Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 21.071
Filtrar
1.
PLoS One ; 15(8): e0238315, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866202

RESUMO

BACKGROUND: In low resource settings recall of the date of the mother's last menstrual period may be unreliable and due to limited availability of prenatal ultrasound, gestational age of newborns may not be assessed reliably. Preterm babies are at high risk of morbidity and mortality so an alternative strategy is to identify them soon after birth is needed for early referral and management. OBJECTIVE: The objective of this study was to assess the accuracy in assessing prematurity of newborn, over and above birthweight, using a pictorial Simplified Gestational Age Score adapted for use as a Tablet App. METHODS: Two trained nurse midwives, blinded to each other's assessment and the actual gestational age of the baby used the app to assess gestational age at birth in 3 hospitals based on the following 4 parameters-newborn's posture, skin texture, breast and genital development. Inter-observer variation was evaluated and the optimal scoring cut-off to detect preterm birth was determined. Sensitivity and specificity of gestational age score using the tablet was estimated using combinations of last menstrual period and ultrasound as reference standards to assess preterm birth. The predictive accuracy of the score using the area under a receiver operating characteristic curve was also determined. To account for potential reference standard bias, we also evaluated the score using latent class models. RESULTS: A total of 8,591 live singleton births whose gestational age by last menstrual period and ultrasound was within 1 weeks of each other were enrolled. There was strong agreement between assessors (concordance correlation coefficient 0.77 (95% CI 0.76-0.78) and Fleiss' kappa was 0.76 (95% CI 0.76-0.78). The optimal cut-off for the score to predict preterm was 13. Irrespective of the reference standard, the specificity of the score was 90% and sensitivity varied from 40-50% and the predictive accuracy between 74%-79% for the reference standards. The likelihood ratio of a positive score varied between 3.75-4.88 while the same for a negative likelihood ratio consistently varied between 0.57-0.72. Latent class models showed similar results indicating no reference standard bias. CONCLUSION: Gestational age scores had strong inter-observer agreement, robust prediction of preterm births simplicity of use by nurse midwives and can be a useful tool in resource-limited scenarios. TRIAL REGISTRATION: The Tablet App for the Simplified Gestational Age Score (T-SGAS) study was registered at ClinicalTrials.gov NCT02408783.


Assuntos
Recém-Nascido Prematuro/fisiologia , Parto/fisiologia , Nascimento Prematuro/diagnóstico , Nascimento Prematuro/fisiopatologia , Peso ao Nascer/fisiologia , Estudos Transversais , Feminino , Idade Gestacional , Humanos , Recém-Nascido de Baixo Peso/fisiologia , Recém-Nascido , Aplicativos Móveis , Gravidez , Medição de Risco/métodos , Sensibilidade e Especificidade , Ultrassonografia Pré-Natal/métodos
2.
Rev Paul Pediatr ; 38: e2020165, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32876282

RESUMO

OBJECTIVE: Recently, there have been reports of children with severe inflammatory syndrome and multiorgan dysfunction associated with elevated inflammatory markers. These cases are reported as presenting the Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19. In this study, we describe with parental permission a case of MIS-C in an infant with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. CASE DESCRIPTION: A seven-month-old infant, with SARS-CoV-2 infection and a history of extreme preterm birth and very low weight at birth, with an initial course of mild respiratory symptoms and abrupt progression to vasoplegic shock, myocarditis and hyperinflammation syndrome, shown by high levels of troponin I, ferritin, CRP, D-dimer and hypoalbuminemia. Despite the intensive care provided, the child developed multiple organ dysfunction and died. COMMENTS: Patients with a history of extreme prematurity may present with MIS-C in the presence of COVID-19 and are a group of special concern.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Insuficiência de Múltiplos Órgãos , Pandemias , Pneumonia Viral , Ressuscitação , Choque , Síndrome de Resposta Inflamatória Sistêmica , Deterioração Clínica , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Evolução Fatal , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Doenças do Recém-Nascido , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/terapia , Pneumonia Viral/sangue , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Nascimento Prematuro , Respiração Artificial/métodos , Ressuscitação/métodos , Fatores de Risco , Choque/etiologia , Choque/terapia , Síndrome de Resposta Inflamatória Sistêmica/terapia , Síndrome de Resposta Inflamatória Sistêmica/virologia , Tomografia Computadorizada por Raios X/métodos
3.
PLoS One ; 15(9): e0237700, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966295

RESUMO

The reduction of food intake during pregnancy is part of many cultural and religious traditions around the world. The impact of such practices on fetal growth and development are poorly understood. Here, we examined the patterns of diet intake among Maasai pregnant women and assessed their effect on newborn morphometrics. We recruited 141 mother-infant pairs from Ngorongoro Conservation Area (NCA) in Northern Tanzania and quantified dietary intake and changes in maternal diet during pregnancy. We obtained measurements of body weight (BW) and head circumference (HC) at birth. We found that Maasai women significantly reduced their dietary intake during the third trimester, going from an average of 1601 kcal/day during the first two trimesters to 799 kcal/day in the final trimester. The greatest proportion of nutrient reduction was in carbohydrates. Overall, 40% of HC Z-scores of the NCA sample were more than 2 standard deviations below the WHO standard. Nearly a third of neonates classify as low birth weight (< 2500g). HC was smaller relative to BW in this cohort than predicted using the WHO standard. This contrasts markedly to a Tanzanian birth cohort obtained at the same time in an urban context in which only 12% of infants exhibited low weight, only two individuals had HC Z-scores < 2 and HC's relative to birth weight were larger than predicted using the WHO standards. The surprising lack of head sparing in the NCA cohort suggests that the impact of third trimester malnutrition bears further investigation in both animal models and human populations, especially as low HC is negatively associated with long term health outcomes.


