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1.
Natl Vital Stat Rep ; 70(2): 1-51, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33814033

RESUMEN

Objectives-This report presents 2019 data on U.S. births according to a wide variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Methods-Descriptive tabulations of data reported on the birth certificates of the 3.75 million births that occurred in 2019 are presented. Data are presented for maternal age, livebirth order, race and Hispanic origin, marital status, tobacco use, prenatal care, source of payment for the delivery, method of delivery, gestational age, birthweight, and plurality. Selected data by mother's state of residence and birth rates by age are also shown. Trend data for 2010 through 2019 are presented for selected items. Trend data by race and Hispanic origin are shown for 2016-2019. Results-A total of 3,747,540 births were registered in the United States in 2019, down 1% from 2018. The general fertility rate declined from 2018 to 58.3 births per 1,000 women aged 15-44 in 2019. The birth rate for females aged 15-19 fell 4% between 2018 and 2019. Birth rates declined for women aged 20-34 and increased for women aged 35-44 for 2018-2019. The total fertility rate declined to 1,706.0 births per 1,000 women in 2019. Birth rates declined for both married and unmarried women from 2018 to 2019. The percentage of women who began prenatal care in the first trimester of pregnancy rose to 77.6% in 2019; the percentage of all women who smoked during pregnancy declined to 6.0%. The cesarean delivery rate decreased to 31.7% in 2019 (Figure 1). Medicaid was the source of payment for 42.1% of all births in 2019. The preterm birth rate rose for the fifth straight year to 10.23% in 2019; the rate of low birthweight was essentially unchanged from 2018 at 8.31%. Twin and triplet and higher-order multiple birth rates both declined in 2019 compared with 2018.


Asunto(s)
Tasa de Natalidad/tendencias , Adolescente , Adulto , Certificado de Nacimiento , Orden de Nacimiento , Tasa de Natalidad/etnología , Peso al Nacer , Grupos de Población Continentales/estadística & datos numéricos , Parto Obstétrico/economía , Parto Obstétrico/métodos , Femenino , Edad Gestacional , Hispanoamericanos/estadística & datos numéricos , Humanos , Recién Nacido , Masculino , Estado Civil/etnología , Estado Civil/estadística & datos numéricos , Edad Materna , Persona de Mediana Edad , Madres/estadística & datos numéricos , Progenie de Nacimiento Múltiple/estadística & datos numéricos , Embarazo , Atención Prenatal/estadística & datos numéricos , Uso de Tabaco/epidemiología , Uso de Tabaco/etnología , Estados Unidos/epidemiología , Adulto Joven
2.
Wiad Lek ; 74(2): 213-219, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813474

RESUMEN

OBJECTIVE: The aim: To elucidate the possible involvement of M1 and M2 macrophages in the placentas of women, whose pregnancies were complicated by fetal growth restriction (FGR) and resulted in term births after 37 weeks of gestation and preterm births up to 37 weeks of gestation. PATIENTS AND METHODS: Materials and methods: CD68+ and CD163+ macrophages were studied by immunohistochemical method, placental morphology in the placentas of 16 women whose pregnancies were complicated by FGR and resulted in term births at a gestational age after 37 weeks (1-st group, n = 7) or resulted in preterm births at a gestational age up to 37 weeks (2-nd group, n = 9). The control group consisted of 10 placentas of women with physiological pregnancies and births. RESULTS: Results: Women 2-nd group showed significantly low weight of the placenta, a short gestation period at the time of delivery, and a prolonged labor period than women of the control group (p <0.001; p <0.001; p <0.05, respectively). The level of CD68+ and CD163+ macrophages in the placentas of women 2-nd group was significantly higher than in woman 1-st group (p <0.001, p <0.001, respectively). A significant correlation was found between the expression level of CD68+ monocytes in the intervillous space and the weight of a newborn (r = - 0.765; p = 0.016) in women 2-nd group. CONCLUSION: Conclusions: These studies suggest that in the placentas of women whose pregnancies were complicated by FGR and resulted in preterm births, the increased activation of CD68+ macrophages of the pro-inflammatory pool may be associated with disorders of the vascular and stromal component of the villous chorion with the development of involutive and dystrophic changes. In general, this fact probably determines the progress of chronic placental insufficiency and aggravates the development of fetal growth restriction.


Asunto(s)
Retardo del Crecimiento Fetal , Insuficiencia Placentaria , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido , Macrófagos , Placenta , Embarazo
3.
Zhonghua Er Ke Za Zhi ; 59(3): 181-188, 2021 Mar 02.
Artículo en Chino | MEDLINE | ID: mdl-33657691

