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lung maturity preterm

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https://www.readbyqxmd.com/read/29229321/the-role-of-aspirin-heparin-and-other-interventions-in-the-prevention-and-treatment-of-fetal-growth-restriction
#1
REVIEW
Katie M Groom, Anna L David
Fetal growth restriction and related placental pathologies such as preeclampsia, stillbirth, and placental abruption are believed to arise in early pregnancy when inadequate remodeling of the maternal spiral arteries leads to persistent high-resistance and low-flow uteroplacental circulation. The consequent placental ischaemia, reperfusion injury, and oxidative stress are associated with an imbalance in angiogenic/antiangiogenic factors. Many interventions have centered on the prevention and/or treatment of preeclampsia with results pertaining to fetal growth restriction and small-for-gestational-age pregnancy often included as secondary outcomes because of the common pathophysiology...
December 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29191292/long-term-childhood-outcomes-after-interventions-for-prevention-and-management-of-preterm-birth
#2
REVIEW
Sarah R Murray, Sarah J Stock, Jane E Norman
Globally, preterm birth rates are rising and have a significant impact on neonatal morbidity and mortality. Preterm birth remains difficult to prevent and a number of strategies for preterm birth prevention (progesterone, cervical pessaries, cervical cerclage, tocolytics, and antibiotics) have been identified. While some of these show more promise, there is a paucity of evidence regarding the long-term effects of these strategies on childhood outcomes. Strategies used to improve the health of babies if born preterm, such as antenatal magnesium sulfate for fetal neuroprotection and antenatal corticosteroids for fetal lung maturation, show evidence of short-term benefit but lack large-scale follow-up data of long-term childhood outcomes...
December 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29181000/prenatal-administration-of-betamethasone-causes-changes-in-the-t-cell-receptor-repertoire-influencing-development-of-autoimmunity
#3
Anna Gieras, Christina Gehbauer, David Perna-Barrull, Jan Broder Engler, Ines Diepenbruck, Laura Glau, Simon A Joosse, Nora Kersten, Stefanie Klinge, Hans-Willi Mittrücker, Manuel A Friese, Marta Vives-Pi, Eva Tolosa
Prenatal glucocorticoids are routinely administered to pregnant women at risk of preterm delivery in order to improve survival of the newborn. However, in half of the cases, birth occurs outside the beneficial period for lung development. Glucocorticoids are potent immune modulators and cause apoptotic death of immature T cells, and we have previously shown that prenatal betamethasone treatment at doses eliciting lung maturation induce profound thymocyte apoptosis in the offspring. Here, we asked if there are long-term consequences on the offspring's immunity after this treatment...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29138038/low-dose-betamethasone-acetate-for-fetal-lung-maturation-in-preterm-sheep
#4
Augusto F Schmidt, Matthew W Kemp, Judith Rittenschober-Böhm, Paranthaman S Kannan, Haruo Usuda, Masatoshi Saito, Lucy Furfaro, Shimpei Watanabe, Sarah Stock, Boris W Kramer, John P Newnham, Suhas G Kallapur, Alan H Jobe
BACKGROUND: Antenatal steroids (ANS) are standard of care for women at risk of preterm delivery; however ANS dosing and formulation have not been adequately evaluated. The standard clinical 2-dose treatment with betamethasone-acetate+betamethasone-phosphate (Beta-P+Beta-Ac) is more effective than 2 doses of Beta-P for inducing lung maturation in preterm fetal sheep. We hypothesized that the slowly-released Beta-Ac component induces similar lung maturation to Beta-P+Beta-Ac with decreased dose and fetal exposure...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138031/mortality-and-pulmonary-outcomes-of-extremely-preterm-infants-exposed-to-antenatal-corticosteroids
#5
Colm P Travers, Waldemar A Carlo, Scott A Mcdonald, Abhik Das, Edward F Bell, Namasivayam Ambalavanan, Alan H Jobe, Ronald N Goldberg, Carl T D'Angio, Barbara J Stoll, Seetha Shankaran, Abbot R Laptook, Barbara Schmidt, Michele C Walsh, Pablo J Sanchez, M Bethany Ball, Ellen C Hale, Nancy S Newman, Rosemary D Higgins
BACKGROUND: Antenatal corticosteroids are given primarily to induce fetal lung maturation but results from meta-analyses of randomized controlled trials have not shown mortality or pulmonary benefits for extremely preterm infants although these are the infants most at risk of mortality and pulmonary disease. OBJECTIVE: To determine if exposure to antenatal corticosteroids is associated with a lower rate of death and pulmonary morbidities by 36 weeks' postmenstrual age...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29129516/is-there-a-potential-link-between-vitamin-d-and-pulmonary-morbidities-in-preterm-infants
#6
Yang Yang, Yun Feng, Xu Chen, Xiao-Nan Mao, Jing-Han Zhang, Li Zhao, You-Yan Zhao, Rui Cheng
BACKGROUND: There hasn't been conclusive proof about the association between vitamin D and pulmonary morbidities of prematurity. METHODS: 106 preterm infants were retrospectively included into this study. Clinical data and blood samples of all the patients were collected within 24 h of admission. RESULTS: (1) Respiratory distress syndrome (RDS) patients were mainly concentrated in "≤30 weeks" stage when compared with other two gestational age groups...
