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Preterm survival

Neha Bairoliya, Günther Fink
BACKGROUND: While the high prevalence of preterm births and its impact on infant mortality in the US have been widely acknowledged, recent data suggest that even full-term births in the US face substantially higher mortality risks compared to European countries with low infant mortality rates. In this paper, we use the most recent birth records in the US to more closely analyze the primary causes underlying mortality rates among full-term births. METHODS AND FINDINGS: Linked birth and death records for the period 2010-2012 were used to identify the state- and cause-specific burden of infant mortality among full-term infants (born at 37-42 weeks of gestation)...
March 2018: PLoS Medicine
D Valenzuela, F Moya, M Luco, J L Tapia
50 years ago, Northway described Broncopulmonary Dysplasia (BPD) in preterm infants exposed to mechanical ventilation. Since then, their survival has increased, nevertheless a "new BPD" has appeared and its incidence has not diminished. One of the characteristics of this pathology is the the abnormal vascular remodeling, which in its most severe expression is known as Pulmonary Hyper tension (PH); with an incidence of 17% in patients with BPD, which is proportional to the severity of the disease (33% in severe BPD), and as mortality factor (up to 48% 2-year mortality in PH-BPD)...
December 2017: Revista Chilena de Pediatría
Jennifer Carns, Kondwani Kawaza, M K Quinn, Yinsen Miao, Rudy Guerra, Elizabeth Molyneux, Maria Oden, Rebecca Richards-Kortum
BACKGROUND: Neonatal hypothermia is widely associated with increased risks of morbidity and mortality, but remains a pervasive global problem. No studies have examined the impact of hypothermia on outcomes for preterm infants treated with CPAP for respiratory distress syndrome (RDS). METHODS: This retrospective analysis assessed the impact of hypothermia on outcomes of 65 neonates diagnosed with RDS and treated with either nasal oxygen (N = 17) or CPAP (N = 48) in a low-resource setting...
2018: PloS One
X Q Wang, W J Li, R L Yan, J W Xiang, M Y Liu
Objective: To optimize the clinical managements of primary fetal hydrothorax (PFHT) fetus by comparing the perinatal survival rate of different prenatal treatments. Methods: Totally 13 fetuses diagnosed with PFHT from July 2009 to December 2015 in the First Affiliated Hospital of Jinan University were collected and received prenatal expectant treatment, thoracocentesis (TC), and thoraco-amniotic shunting (TAS), respectively. The perinatal survival rate was compared among the three treatments. Results: Among 13 fetuses of PFHT, pleural effusion was absorbed or remained stable in 2(2/13) cases, and progressed in 11(11/13) cases...
February 25, 2018: Zhonghua Fu Chan Ke za Zhi
Ruben Barakat, Evelia Franco, María Perales, Carmina López, Michelle F Mottola
OBJECTIVE: to examine the influence of an exercise program throughout pregnancy on the duration of labor in healthy pregnant women. STUDY DESIGN: A randomized clinical trial was used (Identifier: NCT02109588). In all, 508 healthy pregnant women were randomly assigned between 9 and 11 weeks of gestation to either a Control Group (CG, N = 253) or an Exercise Group (EG, N = 255). A moderate aerobic exercise program throughout pregnancy (three weekly sessions) was used as the intervention...
March 6, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Mary Judith Berry
The advances in perinatal medicine over the last 20 years are unprecedented. Babies born at extremes of gestational age and birthweight are now able to benefit from innovation in intensive care and many survive into adulthood. This article is protected by copyright. All rights reserved.
March 11, 2018: Journal of Physiology
Kaia Skromme, Maria Vollsæter, Knut Øymar, Trond Markestad, Thomas Halvorsen
BACKGROUND: Advances in perinatal care have markedly increased the prospects of survival for infants born extremely preterm (EP). The aim of this study was to investigate hospitalisation rates and respiratory morbidity from five to 11 years of age in a prospective national cohort of EP children born in the surfactant era. METHODS: This was a national prospective cohort study of all children born in Norway during 1999 and 2000 with gestational age (GA) < 28 weeks or birth weight < 1000 grams, and of individually matched term-born controls recruited for a regional subsample...