RESUMEN

Objective: To establish the reference values and growth curves of weight/length, body mass index, and ponderal index for Chinese newborns with gestational ages of 24 to 42 weeks, in order to provide a reference for the assessment of body proportionality and nutritional status at birth. Methods: Cross-sectional study design was applied. From June 2015 to November 2018, a total of 24 375 singleton live birth newborns with gestational ages of 24 to 42 weeks from 13 cities including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, Kunming, Tianjin, Shenyang, Changsha, and Shenzhen were selected, excluding those impacting the establishment of the reference values. The generalized additive model for location, scale, and shape (GAMLSS) was employed to establish percentile (P3, P10, P25, P50, P75, P90, P97) reference values and growth curves of weight/length, body mass index, and ponderal index for male and female newborns with gestational ages of 24 to 42 weeks. The established growth standards in this study were compared with the standards from the 1988 Chinese data, the INTERGROWTH project, and the USA reference values. Results: A total of 24 375 newborns with 12 264 preterm newborns (7 042 males and 5 222 females) and 12 111 full-term newborns (6 155 males and 5 956 females) were included in this study. The percentile reference values and growth curves of weight/length, body mass index, and ponderal index were obtained for male and female newborns with gestational ages of 24 to 42 weeks. Weight/length of males in all gestational ages at P10, P50 and P90 was 0 to 0.2 kg/m higher than that of females, and body mass index of males in all gestational ages at the P10, P50 and P90 was 0.1 to 0.3 kg/m2 higher than that of females. The established growth curves of weight/length and body mass index at the upper percentile and ponderal index at both upper and lower percentiles were greatly different from those of the 1988 Chinese data, which, for example, reported the difference ranges at P90 as -1.09 to 0.40 kg/m for weight/length, -1.19 to 0.92 kg/m2 for body mass index, and -0.64 to 0.81 kg/m3 for ponderal index. The established weight/length curves were generally consistent with the reference values from the INTERGROWTH project with a difference of -0.17 to 0.20 kg/m at P50, while being 0.02 to 0.40 kg/m lower at P90 and 0.13 to 0.41 kg/m higher at P10 than that of the INTERGROWTH reference values at gestational ages of ≤32 weeks. The established body mass index curves differed from that of the USA reference values with a difference of -0.47 to 0.17 kg/m2 at P50, while being 0.53 to 1.10 kg/m2 lower at gestational ages of ≥37 weeks but 0.17 to 0.45 kg/m2 higher at gestational ages of ≤28 weeks than that of the USA reference values at P90. Conclusion: The establishment of the new standardized growth reference values of weight/length, body mass index, and ponderal index for Chinese newborns by different gestational ages are useful for clinical practice and scientific research.


Asunto(s)
Estatura , Beijing , Peso al Nacer , Índice de Masa Corporal , China , Ciudades , Estudios Transversales , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido , Masculino , Valores de Referencia
4.
Harefuah ; 160(2): 81-86, 2021 Feb.
Artículo en Hebreo | MEDLINE | ID: mdl-33760408

RESUMEN

OBJECTIVES: The study aimed to assess the fetal heart defects that led to termination of pregnancy (TOP), the weeks' gestation that the defect was first diagnosed, whether TOP was conducted and the timeline of events that led to the decision. This is in order to encourage pregnant women to conduct sonographic screening tests that are recommended during pregnancy. METHODS: All pregnant women with singleton pregnancy who underwent TOP in our institute because of fetal heart defects as an only finding between 2000-2017 were included. TOPs preformed because of multisystem defects, abnormal karyotype and chromosomal or genetic defect were excluded. The patients were stratified into late TOP (≥24 weeks' gestation) and early TOP (<24 weeks' gestation). RESULTS: There were 3469 TOP and 228 (6.5%) cases because of fetal heart defects as the only abnormal finding. Of these cases, 191 (83.7%) and 37 (16.3%) were conducted before and after 24 weeks' gestation respectively. The mean weeks' gestation during which the heart defect was first diagnosed and TOP was conducted was 18.7±4.1 and 20.6± 3.7 respectively. The single most common heart defect was of the ventricular outflow tract that was found in 102 cases (44.7%), followed by functionally univentricular heart in 79 cases (34.6%). A combination of two defects was found in 5 cases (2.2%) and was mostly diagnosed after 24 weeks' gestation. Out of all cases 16.8% did not go through early fetal anomaly scan (conducted between 14-16 weeks' gestation), compared to 66.7% of late TOP cases; 22.2% of cases were not diagnosed during routine anomaly scans. CONCLUSIONS: In most cases the fetal heart defect was diagnosed during routine 14-16 gestational weeks anomaly scan. DISCUSSION: This information should encourage pregnant women to perform timely sonographic scanning.