November 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29104474/association-of-surfactant-protein-with-expression-of-hoxa5-and-hoxb5-in-rabbit-fetal-lung
#7
Sung-Hoon Chung, Chong-Woo Bae
Hox genes regulate organ formation and identity of the embryo, and expressed in specific temporo-spatial patterns in the developing embryo. We compared the expression levels of the Hoxa5, Hoxb5, surfactant protein (SP)-A, and SP-B genes in immature and mature rabbit fetal lung tissues, and to uncover roles for Hoxa5, Hoxb5, SP-A, and SP-B. Cesarean sections were performed after rabbits were divided into two groups of 30-31 days of gestation (term group, n = 24) and 26-27 days of gestation (preterm group, n = 24)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29079144/society-for-maternal-fetal-medicine-smfm-consult-series-44-management-of-bleeding-in%C3%A2-the-late-preterm-period
#8
Cynthia Gyamfi-Bannerman
Third-trimester bleeding is a common complication arising from a variety of etiologies, some of which may initially present in the late preterm period. Previous management recommendations have not been specific to this gestational age window, which carries a potentially lower threshold for delivery. The purpose of this document is to provide guidance on management of late preterm (34 0/7-36 6/7 weeks of gestation) vaginal bleeding. The following are Society for Maternal-Fetal Medicine recommendations: (1) we recommend delivery at 36-37 6/7 weeks of gestation for stable women with placenta previa without bleeding or other obstetric complications, such as preeclampsia or fetal growth restriction (Grade 1B); (2) we do not recommend routine cervical length screening for women with placenta previa in the late preterm period because of a lack of data on an appropriate management strategy (Grade 2C); (3) we recommend a planned delivery between 34 and 37 weeks of gestation for stable women with placenta accreta (Grade 1C); (4) we recommend delivery between 34 and 37 weeks of gestation for stable women with vasa previa (Grade 1C); (5) we recommend that in women with active hemorrhage in the late preterm period, delivery should not be delayed for the purpose of administering antenatal corticosteroids (Grade 1B); (6) we recommend that fetal lung maturity testing should not be used to guide management in the late preterm period when an indication for delivery is present (Grade 1B); and (7) we recommend that antenatal corticosteroids should be administered to women who are eligible and are managed expectantly if delivery is likely within 7 days, the gestational age is between 34 0/7 and 36 6/7 weeks of gestation, and antenatal corticosteroids has not previously been administered (Grade 1A)...
October 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29022513/discrepancies-in-animal-models-of-preterm-birth
#9
Clarence R Manuel, Charles R Ashby, Sandra E Reznik
BACKGROUND: Preterm birth (PTB) is a multifactorial syndrome occurring before the 37th week of full-term pregnancy [1]. Babies delivered preterm experience short-term and long-term complications affecting multiple organ systems, and serious maternal complications include hemorrhage and infection. Each year, an estimated 15 million babies are born preterm, and complications from prematurity are the leading cause of death among children up to 5 years of age [2]. With another increase in PTB rates over the last several years, the United States continues to have the highest incidence of any industrialized country [3]...