Assuntos
Restrição Calórica , Desenvolvimento Fetal , Restrição Calórica/efeitos adversos , Feminino , Cabeça/embriologia , Cabeça/crescimento & desenvolvimento , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Mães , Gravidez , Primeiro Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Tanzânia
4.
Middle East Afr J Ophthalmol ; 27(2): 105-109, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874043

RESUMO

PURPOSE: Retinopathy of prematurity (ROP) is becoming a leading cause of preventable blindness. The current study aimed to assess ROP and its risk factors in Tabuk City, Northern Kingdom of Saudi Arabia. METHODS: A retrospective study was conducted in King Khalid Hospital, Tabuk City, Saudi Arabia. The premature infants' records during the period of January 2016 to April 2018 were approached. One hundred and eight records were eligible; the infants' gestational age, weight, if received oxygen, surfactant use, blood transfusion, intraventricular hemorrhage, and patent ductus arteriosus were reported. Chi-square test was used to compare premature infants and their counterparts regarding various risk factors. P < 0.05 was considered statistically significant. RESULTS: Out of 108 premature infants, 33.3% had ROP (Many were sightthreatening [stages required treatment] and more than twothirds involving both eyes); a statistically significant difference (P < 0.05) was evident between infants with prematurity, and low birth weight. No significant differences were found regarding other risk factors (P > 0.05). Only 8.3% received interventional therapy. CONCLUSION: ROP is common in King Khalid Hospital, which is the referral tertiary hospital in Tabuk city, KSA . The low birth weight is a significant risk factor to develop ROP. Many of ROP cases were sightthreatening (cases that required treatment) and most cases involving both eyes. Treatment availability at Tabuk city is recommended, instead of referral to another centers especially among those with low weight at birth.


Assuntos
Retinopatia da Prematuridade/epidemiologia , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Incidência , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Estudos Retrospectivos , Fatores de Risco , Arábia Saudita/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos
5.
Yonsei Med J ; 61(9): 805-815, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32882765

RESUMO

PURPOSE: We explored the role of parental social class in preterm birth (PTB) and low birth weight (LBW) in association with child mortality in Korea. MATERIALS AND METHODS: A total of 7,302,732 births in Korea between 1995 and 2007 were used for designing the national retrospective cohort study. Kaplan-Meier survival curves and Cox proportional hazard models were used to determine the risk of child death after adjusting for covariates. RESULTS: Parental social class was associated with adverse birth outcomes and child mortality in Korea. Parental social class increased the strength of the relationship of adverse birth outcomes with child mortality. Child mortality was higher among PTB and LBW infants from parents with a lower social class than normal births from parents with a higher social class. In particular, the disparity in child mortality according to parental social class was greater for LBW and PTB than intrauterine growth retardation births. When one of the parents had a middle-school education or lower, the disparity in child mortality due to adverse birth outcomes was large regardless of the other spouse's educational status. Inactive economic status for the father, as well as an occupation in manual labor by the mother, increased the risk of child mortality. CONCLUSION: Strong relationships for social inequalities and adverse birth outcomes with inequalities in child mortality in South Korea were found in this study. Tackling social inequalities, as well as reducing adverse birth outcomes, are needed to reduce the disparities in child mortality in South Korea.


Assuntos
Mortalidade da Criança , Nascimento Prematuro/epidemiologia , Classe Social , Adulto , Criança , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Estimativa de Kaplan-Meier , Masculino , Gravidez , Resultado da Gravidez/epidemiologia , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores Socioeconômicos
6.
Revista Digital de Postgrado ; 9(2): 217, ago. 2020. ilus, graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1103536