Asunto(s)
Enfermedades Fetales , Mujeres Embarazadas , Femenino , Corazón Fetal , Edad Gestacional , Humanos , Embarazo , Tercer Trimestre del Embarazo , Ultrasonografía Prenatal
5.
Zhonghua Er Ke Za Zhi ; 59(4): 273-279, 2021 Apr 02.
Artículo en Chino | MEDLINE | ID: mdl-33775045

RESUMEN

Objective: To analyze the risk factors and the adverse outcomes of failure in non-invasive continuous positive airway pressure (CPAP) as the initial respiratory support in very preterm infants with gestational age at birth <32 weeks. Methods: This multicenter prospective cohort study was conducted from January 1, 2019 to December 31, 2019 based on the data from Shandong Neonatal Network (SNN). Perinatal information, clinical treatment, and the short-term outcomes of very preterm infants with gestational age at birth of 25-31+6 weeks in 30 neonatal intensive care units (NICU) in SNN were collected. The very preterm infants with non-invasive CPAP as the initial respiratory support were divided into the group of non-invasive CPAP failure and the group of non-invasive CPAP success. The difference in the risk factors between the two groups were tested by χ2 test or Fisher exact and the Mann-Whitney U test, followed by Logistic regression analysis for all the risk factors with statistically significant difference. Results: A total of 1 040 very preterm infants were included in this study, including 577 males (55.5%) and 463 females (44.5%). There were 195 cases (18.8%) with gestational age of 25-28+6 weeks, 845 cases (81.2%) with gestational age of 29-31+6 weeks, 81 cases (7.8%) with birth weight<1 000 g and 959 cases (92.2%) with birth weight≥1 000 g. Overall, the rate of CPAP success (n=902, 86.7%) was higher than that of CPAP failure (n=138, 13.3%). The incidence of CPAP failure was 24.6% (48/195) and 10.7% (90/845) respectively for infants with gestational age of 25-28+6 weeks and of 29-31+6 weeks. The Logistic regression analysis showed that smaller gestational age at birth, maternal gestational hypertension disease, and severe respiratory distress syndrome (RDS, grade Ⅲ-Ⅳ) requiring pulmonary surfactant (PS) for more than twice and fraction of inspired oxygen (FiO2)>0.30 after birth were independent risk factors for the failure of initially used non-invasive CPAP (OR=0.718, 1.847, 4.003, 6.712, 1.948; 95%CI:0.590-0.873, 1.130-3.018, 2.435-6.579, 3.160-14.259, 1.189-3.192; all P<0.05). The incidence of adverse outcomes in the group of failure was significantly higher than in the group of success, including death, neonatal pulmonary hemorrhage, moderate or severe broncho pulmonary dysplasia (BPD), and severe intraventricular hemorrhage (IVH) (OR=4.436, 26.393, 1.998, 4.545; 95%CI:2.106-9.344, 9.690-71.885, 1.031-3.875, 1.615-12.795; all P<0.05). Conclusions: The very preterm infants with gestational age at birth<32 weeks have a higher incidence of major adverse outcomes after the failure of initially used non-invasive CPAP. Smaller gestational age at birth, maternal gestational hypertension disease and severe RDS (grade Ⅲ-Ⅳ) requiring PS for more than twice and FiO2>0.30 after birth are independent risk factors for the failure of initially used non-invasive CPAP.


Asunto(s)
Surfactantes Pulmonares , Síndrome de Dificultad Respiratoria del Recién Nacido , Presión de las Vías Aéreas Positiva Contínua , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Masculino , Embarazo , Estudios Prospectivos , Surfactantes Pulmonares/uso terapéutico , Síndrome de Dificultad Respiratoria del Recién Nacido/tratamiento farmacológico , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia
7.
Biomed Environ Sci ; 34(2): 163-169, 2021 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-33685575

RESUMEN

Objective: This study aims to investigate the correlation of an ultrasonic scoring system with intraoperative blood loss (IBL) in placenta accreta spectrum (PAS) disorders. Methods: A retrospective cohort study was conducted between January 2015 and November 2019. Clinical data for patients with PAS have been obtained from medical records. Generalized additive models were used to explore the nonlinear relationships between ultrasonic scores and IBL. Logistic regressions were used to determine the differences in the risk of IBL ≥ 1,500 mL among groups with different ultrasonic scores. Results: A total of 332 patients participated in the analysis. Generalized additive models showed a significant positive correlation between score and blood loss. The amount of IBL was increased due to the rise in the ultrasonic score. All cases were divided into three groups according to the scores (low score group: ≤ 6 points, n = 147; median score group: 7-9 points, n = 126; and high score group: ≥ 10 points, n = 59). Compared with the low score group, the high score group showed a higher risk of IBL ≥ 1,500 mL [odds ratio, 15.09; 95% confidence interval (3.85, 59.19); P ≤ 0.001] after a multivariable adjustment. Conclusions: The risk of blood loss equal to or greater than 1,500 mL increases further when ultrasonic score greater than or equal to 10 points, the preparation for transfusion and referral mechanism should be considered.


Asunto(s)
Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Placenta Accreta/diagnóstico por imagen , Ultrasonografía Prenatal/estadística & datos numéricos , Adulto , Pérdida de Sangre Quirúrgica/prevención & control , Femenino , Edad Gestacional , Humanos , Modelos Logísticos , Placenta Accreta/cirugía , Valor Predictivo de las Pruebas , Embarazo , Estudios Retrospectivos , Riesgo
8.
S D Med ; 74(1): 28-35, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33691054

RESUMEN

Respiratory distress is a commonly encountered problem in newborn infants. Recognizing an infant with respiratory distress is not difficult, but determining the etiology and initiating proper management can be challenging. This review will focus on pulmonary causes of respiratory distress in the late preterm (34-366/7 weeks gestation) through late term (41-416/7 weeks gestation) infant with guidance for diagnosis and proper management of these infants. Many newborns with respiratory distress will require transfer to a higher level of care, but a select group may be safely managed at the delivery hospital.


