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Perinatal care

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
Tiffany A Moore Simas, Michael P Flynn, Aimee R Kroll-Desrosiers, Stephanie M Carvalho, Leonard L Levin, Kathleen Biebel, Nancy Byatt
This systematic review searched 4 databases (PubMed/MEDLINE, Scopus, CINAHL, and PsychINFO) and identified 21 articles eligible to evaluate the extent to which interventions that integrate depression care into outpatient obstetric practice are feasible, effective, acceptable, and sustainable. Despite limitations among the available studies including marked heterogeneity, there is evidence supporting feasibility, effectiveness, and acceptability. In general, this is an emerging field with promise that requires additional research...
March 16, 2018: Clinical Obstetrics and Gynecology
Rainey Banick Wood
During prenatal care and postpartum hospitalization, nurses have an important role in assisting new mothers to make informed decisions about feeding their newborn infants. There is overwhelming evidence that breastfeeding is beneficial for most new mothers and babies; therefore, perinatal nurses encourage breastfeeding. Newborn infant feeding conversations with women who have chosen to formula feed may be complicated and may cause tension in the nurse-patient relationship. Despite this po tential difficulty, these conversations are essential to establish a feeding plan for the newborn infant and to promote healthy outcomes for mothers and babies...
March 16, 2018: MCN. the American Journal of Maternal Child Nursing
Gayathri Priyadarshni Elangovan, Jananni Muthu, Indra Kumar Periyasamy, Pratebha Balu, R Saravana Kumar
Background: The differences in the oral health status between the individuals with a high socioeconomic status (SES) and those with a low SES had markedly increased. There is, however, minimal information available on women understanding the need of dental hygiene for overall health and whether pregnant women comply with the current oral health strategies. In Lieu with the above, the present study aims to assess the awareness, dental hygiene practices, and the frequency of dental visits during pregnancy in postnatal women who delivered preterm low birth weight babies of different SES in and around Puducherry...
November 2017: Journal of Indian Society of Periodontology
Cathy Liu, Jade Lodge, Christopher Flatley, Alexander Gooi, Cameron Ward, Karen Eagleson, Sailesh Kumar
OBJECTIVE: To determine obstetric, intrapartum and perinatal outcomes for pregnancies with isolated fetal congenital heart defects (CHD). METHODS: This was a retrospective cohort study of women that delivered an infant with an isolated major CHD between January 2010 and April 2017 at a major Australian perinatal centre. The study cohort was compared with a cohort of women with infants without CHD. Cardiac abnormalities were broadly subdivided into the following five categories using the International Classification of Diseases Tenth Revision (ICD-10) as a guide - transposition of the great arteries (TGA), septal defects, right heart lesions (RHL), left heart lesions (LHL) and "other"...
March 16, 2018: Journal of Maternal-fetal & Neonatal Medicine
Claire Wendland
Maternal and neonatal mortality statistics foreground some possible causes of death at the expense of others. Political place (nation, state) and place of birth (hospital, home) are integral to these statistics; respect for women as persons is not. Using case examples from Malawi and the United States, I argue that the focus on place embedded in these indicators can legitimate coercive approaches to childbirth. Qualitative assessments in both cases reveal that respectful care, while not represented in current indicators, is critical for the health of women and newborns...
March 1, 2018: AMA Journal of Ethics
Charlene Eliza Thornton, Hannah Grace Dahlen
OBJECTIVES: To determine incidence, associated factors, outcomes and geographical occurrence of born before arrival (BBA) in New South Wales, Australia. DESIGN: A linked population data study involving population-based surveillance systems was undertaken for the years 2000-2011. SETTING: New South Wales, Australia. PARTICIPANTS: All women who underwent BBA compared with women who birthed in hospital/birth centre settings...