March 7, 2018: BMC Pediatrics
David Wright, Daniel L Rolnik, Argyro Syngelaki, Catalina de Paco Matallana, Mirian Machuca, Mercedes de Alvarado, Sofia Mastrodima, Min Yi Tan, Siobhan Shearing, Nicola Persico, Jacques C Jani, Walter Plasencia, George Papaioannou, Francisca S Molina, Liona C Poon, Kypros H Nicolaides
BACKGROUND: Preeclampsia is a major pregnancy complication with adverse short- and long-term implications for both the mother and baby. Screening for preeclampsia at 11-13 weeks' gestation by a combination of maternal demographic characteristics and medical history with measurements of biomarkers can identify about 75% of women that develop preterm-preeclampsia with delivery at <37 weeks' gestation and 90% of those with early-preeclampsia at <32 weeks, at a screen positive rate of 10%...
March 2, 2018: American Journal of Obstetrics and Gynecology
David A Osborn, Tim Schindler, Lisa J Jones, John Kh Sinn, Srinivas Bolisetty
BACKGROUND: Sick newborn and preterm infants frequently are not able to be fed enterally, necessitating parenteral fluid and nutrition. Potential benefits of higher parenteral amino acid (AA) intake for improved nitrogen balance, growth, and infant health may be outweighed by the infant's ability to utilise high intake of parenteral AA, especially in the days after birth. OBJECTIVES: The primary objective is to determine whether higher versus lower intake of parenteral AA is associated with improved growth and disability-free survival in newborn infants receiving parenteral nutrition...
March 5, 2018: Cochrane Database of Systematic Reviews
Annemarie Stroustrup, Jennifer B Bragg, Syam S Andra, Paul C Curtin, Emily A Spear, Denise B Sison, Allan C Just, Manish Arora, Chris Gennings
Every year in the United States, more than 300,000 infants are admitted to neonatal intensive care units (NICU) where they are exposed to a chemical-intensive hospital environment during a developmentally vulnerable period. The neurodevelopmental impact of environmental exposure to phthalates during the NICU stay is unknown. As phthalate exposure during the third trimester developmental window has been implicated in neurobehavioral deficits in term-born children that are strikingly similar to a phenotype of neurobehavioral morbidity common among children born premature, the role of early-life phthalate exposure on the neurodevelopmental trajectory of premature infants may be clinically important...
2018: PloS One
T Isnard, A Vincent-Rohfritsch, C Le Ray, F Goffinet, J Patkai, J Sibiude
OBJECTIVE: To describe survival rate after preterm premature rupture of membranes (PPROM) before 25 weeks of gestation and compare neonatal morbidity and mortality among those born alive with a control group of infants born at a similar gestational age without premature rupture of membranes. METHODS: We conducted a retrospective single-centre study at Port-Royal maternity, from 2007 to 2015, comparing neonatal outcomes between liveborninfants exposed to PPROM prior to 25 weeks of gestation (WG) and a control group not exposed to premature rupture of the membranes...
February 26, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Brigitte Lemyre, Gregory Moore
Counselling couples facing the birth of an extremely preterm infant is a complex and delicate task, entailing both challenges and opportunities. This revised position statement proposes using a prognosis-based approach that takes the best estimate of gestational age into account, along with additional factors, including estimated fetal weight, receipt of antenatal corticosteroids, singleton versus multiple pregnancy, fetal status and anomalies on ultrasound and place of birth. This statement updates data on survival in Canada, long-term neurodevelopmental disability at school age and quality of life, with focus on strategies to communicate effectively with parents...
September 2017: Paediatrics & Child Health
David E Lowe, Jennifer R Robbins, Anna I Bakardjiev
Intrauterine infections lead to serious complications for mother and fetus including preterm birth, maternal and fetal death, and neurologic sequelae in the surviving offspring. Improving maternal-child heath is a global priority. Yet, the development of strategies to prevent and treat pregnancy-related diseases has lagged behind progress made in other medical fields. One of the challenges is finding tractable model systems that replicate the human maternal-fetal interface. Animal models offer the ability to study pathogenesis and host defenses in vivo However, the anatomy of the maternal-fetal interface is highly divergent across species...
February 26, 2018: Infection and Immunity
Arvind Sehgal, Kenneth Tan, Peter Ferguson
The objectives of this study were to characterize peri-operative echocardiographic (ECHO) assessments of right ventricular (RV) function and pulmonary hypertension (PH) and ascertain correlation with clinical outcomes in infants with left Bochdalek's hernia (LBH). This retrospective study in a quaternary neonatal intensive care unit involved electronic database search for infants with LBH during January 2009 to July 2017. Demographics, outcomes, and ECHO parameters were accessed from archived databases. Thirty-one infants with mean gestational age and birthweight (BW) 38...
