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American Journal of Perinatology

Karen Kovey, Kelsi Barnes, Robert D Beckett, Melissa Rice
OBJECTIVE:  The objective was to compare the efficacy and adverse effects of beractant administration in neonates via a single aliquot in a neutral position versus positioning the neonates on their left then right side and two aliquots administration. STUDY DESIGN:  This was a retrospective cohort chart review of neonates who were diagnosed with respiratory distress syndrome and received beractant during two 15-month periods between 2013 and 2015 and 2015 and 2016 to compare the change in the fraction of inspired oxygen (FiO2 ) 1 hour after beractant administration...
May 7, 2018: American Journal of Perinatology
Jacquelyn Blackstone, Vanessa K Will, William F Rayburn
OBJECTIVE:  To examine trends of female physicians either pursuing fellowships or in active practice in maternal-fetal medicine (MFM). METHODS:  This observational study examined complete sets of MFM fellows and active members of the Society for Maternal-Fetal Medicine (SMFM) between 1985 and 2016. Databases from SMFM, American College of Obstetricians and Gynecologists (ACOG), and Accreditation Council for Graduate Medical Education were used. Analysis of covariance testing was used to assess interactions over time between groups...
May 7, 2018: American Journal of Perinatology
Annie M Dude, William A Grobman, Lynn M Yee
OBJECTIVE:  The objective of this study was to examine the association between an ultrasound-estimated fetal weight (US-EFW) and mode of delivery among nulliparous diabetic women. STUDY DESIGN:  This is a retrospective cohort study of nulliparous women with medication-requiring gestational or pregestational diabetes who delivered term, singleton gestations following a trial of labor. We determined whether having had an US-EFW within 35 days of delivery was associated with cesarean delivery...
May 4, 2018: American Journal of Perinatology
Tetsuya Kawakita, Katherine Bowers, Jane C Khoury
OBJECTIVE:  This article compares maternal and neonatal outcomes in women aged ≥ 35 years who experienced nonmedically indicated induction of labor (NMII) versus expectant management. STUDY DESIGN:  This was a retrospective cohort study of nulliparas aged ≥ 35 years with a singleton and cephalic presentation who delivered at term. Outcomes were compared between women who underwent NMII at 37, 38, 39, and 40 weeks' gestation and those with expectant management that week...
May 3, 2018: American Journal of Perinatology
Kaitlin Forsberg, Lauren Christiansen-Lindquist, Robert M Silver
OBJECTIVE:  This article determines whether demographic, delivery, and medical factors are associated with stillbirth autopsy performance in Georgia and Utah. STUDY DESIGN:  This study used fetal death certificates from 2010 to 2014 to determine which factors are associated with stillbirth autopsy performance in Georgia and Utah. Analyses were conducted using logistic regression with a predicted margins approach. RESULTS:  The stillbirth autopsy rate was low in both states: 11...
May 3, 2018: American Journal of Perinatology
Katherine M Scolari Childress, Christina Dothager, Jeffrey A Gavard, Sara Lebovitz, Catherine Laska, Dorothea J Mostello
OBJECTIVE:  We investigated whether metoclopramide administered with diphenhydramine (MAD) relieves headache in pregnant women when acetaminophen alone is ineffective, using codeine for comparison. STUDY DESIGN:  Normotensive pregnant women in the second or third trimester were randomized to MAD intravenously (10 mg and 25 mg, respectively) or codeine orally (30 mg) for headache after 650 to 1,000 mg of acetaminophen failed to relieve their headaches. Headache severity (pain score 0-10) was noted at intervals over 24 hours...
May 3, 2018: American Journal of Perinatology
Han-Yang Chen, Suneet P Chauhan, Sean C Blackwell
OBJECTIVE:  The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization. STUDY DESIGN:  We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. The delivery hospitalizations with SMM were identified by having at least one of the 25 previously established list of diagnosis and procedure codes...
May 3, 2018: American Journal of Perinatology
Nahid Lorzadeh, Nastaran Kazemirad
Stem cells are a population of undifferentiated cells that originated from embryonic and fetal stages of development. Stem cells possess the potency to produce cells that ultimately form different tissues and organs. They are considered as potential alternative novel therapeutic agents for patients suffering from infertility due to their unlimited source and high differentiation potency. There are several studies that have shown that different types of stem cells (mesenchymal stem cells, embryonic, endometrial, and ovarian stem cells) can be differentiated into both spermatozoa and oocytes in vitro, proving their potential clinical use in management and cure of infertility issues...