October 12, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28920101/potential-therapeutic-targets-in-nrf2-dependent-protection-against-neonatal-respiratory-distress-disease-predicted-by-cdna-microarray-analysis-and-bioinformatics-tools
#10
Hye-Youn Cho, Xuting Wang, Jianying Li, Douglas A Bell, Steven R Kleeberger
Hyperoxia exposure of newborn rodents has served as a model for bronchopulmonary dysplasia (BPD) phenotypes found in a sub-population of human premature infants. We previously demonstrated that Nrf2 modulates molecular events during saccular-to-alveolar lung maturation and also has a protective role in the pathogenesis of hyperoxia-induced acute lung injury, mortality, arrest of saccular-to-alveolar transition, and lung injury, using Nrf2-deficient and wild-type neonate mice. In this review, we describe how whole-genome transcriptome analyses can identify the means through which Nrf2 transcriptionally modulates organ injury and morphology, cellular growth/proliferation, vasculature development, and immune response during BPD-like pathogenesis...
December 2016: Current Opinion in Toxicology
https://www.readbyqxmd.com/read/28883045/breath-to-breath-variability-of-exhaled-co2-as-a-marker-of-lung-dysmaturity-in-infancy
#11
Sotirios Fouzas, Ilias Theodorakopoulos, Edgar Wilfried Delgado-Eckert, Philipp Latzin, Urs Frey
The concept of diffusional screening implies that breath-to-breath variations in CO2 clearance, when related to the variability of breathing, may contain information on the quality and utilization of the available alveolar surface. We explored the validity of the above hypothesis in a cohort of young infants of comparable post-menstrual age but born at different stages of lung maturity, namely, in term-born infants (N = 128), preterm-born infants without chronic lung disease of infancy (CLDI) (N = 53) and preterm infants with moderate/severe CLDI (N = 87)...
September 7, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28856015/antenatal-corticosteroid-treatment-for-the-prevention-of-peri-intraventricular-haemorrhage-in-preterm-newborns-a-retrospective-cohort-study-using-transfontanelle-ultrasonography
#12
Bianca A Almeida, Livia T Rios, Edward Araujo Júnior, Luciano M Nardozza, Antonio F Moron, Marília G Martins
OBJECTIVE: The objective of this study was to assess the correlation between antenatal corticosteroids and peri-intraventricular haemorrhage (PIVH) using transfontanelle ultrasonography, as well as to evaluate the risk factors for its incidence. METHODS: We performed a retrospective cohort study using medical records of preterm newborns. The protocol for maternal corticoid administration for foetal lung maturation included dexamethasone 4 mg (intramuscular) 8/8 hours per 48 hours, with one cycle per week...
June 2017: Journal of Ultrasonography
https://www.readbyqxmd.com/read/28751157/end-of-life-decision-making-for-parents-of-extremely-preterm-infants
#13
Manya J Hendriks, Andrea Abraham
OBJECTIVE: To explore parental attitudes and values in the end-of-life decision-making process of extremely preterm infants (gestational age < 28 weeks). DESIGN: Hermeneutically oriented qualitative research design with in-depth interviews. SETTING: Level III NICU in Switzerland. PARTICIPANTS: Purposive sample of seven couples, five mothers, and one father (20 parents). METHODS: Qualitative content analysis was used to categorize and interpret themes from parents' narratives...
July 24, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28735176/reduced-short-term-variation-following-antenatal-administration-of-betamethasone-is-reduced-fetal-size-a-predisposing-factor
#14
Tullio Ghi, Andrea Dall'Asta, Gabriele Saccone, Federica Bellussi, Tiziana Frusca, Pasquale Martinelli, Gianluigi Pilu, Nicola Rizzo
OBJECTIVE: To assess the association between fetal size and the incidence of reduced short-term variability (STV) following bethametasone administration for fetal lung maturity. STUDY DESIGN: This was a retrospective, multicenter, cohort study conducted in two Tertiary University Units. Only uncomplicated singleton pregnancies admitted for threatened preterm labor between 26 and 34 weeks and submitted to betamethasone for fetal lung maturity were included. Delivery occurring within 72h from betamethasone administration represented criteria for exclusion...
