المؤلفون: Gonçalves, Joana L.¹ joanaglopes@gmail.com, Fuertes, Marina¹, Alves, Maria João¹, Antunes, Sandra², Almeida, Ana Rita³, Casimiro, Rute³, Santos, Margarida^2,4

المصدر: BMC Pregnancy & Childbirth. 5/6/2020, Vol. 20 Issue 1, p1-16. 16p.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *MOTHER-infant relationship, *MATERNAL health services, *CHILDBIRTH, *POSTPARTUM depression, *PREGNANCY, *NEONATAL intensive care, *PSYCHOLOGY of mothers, *GESTATIONAL age, *NEONATAL intensive care units, *RESEARCH funding, *LABOR (Obstetrics), *MOTHER-child relationship

مستخلص: Background: Mothers' reports about pregnancy, maternity and their experiences during the perinatal period have been associated with infants' later quality of attachment and development. Yet, there has been little research with mothers of very preterm newborns. This study aimed to explore mothers' experiences related to pregnancy, premature birth, relationship with the newborn, and future perspectives, and to compare them in the context of distinct infants' at-birth-risk conditions.Methods: A semi-structured interview was conducted with women after birth, within the first 72 h of the newborn's life. A total of 150 women participated and were divided in three groups: (1) 50 mothers of full-term newborns (Gestational Age (GA) ≥ 37 weeks; FT), (2) 50 mothers of preterm newborns (GA 32-36 weeks; PT) and (3) 50 mothers of very preterm newborns (GA < 32 weeks; VPT).Results: Mothers of full-term infants responded more often that their children were calm and that they did not expect difficulties in taking care of and providing for the baby. Mothers of preterm newborns although having planned and accepted well the pregnancy (with no mixed or ambivalent feelings about it) and while being optimistic about their competence to take care of the baby, mentioned feeling frightened because of the unexpected occurrence of a premature birth and its associated risks. Mothers of very preterm newborns reported more negative and distressful feelings while showing more difficulties in anticipating the experience of caring for their babies.Conclusion: The results indicate that Health Care Systems and Neonatal Care Policy should provide differentiated psychological support and responses to mothers, babies and families, taking into account the newborns' GA and neonatal risk factors. [ABSTRACT FROM AUTHOR]

المؤلفون: Barnea, Eytan R.^1,2 barnea@earlypregnancy.org, Muller, Martin^3,4, Di Simone, Nicoletta^5,6, Inversetti, Annalisa^5,6, Pacagnella, Rodolfo⁷, Borovac-Pinheiro, Anderson⁶, Nicholson, Wanda⁸

المصدر: International Journal of Gynecology & Obstetrics. 2023 Supplement, Vol. 163, p34-39. 6p.

مصطلحات موضوعية: *DELIVERY (Obstetrics), *LABOR (Obstetrics), *PREMATURE labor, *CESAREAN section, *HIGH-risk pregnancy, *MATERNITY nursing

مستخلص: Childbirth is an intense event in which decisions may need to be made in seconds to guarantee the health of both mother and newborn. Despite health systems and care approaches varying widely according to real-life scenarios, availability of facilities, beliefs, resources, staff, and geography, among others, optimal outcomes should be ensured worldwide. Triaging low-risk pregnancies from high-risk pregnancies is the first step to ensure proper allocation of resources. From this need, we developed FIGO's Prep-For-Labor triage methods, a series of 2-minute labor and delivery bundles of care, with special regard given to low-and middle-income countries and rural settings. Around 80% of women, once properly triaged, can pursue vaginal delivery with minimal intervention, while those at risk can either be managed on site or transferred promptly to an advanced care site. FIGO's bundles of care and good practice recommendations for labor and delivery and immediate newborn triage cover four clinical scenarios: (1) preterm labor; (2) induced or spontaneous labor at term; (3) cesarean delivery; and (4) newborn care. From rapid triage of the mother (low vs high risk) to the list of required equipment, description of skilled staff, and coordination of resources, the recommendations for care are introduced across these four areas in this overview article. Implementing the proposed management steps described in each summary can improve maternal and neonatal outcomes. [ABSTRACT FROM AUTHOR]

المؤلفون: Papanna, R.¹, Mann, L. K.¹, Baschat, A. A.², Bebbington, M. W.¹, Khalek, N.³, Johnson, A.¹, Snowise, S.¹, Moise, K. J.¹

المصدر: Ultrasound in Obstetrics & Gynecology. Feb2015, Vol. 45 Issue 2, p175-182. 8p.

