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https://www.readbyqxmd.com/read/29686009/influence-of-gestational-age-at-initiation-of-antihypertensive-therapy-secondary-analysis-of-chips-trial-data-control-of-hypertension-in-pregnancy-study
#1
Anouk Pels, Ben Willem J Mol, Joel Singer, Terry Lee, Peter von Dadelszen, Wessel Ganzevoort, Elizabeth Asztalos, Laura A Magee
For hypertensive women in CHIPS (Control of Hypertension in Pregnancy Study), we assessed whether the maternal benefits of tight control could be achieved, while minimizing any potentially negative effect on fetal growth, by delaying initiation of antihypertensive therapy until later in pregnancy. For the 981 women with nonsevere, chronic or gestational hypertension randomized to less-tight (target diastolic blood pressure, 100 mm Hg), or tight (target, 85 mm Hg) control, we used mixed-effects logistic regression to examine whether the effect of less-tight (versus tight) control on major outcomes was dependent on gestational age at randomization, adjusting for baseline factors as in the primary analysis and including an interaction term between gestational age at randomization and treatment allocation...
April 23, 2018: Hypertension
https://www.readbyqxmd.com/read/29683522/magnifying-lenses-to-aid-umbilical-catheter-insertion
#2
Aisling M O'Riordan, Oksana Kozdoba, John Fa Murphy, Lisa K McCarthy
Umbilical venous and arterial catheters are frequently inserted into critically ill and preterm newborns in the neonatal intensive care unit (NICU) to administer fluids, drugs and parenteral nutrition; to monitor blood pressure; and for blood sampling(1). Successful catheterisation can be difficult and failure is common because the vessels are small, they are mobile, slippery and easily traumatised. Repeated probing and failure to adequately dilate the opening can cause a false passage adjacent to the vessel that is difficult to correct(2)...
April 23, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29682496/inotropes-for-preterm-infants-50-years-on-are-we-any-wiser
#3
REVIEW
Aisling A Garvey, Elisabeth M W Kooi, Eugene M Dempsey
For almost half a century, inotropes have been administered to preterm infants with the ultimate goal of increasing their blood pressure. A number of trials, the majority of which focused on dopamine administration, have demonstrated increased blood pressure following inotrope administration in preterm infants and have led to continued use of inotropes in our neonatal units. We have also seen an increase in the number of potential agents available to the clinician. However, we now know that hypotension is a much broader concept than blood pressure alone, and our aim should instead be focused on improving end organ perfusion, specifically cerebral perfusion...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29664499/ambulatory-blood-pressure-monitoring-in-school-children-with-a-history-of-extreme-prematurity
#4
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/29642731/the-effect-of-hemodynamically-significant-patent-ductus-arteriosus-on-acute-kidney-injury-and-systemic-hypertension-in-extremely-low-gestational-age-newborns
#5
Danitza M Velazquez, Kimberly J Reidy, Madhu Sharma, Mimi Kim, Melissa Vega, Tomas Havranek
BACKGROUND: Acute kidney injury (AKI) in preterm neonates is becoming an increasingly recognized morbidity in the neonatal intensive care unit neonatal intensive care unit (NICU), yet its epidemiology, delineation and relation to numerous toxic exposures and common morbidities such as systemic hypertension is just evolving. With a frequency of the patent ductus arteriosus (PDA) as high as 70% in preterm infants born before 28-week gestation, the role of the hemodynamically significant PDA (hs-PDA) remains unclear...
April 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29630010/perinatal-outcomes-in-women-with-a-history-of-chronic-hypertension-but-normal-blood-pressures-before-20-weeks-of-gestation
#6
Mallory Youngstrom, Alan Tita, Janatha Grant, Jeff M Szychowski, Lorie M Harper
OBJECTIVE: To compare the perinatal outcomes of normotensive women with those of women with a history of chronic hypertension with normal blood pressures before 20 weeks of gestation, stratifying the latter by whether they were receiving antihypertensive medication. METHODS: We conducted a retrospective cohort study of all singletons with a history of chronic hypertension from 2000 to 2014. Exclusions were blood pressure greater than 140/90 mm Hg before 20 weeks of gestation, fetal anomalies, major medical problems other than hypertension, and diabetes...
April 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29604486/effects-of-caffeine-on-the-preterm-brain-an-observational-study
#7
Laura M L Dix, Frank van Bel, Willem Baerts, Petra M A Lemmers
BACKGROUND AND AIM: Caffeine improves neurodevelopmental outcome of preterm infants. This study analyses the effects of caffeine on the neonatal brain. We hypothesized that caffeine has a neuroprotective effect through an increase in oxygen metabolism; reflected by increased cerebral oxygen extraction, electrical function, and perfusion. METHODS: Preterm infants <32 weeks gestation (GA) receiving their primary dose caffeine-base (10 mg/kg) were included. Ten minutes of stable monitoring were selected before, during, and every hour up to 6 h after caffeine...