Asunto(s)
Síndrome de Dificultad Respiratoria del Recién Nacido , Edad Gestacional , Humanos , Lactante , Recién Nacido , Síndrome de Dificultad Respiratoria del Recién Nacido/diagnóstico , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia
9.
JAMA Netw Open ; 4(3): e211816, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33729505

RESUMEN

Importance: The coronavirus disease 2019 (COVID-19) pandemic may exacerbate existing racial/ethnic inequities in preterm birth. Objective: To assess whether racial/ethnic disparities in very preterm birth (VPTB) and preterm birth (PTB) increased during the first wave of the COVID-19 pandemic in New York City. Design, Setting, and Participants: This cross-sectional study included 8026 Black, Latina, and White women who gave birth during the study period. A difference-in-differences (DID) analysis of Black vs White disparities in VPTB or PTB in a pandemic cohort was compared with a prepandemic cohort by using electronic medical records obtained from 2 hospitals in New York City. Exposures: Women who delivered from March 28 to July 31, 2020, were considered the pandemic cohort, and women who delivered from March 28 to July 31, 2019, were considered the prepandemic cohort. Reverse transcription-polymerase chain reaction tests for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were performed using samples obtained via nasopharyngeal swab at the time of admission. Main Outcomes and Measures: Clinical estimates of gestational age were used to calculate VPTB (<32 weeks) and PTB (<37 weeks). Log binomial regression was performed to estimate Black vs White risk differences, pandemic cohort vs prepandemic cohort risk difference, and an interaction term representing the DID estimator. Covariate-adjusted models included age, insurance, prepregnancy body mass index, and parity. Results: Of 3834 women in the pandemic cohort, 492 (12.8%) self-identified as Black, 678 (17.7%) as Latina, 2012 (52.5%) as White, 408 (10.6%) as Asian, and 244 (6.4%) as other or unspecified race/ethnicity, with approximately half the women 25 to 34 years of age. The prepandemic cohort comprised 4192 women with similar sociodemographic characteristics. In the prepandemic cohort, VPTB risk was 4.4% (20 of 451) and PTB risk was 14.4% (65 of 451) among Black infants compared with 0.8% (17 of 2188) VPTB risk and 7.1% (156 of 2188) PTB risk among White infants. In the pandemic cohort, VPTB risk was 4.3% (21 of 491) and PTB risk was 13.2% (65 of 491) among Black infants compared with 0.5% (10 of 1994) VPTB risk and 7.0% (240 of 1994) PTB risk among White infants. The DID estimators indicated that no increase in Black vs White disparities were found (DID estimator for VPTB, 0.1 additional cases per 100 [95% CI, -2.5 to 2.8]; DID estimator for PTB, 1.1 fewer case per 100 [95% CI, -5.8 to 3.6]). The results were comparable in covariate-adjusted models when limiting the population to women who tested negative for SARS-CoV-2. No change was detected in Latina vs White PTB disparities during the pandemic. Conclusions and Relevance: In this cross-sectional study of women who gave birth in New York City during the COVID-19 pandemic, no evidence was found for increased racial/ethnic disparities in PTB, among women who tested positive or tested negative for SARS-CoV-2.


Asunto(s)
Afroamericanos , Edad Gestacional , Disparidades en el Estado de Salud , Hispanoamericanos , Pandemias , Nacimiento Prematuro/etnología , Adulto , Estudios de Cohortes , Estudios Transversales , Grupo de Ascendencia Continental Europea , Femenino , Humanos , Lactante , Recién Nacido , Ciudad de Nueva York/epidemiología , Embarazo , Nacimiento Prematuro/virología , Adulto Joven
10.
Obstet Gynecol ; 137(4): 585-596, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33706357

RESUMEN

OBJECTIVE: To compare the risk of intrauterine fetal death (20 weeks of gestation or later) and neonatal death among individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with those who tested negative for SARS-CoV-2 on admission for delivery. DATA SOURCES: MEDLINE, Ovid, EMBASE, Cumulative Index to Nursing and Allied Health, and Cochrane Library were searched from their inception until July 17, 2020. Hand search for additional articles continued through September 24, 2020. ClinicalTrials.gov was searched on October 21, 2020. METHODS OF STUDY SELECTION: The inclusion criteria were publications that compared at least 20 cases of both pregnant patients who tested positive for SARS-CoV-2 on admission to labor and delivery and those who tested negative. Exclusion criteria were publications with fewer than 20 individuals in either category or those lacking data on primary outcomes. A systematic search of the selected databases was performed, with co-primary outcomes being rates of intrauterine fetal death and neonatal death. Secondary outcomes included rates of maternal and neonatal adverse outcomes. TABULATION, INTEGRATION, AND RESULTS: Of the 941 articles and completed trials identified, six studies met criteria. Our analysis included 728 deliveries to patients who tested positive for SARS-CoV-2 and 3,836 contemporaneous deliveries to patients who tested negative. Intrauterine fetal death occurred in 8 of 728 (1.1%) patients who tested positive and 44 of 3,836 (1.1%) who tested negative (P=.60). Neonatal death occurred in 0 of 432 (0.0%) patients who tested positive and 5 of 2,400 (0.2%) who tested negative (P=.90). Preterm birth occurred in 95 of 714 (13.3%) patients who tested positive and 446 of 3,759 (11.9%) who tested negative (P=.31). Maternal death occurred in 3 of 559 (0.5%) patients who tested positive and 8 of 3,155 (0.3%) who tested negative (P=.23). CONCLUSION: The incidences of intrauterine fetal death and neonatal death were similar among individuals who tested positive compared with negative for SARS-CoV-2 when admitted to labor and delivery. Other immediate outcomes of the newborns were also similar among those born to individuals who tested positive compared with negative for SARS-CoV-2. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42020203475.