مصطلحات موضوعية: *PREMATURE labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *OBSTETRICS, *LABOR (Obstetrics), *LASER surgery

مستخلص: ABSTRACT Objectives To determine the risk factors for spontaneous preterm delivery ( PTD) or preterm prelabor rupture of membranes ( PPROM) at < 34 weeks' gestation after fetoscopic laser surgery for twin-twin transfusion syndrome and to identify the optimal threshold for preoperative cervical length ( CL) that indicates a high risk for spontaneous PTD. Methods This was a secondary analysis of data prospectively collected from 449 patients at three fetal centers. CL measurements were obtained by preoperative transvaginal ultrasound, at a gestational age of 16-26 weeks. The risk factors associated with spontaneous PTD before 34 weeks' gestation were determined using multivariable logistic regression analysis. We excluded patients with dual fetal demise and those with maternal or fetal indications for delivery without PPROM ( n = 63). The optimal threshold for cervical length to predict spontaneous PTD before 34 weeks was determined using a receiver-operating characteristics ( ROC) curve and Youden index. Additionally, the CL threshold for spontaneous PTD at 2-week intervals between 24 and 34 weeks was determined. Results Spontaneous PTD before 34 weeks occurred in 206 (53.4%) of the included patients. Only the preoperative CL was significantly associated with spontaneous PTD. The preoperative CL was normally distributed with a mean of 37.6 ± 10.3 mm (range, 5-66 mm). Maternal age and parity were positively associated, and gestational age at procedure and anterior placenta were negatively associated, with CL on multivariable linear regression analysis. The area under the ROC curve for predicting spontaneous PTD with CL measurements was 0.61 ( P = 0.02) and the optimal threshold was 28 mm with a Youden index of 0.19 (sensitivity and specificity of 92% and 27%, respectively). A CL measurement of < 28 mm increased the risk of spontaneous PTD for all gestational age thresholds. Conclusions Spontaneous PTD at < 34 weeks' gestation is associated with a preoperative CL of < 28 mm. Preventive strategies should focus on this high-risk group. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

المؤلفون: Hailemichael, Helen Tsehaye, Debelew, Gurmesa Tura, Alema, Haileselasie Berhane, Weldu, Meresa Gebremedhin, Misgina, Kebede Haile

المصدر: BMC Pediatrics; 1/8/2020, Vol. 20 Issue 1, p1-9, 9p, 3 Charts

مصطلحات موضوعية: LABOR (Obstetrics), CHILDBIRTH, PRENATAL care, NUTRITION counseling, PREMATURE labor, ASPHYXIA neonatorum

مصطلحات جغرافية: ETHIOPIA

مستخلص: Background: Adverse birth outcome which attributes to most perinatal deaths is an important indicator of child health and survival. Hence, this study aims to identify determinants of adverse birth outcome among mothers who gave birth in public hospitals of Tigrai region, North Ethiopia.Methods: Hospital based case-control study was conducted in Tigrai region, Ethiopia between December 2015 and January 2016 among 405 (135 cases and 270 controls) consecutively selected mothers who gave birth in four randomly selected public Hospitals. Mothers with adverse birth outcome (preterm birth; < 37 gestational weeks at birth, low birth weight; < 2.5 kg at birth, or still birth) were the cases while mothers without adverse birth outcome (live birth, birth weight ≥ 2.5 kg and of ≥37 gestational weeks at birth) were the controls. Data were collected by interview and reviewing medical records using structured questionnaire. The collected data were entered into database using EPI info version 3.5.1 then exported to SPSS version 21 for analysis. Finally, multivariate logistic regression was used to identify determinants of adverse birth outcomes at P value < 0.05.Result: The mean age of cases and controls was 27.3 (SD = 6.6) and 26.14 (SD = 4.9) years, respectively. In a multivariate analysis; less than four antenatal care visits [AOR = 4.35, 95% CI: 1.15-13.50], not receiving dietary counseling [AOR = 11.24, 95% CI: 3.92-36.60], not using family planning methods [AOR = 4.06, 95% CI:1.35-17.34], less than 24 months inter pregnancy interval [AOR = 5.21, 95% CI: 1.89-13.86], and less than 11 g/dl hemoglobin level [AOR = 4.86, 95% CI: 1.83-14.01] were significantly associated with adverse birth outcomes.Conclusion and Recommendation: The number of antenatal care visits, ever use of family planning methods, not receiving dietary counseling during antenatal care follow up visits, short inter-pregnancy interval, and low hemoglobin level were identified as independent determinants of adverse birth outcome. A concerted effort should be taken improve family planning use, and antenatal care follow-up with special emphasis to maternal nutrition to prevent adverse birth outcomes. [ABSTRACT FROM AUTHOR]

: Copyright of BMC Pediatrics is the property of BioMed Central 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: Sujan, Ayesha C., Quinn, Patrick D., Rickert, Martin E., Wiggs, Kelsey K., Lichtenstein, Paul, Larsson, Henrik, Almqvist, Catarina, Öberg, A. Sara, D'Onofrio, Brian M.