March 14, 2018: BMJ Open
Shefaly Shorey, Cornelia Chee, Yap-Seng Chong, Esperanza Debby Ng, Ying Lau, Cindy-Lee Dennis
BACKGROUND: Multiple international agencies, including the World Health Organization and the International Monetary Fund, have emphasized the importance of maternal mental health for optimal child health and development. Adequate social support is vital for the most vulnerable to postpartum mood disorders. Hence, an urgent need for sustainable social support programs to aid mothers ease into their new parenting role exists. OBJECTIVE: This study protocol aims to examine the effectiveness of a technology-based peer support intervention program among mothers at risk for postnatal depression in the early postpartum period...
March 14, 2018: JMIR Research Protocols
Karen Broekhuizen, David Simmons, Roland Devlieger, André van Assche, Goele Jans, Sander Galjaard, Rosa Corcoy, Juan M Adelantado, Fidelma Dunne, Gernot Desoye, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R Mathiesen, Dorte M Jensen, Liselotte L Andersen, Annunziata Lapolla, Maria G Dalfra, Alessandra Bertolotto, Ewa Wender-Ozegowska, Agnieszka Zawiejska, David Hill, Frank J Snoek, Judith G M Jelsma, Judith E Bosmans, Mireille N M van Poppel, Johanna M van Dongen
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with perinatal health risks to both mother and offspring, and represents a large economic burden. The DALI study is a multicenter randomized controlled trial, undertaken to add to the knowledge base on the effectiveness of interventions for pregnant women at increased risk for GDM. The purpose of this study was to evaluate the cost-effectiveness of the healthy eating and/or physical activity promotion intervention compared to usual care among pregnant women at increased risk of GDM from a societal perspective...
March 14, 2018: International Journal of Behavioral Nutrition and Physical Activity
Julia F Litzky, Maya A Deyssenroth, Todd M Everson, Barry M Lester, Luca Lambertini, Jia Chen, Carmen J Marsit
BACKGROUND: Depression and/or anxiety during pregnancy have been associated with impaired fetal growth and neurodevelopmental. Because placental imprinted genes play a central role in fetal development and respond to environmental stressors, we hypothesized that imprinted gene expression would be affected by prenatal depression and anxiety. METHODS: Placental gene expression was compared between mothers with prenatal depression and/or anxiety/obsessive compulsive disorder/panic and control mothers without psychiatric history (n=458) in the Rhode Island Child Health Study...
March 14, 2018: Pediatric Research
Nathali Gunawardena, Ghose Bishwajit, Sanni Yaya
Background: For exploring maternal death, supply and demand-side factors can be characterized by the three delays model developed by Thaddeus and Maine (1994). The model comprises delay in deciding to seek care (delay 1), delay in reaching the health facility (delay 2), and delay in receiving quality care once at the health facility (delay 3). Few studies have comprehensively dealt with the health systems delays that prevent the receipt of timely and appropriate obstetric care once a woman reaches a health facility (phase III delays)...
2018: Frontiers in Public Health
Rajesh Kumari, Venus Dalal, Garima Kachhawa, Ipshita Sahoo, Rajesh Khadgawat, Reeta Mahey, Vidushi Kulshrestha, Perumal Vanamail, J B Sharma, Neerja Bhatla, Alka Kriplani
Background: Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance first diagnosed in pregnancy and may be associated with adverse maternal and perinatal outcome. Aim: The aim of the study was to determine the maternal and perinatal outcome in GDM during pregnancy. Materials and Methods: It is a retrospective analysis of women diagnosed with GDM who got antenatal care and delivered in our hospital in previous 5 years...
January 2018: Indian Journal of Endocrinology and Metabolism
Annie Dude, Charlotte M Niznik, Emily D Szmuilowicz, Alan M Peaceman, Lynn M Yee
Achieving maternal euglycemia in women with pregestational and gestational diabetes mellitus is critical to decreasing the risk of neonatal hypoglycemia, as maternal blood glucose levels around the time of delivery are directly related to the risk of hypoglycemia in the neonate. Many institutions use continuous insulin and glucose infusions during the intrapartum period, although practices are widely variable. At Northwestern Memorial Hospital, the "Management of the Perinatal Patient with Diabetes" policy and protocol was developed to improve consistency of management while also allowing individualization appropriate for the patient's specific diabetic needs...