March 28, 2018: Early Human Development
https://www.readbyqxmd.com/read/29604124/risk-factors-and-mortality-rate-in-premature-babies-with-acute-kidney-injury
#8
Ahmet Taner Elmas, Yılmaz Tabel, Ramazan Özdemir
BACKGROUND: Acute kidney injury (AKI) is a common morbidity in neonatal intensive care units and associated with poor outcome. This study aimed to determine the prevalence of AKI and provide a demographic data and risk factors associated with the mortality and morbidity. METHODS: This is a retrospective study included 105 premature babies. Diagnosis of AKI was based on neonatal KDIGO classification criteria. The babies were stratified into two groups according to AKI status during the hospitalization...
March 31, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29601410/increased-aortic-wave-reflection-contributes-to-higher-systolic-blood-pressure-in-adolescents-born-preterm
#9
Remi R Kowalski, Richard Beare, Jonathan P Mynard, Jeanie L Y Cheong, Lex W Doyle, Joseph J Smolich, Michael M H Cheung
OBJECTIVE: To evaluate the wave reflection characteristics in the aortic arch and common carotid artery of ex-preterm adolescents and assess their relationship to central blood pressure in a cohort followed prospectively since birth. METHODS: Central blood pressures, pulse wave velocity, augmentation index, microvascular reactive hyperemia, arterial distensibility, compliance and stiffness index, and also aortic and carotid wave intensity were measured in 18-year-olds born extremely preterm at below 28 weeks' gestation (n = 76) and term-born controls (n = 42)...
March 29, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29581556/salt-sensitivity-of-blood-pressure-at-age-8-years-in-children-born-preterm
#10
Charlotte A Ruys, Joost Rotteveel, Monique van de Lagemaat, Harrie N Lafeber, Martijn J J Finken
Preterm birth and low birth weight have been associated with an increased risk of hypertension; postnatal growth and dietary salt intake may contribute to these associations. In adults, the change of blood pressure (BP) in response to modifications in salt intake, i.e., salt sensitivity of BP, has been independently associated with cardiovascular disease. Little is known about salt sensitivity in children. We hypothesize that it may partly explain the association between preterm birth and higher BP in later life...
March 27, 2018: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29574536/does-maternal-exposure-to-secondhand-tobacco-smoke-during-pregnancy-increase-the-risk-for-preterm-or-small-for-gestational-age-birth
#11
Adrienne T Hoyt, Mark A Canfield, Paul A Romitti, Lorenzo D Botto, Marlene T Anderka, Sergey V Krikov, Marcia L Feldkamp
Introduction While associations between active smoking and various adverse birth outcomes (ABOs) have been reported in the literature, less is known about the impact of secondhand smoke (SHS) on many pregnancy outcomes. Methods We examined the relationship between maternal exposure to SHS during pregnancy and preterm (< 37 weeks gestation) and small-for-gestational age (SGA; assessed using sex-, race/ethnic-, and parity-specific growth curves) singleton births using non-smoking controls from the National Birth Defects Prevention Study (1997-2011)...
March 24, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29558860/pregnant-sheep-develop-hypoxaemia-during-short-term-anaesthesia-for-caesarean-delivery
#12
Gabrielle C Musk, Matthew W Kemp
Short-term anaesthesia of the pregnant ewe may be required for caesarean delivery of a preterm foetus within a research protocol. The aim of this study was to evaluate and compare the acid-base and haematological status of the ewe and foetus at the time of surgical delivery by collecting maternal and foetal arterial blood samples. Fifteen date-mated singleton-pregnant merino cross ewes at 122.0 (±0.5) days of gestation were anaesthetised with a combination of midazolam (0.5 mg/kg) and ketamine (10 mg/kg) by intravenous injection...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29558518/risk-factors-for-type-2-diabetes-mellitus-an-exposure-wide-umbrella-review-of-meta-analyses
#13
Vanesa Bellou, Lazaros Belbasis, Ioanna Tzoulaki, Evangelos Evangelou
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a global epidemic associated with increased health expenditure, and low quality of life. Many non-genetic risk factors have been suggested, but their overall epidemiological credibility has not been assessed. METHODS: We searched PubMed to capture all meta-analyses and Mendelian randomization studies for risk factors of T2DM. For each association, we estimated the summary effect size, its 95% confidence and prediction interval, and the I2 metric...
