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https://www.readbyqxmd.com/read/29783963/he-tamariki-kokoti-tau-tackling-preterm-a-data-linkage-methodology-to-explore-the-clinical-care-pathway-in-preterm-deliveries
#1
Sara Filoche, Fiona Cram, Angela Beard, Dalice Sim, Stacie Geller, Liza Edmonds, Bridget Robson, Beverley Lawton
BACKGROUND: Significant health inequities exist around maternal and infant health for Māori, the indigenous people of Aotearoa New Zealand - and in particular around a premature (preterm) delivery. Māori babies are more likely to be born preterm (8.1%, compared to an overall rate of 7.4%) and they are more likely to have a preterm death. An essential part of redressing these disparities is to examine the clinical care pathway and outcomes associated with preterm deliveries. This paper describes a protocol utilising national and local health collections to enable such a study...
May 21, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29777635/reducing-the-number-of-obstetrical-beds-by-challenging-traditions
#2
Camilla Dalby Salvig, Marie Højriis Storkholm, Jannie Dalby Salvig, Niels Uldbjerg
The aim of this commentary is to describe changes in women care at an obstetric department that made it possible to reduce the number of beds from 40 to 29. Patient pathways were reviewed and revised using lean methodology. The mean length of stay was reduced from 70 to 59 hours and the mean numbers of hospitalizations per woman from 1.26 to 1.20. At the organizational level, we introduced a Family Department, home management of newborns, home monitoring of the women with cardiotocography and blood samples, and intrapartum Group B Streptococcus-PCR...
May 19, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29765787/liver-failure-and-conjugated-hyperbilirubinemia-in-a-preterm-neonate-role-of-early-ivig-and-exchange-transfusion
#3
Jayasree Nair, Vasantha H S Kumar
Neonatal liver failure (NLF) is a rare diagnosis but carries with it significant risks of mortality and morbidity. Common etiologies for NLF include metabolic causes, gestational alloimmune liver disease (GALD or neonatal hemochromatosis), and viral infections. We report a case of liver failure in a premature infant with abnormal iron profile within 48 hours of birth. Lack of accepted guidelines for the initial management of severe jaundice with a high direct component in the first week after birth made treatment challenging...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29756788/identifying-job-characteristics-related-to-employed-women-s-breastfeeding-behaviors
#4
Christiane Spitzmueller, Jing Zhang, Candice L Thomas, Zhuxi Wang, Gwenith G Fisher, Russell A Matthews, Lane Strathearn
For employed mothers of infants, reconciliation of work demands and breastfeeding constitutes a significant challenge. The discontinuation of breastfeeding has the potential to result in negative outcomes for the mother (e.g., higher likelihood of obesity), her employer (e.g., increased absenteeism), and her infant (e.g., increased risk of infection). Given previous research findings identifying return to work as a major risk factor for breastfeeding cessation, we investigate what types of job characteristics relate to women's intentions to breastfeed shortly after giving birth and women's actual breastfeeding initiation and duration...
May 14, 2018: Journal of Occupational Health Psychology
https://www.readbyqxmd.com/read/29752389/pregnancy-in-women-with-a-fontan-circulation-a-systematic-review-of-the-literature
#5
Alvaro Garcia Ropero, Shankar Baskar, Jolien W Roos Hesselink, Andrea Girnius, Dominica Zentner, Lorna Swan, Magalie Ladouceur, Nicole Brown, Gruschen R Veldtman
BACKGROUND: The Fontan operation has provided life-saving palliation and adult survival for individuals born with single ventricle physiology. Many now seek advice about safe pregnancy. Little data are, however, available, consisting mainly of anecdotal experience and small series. This article seeks to review the published literature and identify lessons learnt from this collective experience. METHODS AND RESULTS: We conducted a systematic review to evaluate maternal and fetal outcomes of pregnancy in women with a Fontan circulation...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29747882/antenatal-corticosteroids-who-should-we-be-treating
#6
REVIEW
Whitney A Booker, Cynthia Gyamfi-Bannerman
Antenatal corticosteroids remain one of the crucial interventions in those at risk for imminent preterm birth. Therapeutic benefits include reducing major complications of prematurity such as respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis, as well as an overall decrease in neonatal deaths. Optimal reductions in neonatal morbidity and mortality require a thoughtful review of the timing of administration. In addition, a thorough understanding is required of which patients maximally benefit from this intervention in the management and counseling of those at risk for preterm birth...