المصدر: PLoS Medicine; 12/2/2019, Vol. 16 Issue 12, p1-18, 18p, 3 Charts

مصطلحات موضوعية: PREGNANCY, CHILDBIRTH, MATERNAL age, PREGNANT women, PREMATURE labor, RESEARCH, SUBSTANCE abuse, PREMATURE infants, RESEARCH methodology, RETROSPECTIVE studies, GESTATIONAL age, EVALUATION research, PREGNANCY outcomes, LOW birth weight, COMPARATIVE studies, BIRTH weight, RESEARCH funding, LABOR (Obstetrics), SMALL for gestational age

مصطلحات جغرافية: SWEDEN

مستخلص: Background: Published research on prescribed opioid analgesic (POA) use during pregnancy and birth outcomes is limited in scope and has not adequately adjusted for potential confounding factors. To help address these gaps, we estimated associations between maternal POAs during pregnancy and two adverse birth outcomes using a large population-based dataset, multiple definitions of POA exposure, and several methods to evaluate the influence of both measured and unmeasured confounding factors.Methods and Findings: We obtained data by linking information from several Swedish registers and conducted a retrospective cohort study on a population-based sample of 620,458 Swedish births occurring between 2007 and 2013 (48.6% female; 44.4% firstborn). We evaluated associations between prenatal POA exposure and risk for preterm birth (PTB; <37 gestational weeks) and small for gestational age (SGA; birth weight 2 standard deviations below the expected weight for gestational age or lower). We evaluated the influence of confounding by adjusting for a wide range of measured covariates while comparing exposed and unexposed infants. Additionally, we adjusted for unmeasured confounding factors by using several advanced epidemiological designs. Infants exposed to POAs anytime during pregnancy were at increased risk for PTB compared with unexposed infants (6.4% exposed versus 4.4% unexposed; adjusted odds ratio [OR] = 1.38, 95% confidence interval [CI] 1.31-1.45, p < 0.001). This association was attenuated when we compared POA-exposed infants with acetaminophen-exposed infants (OR = 1.18, 95% CI 1.07-1.30, p < 0.001), infants born to women who used POAs before pregnancy only (OR = 1.05, 95% CI 0.96-1.14, p = 0.27), and unexposed siblings (OR = 0.99, 95% CI 0.85-1.14, p = 0.92). We also evaluated associations with short-term versus persistent POA use during pregnancy and observed a similar pattern of results, although the magnitudes of associations with persistent exposure were larger than associations with any use or short-term use. Although short-term use was not associated with SGA (adjusted ORsingle-trimester = 0.95, 95% CI 0.87-1.04, p = 0.29), persistent use was associated with increased risk for SGA (adjusted ORmultiple-trimester = 1.40, 95% CI 1.17-1.67, p < 0.001) compared with unexposed infants. The association with persistent exposure was attenuated when we used alternative comparison groups (e.g., sibling comparison OR = 1.22, 95% CI 0.60-2.48, p = 0.58). Of note, our study had limitations, including potential bias from exposure misclassification, an inability to adjust for all sources of confounding, and uncertainty regarding generalizability to countries outside of Sweden.Conclusions: Our results suggested that observed associations between POA use during pregnancy and risk of PTB and SGA were largely due to unmeasured confounding factors, although we could not rule out small independent associations, particularly for persistent POA use during pregnancy. [ABSTRACT FROM AUTHOR]

: Copyright of PLoS Medicine is the property of Public Library of Science 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: Ferguson, Kelly K., Rosario, Zaira, McElrath, Thomas F., Vélez Vega, Carmen, Cordero, José F., Alshawabkeh, Akram, Meeker, John D.