2018: PloS One
https://www.readbyqxmd.com/read/29538367/left-ventricular-pumping-during-the-transition-adaptation-sequence-in-preterm-infants-impact-of-the-patent-ductus-arteriosus
#14
Sigrid Baumgartner, Monika Olischar, Martin Wald, Tobias Werther, Angelika Berger, Thomas Waldhör, Georg Fischer, Ulrike Salzer-Muhar
BACKGROUND: Postnatally, the immature left ventricle (LV) is subjected to high systemic afterload. Hypothesizing that LV pumping would change during transition-adaptation we analyzed the LV in preterm infants (GA≤32+6), clinically stable or with a hemodynamically significant PDA (hPDA) by applying a pump model. METHODS: Pumping was characterized by EA (effective arterial elastance, reflecting afterload), EES (endsystolic LV elastance, reflecting contractility), EA /EES -coupling ratios, descriptive EA :EES relations and EA /EES -graphs...
March 14, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29535993/placental-transfusion-and-cardiovascular-instability-in-the-preterm-infant
#15
REVIEW
Zbynĕk Straňák, Simona Feyereislová, Peter Korček, Eugene Dempsey
Postnatal adaptation in preterm newborn comprises complex physiological processes that involve significant changes in the circulatory and respiratory system. Increasing hemoglobin level and blood volume following placental transfusion may be of importance in enhancing arterial oxygen content, increasing cardiac output, and improving oxygen delivery. The European consensus on resuscitation of preterm infants recommends delayed cord clamping (DCC) for at least 60 s to promote placenta-fetal transfusion in uncompromised neonates...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29535674/investigation-of-eeg-activity-compared-with-mean-arterial-blood-pressure-in-extremely-preterm-infants
#16
Sujith S Pereira, Stephen T Kempley, David F Wertheim, Ajay K Sinha, Joan K Morris, Divyen K Shah
Background: Cerebral electrical activity in extremely preterm infants is affected by various factors including blood gas and circulatory parameters. Objective: To investigate whether continuously measured invasive mean arterial blood pressure (BP) is associated with electroencephalographic (EEG) discontinuity in extremely preterm infants. Study design: This prospective observational study examined 51 newborn infants born <29 weeks gestation in the first 3 days after birth...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29523269/early-diagnosis-of-preeclampsia-using-placental-growth-factor-an-operational-pilot-study-in-maputo-mozambique
#17
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
https://www.readbyqxmd.com/read/29516473/provision-of-respiratory-support-compared-to-no-respiratory-support-before-cord-clamping-for-preterm-infants
#18
REVIEW
Michael P Meyer, Elizabeth Nevill, Maisie M Wong
BACKGROUND: Placental transfusion (by means of delayed cord clamping (DCC), cord milking, or cord stripping) confers benefits for preterm infants. It is not known if providing respiratory support to preterm infants before cord clamping improves outcomes. OBJECTIVES: To assess the efficacy and safety of respiratory support provided during DCC compared with no respiratory support during placental transfusion (in the form of DCC, milking, or stripping) in preterm infants immediately after delivery...
March 8, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29515224/blood-potassium-and-urine-aldosterone-after-doxapram-therapy-for-preterm-infants
#19
Tomoyuki Shimokaze, Katsuaki Toyoshima, Jun Shibasaki, Yasufumi Itani
OBJECTIVE: We often encounter infants who developed hypokalaemia following low-dose doxapram for apnea of prematurity (AOP). AIMS: To determine changes in blood potassium (K+) levels after doxapram administration. STUDY DESIGN: We studied infants born before 30 weeks gestation. Doxapram (0.1-0.3 mg/kg/h) in addition to methylxanthines was used to treat AOP refractory to methylxanthines. RESULTS: Twenty-five infants received doxapram were studied...
March 7, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29508407/moderate-preterm-birth-impacts-right-ventricular-structure-and-function-and-pulmonary-artery-blood-flow-in-adult-sheep
#20
Marshall M Mrocki, Vivian B Nguyen, Paul Lombardo, Megan R Sutherland, Jonathan G Bensley, Ilias Nitsos, Beth J Allison, Richard Harding, Robert De Matteo, Michal Schneider, Graeme R Polglase, M Jane Black
Preterm birth prematurely exposes the immature heart to the haemodynamic transition at birth, which has the potential to induce abnormal cardiac remodelling. Magnetic resonance imaging studies in young adults born preterm have shown abnormalities in the gross structure of the ventricles (particularly the right ventricle; RV), but the cellular basis of these alterations is unknown. The aim of this study, conducted in sheep, was to determine the effect of moderate preterm birth on RV cellular structure and function in early adulthood...
March 6, 2018: Journal of Physiology
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