a population-based study

2019 ◽  
Author(s):  
Eline Skirnisdottir Vik ◽  
Roy Miodini Nilsen ◽  
Vigdis Aasheim ◽  
Rhonda Small ◽  
Dag Moster ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Population Based ◽  
Neonatal Outcomes ◽  
Migrant Women ◽  
First Birth ◽  
Population Based Study ◽  
Very Preterm ◽  
Very Preterm Birth ◽  
Adverse Neonatal Outcomes ◽  
Moderately Preterm

Abstract Background: This study compares subsequent birth outcomes in migrant women who had already had a child before arriving in Norway with those in migrant women whose first birth occurred in Norway. The aim of this study was to investigate the associations between country of first birth and adverse neonatal outcomes (very preterm birth, moderately preterm birth, post-term birth, small for gestational age, large for gestational age, low Apgar score, stillbirth and neonatal death) in parous migrant and Norwegian-born women. Methods: National population-based study including second and subsequent singleton births in Norway from 1990-2016. Data were retrieved from the Medical Birth Registry of Norway and Statistics Norway. Neonatal outcomes were compared between births to: 1) migrant women with a first birth before immigration to Norway (n=30,062) versus those with a first birth after immigration (n=66,006), and 2) Norwegian-born women with a first birth outside Norway (n=6,205) versus those with a first birth in Norway (n=514,799). Associations were estimated as crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) using multiple logistic regression. Results: Migrant women with a first birth before immigrating to Norway had increased odds of adverse outcomes in subsequent births relative to those with a first birth after immigration: very preterm birth (22-31 gestational weeks (gwks); aOR=1.27; CI 1.09-1.48), moderately preterm birth (32-36 gwks; aOR=1.10; CI 1.02-1.18), post-term birth (≥42 gwks; aOR=1.19; CI 1.11-1.27), low Apgar score (<7 at 5 minutes; aOR=1.27; CI 1.16-1.39) and stillbirth (aOR=1.29; CI 1.05-1.58). Similar results were found in the sample of births to Norwegian-born women. Conclusions: The increased odds of adverse neonatal outcomes for migrant and Norwegian-born women who had their first births outside Norway should serve as a reminder of the importance of taking a careful obstetric history in these parous women to ensure appropriate care for their subsequent pregnancies and births in Norway. Keywords: immigration, parous women, neonatal outcomes, obstetric history, predictor

scholarly journals Use of Antibiotic Treatment in Pregnancy and the Risk of Several Neonatal Outcomes: A Population-Based Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12621
Author(s):  
Anna Cantarutti ◽  
Federico Rea ◽  
Matteo Franchi ◽  
Benedetta Beccalli ◽  
Anna Locatelli ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Subgroup Analysis ◽  
Apgar Score ◽  
Late Pregnancy ◽  
Population Based ◽  
Neonatal Outcomes ◽  
Lombardy Region ◽  
Increased Risk

Background: Limited evidence is available on the safety and efficacy of antimicrobials during pregnancy, with even less according to the trimester of their use. Objective: This study aimed to evaluate the association between exposure to antibiotics therapy (AT) during pregnancy and short-term neonatal outcomes. Methods: We considered 773,237 deliveries that occurred between 2007–2017 in the Lombardy region of Italy. We evaluated the risk of neonatal outcomes among infants that were born to mothers who underwent AT during pregnancy. The odds ratios and the hazard ratios, with the 95% confidence intervals, were estimated respectively for early (first/second trimester) and late (third trimester) exposure. The propensity score was used to account for potential confounders. We also performed subgroup analysis for the class of AT. Results: We identified 132,024 and 76,921 singletons that were exposed to AT during early and late pregnancy, respectively. Infants born to mothers with early exposure had 17, 11, and 16% increased risk of preterm birth, low birth weight, and low Apgar score, respectively. Infants that were exposed in late pregnancy had 25, 11, and 13% increased risk of preterm birth, low birth weight, and low Apgar score, respectively. The results were consistent in the subgroup analysis. Conclusion: Our results suggested an increased risk of several neonatal outcomes in women exposed to ATs during pregnancy, albeit we were not able to assess to what extent the observed effects were due to the infection itself. To reduce the risk of neonatal outcomes, women that are prescribed AT during pregnancy should be closely monitored.

scholarly journals Neonatal outcomes of preterm infants born during COVID-19 community lockdowns in Melbourne, Australia

2021 ◽  
Author(s):  
Brendan Mulcahy ◽  
Daniel Rolnik ◽  
Alexia Matheson ◽  
Yizhen Liu ◽  
Kirsten Palmer ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Continuous Positive Airway Pressure ◽  
Preterm Infants ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Neonatal Morbidity ◽  
Exposed Group ◽  
White Cell ◽  
Neonatal Outcomes ◽  
Control Group

Background: Community lockdowns during the COVID-19 pandemic may influence preterm birth rates, but mechanisms are unclear. Methods: We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results: Median gestational age was 35+4 weeks (295 infants, exposed group) vs. 35+0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions: COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes, and early white cell and neutrophil counts.

scholarly journals Labor Dystocia and Risk of Histological Chorioamnionitis and Funisitis: A Study from a Single Tertiary Referral Center

2020 ◽  
Author(s):  
Hyo Kyozuka ◽  
Tuyoshi Murata ◽  
Toma Fukuda ◽  
Shun Yasuda ◽  
Aya Kanno ◽  
...  
Keyword(s):  
Risk Factor ◽  
Preterm Birth ◽  
Confidence Interval ◽  
Umbilical Cord ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Neonatal Outcomes ◽  
Spontaneous Preterm Birth ◽  
Labor Dystocia

Abstract Background: Intrauterine inflammation affects short- and long-term neonatal outcomes. Histological chorioamnionitis and funisitis are acute inflammatory responses in the fetal membranes and umbilical cord, respectively. Although labor dystocia includes a potential risk of intrauterine inflammation, the risk of labor dystocia in histological chorioamnionitis and funisitis has not been evaluated yet. This study aimed to examine the association between labor dystocia and risk of histological chorioamnionitis and funisitis.Methods: In this retrospective cohort study, the patients who underwent histopathological examinations of the placenta and umbilical cord at Fukushima Medical University Hospital, Japan, between 2015 and 2020, were included. From the dataset, the pathological findings of the patients with labor dystocia and spontaneous preterm birth were reviewed. Based on the location of leukocytes, the inflammation in the placenta (histological chorioamnionitis) and umbilical cord (funisitis) was graded as 0–3. Multiple logistic regression analysis was performed to evaluate the risk of histological chorioamnionitis, histological chorioamnionitis stage ≥2, funisitis, and funisitis stage ≥2.Result: Of 317 women who met the study criteria, 83 and 144 women had labor dystocia and spontaneous preterm birth, respectively, and 90 women were included as controls. Labor dystocia was a risk factor for histological chorioamnionitis (adjusted odds ratio, 6.3; 95% confidential interval, 1.9-20.5), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 6.0; 95% confidence interval, 1.7-21.8), funisitis (adjusted odds ratio, 9.4; 95% confidence interval, 1.8-48.2), and funisitis stage ≥2 (adjusted odds ratio, 23.5; 95% confidence interval, 2.3-23.8). Spontaneous preterm birth was also a risk factor for histological chorioamnionitis (adjusted odds ratio, 3.7; 95% confidence interval, 1.7-7.8), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 3.0; 95% confidence interval, 1.2-7.9), and funisitis (adjusted odds ratio, 4.5; 95% confidence interval, 1.2-16.8). However, the adjusted odds ratio was smaller in spontaneous preterm births than in labor dystocia. Conclusion: Labor dystocia is a risk factor for severe histological chorioamnionitis and funisitis. Further studies are required to evaluate the effects of histological chorioamnionitis and funisitis on long-term neonatal outcomes.

Effectiveness of cerclage for the prevention of premature birth depending on the suture material used

2020 ◽  
Vol 18 (6) ◽  
pp. 30-33
Author(s):  
O. V. YAKOVLEVA ◽  
◽  
A. G. YASHCHUK ◽  
A. V. MASLENNIKOV ◽  
A. A. TYURINA ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Suture Material ◽  
Neonatal Outcomes ◽  
Absorbable Suture ◽  
Silk Thread ◽  
Suture Materials ◽  
Significant Difference ◽  
Suture Complications ◽  
Group 2 ◽  
Duration Of Pregnancy

The purpose — to compare the effectiveness of cerclage to reduce the frequency of preterm birth when using non-absorbable suture material in the form of a braided silk thread (4 mm) and a braided tape (5 mm), as well as to identify the frequency of complications when using them. Material and methods. A retrospective analysis of cases and childbirth was conducted, as well as the analysis of own experience of applying cerclage with various suture materials in patients with isthmic-cervical insufficiency. A total of 157 patients were examined. Pregnancy outcomes, neonatal outcomes, and post-suture complications were evaluated. Results. 157 women were given cerclage at gestation periods of 14 to 23 weeks. There was no significant difference in the choice of suture material relative to the duration of pregnancy. Cerclage with thread was performed in 92 patients (58,6%) — group 1 and 65 patients were sutured with tape (41,4%) — group 2. Preterm birth occurred in 28 patients of the 2nd comparison group (18%) and 45 patients of the 1st group (29%). The duration of pregnancy in preterm birth was comparable in both groups. Conclusions. The study found that preterm birth after cerclage using a braided tape occurred less frequently than with the use of a braided silk thread. There were no significant differences in neonatal outcomes in the comparison groups. Complications after cerclage, such as suture and cervical rupture, were found only in the group of women who underwent surgery using a woven silk thread.

Does antenatal corticosteroid therapy improve neonatal outcomes in late preterm birth?

2020 ◽  
pp. 1-7
Author(s):  
Nuran Üstün ◽  
Meryem Hocaoğlu ◽  
Abdülkadir Turgut ◽  
Sertaç Arslanoğlu ◽  
Fahri Ovalı
Keyword(s):  
Preterm Birth ◽  
Corticosteroid Therapy ◽  
Neonatal Outcomes ◽  
Late Preterm ◽  
Antenatal Corticosteroid ◽  
Late Preterm Birth
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