March 13, 2018: American Journal of Perinatology
R M Tribe, P D Taylor, N M Kelly, D Rees, J Sandall, H P Kennedy
Caesarean section and instrumental delivery rates are increasing in many parts of the world due to a range of cultural and medical reasons, with limited consideration as to how 'mode of delivery' may impact on childhood and long-term health. However, babies born particularly by pre-labour caesarean section appear to have a subtly different physiology to those born by normal vaginal delivery, with both acute and chronic complications such as respiratory and other morbidities being apparent. It has been hypothesised that inherent mechanisms within the process of labour and vaginal delivery, far from being a passive mechanical process by which the fetus and placenta are expelled from the birth canal, may trigger certain protective developmental processes permissive for normal immunological and physiological development of the fetus postnatally...
March 13, 2018: Journal of Physiology
Ali Judd, Mary-Ann Davies
PURPOSE OF REVIEW: To summarize evidence for health outcomes among adolescents and young people living with HIV (AYLHIV) who have transitioned to adult care/adulthood, views of AYLHIV and providers on the transition process, and the effect of adolescent and youth friendly services (AYFS) on outcomes. RECENT FINDINGS: A total of 43 studies were identified [n = 13 high-income countries (HICs), n = 30 low-/middle-income countries (LMICs)]. In HICs, around 75% of patients were retained in care at approximately 4 years posttransition...
March 9, 2018: Current Opinion in HIV and AIDS
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
Angelina Kakooza-Mwesige, Abdul H Mohammed, Krister Kristensson, Sharon L Juliano, Julius J Lutwama
The global public health concern is heightened over the increasing number of emerging viruses, i.e., newly discovered or previously known that have expanded into new geographical zones. These viruses challenge the health-care systems in sub-Saharan Africa (SSA) countries from which several of them have originated and been transmitted by insects worldwide. Some of these viruses are neuroinvasive, but have been relatively neglected by neuroscientists. They may provide experiments by nature to give a time window for exposure to a new virus within sizeable, previously non-infected human populations, which, for instance, enables studies on potential long-term or late-onset effects on the developing nervous system...
2018: Frontiers in Neurology
Napoleon N Ekem, Lucky O Lawani, Robinson C Onoh, Chukwuemeka A Iyoke, Leonard O Ajah, Emeka O Onwe, Azubuike K Onyebuchi, Love C Okafor
Preconception care (PCC) is a preventive strategy for maternal and perinatal morbidity and mortality. This study aimed to assess the level of awareness and utilisation of PCC services. A descriptive cross-sectional survey was conducted at a teaching hospital. Interviewer-administered questionnaires were used to extract information. A total of 450 participants responded; 44.2% (190/450) were aware, 31.7% (143/450) had good knowledge, while only 10.3% (46/450) received PCC. Health care providers were the main source of information (77...
March 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Beatriz Manriquez Rocha, Francisco Mbofana, Osvaldo Loquiha, Chishamiso Mudenyanga, U Vivian Ukah, Laura A Magee, Peter von Dadelszen
In well-resourced settings, reduced circulating maternal free placental growth factor (PlGF) aids in either predicting or confirming the diagnosis of preeclampsia, fetal growth restriction, stillbirth, preterm birth, and delivery within 14 days of testing when pre-eclampsia is suspected. This operational pilot implementation of maternal plasma PlGF in women with suspected preeclampsia was conducted in six antenatal clinics in Maputo, Mozambique (six control clinics for comparison). The primary outcome was transfer to higher levels of care, following the informative PlGF assay...
January 2018: Pregnancy Hypertension
Patricia Anafi, Wisdom K Mprah, Allen M Jackson, Janelle J Jacobson, Christopher M Torres, Brent M Crow, Kathleen M O'Rourke
In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative...
January 1, 2018: International Quarterly of Community Health Education
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