المصدر: PLoS ONE; 6/13/2019, Vol. 14 Issue 6, p1-15, 15p

مصطلحات موضوعية: LABOR (Obstetrics), CHILDBIRTH, PREGNANT women, DISEASE risk factors, BIRTH rate, PREMATURE labor

مصطلحات جغرافية: PUERTO Rico

مستخلص: Preterm birth is a major public health problem, especially in Puerto Rico where the rates are among the highest observed worldwide, reaching 18% in 2011. The Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) study is an ongoing investigation of environmental factors that contribute to this condition. In the present analysis, we sought to examine common risk factors for preterm birth and other adverse birth outcomes which have not been characterized previously in this unique population. Pregnant women from the PROTECT cohort are recruited from the heavily contaminated Northern coast of the island of Puerto Rico and are free of pre-existing conditions like diabetes. We examined associations between basic demographic, behavioral (e.g., tobacco and alcohol use), and pregnancy (e.g., season and year of delivery) characteristics as well as municipality of residence in relation to preterm birth (<37 weeks gestation), postterm birth (≥41 weeks gestation), and small and large for gestational age in univariate and multivariate logistic regression models. Between 2011 and 2017, 1028 live singleton births were delivered as part of the PROTECT cohort. Of these, 107 (10%) were preterm. Preterm birth rates were higher among women with low socioeconomic status, as indicated by education level and income, and among women with high pre-pregnancy body mass index (BMI). Odds ratios of small for gestational age delivery were higher for women who reported tobacco use in pregnancy and lower for women who delivered in the hurricane and dengue season (July-October). Overall, in pregnant women residing in Puerto Rico, socioeconomic status was associated with preterm birth but few other factors were associated with this or other adverse outcomes of pregnancy. Research to understand environmental factors that could be contributing to the preterm birth epidemic in Puerto Rico is necessary. [ABSTRACT FROM AUTHOR]

: Copyright of PLoS ONE is the property of Public Library of Science 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: Mcintyre, SafinaHassan¹ (AUTHOR), Newburn-Cook, ChristineV.¹ (AUTHOR) christine.newburn-cook@ualberta.ca, O'Brien, Beverley¹ (AUTHOR), Demianczuk, NestorN.² (AUTHOR)

المصدر: Health Care for Women International. Aug2009, Vol. 30 Issue 8, p670-689. 20p. 1 Diagram.

مصطلحات موضوعية: *RISK factors in premature labor, *LABOR (Obstetrics), *MATERNAL age, *CHILDBIRTH in middle age, *CHILDBIRTH, *MOTHERS

مستخلص: To determine if older maternal age (35 years and older) at first birth was an independent risk factor for spontaneous preterm labor, we conducted a retrospective population-based cohort study. Using provincial perinatal data, we developed separate risk models for low- and high-risk women using multivariate logistic regression. We found that older maternal age exerted a direct and independent effect on spontaneous preterm labor for both nulliparous women with no preexisting chronic illnesses or pregnancy complications (low-risk) and nulliparous women who did not have any preexisting chronic illnesses, but developed one or more pregnancy complications (high-risk). [ABSTRACT FROM AUTHOR]

المؤلفون: Tracy, S. K.¹ stracy@ozemail.com.au, Tracy, M. B.², Dean, J.¹, Laws, P.¹, Sullivan, E.¹

المصدر: BJOG: An International Journal of Obstetrics & Gynaecology. Jun2007, Vol. 114 Issue 6, p731-735. 5p. 3 Charts.

مصطلحات موضوعية: *PREMATURE labor, *CHILDBIRTH, *PREGNANT women, *LABOR (Obstetrics), *SINGLE mothers

مصطلحات جغرافية: AUSTRALIA

مستخلص: Objectives To describe a 10-year trend in preterm birth. Design Population-based study. Setting Australia. Population All women who gave birth during 1994–03. Methods The proportion of spontaneous preterm births (greater than or equal to 22 weeks of gestation and less than 37 completed weeks of gestation) was calculated by dividing the number of women who had a live spontaneous preterm birth (excluding elective caesarean section and induction of labour) by the total number of women who had a live birth after spontaneous onset of labour (excluding elective caesarean section and induction of labour). This method was repeated for the selected population of women at low risk. Main outcome measure Preterm birth rates among the overall population of women; preterm birth among all women with a spontaneous onset of labour; and preterm birth in a selected population of women who were either primiparous or multiparous, non-Indigenous; aged 20–40 years and who gave birth to a live singleton baby after the spontaneous onset of labour. Results Over the 10-year study period, the proportion of all women having a live preterm birth in Australia increased by 12.1% (from 5.9% in 1994 to 6.6% in 2003). Among women with a spontaneous onset of labour, there was an increase of 18.3% (from 5.7 to 6.7%). Among the selected population of low-risk women after the spontaneous onset of labour, the rate increased by 10.7% (from 5.6 to 6.2%) among first time mothers and by 19.2% (4.4–5.2%) among selected multiparous women. Conclusions Over the 10-year period of 1994–03, the rate of spontaneous preterm birth among low-risk women having a live singleton birth has risen in Australia. [ABSTRACT FROM AUTHOR]

المؤلفون: Varner, Michael W.¹, Esplin, M. Sean¹

المصدر: BJOG: An International Journal of Obstetrics & Gynaecology. Mar2005 Supplement 1, Vol. 112, p28-31. 4p.