RESUMO

Los primeros mil días de vida son parte del Curso de Vida, al tomar en consideración la Epigenética, término postulado por Waddington en 1942: modifica la expresión genética SIN cambiar la secuencia de las bases de ADN. El proyecto internacional llamado DOHaD (Developmental Origins of Health and Disease) u ODSE (Orígenes del Desarrollo de la Salud y Enfermedad), está inserto dentro de la Transición Alimentaria y Nutricional (TAN), que, en países en desarrollo­ocurre en forma muy rápida ­produce tanto la malnutrición por déficit como por exceso; es decir la doble carga nutricional. La TAN es producto en nuestro país, de una urbanización acelerada y anárquica, y de cambios socioculturales, como la incorporación de la mujer al mercado de trabajo con menos tiempo para cocinar; está acompañada de una transición epidemiológica con la emergencia y prevalencia de la obesidad y de las enfermedades crónicas como morbiletalidad. Esta doble carga nutricional se modificó, por la situación país, y prevalece más el déficit que el exceso. Se presenta el PROYECTO FUNDACIÓN BENGOA ­ SVPP ­ SOGV ­ CANIA, cuya meta es: Elaborar una agenda preventiva común contra la malnutrición tanto por déficit como por exceso y sus comorbilidades, bajo el enfoque de los primeros mil días de vida y su efecto sobre todo el curso de vida. Se realizó el diseño y aplicación de tres cuestionarios digitales, que se utilizaran para la elaboración de esta meta. Se consolidó un CONSENSO NACIONAL formado por profesionales de la salud involucrados en los primeros mil días de vida(AU)


The first 1000 days of life is the new paradigm that determines health and nutrition during the life course, based on epidemiological models that incorporate the concept of Epigenetics, term introduced by Waddington, that refers to changes that affect the genetic expression without changing the DNA sequence, within the international program DOHaD/ODSE as well as the Food and Nutrition Transition(FNT). This FNT, product of an accelerated and anarchic urbanization that led to sedentary activities, plus the incorporation of women to the work media, with less time for cooking, with the substitution of the traditional diet for one much more practical and efficient in time and effort. It is accompanied by demographic and epidemiologic changes and transitions. The Double Burden of Nutrition in VENEZUELA has changed due to the effect of the recent crisis with a rise in malnutrition and a fall in obesity/overweight. The current project: Fundación Bengoa- Pediatric Society Venezuela (SVPP) ­ CANIA - Obstetric Society of Venezuela (SOGV) is called Developmental Origins of Health and Disease in Venezuela (DOHaD Venezuela): and by means of a national consensus of medical societies and institutions, its goal is "To elaborate a Preventive Agenda both for Malnutrition and for Overweight and Obesity and its comorbidities, considering the First 1000 Days of life and its effect over the life course"


Assuntos
Humanos , Masculino , Feminino , Gravidez na Adolescência , Características da População , Recém-Nascido de Baixo Peso , Mortalidade Materna , Epigenômica , Doenças Cardiovasculares , Epidemiologia , Desnutrição , Transição Nutricional
7.
PLoS One ; 15(8): e0238223, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32853260

RESUMO

Being delivered as a low birthweight (LBW) infant is a risk factor for elevated blood pressure and future problems with cardiovascular and cerebellar diseases. Although premature babies are reported to have low numbers of nephrons, some unclear questions remain about the mechanisms underlying elevated blood pressure in full-term LBW infants. We previously reported that glucocorticoids increased miR-449a expression, and increased miR-449a expression suppressed Crhr1 expression and caused negative glucocorticoid feedback. Therefore, we conducted this study to clarify the involvement of pituitary miR-449a in the increase in blood pressure caused by higher glucocorticoids in LBW rats. We generated a fetal low-carbohydrate and calorie-restricted model rat (60% of standard chow), and some individuals showed postnatal growth failure caused by growth hormone receptor expression. Using this model, we examined how a high-fat diet (lard-based 45kcal% fat)-induced mismatch between prenatal and postnatal environments could elevate blood pressure after growth. Although LBW rats fed standard chow had slightly higher blood pressure than control rats, their blood pressure was significantly higher than controls when exposed to a high-fat diet. Observation of glomeruli subjected to periodic acid methenamine silver (PAM) staining showed no difference in number or size. Aortic and cardiac angiotensin II receptor expression was altered with compensatory responses. Blood aldosterone levels were not different between control and LBW rats, but blood corticosterone levels were significantly higher in the latter with high-fat diet exposure. Administration of metyrapone, a steroid synthesis inhibitor, reduced blood pressure to levels comparable to controls. We showed that high-fat diet exposure causes impairment of the pituitary glucocorticoid negative feedback via miR-449a. These results clarify that LBW rats have increased blood pressure due to high glucocorticoid levels when they are exposed to a high-fat diet. These findings suggest a new therapeutic target for hypertension of LBW individuals.


Assuntos
Pressão Sanguínea/fisiologia , Retroalimentação Fisiológica/fisiologia , Glucocorticoides/sangue , Doenças da Hipófise/sangue , Doenças da Hipófise/fisiopatologia , Hipófise/fisiologia , Animais , Peso ao Nascer/efeitos dos fármacos , Peso ao Nascer/fisiologia , Pressão Sanguínea/efeitos dos fármacos , Corticosterona/sangue , Dieta Hiperlipídica/efeitos adversos , Feminino , Humanos , Hipertensão/sangue , Hipertensão/fisiopatologia , Recém-Nascido de Baixo Peso/sangue , Recém-Nascido de Baixo Peso/fisiologia , Recém-Nascido , Masculino , Metirapona/uso terapêutico , Doenças da Hipófise/tratamento farmacológico , Hipófise/efeitos dos fármacos , Gravidez , Efeitos Tardios da Exposição Pré-Natal/sangue , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Ratos , Ratos Wistar
8.
PLoS One ; 15(8): e0237241, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764800