Asunto(s)
/epidemiología , Mortalidad Fetal , Mortalidad Materna , Mortalidad Perinatal , Nacimiento Prematuro/epidemiología , /diagnóstico , Femenino , Edad Gestacional , Humanos , Recién Nacido , Admisión del Paciente , Embarazo
11.
Artículo en Inglés | MEDLINE | ID: mdl-33753426

RESUMEN

BACKGROUND: The impact of COVID-19 on pregnant inflammatory bowel disease (IBD) patients is currently unknown. Reconfiguration of services during the pandemic may negatively affect medical and obstetric care. We aimed to examine the impacts on IBD antenatal care and pregnancy outcomes. METHODS: Retrospective data were recorded in consecutive patients attending for IBD antenatal care including outpatient appointments, infusion unit visits and advice line encounters. RESULTS: We included 244 pregnant women with IBD, of which 75 (30.7%) were on biologics in whom the treatment was stopped in 29.3% at a median 28 weeks gestation. In addition, 9% of patients were on corticosteroids and 21.5% continued on thiopurines. The care provided during 460 patient encounters was not affected by the pandemic in 94.1% but 68.2% were performed via telephone (compared with 3% prepandemic practice; p<0.0001). One-hundred-ten women delivered 111 alive babies (mean 38.2 weeks gestation, mean birth weight 3324 g) with 12 (11.0%) giving birth before week 37. Birth occurred by vaginal delivery in 72 (56.4%) and by caesarean section in 48 (43.6%) cases. Thirty-three were elective (12 for IBD indications) and 15 emergency caesarean sections. Breast feeding rates were low (38.6%). Among 244 pregnant women with IBD, 1 suspected COVID-19 infection was recorded. CONCLUSION: IBD antenatal care adjustments during the COVID-19 pandemic have not negatively affected patient care. Despite high levels of immunosuppression, only a single COVID-19 infection occurred. Adverse pregnancy outcomes were infrequent.


Asunto(s)
/complicaciones , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Inflamatorias del Intestino/epidemiología , Atención Prenatal/estadística & datos numéricos , Corticoesteroides/uso terapéutico , Adulto , Alopurinol/análogos & derivados , Alopurinol/uso terapéutico , Productos Biológicos/uso terapéutico , Lactancia Materna/estadística & datos numéricos , /epidemiología , Cesárea/estadística & datos numéricos , Parto Obstétrico/estadística & datos numéricos , Femenino , Edad Gestacional , Humanos , Enfermedades Inflamatorias del Intestino/virología , Embarazo , Resultado del Embarazo/epidemiología , Estudios Retrospectivos , Reino Unido/epidemiología , Privación de Tratamiento
13.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(3): 236-241, 2021 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33691915

RESUMEN

OBJECTIVE: To study the effect of weight growth velocity in the early stage after birth on the neurodevelopment of preterm infants at the corrected age of 12 months. METHODS: Related data were collected from the preterm infants who were discharged from the Department of Neonatology, Third Affiliated Hospital of Guangzhou Medical University, from July 1, 2015 to December 31, 2019 and were followed up at the outpatient service of high-risk infants. According to the weight growth velocity from birth to the corrected gestational age of 40 weeks, the infants were divided into two groups: low velocity [< 10 g/(kg·d); n=21] and high velocity [≥10 g/(kg·d); n=87]. At the corrected ages of 3, 6, and 12 months, Gesell Developmental Schedules were used to evaluate and compare neurodevelopment between the two groups. RESULTS: At the corrected age of 12 months, the low velocity group had a significantly lower score of fine motor (P < 0.05) and a significantly higher abnormal rate of language ability score compared with high velocity (P < 0.05). For the preterm infants with a birth weight of < 1 500 g or ≥1 500 g, the low velocity group had a significantly lower score of fine motor than the high velocity group (P < 0.05); for the preterm infants with a birth weight of ≥1 500 g, the low velocity group had a significantly higher abnormal rate of language ability score than the high velocity group (P < 0.05). CONCLUSIONS: The weight growth velocity from birth to the corrected age of 40 weeks affects the development of fine motor and language in preterm infants at the corrected age of 12 months; however it needs to be further verified by large-sample studies.