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

مستخلص: Several lines of evidence support a genetic predisposition to spontaneous preterm labour and preterm birth. Firstly, a leading risk factor for spontaneous preterm labour and preterm birth is a personal or family history. If a woman previously delivered preterm, her subsequent babies are also more likely to be born preterm. Women who experienced an early preterm birth (<32 completed weeks) in their first pregnancy have the highest rate of recurrent preterm birth in subsequent pregnancies. Spontaneous preterm labour and preterm birth in subsequent pregnancies tend to recur at equivalent gestational ages. If a woman herself was born preterm, she is also at an increased risk of spontaneous preterm labour and preterm birth, with the risks being highest for those women who themselves were born most preterm. This predisposition does not apply to men who were born preterm. Racial predispositions to preterm birth have also been observed. Black women suffer twice the rate of preterm birth compared with Caucasians, even when confounding social and economic variables are controlled. It is well established that upper genital tract infection and/or inflammation is seen in association with spontaneous preterm labour and preterm birth. Previous investigations have focussed primarily on an infectious aetiology for this finding. However, an alternative hypothesis has emerged, which suggests that this finding may represent an abnormal inflammatory response. The frequent association of spontaneous preterm labour and preterm birth with histological infection/inflammation and elevated body fluid concentrations of inflammatory cytokines has focussed investigations on single gene polymorphisms of these cytokines in both mother and fetus. The polymorphisms tumour necrosis factor-α-308 (TNF-α-308), interleukin-1β (IL-1β)+ 3953/3954 and IL-6–174 have been most consistently associated with spontaneous preterm labour and preterm birth. Toll-like receptors (TLRs) are important components of the innate immune systems, which have also been linked to spontaneous preterm labour and preterm birth. Both maternal and fetal polymorphisms of the TLR-4 gene have been associated with spontaneous preterm labour and preterm birth in certain populations, but in others no apparent link has been observed. These findings confirm a clear genetic predisposition to spontaneous preterm labour and preterm birth and raise hopes that patient-specific therapies may be developed in the future. [ABSTRACT FROM AUTHOR]

المؤلفون: Leitich, Harald¹, Kaider, Alexandra²

المصدر: BJOG: An International Journal of Obstetrics & Gynaecology. Apr2003 Supplement 1, Vol. 110, p66. 5p.

مصطلحات موضوعية: *PREMATURE labor, *CHILDBIRTH, *LABOR (Obstetrics), *PREGNANCY, *META-analysis

مستخلص: : ObjectiveTo determine the value of cervicovaginal fetal fibronectin as a marker for preterm delivery, a previously published meta-analysis was updated.: Study designSelection criteria confined the analysis to English-language original reports of prospective studies including women at <37 weeks'' gestation with intact amniotic membranes. For the outcomes of delivery <37 or <34 weeks'' gestation or delivery within 7, 14, or 21 days after fibronectin sampling, we calculated sensitivity and specificity rates for each study, for subgroups of studies, and for all studies combined.: ResultsA total of 40 studies were included. Statistical heterogeneity was seen in the majority of calculations of combined results and a random-effects model was used in these cases. For the outcomes of delivery <37 and <34 weeks'' gestation, overall sensitivity rates were 52% and 53%, and overall specificity rates were 85% and 89%, respectively. For the outcomes of delivery within 7, 14, and 21 days, we calculated sensitivity rates of 71%, 67%, and 59% and specificity rates of 89%, 89%, and 92%, respectively. For the subgroup of women with symptoms of preterm labour, sensitivity rates for delivery <37 and <34 weeks'' gestation or delivery within 7, 14, and 21 days of 54%, 63%, 77%, 74%, and 70% and specificity rates of 85%, 86%, 87%, 87%, and 90% were calculated.: ConclusionCervicovaginal fetal fibronectin is an effective short-term marker of preterm delivery, especially in women with symptoms of preterm labour. Because results appear to be heterogeneous in different studies, caution should be taken when they are applied to a specific population. [Copyright &y& Elsevier]