September 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28693356/contemporary-practice-patterns-in-the-use-of-amniocentesis-for-fetal-lung-maturity
#15
Kevin C Visconti, Emily DeFranco, Beena D Kamath-Rayne
PURPOSE: Fetal lung maturity (FLM) testing has been performed to help direct delivery timing in complex obstetrical conditions. We explored current practice patterns of FLM testing attempting to identify factors affecting its use. MATERIALS AND METHODS: We distributed a 31-question survey to obstetricians and perinatologists that examined practice characteristics potentially affecting FLM usage. Logistic regression measured associations between these factors and test utilization...
July 25, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28690548/optimization-of-variable-ventilation-for-physiology-immune-response-and-surfactant-enhancement-in-preterm-lambs
#16
Erzsébet Bartolák-Suki, Peter B Noble, Samer Bou Jawde, Jane J Pillow, Béla Suki
Preterm infants often require mechanical ventilation due to lung immaturity including reduced or abnormal surfactant. Since cyclic stretch with cycle-by-cycle variability is known to augment surfactant release by epithelial cells, we hypothesized that such in vivo mechanotransduction improves surfactant maturation and hence lung physiology in preterm subjects. We thus tested whether breath-by-breath variability in tidal volume (VT) in variable ventilation (VV) can be tuned for optimal performance in a preterm lamb model...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28665932/surfactant-phospholipid-composition-of-gastric-aspirate-samples-differs-between-male-and-female-very-preterm-infants
#17
Foula Sozo, Noreen Ishak, Risha Bhatia, Peter G Davis, Richard Harding
BackgroundAmong preterm infants, males have a greater incidence of respiratory distress and death than do females born at the same gestational age, likely due to sex-related differences in lung maturation. Our aim was to determine whether surfactant phospholipid composition differs between male and female preterm infants.MethodsGastric aspirate samples from male and female infants born between 25 and 30 weeks of gestation at The Royal Women's Hospital, Melbourne, Australia, were collected within 1 h after birth...
November 2017: Pediatric Research
https://www.readbyqxmd.com/read/28627012/effect-of-betamethasone-on-fetal-pulmonary-and-umbilical-artery-doppler-velocimetry-and-relationship-with-respiratory-distress-syndrome-development
#18
Emre Sinan Güngör, Gülşah İlhan, Hüseyin Gültekin, Ali Galip Zebitay, Serdar Cömert, Fatma Ferda Verit
OBJECTIVES: Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality. It is primarily a disease of premature neonates. The aim of this study was to evaluate the impact of maternal betamethasone administration on the fetal pulmonary arteries (PAs) and umbilical arteries (UAs) and the correlation between RDS development and PA Doppler results. METHODS: Forty singleton pregnancies between 24 and 34 gestational weeks with a diagnosis of preterm birth were included prospectively...
June 19, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28610460/vitamin-d-levels-in-newborns-and-association-with-neonatal-hypocalcemia
#19
Büşra Yılmaz, Canan Aygün, Erhan Çetinoğlu
OBJECTIVE: Vitamin D has many important functions in our body. Especially in intrauterine and early infancy periods, Vitamin D plays a major role in bone development, growth, and the maturation of tissues such as lung and brain. Fetus is dependent on the mother in terms of Vitamin D and maternal Vitamin D deficiency results in a Vitamin D deficient newborn. The purpose of this study was to determine the levels of Vitamin D in newborns and to investigate the association between Vitamin D status of the baby and neonatal hypocalcemia...
June 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28583603/influence-of-prenatal-maternal-corticosteroid-therapy-on-clinical-and-metabolic-features-and-pulmonary-function-of-preterm-newborn-puppies
#20
F M Regazzi, L C G Silva, C F Lúcio, G A L Veiga, D S R Angrimani, D Kishi, M M M Barbosa, C I Vannucchi
Although the effects of antenatal corticosteroid therapy in clinical improvement and pulmonary maturation in preterm have been described, little is known on premature newborn puppies. This study aimed to evaluate the effect of maternal administration of a single dose of prenatal betamethasone on lung function of preterm newborn puppies in the first hours of life, especially from the clinical point of view and acid-base balance. A prospective study was conducted involving 21 puppies allocated into three experimental groups: Term Group (63 days post-ovulation), Preterm-Treated Group (57 days post-ovulation and maternal administration of a single dose of 0...
July 15, 2017: Theriogenology
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