May 1, 2018: American Journal of Perinatology
Nadya Yousef, Mostafa Mokhtari, Philippe Durand, Francesco Raimondi, Fiorella Migliaro, Alexandra Letourneau, Pierre Tissières, Daniele De Luca
BACKGROUND AND OBJECTIVE:  Congenital pulmonary airway malformation (CPAM) is a group of rare congenital malformations of the lung and airways. Lung ultrasound (LU) is increasingly used to diagnose neonatal respiratory diseases since it is quick, easy to learn, and radiation-free, but no formal data exist for congenital lung malformations. We aimed to describe LU findings in CPAM neonates needing neonatal intensive care unit (NICU) admission and to compare them with a control population...
May 1, 2018: American Journal of Perinatology
K Setti Ahmed, O Kharoubi, A E K Aoues, M Bouchekara, B Khaladi, M Taleb
INTRODUCTION:  The diesters of 1,2-benzenedicarboxylic acid (phthalic acid), commonly known as phthalates, are used primarily as plasticizers of polyvinyl chloride and as additives in consumer and personal care products. OBJECTIVE:  This study was designed to evaluate the impact of in utero and postnatal exposure to diisononyl phthalate (DINP), diethylhexyl phthalate (DEHP), and diethyl phthalate (DEP) on gut maturation in a Wistar rat model. MATERIALS AND METHODS:  Pregnant females were gavaged from day 8 of gestation through postnatal day (pd) 30 with 0 (vehicle control), DEHP (380 mg/kg/d), DINP (380 mg/kg/d), or DEP (800 mg/kg/d) dissolved in corn oil...
May 1, 2018: American Journal of Perinatology
Michael W Cookson, Sharon L Ryan, Gregory J Seedorf, R Blair Dodson, Steve H Abman, Erica W Mandell
BACKGROUND:  Chorioamnionitis (CA) is associated with a high risk for the development of bronchopulmonary dysplasia (BPD) after preterm birth, but mechanisms that increase susceptibility for BPD and strategies to prevent BPD are uncertain. As a model of CA, antenatal intra-amniotic (IA) endotoxin (ETX) exposure alters placental structure, causes fetal growth restriction, increases perinatal mortality, and causes sustained cardiorespiratory abnormalities throughout infancy. Vitamin D (Vit D) has been shown to have both anti-inflammatory and proangiogenic properties...
May 1, 2018: American Journal of Perinatology
Krisa P Van Meurs, Elisabeth S Yan, Kathi S Randall, Valerie Y Chock, Alexis S Davis, Cecelia S Glennon, Catherine L Clark, Courtney J Wusthoff, Sonia L Bonifacio
OBJECTIVE:  Many critically ill neonates have an existing brain injury or are at risk of neurologic injury. We developed a "NeuroNICU" (neurologic neonatal intensive care unit) to better provide neurologically focused intensive care. STUDY DESIGN:  Demographic and clinical variables, services delivered, and patient outcomes were recorded in a prospective database for all neonates admitted to the NeuroNICU between April 23, 2013, and June 25, 2015. RESULTS:  In total, 546 neonates were admitted to the NeuroNICU representing 32% of all NICU admissions...
April 27, 2018: American Journal of Perinatology
Michael F Nyp, Jane B Taylor, Antonio Petralia, Alexandra Oschman, Mike Norberg, Robert A Weatherly, William Truog, Winston Manimtim
OBJECTIVE:  To report on the population of infants receiving a tracheostomy, identify acute post-tracheostomy clinical decompensations, and seek predictive markers associated with acute complications following the placement of a tracheostomy. STUDY DESIGN:  Retrospective deidentified clinical data was provided by the Infant Pulmonary Data Repository at Children's Mercy Hospital, Kansas City. Data from infants undergoing tracheostomy from January 1, 2008 through September 30, 2016 were divided into one of two study groups based on clinical correlations: (1) no acute decompensations within 72 hours post-tracheostomy or (2) acute clinical decompensation defined as sustained escalation of respiratory care within the 72 hours following tracheostomy...
April 27, 2018: American Journal of Perinatology
Sanjay Chawla, Girija Natarajan, Dhuly Chowdhury, Abhik Das, Michele Walsh, Edward F Bell, Abbot R Laptook, Krisa Van Meurs, Carl T D'Angio, Barbara J Stoll, Sara B DeMauro, Seetha Shankaran
OBJECTIVE:  We aimed to compare the rates of "surfactant treated respiratory disease" and other neonatal morbidities among moderately preterm (MPT) infants exposed to no, partial, or a complete course of antenatal corticosteroids (ANS). STUDY DESIGN:  This observational cohort study evaluated MPT infants (290/7 -336/7 weeks' gestational age), born between January 2012 and November 2013 and enrolled in the "MPT Registry" of the National Institute of Child Health and Human Development Neonatal Research Network...