June 2018: Clinics in Perinatology
https://www.readbyqxmd.com/read/29746007/preterm-growth-restriction-and-bronchopulmonary-dysplasia-the-vascular-hypothesis-and-related-physiology
#7
Arvind Sehgal, Stella M Gwini, Samuel Menahem, Beth J Allison, Suzanne L Miller, Graeme R Polglase
KEY POINTS: Approximately 5-10% pregnancies are affected by fetal growth restriction. Preterm infants affected by fetal growth restriction have a higher incidence of bronchopulmonary dysplasia. This study is the first to measure pulmonary artery thickness and stiffness. It highlights that impaired vasculogenesis may be a contributory factor in the higher incidence of bronchopulmonary dysplasia in preterm growth restricted infants. The study addresses the mechanistic link between fetal programming and vascular architecture and mechanics...
May 10, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29733021/axial-torsion-and-infarction-of-meckel-s-diverticulum-in-the-3rd-trimester-of-pregnancy
#8
Radu Botezatu, Radu Marian, Nicolae Gica, George Iancu, Gheorghe Peltecu, Anca Maria Panaitescu
Meckel's diverticulum is a congenital anomaly which can become complicated or remain asymptomatic throughout life. During pregnancy, however, diverticulum infection could become a serious complication. Diverticulum necrosis and perforation are complications that increase morbidity in pregnancy, both maternal and fetal. The rarity of the condition and the maternal physiological changes in pregnancy make the diagnosis difficult. We present the case of a Meckel's diverticulum gangrene in third trimester pregnancy, atypical case due to advanced pregnancy where the risk-benefit balance was carefully evaluated on one hand because of the risk of infection associated with expectant management and on the other hand the risk and complications of iatrogenic preterm premature birth...
March 2018: Chirurgia
https://www.readbyqxmd.com/read/29727785/gender-and-preterm-birth-is-male-fetal-gender-a-clinically-important-risk-factor-for-preterm-birth-in-high-risk-women
#9
P J Teoh, A Ridout, P Seed, R M Tribe, A H Shennan
Gender differences in several adverse pregnancy outcomes have been described, including preterm labour and delivery. In the low risk population, the male fetus is at significantly higher risk of spontaneous preterm birth. OBJECTIVES: Our objective was to examine the risk effect of fetal gender on pregnant women at higher risk of preterm birth, and therefore its potential impact on targeting management. STUDY DESIGN: This was an analysis of prospectively collected data from a dedicated inner-city Prematurity Surveillance Clinic over a sixteen-year period...
April 22, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29709964/bacterial-culture-negative-subclinical-intra-amniotic-infection-can-be-detected-by-bacterial-16s-ribosomal-dna-amplifying-polymerase-chain-reaction
#10
Sachi Morimoto, Hirokazu Usui, Tatsuya Kobayashi, Eiji Katou, Shunji Goto, Hirokazu Tanaka, Makio Shozu
Comprehensive analysis of bacterial DNA enhanced our understanding of the maternal microbiome and its disturbance in preterm birth, although clinical utility of these techniques remains to be determined. We examined whether broad-range polymerase technique is useful for detection of culture-negative intra-amniotic infection (IAI). Pregnant women who underwent amniocentesis for the management of preterm birth with or without the premature rupture of membranes. Bacterial 16S ribosomal DNA in the amniotic fluid was detected by polymerase chain reaction (PCR) using primers for a sequence shared by Ureaplasma, Mycoplasma, and other bacteria...