Asunto(s)
Recien Nacido Prematuro , Alta del Paciente , Peso al Nacer , Edad Gestacional , Humanos , Lactante , Recién Nacido
14.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(3): 242-247, 2021 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33691916

RESUMEN

OBJECTIVE: To study the perinatal complications of late preterm twins (LPTs) versus early term twins (ETTs). METHODS: A retrospective analysis was performed for the complications of 246 LPTs, 496 ETTs, and their mothers. The risk factors for late preterm birth were analyzed. According to gestational age, the twins were divided into five groups: 34-34+6 weeks (n=44), 35-35+6 weeks (n=70), 36-36+6 weeks (n=132), 37-37+6 weeks (n=390), and 38-38+6 weeks (n=106). The perinatal complications were compared between groups. RESULTS: Maternal hypertension, maternal thrombocytopenia, placenta previa, and premature rupture of membranes were independent risk factors for late preterm birth in twins (P < 0.05). The LPT group had higher incidence rates of respiratory diseases, feeding intolerance, and hypoglycemia than the ETT group (P < 0.05). The 34-34+6 weeks group had a higher incidence rate of neonatal asphyxia than the 37-37+6 weeks and 38-38+6 weeks groups; and had a higher incidence rate of septicemia than 36-36+6 weeks group (P < 0.0045). The 34-34+6 weeks and 35-35+6 weeks groups had higher incidence rates of neonatal respiratory distress syndrome, neonatal apnea, and anemia than the other three groups; and had higher incidence rates of neonatal pneumonia, hypoglycemia and septicemia than the 37-37+6 weeks and 38-38+6 weeks groups (P < 0.0045). The 35-35+6 weeks group had a higher incidence rate of feeding intolerance than the 36-36+6 weeks, 37-37+6 weeks, and 38-38+6 weeks groups (P < 0.0045). The 36-36+6 weeks group had a lower incidence rate of hypoglycemia than the 34-34+6 weeks group and a higher incidence rate of hypoglycemia than the 37-37+6 weeks group (P < 0.0045). CONCLUSIONS: Compared with ETTs, LPTs have an increased incidence of perinatal complications. The incidence of perinatal complications is associated with gestational ages in the LPTs and ETTs.


Asunto(s)
Nacimiento Prematuro , Síndrome de Dificultad Respiratoria del Recién Nacido , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido , Embarazo , Estudios Retrospectivos , Gemelos
15.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(3): 248-253, 2021 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33691917

RESUMEN

OBJECTIVE: To study the association of different stages of histological chorioamnionitis (HCA) with the incidence rate and severity of respiratory distress syndrome (RDS) in preterm infants. METHODS: Related data were collected from the infants and their mothers who were treated in the Neonatal Intensive Care Unit of Qingdao Women and Children's Hospital, Qingdao University, from January 2018 to June 2020. According to the presence or absence of HCA and its stage, the infants were divided into four groups: control (n=109), early-stage HCA (n=126), middle-stage HCA (n=105), and late-stage HCA (n=36). The four groups were compared in terms of gestational age, birth weight, sex, maternal age, placental abruption, prenatal use of antibiotics, and incidence rate of RDS. The correlation between HCA stage and RDS severity was analyzed. RESULTS: Compared with the control and late-stage HCA groups, the early-stage HCA group had a significantly lower incidence rate of placental abruption and a significantly higher rate of prenatal use of antibiotics (P < 0.05), and the early-stage HCA group had a significantly lower incidence rate of RDS than the control group (P < 0.05). The multivariate logistic regression analysis showed that early-, middle-, and late-stage HCA were protective factors against RDS (P < 0.05). The Spearman test showed that the severity of RDS in preterm infants was not correlated with the HCA stage (P > 0.05). CONCLUSIONS: Early-, middle-, and late-stage HCA can reduce the incidence rate of RDS in preterm infants. HCA stage may not be correlated with RDS severity in preterm infants, which needs to be verified by further research.


Asunto(s)
Corioamnionitis , Síndrome de Dificultad Respiratoria del Recién Nacido , Peso al Nacer , Niño , Corioamnionitis/epidemiología , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Embarazo , Síndrome de Dificultad Respiratoria del Recién Nacido/epidemiología , Síndrome de Dificultad Respiratoria del Recién Nacido/etiología
16.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(3): 254-258, 2021 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33691918

