المؤلفون: Armstrong-Buisseret, Lindsay, Powers, Katie, Dorling, Jon, Bradshaw, Lucy, Johnson, Samantha, Mitchell, Eleanor, Duley, Lelia

المصدر: Archives of Disease in Childhood -- Fetal & Neonatal Edition; May2020, Vol. 105 Issue 3, pF292-F298, 7p, 1 Diagram, 4 Charts

مصطلحات موضوعية: PREMATURE labor, CHILDBIRTH

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Objective: To report outcomes at 2 years corrected age for children of women recruited to a trial comparing alternative policies for timing of cord clamping and immediate neonatal care at very preterm birth.Design: Parallel group randomised (1:1) trial.Setting: Eight UK tertiary maternity units.Participants: Two hundred and seventy-six babies born to 261 women expected to have a live birth before 32+0 weeks' gestation.Interventions: Deferred cord clamping (≥2 min) and immediate neonatal care with cord intact or immediate (≤20 s) clamping and immediate neonatal care after clamping.Main Outcome Measure: Composite of death or adverse neurodevelopmental outcome at 2 years corrected age.Results: Six babies born after 35+6 weeks were excluded. At 2 years corrected age, outcome data were not available for a further 52 children, leaving 218 for analysis (115 deferred clamping, 103 immediate clamping). Overall, 24/115 (21%) children allocated deferred clamping died or had an adverse neurodevelopmental outcome compared with 35/103 (34%) allocated immediate clamping; risk ratio (RR) 0.61 (95% CI 0.39 to 0.96); risk difference (RD) -13% (95% CI -25% to -1%). Multiple imputation for missing data gave an RR 0.69 (95% CI 0.44 to 1.09) and RD -9% (95% CI -21% to 2%).Conclusions: Deferred clamping and immediate neonatal care with cord intact may reduce the risk of death or adverse neurodevelopmental outcome at 2 years of age for children born very premature. Confirmation in larger studies is needed to determine the real benefits and harms.Trial Registration Number: ISRCTN21456601. [ABSTRACT FROM AUTHOR]

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المؤلفون: Field, D.¹ david.field@uhl-tr.nhs.uk, Bajuk, B.², Manktelow, B. N.¹, Vincent, T.², Dorling, J.¹, Tarnow-Mordi, W.³, Draper, E. S.¹, Henderson Smart, D.²

المصدر: Archives of Disease in Childhood -- Fetal & Neonatal Edition. May2008, Vol. 93 Issue 3, pF212-F216. 5p. 3 Charts.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *CHILDBIRTH, *NEONATAL intensive care

مصطلحات جغرافية: AUSTRALIA, UNITED Kingdom

مستخلص: Background: Comparisons of national perinatal and neonatal mortality often neglect the underlying causes. Objective: To assess effects of very-preterm births in the UK and Australia. Setting: Two geographically defined populations: the former Trent Health Region of the UK and New South Wales (NSW)/the Australian Capital Territory (ACT), Australia. Method: All births 22+0 to 31+6 weeks in 2000, 2001 and 2002 were identified by established surveys of perinatal care. Rates of birth and death were compared. Results: The population of NSW/ACT was 35% higher and there were 66% more births than in Trent (273 495 vs 164 824). The proportion of liveborn infants between 22 and 31 weeks gestation was about 25% higher in Trent (NSW/ACT 2945, rate per 1000 live births 10.82 (95% Cl 10.43 to 11.22); Trent 2208, rate per 1000 live births 13.47 (95% Cl 12.92 to 14.05)). The proportion of these infants admitted to a neonatal unit was also higher in Trent (91.2% vs 94.4%; OR 1.63(95% Cl 1.30 to 2.05)). Unadjusted mortality in infants admitted to a neonatal unit was similar: NSW/ACT 332/2686 (12.4%); Trent 284/ 2085 113.6%); unadjusted OR 1.12 (95% Cl 0.94 to 1.33; p=0.21). Conclusions: The higher rates of very premature birth and more ready admission to neonatal intensive care for infants in the UK may help to explain why perinatal and neonatal mortality are higher there than in Australia. Efforts to understand why the rate of premature birth in the UK is so high should be a national priority. [ABSTRACT FROM AUTHOR]

المؤلفون: de Heus, Roel¹ R.deHeus-2@umcutrecht.nl, Mol, Ben Willem^2,3, Erwich, Jan-Jaap H.M.⁴, van Geijn, Herman P.⁵, Gyselaers, Wilfried J.⁶, Hanssens, Myriam⁷, Härmark, Linda⁸, van Holsbeke, Caroline D.⁶, Duvekot, Johannes J.⁹, Schobben, Fred F.A.M.¹⁰, Wolf, Hans³, Visser, Gerard H.A.¹

المصدر: BMJ: British Medical Journal (Overseas & Retired Doctors Edition). 3/28/2009, Vol. 338 Issue 7697, p758-760. 3p. 1 Chart.