February 23, 2018: Pediatric Cardiology
Hans Ulrich Bucher, Sabine D Klein, Manya J Hendriks, Ruth Baumann-Hölzle, Thomas M Berger, Jürg C Streuli, Jean-Claude Fauchère
BACKGROUND: In the last 20 years, the chances for intact survival for extremely preterm infants have increased in high income countries. Decisions about withholding or withdrawing intensive care remain a major challenge in infants born at the limits of viability. Shared decision-making regarding these fragile infants between health care professionals and parents has become the preferred model today. However, there is an ongoing ethical debate on how decisions regarding life-sustaining treatment should be reached and who should have the final word when health care professionals and parents do not agree...
February 22, 2018: BMC Pediatrics
Janneke van 't Hooft, Johanna H van der Lee, Brent C Opmeer, Aleid G van Wassenaer-Leemhuis, Anneloes L van Baar, Dick J Bekedam, Leonie J P Steenis, Sophie Liem, Ewoud Schuit, Cuny Cuijpers, Elise Bleeker, Margot E Vinke, Noor Simons, Irene M de Graaf, Ben Willem J Mol, Cornelieke van de Beek
OBJECTIVE: We recently found in a randomized clinical trial (ProTWIN) that cervical pessary prevented preterm birth and improved neonatal outcome in women with a multiple pregnancy and a cervical length (CL) <38mm. In this follow-up study we evaluated long-term developmental outcomes in the offspring of these women at three years corrected age. METHODS: We conducted a follow-up study of the ProTWIN trial, a trial in which between 2009 and 2012 asymptomatic women with a multiple pregnancy had been randomized to pessary or no pessary...
February 22, 2018: Ultrasound in Obstetrics & Gynecology
Gaston Ofman, Marta Perez, Kathryn N Farrow
TYPE OF INVESTIGATION: Prognosis; exploratory secondary analysis of an interventional randomized controlled trial. QUESTION: In extremely preterm infant (<28 weeks), is early low-dose hydrocortisone compared to placebo associated with neurodevelopmental impairment at 2 years of age? METHODS: Patients: Surviving infants enrolled in the PREMILOC trial conducted in France between 2008 and 2014. INTERVENTION: Double-blind, multicenter, randomized, placebo-controlled trial of infants born between 24 0/7 weeks and 27 6/7 weeks of gestation and before 24 h of postnatal age, assigned to receive either placebo or low-dose hydrocortisone (0...
February 21, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
M A Mannan, M A Hossain, J Nasim, Y Sabina, F Navila, D Subir
Since its inception, the neonatal mechanical ventilator has been considered an essential tool for managing preterm neonates with Respiratory Distress Syndrome (RDS) and is still regarded as an integral component in the neonatal respiratory care continuum. Mechanical ventilation of newborn has been practiced for several years with several advances made in the way. This clinical intervention study was done to analyze immediate outcome of preterm neonates with RDS required mechanical ventilation and conducted on preterm neonates with RDS required mechanical ventilation from July 2014 to June 2015...
January 2018: Mymensingh Medical Journal: MMJ
Ivete F R Caldas, Marilice F Garotti, Victor K M Shiramizu, Antonio Pereira
Humans are born completely dependent on adult care for survival. To get the necessary support, newborns rely on socio-communicative abilities which have both innate and learned components. Maternal responsiveness (MR), as a critical aspect of mother-infant interaction, is a robust predictor of the acquisition of socio-communicative abilities. However, maternal responsiveness (MR) is influenced by parity, since mothers rely on a limited capacity of cognitive control for efficient attachment with their offspring...
2018: Frontiers in Psychology
Jui-Hsing Chang, Chyong-Hsin Hsu, Kao-Inn Tsou, Wai-Tim Jim
BACKGROUND: Advances in perinatal and neonatal care have increased the survival of extremely preterm infants, but the viability limit is still debated. Here we assess the survival, neonatal morbidity, and neurodevelopmental outcomes at 2 years of age of infants born at 22-26 weeks of gestation in Taiwan between 2007 and 2011. METHODS: This is a prospective longitudinal multicenter cohort study on extremely preterm infants registered in the Taiwan Premature Infant Developmental Collaborative Study Group from 2007 to 2011, including 22 neonatal care centers...
February 14, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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