RESUMO

BACKGROUND: Despite being one of the wealthiest nations, disparities in adverse birth outcomes persist across racial and ethnic lines in the United States. We studied the association between historical redlining and preterm birth, low birth weight (LBW), small-for-gestational age (SGA), and perinatal mortality over a ten-year period (2006-2015) in Los Angeles, Oakland, and San Francisco, California. METHODS: We used birth outcomes data from the California Office of Statewide Health Planning and Development between January 1, 2006 and December 31, 2015. Home Owners' Loan Corporation (HOLC) Security Maps developed in the 1930s assigned neighborhoods one of four grades that pertained to perceived investment risk of borrowers from that neighborhood: green (grade A) were considered "Best", blue (grade B) "Still Desirable", yellow (grade C) "Definitely Declining", and red (grade D, hence the term "redlining") "Hazardous". Geocoded residential addresses at the time of birth were superimposed on HOLC Security Maps to assign each birth a HOLC grade. We adjusted for potential confounders present at the time of Security Map creation by assigning HOLC polygons areal-weighted 1940s Census measures. We then employed propensity score matching methods to estimate the association of historical HOLC grades on current birth outcomes. Because tracts graded A had almost no propensity of receiving grade C or D and because grade B tracts had low propensity of receiving grade D, we examined birth outcomes in the three following comparisons: B vs. A, C vs. B, and D vs. C. RESULTS: The prevalence of preterm birth, SGA and mortality tended to be higher in worse HOLC grades, while the prevalence of LBW varied across grades. Overall odds of mortality and preterm birth increased as HOLC grade worsened. Propensity score matching balanced 1940s census measures across contrasting groups. Logistic regression models revealed significantly elevated odds of preterm birth (odds ratio (OR): 1.02, 95% confidence interval (CI): 1.00-1.05), and SGA (OR: 1.03, 95% CI: 1.00-1.05) in the C vs. B comparison and significantly reduced odds of preterm birth (OR: 0.93, 95% CI: 0.91-0.95), LBW (OR: 0.94-95% CI: 0.92-0.97), and SGA (OR: 0.94, 95% CI: 0.92-0.96) in the D vs. C comparison. Results differed by metropolitan area and maternal race. CONCLUSION: Similar to prior studies on redlining, we found that worsening HOLC grade was associated with adverse birth outcomes, although this relationship was less clear after propensity score matching and stratifying by metropolitan area. Higher odds of preterm birth and SGA in grade C versus grade B neighborhoods may be caused by higher-stress environments, racial segregation, and lack of access to resources, while lower odds of preterm birth, SGA, and LBW in grade D versus grade C neighborhoods may due to population shifts in those neighborhoods related to gentrification.


Assuntos
Resultado da Gravidez , Nascimento Prematuro/epidemiologia , Adulto , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido Pequeno para a Idade Gestacional , Los Angeles/epidemiologia , Masculino , Gravidez , Pontuação de Propensão , Características de Residência , Estudos Retrospectivos , São Francisco/epidemiologia , Segregação Social , Fatores Socioeconômicos , Adulto Jovem
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1072-1075, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741173

RESUMO

Objective: To investigate the impacts of antenatal anxiety on preterm birth and low birth weight. Methods: Women in early pregnancy were recruited for follow-up, antenatal anxiety in three trimesters was screened using Self-Rating Anxiety Scale and the score ≥50 was regarded as anxiety. Logistic regression analysis was conducted to evaluate the associations of the anxiety in three trimesters, new onset anxiety in the second and third trimesters with infant birth outcomes, such as preterm birth and low birth weight. Results: The rates of anxiety in the first, second and third trimesters of pregnancy were 12.5%, 3.7%, and 7.4% respectively. We found that there was no statistical association between anxiety in the first and second trimester and preterm birth. The anxiety in the third trimester was associated with increased odds for preterm birth (OR=3.55, 95%CI: 1.62-7.82). Associations between anxiety in all three trimesters and low birth weight were not significant. New onset anxiety in the third trimester was associated with significant increased risk of premature delivery (OR=5.20, 95%CI: 1.84-14.70) and low birth weight (OR=6.93, 95%CI: 2.42-19.88). Conclusions: Our study showed that anxiety in the third trimester is an important risk factor for premature delivery, new onset anxiety symptoms in the third trimester can significantly increase the incidence of premature birth and low birth weight of infant.