April 27, 2018: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29704487/cervical-pessary-to-reduce-preterm-birth-before-34-weeks-of-gestation-after-an-episode-of-preterm-labor-and-a-short-cervix-a-randomized-controlled-trial
#11
Laia Pratcorona, Maria Goya, Carme Merced, Carlota Rodó, Elisa Llurba, Teresa Higueras, Luis Cabero, Elena Carreras
BACKGROUND: To date, no intervention has proved effective in reducing the spontaneous preterm birth rate in singleton pregnancies following an episode of threatened preterm labor and short cervix remaining. OBJECTIVE: This study was designed to ascertain whether cervical pessaries could be useful in preventing spontaneous preterm birth in women with singleton pregnancies and a short cervix after a threatened preterm labor episode. STUDY DESIGN: This open randomized controlled trial was conducted in 357 pregnant women (between 240 and 336 weeks) who had not delivered 48h after a threatened preterm labor episode and had a short cervix remaining (≤25 mm at 240 -296 weeks; ≤15mm at 300 -336 weeks)...
April 25, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29692380/unsatisfactory-glucose-management-and-adverse-pregnancy-outcomes-of-gestational-diabetes-mellitus-in-the-real-world-of-clinical-practice-a-retrospective-study
#12
Ru Feng, Lu Liu, Yuan-Yuan Zhang, Zhong-Shang Yuan, Ling Gao, Chang-Ting Zuo
Background: Facing the increasing prevalence of gestational diabetes mellitus (GDM), this study aimed to evaluate the management of GDM and its association with adverse pregnancy outcomes. Methods: The data of 996 inpatients with GDM who terminated pregnancies in our hospital from January 2011 to December 2015 were collected. Treatments during pregnancy and the last hospital admission before delivery were analyzed. Pregnancy outcomes of the GDM patients were compared with 996 nondiabetic subjects matched by delivery year and gestational age...
May 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29679617/retinopathy-of-prematurity-a-review-of-risk-factors-and-their-clinical-significance
#13
REVIEW
Sang Jin Kim, Alexander D Port, Ryan Swan, J Peter Campbell, R V Paul Chan, Michael F Chiang
Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease that affects premature infants. Despite improvements in neonatal care and management guidelines, ROP remains a leading cause of childhood blindness worldwide. Current screening guidelines are primarily based on two risk factors: birth weight and gestational age; however, many investigators have suggested other risk factors, including maternal factors, prenatal and perinatal factors, demographics, medical interventions, comorbidities of prematurity, nutrition, and genetic factors...
April 19, 2018: Survey of Ophthalmology
https://www.readbyqxmd.com/read/29664499/ambulatory-blood-pressure-monitoring-in-school-children-with-a-history-of-extreme-prematurity
#14
Andrea Solís, Jaime Cerda, Claudia González
INTRODUCTION: Extremely premature children have a higher incidence of High Blood Pressure (HBP) and risk of renal damage due to decreased glomerular count with consequent hyperfiltration of the remnants. OBJECTIVES: To assess the prevalence of altered blood pressure values in outpatient measurement and ambulatory blood pressure monitoring (ABPM) in preterm infants ≤ 32 weeks and/ or ≤ 1,500 g birth weight between 5 and 7 years of age, as well as the presence of early renal damage markers...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29649290/the-contribution-of-gestational-age-area-deprivation-and-mother-s-country-of-birth-to-ethnic-variations-in-infant-mortality-in-england-and-wales-a-national-cohort-study-using-routinely-collected-data
#15
Yangmei Li, Maria A Quigley, Nirupa Dattani, Ron Gray, Hiranthi Jayaweera, Jennifer J Kurinczuk, Alison Macfarlane, Jennifer Hollowell
OBJECTIVES: We aimed to describe ethnic variations in infant mortality and explore the contribution of area deprivation, mother's country of birth, and prematurity to these variations. METHODS: We analyzed routine birth and death data on singleton live births (gestational age≥22 weeks) in England and Wales, 2006-2012. Infant mortality by ethnic group was analyzed using logistic regression with adjustment for sociodemographic characteristics and gestational age...