مصطلحات موضوعية: *RISK factors in premature labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *PREMATURE labor, *PREGNANCY complications, *DRUG side effects, *PRENATAL care, *HEALTH outcome assessment, *NIFEDIPINE, *COMORBIDITY, *MANAGEMENT, *PHYSIOLOGY, *THERAPEUTICS

مستخلص: Objective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920 consecutive women treated with tocolytics for threatened preterm labour. Main outcome measures Maternal adverse events (those suspected of being causally related to treatment were considered adverse drug reactions) leading to cessation of treatment. Results An independent panel evaluated the recorded adverse events, without knowledge of the type of tocolytic used. Of the 1920 women treated with tocolytics, 1327 received a single course of treatment (69.1%), 282 sequential courses (14.7%), and 311 combined courses (16.2%). Adverse drug reactions were categorised as serious or mild in 14 cases each. The overall incidence of serious adverse drug reaction was 0.7%. Compared with atosiban, the relative risk of an adverse drug reaction for single treatment with a ß adrenoceptor agonist was 22.0 (95% confidence interval 3.6 to 138.0) and for single treatment with a calcium antagonist was 12 (1.9 to 69). Multiple drugtocolysis led to five serious adverse drug reactions (1.6%). Multiple gestation, preterm rupture of membranes, and comorbidity were not independent risk factors for adverse drug reactions. Conclusions The use of ß adrenoceptor agonists or multiple tocolytics for preventing preterm birth is associated with a high incidence of serious adverse drug reactions. Indometacin and atosiban were the only drugs not associated with serious adverse drug reactions. A direct comparison of the effectiveness of nifedipine and atosiban in postponing preterm delivery is needed. [ABSTRACT FROM AUTHOR]

المؤلفون: Bolton, Charlotte E., Bush, Andrew, Hurst, John R., Kotecha, Sailesh, McGarvey, Lorcan

المصدر: Thorax; Jun2015, Vol. 70 Issue 6, p574-580, 7p, 1 Graph

مصطلحات موضوعية: PREMATURE infant death, CHILDBIRTH, CHEST X rays, PREMATURE labor, SYMPTOMS, RESPIRATORY diseases

مستخلص: Although survival has improved significantly in recent years, prematurity remains a major cause of infant and childhood mortality and morbidity. Preterm births (<37 weeks of gestation) account for 8% of live births representing >50 000 live births each year in the UK. Preterm birth, irrespective of whether babies require neonatal intensive care, is associated with increased respiratory symptoms, partially reversible airflow obstruction and abnormal thoracic imaging in childhood and in young adulthood compared with those born at term. Having failed to reach their optimal peak lung function in early adulthood, there are as yet unsubstantiated concerns of accelerated lung function decline especially if exposed to noxious substances leading to chronic respiratory illness; even if the rate of decline in lung function is normal, the threshold for respiratory symptoms will be crossed early. Few adult respiratory physicians enquire about the neonatal period in their clinical practice. The management of these subjects in adulthood is largely evidence free. They are often labelled as asthmatic although the underlying mechanisms are likely to be very different. Smoking cessation, maintaining physical fitness, annual influenza immunisation and a general healthy lifestyle should be endorsed irrespective of any symptoms. There are a number of clinical and research priorities to maximise the quality of life and lung health in the longer term not least understanding the underlying mechanisms and optimising treatment, rather than extrapolating from other airway diseases. [ABSTRACT FROM AUTHOR]

: Copyright of Thorax is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Colombo, David F.

المصدر: BMJ: British Medical Journal (International Edition). 8/10/2002, Vol. 325 Issue 7359, p289-290. 2p.

مصطلحات موضوعية: *PREMATURE labor, *LABOR (Obstetrics), *OBSTETRICS, *CHILDBIRTH, *DURATION of pregnancy

مستخلص: Editorial. Discusses the efforts to predict spontaneous preterm birth. Comparison of asymptomatic patients and symptomatic patients; Methods, including transvaginal ultrasonography and the fetal fibronectin test; Lack of a reliable method of confirming preterm labor.

المؤلفون: Morris, Jonathan

المصدر: Evidence Based Medicine; Jun2013, Vol. 18 Issue 3, following pe23-e23, 2p

مصطلحات موضوعية: FAMILY planning, NEONATAL diseases, SEPTICEMIA prevention, CHILDBIRTH, PREMATURE labor, PREGNANCY complications, PREVENTION

مستخلص: The author comments on a study by van der Ham DP and colleagues which evaluate the effect of planned early birth compared with expectant management for pregnancies complicated with preterm prelabour rupture of membranes (PPROM). It mentions that early planned birth may help to reduce neonatal sepsis as compared to expectant management. The author comments that there is no indication to suggest planned early birth for women who present with PPROM close to term.

المؤلفون: Wyatt, Solange, Guinn, Debra A.

المصدر: Evidence Based Medicine; Jun2006, Vol. 11 Issue 3, p75-75, 1/3p

مصطلحات موضوعية: CRITICISM, MEDICAL research, CLINICAL trials, PREGNANT women, PREMATURE labor, CHILDBIRTH, THERAPEUTICS

مستخلص: The article comments on the medical research entitled "Review: Oxytocin Receptor Antagonists for Preterm Labor Do Not Improve Infant Outcomes More Than Placebo or Other Tocolytics." The author emphasizes that the review for this study summarizes the current evidence for atosiban and reiterates its lack of benefit for the neonate. He also stresses that the efficacy of atosiban and all currently used off label tocolytics is questionable.

المؤلفون: Papatsonis, D.

المصدر: Evidence Based Medicine; Jun2006, Vol. 11 Issue 3, p75-75, 1/2p, 1 Chart

مصطلحات موضوعية: CLINICAL trials, MEDICAL research, PREGNANT women, PREMATURE labor, CHILDBIRTH, THERAPEUTICS

مستخلص: The article presents a study that examines whether oxytocin receptor antagonists would delay delivery and would improve infant outcomes in pregnant women with preterm labor. In this study, two randomized controlled trials (RCTs) compared atosiban with placebo and four RCTs compared with beta mimetic agents. Results indicate that atosiban does not prevent preterm birth or improve infant outcomes compared with placebo or beta mimetics.