Assuntos
Ansiedade/epidemiologia , Recém-Nascido de Baixo Peso , Gestantes/psicologia , Nascimento Prematuro/epidemiologia , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Gravidez , Fatores de Risco
10.
Rev Assoc Med Bras (1992) ; 66(7): 931-936, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32844925

RESUMO

BACKGROUND To determine the magnitude and temporal trends of deaths due to congenital heart disease (CHD) in Pernambuco between 1996 and 2016. METHODS This was an ecological, time-series study, involving all cases of deaths from congenital cardiovascular malformations in the state of Pernambuco, from 1996 to 2016, using data from DATASUS, SINASC and SIM. RESULTS There were 3,584 deaths from congenital cardiovascular malformations amongst individuals aged 0 to 14 years, of which 81.94% were concentrated in children aged under one year. The infant mortality rate (IMR) presented a linear growth trend of 0.4645 per year (p <0.01). The cause-of-death code Q24 (other congenital malformations of the heart) was present in 72.54% of the death records and 48.17% of the deaths occurred in infants aged between 28 and 364 days of life. The highest occurrence of deaths was identified in children with low birth weight (500 and 1,499g), male, premature, children of mothers without schooling, in deliveries at home (p <0.05). CONCLUSIONS Congenital heart disease still represents a public health problem as a cause of death, particularly in the first year of life, with IMR in a linear growth trend. Deaths from CHD were more prevalent in male children, born prematurely, with low birth weight, born to mothers with low schooling and deliveries without medical care.


Assuntos
Cardiopatias Congênitas , Nascimento Prematuro , Adolescente , Brasil/epidemiologia , Causas de Morte , Criança , Pré-Escolar , Feminino , Cardiopatias Congênitas/mortalidade , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Gravidez
11.
Eur J Obstet Gynecol Reprod Biol ; 252: 490-501, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32795828

RESUMO

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has become a global pandemic and may adversely affect pregnancy outcomes. We estimated the adverse maternal and neonatal characteristics and outcomes among COVID-19 infected women and determined heterogeneity in the estimates and associated factors. STUDY DESIGNS: PubMed search was performed of confirmed COVID-19 pregnant cases and related outcomes were ascertained prior to July 8, 2020, in this systematic review and meta-analysis. Studies reporting premature birth, low birth weight, COVID-19 infection in neonates, or mode of delivery status were included in the study. Two investigators independently performed searches, assessed quality of eligible studies as per the Cochrane handbook recommendations, extracted and reported data according to PRISMA guidelines. Pooled proportions of maternal and neonatal outcomes were estimated using meta-analyses for studies with varying sample sizes while a systematic review with descriptive data analysis was performed for case report studies. Maternal and neonatal outcomes included C-section, premature birth, low birth weight, adverse pregnancy events and COVID transmission in neonates. RESULTS: A total of 790 COVID-19 positive females and 548 neonates from 61 studies were analyzed. The rates of C-section, premature birth, low birth weight, and adverse pregnancy events were estimated as 72 %, 23 %, 7 %, and 27 % respectively. In the heterogeneity analysis, the rate of C-section was substantially higher in Chinese studies (91 %) compared to the US (40 %) or European (38 %) studies. The rates of preterm birth and adverse pregnancy events were also lowest in the US studies (12 %, 15 %) compared to Chinese (17 %, 21 %), and European studies (19 %, 19 %). In case reports, the rates of C-section, preterm birth, and low birth weight were estimated as 69 %, 56 %, and 35 %, respectively. Adverse pregnancy outcomes were associated with infection acquired at early gestational ages, more symptomatic presentation, myalgia symptom at presentation, and use of oxygen support therapy. CONCLUSIONS: Adverse pregnancy outcomes were prevalent in COVID-19 infected females and varied by location, type, and size of the studies. Regular screening and early detection of COVID-19 in pregnant women may provide more favorable outcomes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez/epidemiologia , Adulto , Cesárea/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Pandemias , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/virologia , Prevalência
12.
West Afr J Med ; 37(4): 402-406, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32835403

RESUMO

BACKGROUND: Preterm babies have constituted a major constraints on human and material resources due to early mortality and long term disability among survivors. Rates of disability among survivors have increased over the period, with high rates of broncho-pulmonary dysplasia. OBJECTIVE: To determine the survival and management challenges of preterm babies in University of Maiduguri Teaching Hospital, Maiduguri Borno State REUSLTS: Of the 1129 preterm babies managed in the Special Care Baby Unit (SCBU), 714 cases notes were retrieved and analyzed giving a retrieval rate of 63%. There were 256 (35.9%) preterm babies as in-born, while 458 (64.1%) were out-born. Male preterm babies were 372 (52.1%), while female preterm babies were 342 (47.9%); with female to male ratio of 1.08:1. Extreme low birth weight (<1000grams) were 17 (2.3%), very low birth weight (1000-1499 grams) were 288 (40.3%) while low birth weight (1500-2499 grams) were 406 (56.9%). We also documented 3 preterm babies whose weights >2500 grams were large for gestational age weight. Duration of oxygen therapy (p = 0.620), duration of phototherapy (p = 0.474), and EBT (p = 0.466) showed no association with their survival while only duration of incubator care (p = 0.005) demonstrated significant association with outcome. CONCLUSION: The population of preterm babies studied is 32.70% and their survival has remarkably improved. However, this improved survival of preterm babies especially the extreme and very low birth weight categories has posed a big challenge due to limited access to incubator care, use of caffeine and surfactant which might influence the outcome.