2018: PloS One
https://www.readbyqxmd.com/read/29630152/lamellar-ichthyosis-in-a-female-neonate-without-a-collodion-membrane
#16
Kevin Chao, Maria Aleshin, Zachary Goldstein, Scott Worswick, Marcia Hogeling
The term, autosomal recessive congenital ichthyosis (ARCI), describes a group of rare genetic skin diseases of cornification involving hyperkeratotic scaling at birth. The defective skin barrier function may lead to dehydration, body temperature instability, and high susceptibility to infections. In most cases of ARCI, neonates are born with a collodion membrane covering the body, often presenting with ectropion and eclabium. We report a premature female neonate presenting with hyperkeratotic scaling at birth without a collodion membrane...
February 15, 2018: Dermatology Online Journal
https://www.readbyqxmd.com/read/29610159/use-of-insulin-glargine-in-the-management-of-neonatal-hyperglycemia-in-an-elbw-infant
#17
Min J Hwang, Robert Newman, Katherine Philla, Elizabeth Flanigan
Neonatal hyperglycemia is common in extremely low birth weight (ELBW) infants because of physiologic stress, exogenous glucose infusion, and postnatal corticosteroid therapy for hypotension, adrenal insufficiency, and pulmonary immaturity. The use of long-acting insulin glargine has been described in the treatment of transient neonatal diabetes in the premature infant, but in these reports is a lack of regard to its use in the treatment of iatrogenic neonatal hyperglycemia. We present the case of an ELBW infant with significant hyperglycemia that was refractory to usual treatment but demonstrated a favorable response to long-acting subcutaneous insulin glargine...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29605813/association-between-asthma-and-lung-function-in-adolescents-born-very-preterm-results-of-the-epipage-cohort-study
#18
Alice Hadchouel, Jessica Rousseau, Jean-Christophe Rozé, Catherine Arnaud, Adèle Bellino, Laure Couderc, Stéphane Marret, Marie Mittaine, Didier Pinquier, Marie Verstraete, Pierre-Yves Ancel, Christophe Delacourt
Prematurity and bronchopulmonary dysplasia (BPD) affect long-term lung function. We studied the respiratory outcome of adolescents born very preterm and controls from the Etude EPIdémiologique sur les Petits Ages Gestationnels cohort and analysed their current lung function in relation to asthma symptoms (categorised in three age groups) from birth. In models including BPD, asthma at each age and confounding factors in the preterm group, BPD and preschool wheeze were the only independent variables associated with FEV1 Preschool wheeze is an independent factor associated with FEV1 impairment in adolescents born very preterm...
March 31, 2018: Thorax
https://www.readbyqxmd.com/read/29603723/training-of-parental-scaffolding-in-high-socio-economic-status-families-how-do-parents-of-full-and-preterm-born-toddlers-benefit
#19
Kim Angeles Gärtner, Verena Clara Vetter, Michaela Schäferling, Gitta Reuner, Silke Hertel
BACKGROUND: Preterm children have an increased risk regarding self-regulation development. Given the strong link between parenting behaviour (i.e., scaffolding and sensitivity) and children's self-regulation, parental training presents a promising way to counteract the negative consequences of preterm birth. AIMS: We explored the effectiveness of parental training by comparing a basic scaffolding training and a combined scaffolding/sensitivity training to an active treatment-control group (stress management)...
March 30, 2018: British Journal of Educational Psychology
https://www.readbyqxmd.com/read/29601449/antifungal-treatment-and-outcome-in-very-low-birth-weight-infants-a-population-based-observational-study-of-the-german-neonatal-network
#20
Ingmar Fortmann, Annika Hartz, Pia Paul, Ferdinand Pulzer, Andreas Müller, Ralf Böttger, Hans Proquitté, Kristin Dawczynski, Arne Simon, Jan Rupp, Egbert Herting, Wolfgang Göpel, Christoph Härtel
INTRODUCTION: The diagnostic proof of fungal infection in preterm infants is difficult. Antifungal treatment (AFT) is often initiated empirically when infants with suspected infection do not improve despite broad spectrum antibiotic therapy. It was the aim of our study to determine the rate of exposure to empirical AFT in a large cohort of very low birth weight infants (VLBWI) of the German Neonatal Network (GNN) and to address associated risks and outcomes. METHODS: The epidemiological database consisted of n= 13...
March 29, 2018: Pediatric Infectious Disease Journal
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