RESUMEN

OBJECTIVE: To study the clinical features of very preterm small-for-gestational-age infants born by cesarean section due to severe preeclampsia. METHODS: Forty-two small-for-gestational-age infants who were admitted from August 2017 to July 2018 and were born due to severe preeclampsia were enrolled as the observation group. Forty very preterm infants who were born to healthy mothers since uterine contractions could not be suppressed were enrolled as the control group. Perinatal features, clinical manifestations of infection, complications, and clinical outcomes were analyzed for the two groups. RESULTS: Within 6 hours and 2-3 days after birth, the observation group had significantly lower white blood cell count (WBC), absolute neutrophil count (ANC), and platelet count (PLT) than the control group (P < 0.05). At 5-7 days after birth, there was no significant difference in WBC between the two groups (P > 0.05), while the observation group still had significantly lower ANC and PLT than the control group (P < 0.05). The observation group had a significantly higher C-reactive protein (CRP) level than the control group at 2-3 days and 5-7 days after birth (P < 0.05). The observation group had a significantly higher proportion of infants with severe infections than the control group (P < 0.05). The observation group had a significantly higher hemoglobin level than the control group within 6 hours after birth (P < 0.05). The observation group had a significantly higher incidence rate of bronchopulmonary dysplasia than the control group (P < 0.05). There was no significant difference between the two groups in the rate of pulmonary hemorrhage, intracranial hemorrhage, neonatal necrotizing enterocolitis, retinopathy of prematurity, and the rate of use of invasive ventilation, and clinical outcomes (P > 0.05). CONCLUSIONS: Very preterm small-for-gestational-age infants born due to severe preeclampsia have a high incidence rate of infection and severe conditions. Early manifestations include reductions in the infection indicators WBC, ANC, and PLT, and CRP does not increase significantly in the early stage and gradually increases at 2-3 days after birth. Most of these infants require invasive ventilation after birth, with bronchopulmonary dysplasia as the main complication. Clinical changes should be closely observed and inflammatory indicators should be monitored for early identification of infection, timely diagnosis, and timely adjustment of antibiotic treatment, so as to improve the outcome.


Asunto(s)
Displasia Broncopulmonar , Enfermedades del Prematuro , Preeclampsia , Cesárea , Femenino , Edad Gestacional , Humanos , Lactante , Recien Nacido Extremadamente Prematuro , Recién Nacido , Recién Nacido de muy Bajo Peso , Embarazo
17.
Arch. argent. pediatr ; 119(1): 18-24, feb. 2021. tab, ilus
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1147062

RESUMEN

Introducción. A nivel mundial, hay una tendencia ascendente en nacimientos prematuros y cesáreas. El objetivo fue describir edad gestacional (EG), vía de parto, distribución en días y horarios, y relación entre la vía de parto y el momento del nacimiento en dos instituciones privadas.Población y métodos. Estudio prospectivo, transversal, analítico.Resultados. Se incluyeron los 1500 nacidos vivos entre 9-2017 y 8-2018 (1465 embarazadas). El 99,4 % fueron embarazos controlados; el 66,8 % terminaron por cesárea. La causa fue cesárea previa en el 36,4 %, falta de progresión y descenso en el 18,9 % y elección materna en el 9,2 %. El peso promedio al nacer fue de 3232 g ± 561,1 g y la mediana de EG, 39 semanas (rango 38-40) por fecha de última menstruación. El 88,2 % fueron nacidos de término y, de los prematuros, el 76,1 % fueron pretérminos tardíos. Los nacidos de término temprano tuvieron mayor índice de cesáreas (p < 0,001). Los nacimientos por cesárea en días hábiles fueron 849/1201 (el 74,5 %) y, en los días de fin de semana y feriados, 173/299 (el 57,9 %, p < 0,001). Se encontró una relación estadísticamente significativa entre el horario de nacimiento y la realización de cesárea.Conclusiones. La mediana de EG fue 39 semanas. La cesárea fue la vía de nacimiento más frecuente. Los nacimientos se produjeron, predominantemente, de lunes a viernes entre las 8 y las 21 h. El 82,9 % de los nacimientos por cesárea ocurrieron en días de semana laborables


Introduction. There is a worldwide growing trend of preterm births and C-sections. Our objective was to describe gestational age (GA), mode of delivery, day and time distribution, and the relation between the mode of delivery and the time of birth in two private facilities.Population and methods. Prospective, cross-sectional, analytical study.Results. A total of 1500 live newborn infants were included between September 2017 and August 2018 (1465 pregnant women). Of these, 99.4 % had received antenatal care; 66.8 % of pregnancies ended via C-section. The reason was a previous C-section in 36.4 %, lack of progression and descent in 18.9 %, and maternal choice in 9.2 %. The average birth weight was 3232 g ± 561.1 g and the median GA was 39 weeks (range: 38-40) based on the date of the last menstrual period; 88.2 % were term births and, among preterm births, 76.1 % corresponded to late preterm babies. Early term births showed a higher rate of C-sections (p < 0.001). There were 849/1201 (74.5 %) C-sections on weekdays and 173/299 (57.9 %, p < 0.001) on weekends and holidays. A statistically significant relation was observed between the time of birth and the performance of a C-section.Conclusions. The median GA was 39 weeks. C-sections were the most common mode of delivery. Births occurred predominantly Mondays through Fridays between 8 a.m. and 9 p.m.; 82.9 % of C-sections took place on weekdays.


Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Recién Nacido , Cesárea , Edad Gestacional , Factores de Tiempo , Recien Nacido Prematuro , Estudios Transversales , Estudios Prospectivos , Parto
18.
Ecotoxicol Environ Saf ; 212: 112000, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33550075

RESUMEN

Perinatal exposure to polybrominated diphenyl ethers (PBDEs) may be a potential risk factor for autism spectrum disorders (ASD). BDE-47 is one of the most common PBDEs and poses serious health hazards on the central nervous system (CNS). However, effects of perinatal exposure to BDE-47 on social behaviors and the potential mechanisms are largely unexplored. Thus, we aimed to investigate whether BDE-47 exposure during gestation and lactation led to autistic-like behaviors in offspring rats in the present study. Valproic acid (VPA), which is widely used to establish animal model of ASD, was also adopted to induce autistic-like behaviors. A battery of tests was conducted to evaluate social and repetitive behaviors in offspring rats. We found that perinatal exposure to BDE-47 caused mild autistic-like behaviors in offspring, which were similar but less severe to those observed in pups maternally exposed to VPA. Moreover, perinatal exposure to BDE-47 aggravated the autistic-like behaviors in pups maternally exposed to VPA. Abnormal dendritic development is known to be deeply associated with autistic-like behaviors. Golgi-Cox staining was used to observe the morphological characteristics of dendrites in the prefrontal cortex of pups. We found perinatal exposure to BDE-47 reduced dendritic length and complexity of branching pattern, and spine density in the offspring prefrontal cortex, which may contribute to autistic-like behaviors observed in the present study. Perinatal exposure to BDE-47 also exacerbated the impairments of dendritic development in pups maternally exposed to VPA. Besides, our study also provided the evidence that the inhibition of BDNF-CREB signaling, a key regulator of dendritic development, may be involved in the dendritic impairments induced by perinatal exposure to BDE-47 and/or VPA, and the consequent autistic-like behaviors.


Asunto(s)
Trastorno del Espectro Autista/inducido químicamente , Dendritas/efectos de los fármacos , Contaminantes Ambientales/toxicidad , Éteres Difenilos Halogenados/toxicidad , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Ácido Valproico/toxicidad , Animales , Animales Recién Nacidos , Modelos Animales de Enfermedad , Femenino , Edad Gestacional , Lactancia , Masculino , Corteza Prefrontal/efectos de los fármacos , Embarazo , Ratas , Ratas Sprague-Dawley , Transducción de Señal/efectos de los fármacos , Conducta Social
19.
Z Geburtshilfe Neonatol ; 225(1): 55-59, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33601452

RESUMEN

OBJECTIVE: Caesarean rates have increased rapidly for various reasons recently. One of the important reasons among these is medicolegal problems. Our aim with this study was to preoperatively predict abdominal adhesion density by combining the scar tissue morphology formed in the post-caesarean Pfannenstiel incision line and the skin color scoring of the patients. MATERIAL AND METHODS: Patients who had undergone one caesarean section previously, completed their terms (37-39 weeks) and were under 35 years old were included in the study. Skin color scoring of the patients was performed using the Fitzpatrick skin color scale. Intra-abdominal adhesion scoring of the participant patients was performed using Nair's adhesion scoring system. RESULTS: The change in abdominal adhesion scores was evaluated based on the Fitzpatrick color scale. Adhesion scores per the Nair intra-abdominal adhesion scoring system were found to be 0.04±0.209 in the FP1 group, 0.35±0.662 in the FP2 group, 1.58±0.923 in the FP3 group, and 2.33±0.577 in the FP4 group (p<0.05). These results showed a significant increase in adhesion density with increasing skin color darkness. Based on these results, it was observed that the abdominal adhesion scores and the frequency of depressed skin scar were significantly increased with increasing Fitzpatrick scores (p<0.05). CONCLUSION: The aim of this study was to increase the prediction rates by adding the skin color scoring to the scar tissue characteristics, which have been used in previous studies. The results of this study indicate that the combination of these two parameters may be more effective in predicting intra-abdominal adhesions. Nevertheless, there is a need for studies with a much higher number of patients and multiple parameters to be able to predict intra-abdominal adhesion density preoperatively with greater accuracy.


Asunto(s)
Cesárea Repetida/efectos adversos , Cesárea/efectos adversos , Cicatriz/etiología , Pigmentación de la Piel , Adherencias Tisulares/etiología , Adulto , Cicatriz/patología , Femenino , Edad Gestacional , Humanos , Valor Predictivo de las Pruebas , Embarazo , Adherencias Tisulares/diagnóstico
20.
BMJ Case Rep ; 14(2)2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33547119

RESUMEN

We report an ex utero intrapartum therapy-to-airway procedure in which obstetric factors dramatically influenced the sequence of events necessary to complete the procedure.


Asunto(s)
Obstrucción de las Vías Aéreas/congénito , Obstrucción de las Vías Aéreas/cirugía , Enfermedades de la Laringe/congénito , Enfermedades de la Laringe/cirugía , Traqueostomía , Adulto , Cesárea , Femenino , Edad Gestacional , Humanos , Recién Nacido , Complicaciones del Trabajo de Parto , Embarazo , Diagnóstico Prenatal
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