Assuntos
Recém-Nascido de Baixo Peso , Feminino , Idade Gestacional , Hospitais de Ensino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Masculino , Nigéria
13.
J Dent Child (Chic) ; 87(2): 90-97, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32788002

RESUMO

Purpose: To evaluate oral inclusion cysts in newborns and their association with birth weight, preterm birth, newborn health, maternal health, prenatal factors, and socio-economic factors.
Methods: The sample consisted of 411 pairs of mothers and their newborns born at a university hospital in Brazil. The oral inclusion cysts, diagnosed by clinical examination, were Epstein pearls, Bohn's nodules, and dental lamina cysts. Medical records and a questionnaire were used to collect data related to newborns and mothers. Data were analyzed using the chi-square, linear by linear, and Fisher's exact tests for bivariate analysis, while Poisson regression with robust variance was used for multivariate analysis (α =five percent).
Results: The prevalence of inclusion cysts was 56.7 percent. A total of 42 (62.7 percent) low birth weight (LBW) newborns, 192 (56.0 percent) normal weight newborns, 38 (63.3 percent) preterm newborns, and 187 (56.7 percent) full-term newborn had inclusion cysts. Epstein pearls (n=164, 39.9 percent) were more prevalent and associated with prematurity (P =0.025), LBW newborns (P =0.033), and mothers who worked during pregnancy (P =0.019). Bohn's nodules (n=80, 19.9 percent) were more prevalent in newborns of mothers who did not receive welfare support (P =0.004). Dental lamina cysts occurred in 5.6 percent (N=23) of the sample and were not associated with independent variables.
Conclusion: Epstein pearls were more common in LBW and preterm infants.


Assuntos
Cistos , Recém-Nascido Prematuro , Brasil , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Prevalência , Fatores de Risco
14.
Mymensingh Med J ; 29(3): 628-632, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32844804

RESUMO

This prospective study was done to determine fetomaternal outcomes of pregnancy in women with Tetralogy of Fallot (TOF) and carried out in two centres especially in the care of patients with adult congenital heart disease (CHD) from January 2005 to December 2009. Clinical, haemodynamic and obstetric data were reviewed for pregnant women with TOF. Ten (10) pregnant women were identified in the age range 18 to 47 years. Most of the patients were in the age group of 18 to 27 years, 34 to 36 weeks gestational age (in week) and primi gravida (60%). Right-sided aortic arch (20%) and major anomalies of pulmonary collaterals (30%) were common anomalies anatomical association. Normal vaginal delivery was the mode of delivery (70%) in the majority of the patients. Spontaneous abortions were occurred in 3(30%) patients. Primary maternal cardiac events complicating pregnancies were congestive heart failure (20%), arrhythmias and cardiovascular events (10%). Premature labor (40%) was the most common obstetric complication. Premature birth (40%), fetal demise (20%), neonatal death (10%) and cardiac anomaly at birth (10%) were the offspring complications in the study. Women with TOF can go through pregnancy with a low risk to themselves with frequent treatable complications, but there is a high incidence of miscarriage, premature births and low birth weight. An incidence of congenital anomaly in the fetus is higher than that found in the normal population.


Assuntos
Cardiopatias Congênitas , Complicações Cardiovasculares na Gravidez , Tetralogia de Fallot , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Resultado da Gravidez , Estudos Prospectivos , Adulto Jovem
15.
Eur Rev Med Pharmacol Sci ; 24(14): 7804-7815, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32744708

RESUMO

OBJECTIVE: To evaluate the clinical manifestations and outcomes of neonates born to women who had Coronavirus Disease 2019 (COVID-19) during pregnancy. MATERIALS AND METHODS: A systematic literature search was conducted on PubMed and Embase till April 15, 2020, by combining the terms (COVID-19, Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2, Novel Coronavirus, 2019-nCov, Wuhan pneumonia) and (pregnancy, pregnant women, mother, fetus, neonate, newborn, infant). RESULTS: We included 16 case series and 12 case reports describing a total of 223 pregnant women and 201 infants. Four newborns born to mothers affected by COVID-19 were reported to have laboratory-confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection within 48 hours after birth. However, Reverse Transcription-Polymerase Chain Reaction tests of the breast milk, placenta, amniotic fluids, and cord blood and maternal vaginal secretions were all negative for SARS-CoV-2 in the reported cases. Fetal death was reported in two cases, and 48 of 185 newborns (25.9%) were born prematurely. Infants born small for gestational age and low birth weight (< 2,500 g) accounted for 8.3% and 15.6% of reported cases, respectively. Birth asphyxia and respiratory distress syndrome were observed in 1.8% and 6.4% of neonates, respectively. There was one neonatal death due to intractable gastric bleeding among the SARS-CoV-2-negative infants. CONCLUSIONS: Current evidence suggests that COVID-19 during pregnancy rarely affects fetal and neonatal mortality, but can be associated with adverse neonatal morbidities. Vertical transmission has not been observed in the majority of the reported cases. The infants born to mothers with COVID-19 are carefully monitored for accompanying complication, and quarantine of infected mothers is warranted.