April 27, 2018: American Journal of Perinatology
Chase R Cawyer, Spencer G Kuper, Lisa A Dimperio, Alan T Tita, Joseph R Biggio, Lorie M Harper
OBJECTIVE:  To evaluate how duration of exposure to antenatal corticosteroids (ACSs) prior to delivery affects neonatal outcomes in indicated preterm deliveries. STUDY DESIGN:  This is a retrospective cohort of all indicated singleton preterm deliveries (23-34 weeks) in a single tertiary center from 2011 to 2014 comparing those who received ACS 2 to 7 days versus >7 days prior to delivery. The primary neonatal outcome was a composite of arterial cord pH < 7 or base excess ≤ 12, 5-minute Apgar ≤ 3, cardiopulmonary resuscitation, culture-proven neonatal sepsis, intraventricular hemorrhage grade III/IV, necrotizing enterocolitis, and neonatal death...
April 27, 2018: American Journal of Perinatology
Sean C Blackwell, Cynthia Gyamfi-Bannerman, Joseph R Biggio, Suneet P Chauhan, Brenna L Hughes, Judette M Louis, Tracy Manuck, Hugh S Miller, Anita F Das, Robert Birch, Michael J Jozwiakowski
The objective of this commentary is to describe the background, rationale, and methods of the PROLONG (Progestin's Role in Optimizing Neonatal Gestation) trial, which is a multicenter, multinational, placebo-controlled, randomized clinical trial (RCT) designed to assess the safety and efficacy of Makena (hydroxyprogesterone caproate injection, 250 mg/mL) in reducing the risk of preterm birth (PTB) and neonatal morbidity/mortality in women pregnant with a singleton gestation who had a previous singleton spontaneous PTB...
April 27, 2018: American Journal of Perinatology
Kara K Hoppe, Melissa A Schiff, Thomas J Benedetti, Shani Delaney
OBJECTIVE:  Evaluate the association between spontaneous active labor duration utilizing contemporary labor curves and risk of adverse outcomes. MATERIALS AND METHODS:  This is a retrospective cohort study from January 2012 to January 2015. Subjects were nulliparous, 18 to 44 years, with a cephalic, singleton ≥37 weeks in spontaneous labor. Subjects were placed into three subgroups, defined by active labor duration from 6 to 10 cm as less than the median, the median-95th, and >95th percentile based on contemporary labor curves published by Zhang et al...
April 25, 2018: American Journal of Perinatology
Jake X Checketts, M Blake Evans, Abha H Athale, Omar M Jawhar, Micah R Wright, Kristine Bryant, Matt Vassar
BACKGROUND:  The Food and Drug Administration's (FDA's) Amendments Act established a legal mandate requiring registration of certain drug, device, and biologics trials in prior to patient enrollment. One provision of the act requires investigators to report trial results in within 1 year of completion. Preliminary evidence suggests that overall compliance rates are inadequate, and rates specific to obstetrics have not been investigated. OBJECTIVE:  The purpose of this study was to examine the rate of compliance for mandatory reporting of results from obstetrics trials to ClinicalTrials...
April 25, 2018: American Journal of Perinatology
Janine S Rhoades, Molly J Stout, Candice Woolfolk, Methodius G Tuuli, George A Macones, Alison G Cahill
OBJECTIVE:  To estimate the natural history of cervical effacement in labor. STUDY DESIGN:  This is a retrospective cohort study of term, vertex, singletons who reached 10 cm of cervical dilation from 2010 to 2014. Interval-censored regression was used to estimate the median number of hours between changes in effacement (measured in centimeters of the residual cervix) and to estimate the median effacement at a given cervical dilation. Analysis was stratified by parity and labor type...
April 24, 2018: American Journal of Perinatology
Masahiko Kawai
Growth failure caused by undernutrition is considered one of the major causes for psychomotor delay in extremely preterm infants, and the concept for "aggressive nutritional approach" is widely accepted worldwide. Based on this, postnatal early catch-up growth due to sufficient supply of nutrients including sufficient amounts of amino acids is believed to be essential for a better outcome; however, there is no definitive evidence of aggressive nutrition on better outcomes in mortality, growth, and neurodevelopment...
April 24, 2018: American Journal of Perinatology
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