Assuntos
Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Asfixia Neonatal/diagnóstico , Asfixia Neonatal/epidemiologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Transmissão Vertical de Doença Infecciosa , Mães , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Natimorto
16.
Am J Nurs ; 120(9): 67, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32858704

RESUMO

Editor's note: The mission of Cochrane Nursing is to provide an international evidence base for nurses involved in delivering, leading, or researching nursing care. Cochrane Corner provides summaries of recent systematic reviews from the Cochrane Library. For more information, see https://nursing.cochrane.org.


Assuntos
Desenvolvimento Infantil , Nutrição Enteral/métodos , Fórmulas Infantis , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Recém-Nascido Prematuro/crescimento & desenvolvimento , Leite Humano , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Ganho de Peso
17.
Am J Clin Nutr ; 112(3): 695-706, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32651998

RESUMO

BACKGROUND: Preterm birth (PTB), small for gestational age (SGA), and low birth weight (LBW) are risk factors for morbidity and mortality among infants. High-quality maternal diets during pregnancy may protect against these adverse birth outcomes. OBJECTIVES: The aim of this study was to prospectively examine the association of maternal dietary diversity and quality during pregnancy with birth outcomes among women in Dar es Salaam, Tanzania. METHODS: We analyzed data from 7553 HIV-negative pregnant women enrolled in a multivitamin trial at 12-27 weeks of gestation. Dietary intake was assessed using 24-h dietary recalls. Dietary diversity scores (DDS; range: 0-10) were computed as the number of food groups consumed by women, using FAO's Minimum Dietary Diversity for Women index. The Prime Diet Quality Score (PDQS; range: 0-42) assessed maternal diet quality based on consumption of 21 healthy and unhealthy food groups. Log binomial regression methods were used to assess associations of DDS and PDQS with PTB, SGA, LBW, and fetal loss. RESULTS: In the previous 24 h, 99.9% of all women had consumed cereal and staples, 57.9% meats, 4.7% eggs, and 0.5% nuts and seeds. Median DDS was 3.0 (IQR: 2.5-3.5). For the PDQS, all women consumed ≥4 servings/wk of green leafy vegetables and refined grains. Higher DDS was associated with lower risk of SGA (RR highest compared with lowest quintile: 0.74; 95% CI: 0.62, 0.89). Higher PDQS was associated with lower risk of PTB (RR highest compared with lowest quintile: 0.55; 95% CI: 0.46, 0.66), LBW (RR: 0.53; 95% CI: 0.40, 0.70), and fetal loss (RR: 0.53; 95% CI, 0.34, 0.82). CONCLUSIONS: PDQS was inversely associated with PTB, LBW, and fetal loss, and DDS was inversely associated with SGA. These findings suggest that in addition to dietary diversity, diet quality should be considered as important in understanding dietary risk factors for poor birth outcomes.This trial was registered at clinicaltrials.gov as NCT00197548.


Assuntos
Dieta/normas , Resultado da Gravidez , Fenômenos Fisiológicos da Nutrição Pré-Natal , Vitaminas/administração & dosagem , Adulto , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Nascimento Prematuro , Cuidado Pré-Natal , Tanzânia
18.
Arch Gynecol Obstet ; 302(3): 553-567, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32643040

RESUMO

PURPOSE: To analyze the effect of Chlamydia trachomatis (C. trachomatis) on adverse pregnancy outcomes based on the currently available evidence. METHODS: Multiple databases were comprehensively searched from the available date of inception through December 9, 2019. The effect of C. trachomatis on adverse pregnancy outcomes was assessed using pooled odds rations (ORs) and 95% confidence intervals (CIs). Egger's test was used for publication bias. RESULTS: Fifty studies involving 502,141 participants were identified. C. trachomatis infection was found to be associated with preterm birth in antibody detection [OR (95% CI): 1.571 (1.112-2.220), P = 0.010] and high-quality assessment [OR (95% CI): 1.734 (1.295-2.321), P < 0.001], preterm premature rupture of membranes (PPROM) in culture detection [OR (95% CI): 4.339 (1.806-10.424), P = 0.001] and high-quality assessment [OR (95% CI): 2.822 (1.333-5.973), P = 0.007], stillbirth [OR (95% CI): 1.585 (1.219-2.062), P = 0.001], low-birthweight babies [OR (95% CI): 2.205 (1.137-4.274), P = 0.019], and babies small for gestational age [OR (95% CI): 1.193 (1.091-1.305), P < 0.001]. No publication bias was exhibited in miscarriage (P = 0.170), preterm birth (P = 0.303), PPROM (P = 0.341), stillbirth (P = 0.533), and low-birthweight babies (P = 0.535). CONCLUSIONS: C. trachomatis infection during pregnancy is associated with a higher risk of preterm birth, PPROM, stillbirth, low-birthweight babies, and babies small for gestational age.


Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis/isolamento & purificação , Ruptura Prematura de Membranas Fetais/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Aborto Espontâneo , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/microbiologia , Feminino , Ruptura Prematura de Membranas Fetais/microbiologia , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/microbiologia , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Natimorto
19.
PLoS One ; 15(7): e0235626, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32658895

RESUMO

BACKGROUND: Approximately 20.5 million infants were born weighing <2500 g (defined as low birthweight or LBW) in 2015, primarily in low- and middle-income countries (LMICs). Infants born LBW, including those born preterm (<37 weeks gestation), are at increased risk for numerous consequences, including neonatal mortality and morbidity as well as suboptimal health and nutritional status later in life. The objective of this study was to identify predictors of LBW and preterm birth among infants in rural Uganda. METHODS: Data were derived from a prospective birth cohort study conducted from 2014-2016 in 12 districts across northern and southwestern Uganda. Birth weights were measured in triplicate to the nearest 0.1 kg by trained enumerators within 72 hours of delivery. Gestational age was calculated from the first day of last menstrual period (LMP). Associations between household, maternal, and infant characteristics and birth outcomes (LBW and preterm birth) were assessed using bivariate and multivariable logistic regression with stepwise, backward selection analyses. RESULTS: Among infants in the study, 4.3% were born LBW (143/3,337), and 19.4% were born preterm (744/3,841). In multivariable analysis, mothers who were taller (>150 cm) (adjusted Odds Ratio (aOR) = 0.42 (95% CI = 0.24, 0.72)), multigravida (aOR = 0.62 (95% CI = 0.39, 0.97)), or with adequate birth spacing (>24 months) (aOR = 0.60 (95% CI = 0.39, 0.92)) had lower odds of delivering a LBW infant Mothers with severe household food insecurity (aOR = 1.84 (95% CI = 1.22, 2.79)) or who tested positive for malaria during pregnancy (aOR = 2.06 (95% CI = 1.10, 3.85)) had higher odds of delivering a LBW infant. In addition, in multivariable analysis, mothers who resided in the Southwest (aOR = 0.64 (95% CI = 0.54, 0.76)), were ≥20 years old (aOR = 0.76 (95% CI = 0.61, 0.94)), with adequate birth spacing (aOR = 0.76 (95% CI = 0.63, 0.93)), or attended ≥4 antenatal care (ANC) visits (aOR = 0.56 (95% CI = 0.47, 0.67)) had lower odds of delivering a preterm infant; mothers who were neither married nor cohabitating (aOR = 1.42 (95% CI = 1.00, 2.00)) or delivered at home (aOR = 1.25 (95% CI = 1.04, 1.51)) had higher odds. CONCLUSIONS: In rural Uganda, severe household food insecurity, adolescent pregnancy, inadequate birth spacing, malaria infection, suboptimal ANC attendance, and home delivery represent modifiable risk factors associated with higher rates of LBW and/or preterm birth. Future studies on interventions to address these risk factors may be warranted.


Assuntos
Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , População Rural/estatística & dados numéricos , Adolescente , Adulto , Estudos de Coortes , Feminino , Habitação/estatística & dados numéricos , Humanos , Lactente , Masculino , Mães , Gravidez , Uganda/epidemiologia , Adulto Jovem
20.
PLoS One ; 15(7): e0236136, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687541

RESUMO

Birthweight continues to be the leading infant health indicator and the main focus of infant health policy. Low birthweight babies are at a higher risk of mortality and morbidity in most low-income countries. However, the physical activity level of pregnant women and its association with low birthweight is not well studied in Ethiopia. To address the above gap, we aimed to examine the maternal physical activity level and other characteristics during the third trimester and its association with birthweight at term in South Ethiopia. A community-based prospective cohort study was conducted among 247 randomly selected women in their third trimester of pregnancy. We measured the physical activity level using the Global Physical Activity Questionnaire, which included the type and level of various categories of activities. Anthropometric measurements of mothers were taken following standard procedures, and birthweight was recorded within 72 hours of delivery. To identify the effect of physical activity level and other maternal characteristics on low birthweight, we performed a multivariable logistic regression analysis. Overall, 111 (47.2%) mothers were engaged in vigorous physical activities during third trimester. The incidence of low birthweight was 21.6% and 9.68% among newborns of mothers who engaged in vigorous and moderate or low physical activity, respectively. The incidence of low birthweight at term was significantly associated with vigorous physical activity [adjusted odds ratio (AOR) = 2.48; 95% confidence interval (CI): 1.01-6.09], prolonged standing [AOR = 3.37; 95% CI: 1.14-9.93], and squatting [AOR = 2.61; 95% CI: 1.04-6.54)] during the third trimester of pregnancy. The vast majority of pregnant women were engaged in vigorous physical activities in their third trimester. Engagement in vigorous physical activity, standing for longer hours, and squatting were the major contributors to low birthweight at term. Hence, focused counseling should be conducted to reduce vigorous physical activity, standing, and squatting during the third trimester among pregnant women.


Assuntos
Peso Corporal , Exercício Físico , Mães , Terceiro Trimestre da Gravidez , Adolescente , Adulto , Estudos de Coortes , Ingestão de Alimentos , Etiópia , Feminino , Humanos , Recém-Nascido de Baixo Peso , Análise Multivariada , Gravidez , Estudos Prospectivos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA