المؤلفون: Kennedy, Eilis¹ (AUTHOR) ekennedy@tavi-port.nhs.uk, O'Nions, Elizabeth¹ (AUTHOR), Wolke, Dieter² (AUTHOR), Johnson, Samantha³ (AUTHOR)

المصدر: Journal of the American Academy of Child & Adolescent Psychiatry. Sep2021, Vol. 60 Issue 9, p1066-1068. 3p.

مصطلحات موضوعية: *PREMATURE labor, *ADOLESCENT psychiatry, *CHILDBIRTH, *CHILD psychiatry, *HIGH-income countries, *RESEARCH, *PREMATURE infants, *RESEARCH methodology, *GESTATIONAL age, *MEDICAL cooperation, *EVALUATION research, *COMPARATIVE studies

مستخلص: Obstetric factors have long been recognized as risk factors for the later development of poor mental health. One of the most consistently reported of these associations is for preterm birth (birth before 37 weeks' gestation), a form of early adversity that impacts health and development across the life course. Preterm birth is not uncommon: in 2014, 10.6% of live births globally (nearly 15 million babies) were preterm.1 Advances in neonatal care since the early 1990s have dramatically increased the numbers of babies who survive extreme preterm birth (birth at <28 weeks' gestation) in high-income countries. This has led to growing interest in how extreme preterm birth impacts longer term outcomes including psychosocial development across the life span. [ABSTRACT FROM AUTHOR]

المؤلفون: Pradhan, Dinesh¹ (AUTHOR) dinesh.bhutan@gmail.com, Nishizawa, Yoriko¹ (AUTHOR), Chhetri, Hari P² (AUTHOR)

المصدر: Journal of Tropical Pediatrics. Apr2020, Vol. 66 Issue 2, p163-170. 8p.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *NEONATAL mortality, *CHILDBIRTH, *BIRTH rate, *PUBLIC hospitals, *CESAREAN section, *RESEARCH, *NEONATAL intensive care, *NEONATAL diseases, *RESEARCH methodology, *NEONATAL intensive care units, *FETAL growth retardation, *DISEASES, *EVALUATION research, *MEDICAL cooperation, *COMPARATIVE studies, *PREGNANCY complications, *MEDICAL referrals, *DISEASE prevalence, *INFANT mortality, *SMALL for gestational age

مصطلحات جغرافية: BHUTAN

مستخلص: Introduction: Preterm birth-related complications are the leading cause of under-5 mortality globally. Bhutan does not have a reliable preterm birth rate or data regarding outcome of preterm babies.Aim: To determine the preterm birth rate at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu, Bhutan, and assess their outcomes.Methods: All live preterm births at JDWNRH from 1 January 2017 to 31 December 2017 were followed from birth till hospital discharge. Maternal demographic data, pregnancy details and delivery details were collected. Morbidity and mortality information as well as discharge outcome were collected on babies admitted to neonatal intensive care unit (NICU).Results: Preterm birth rate among live births was 6.4%. Most mothers were younger than 30 years, housewives and had secondary education. Pregnancy registration rate and adequacy of antenatal visits were high. Most preterm births were singleton and the predominant mode of delivery was cesarean section. More than half of the births were initiated spontaneously, and the male:female ratio was 1.2:1. Most babies were late preterm and low birth weight. Half of them required NICU admission. Overall mortality rate was 11% and 21.6% for admitted preterm neonates. Preterm small-for-gestational-age neonates, and those born after provider-initiated preterm birth had significantly increased risk of mortality. Most preterm neonates were discharged without complications. The rate of extrauterine growth restriction was high.Conclusion: This is the first study on the prevalence of preterm births and their outcomes in the largest tertiary-care hospital in Bhutan. [ABSTRACT FROM AUTHOR]

المؤلفون: Crump, Casey^1,2 (AUTHOR) casey.crump@mssm.edu, Friberg, Danielle³ (AUTHOR), Li, Xinjun⁴ (AUTHOR), Sundquist, Jan^1,2,4 (AUTHOR), Sundquist, Kristina^1,2,4 (AUTHOR)

المصدر: International Journal of Epidemiology. Dec2019, Vol. 48 Issue 6, p2039-2049. 11p.

مصطلحات موضوعية: *PREMATURE labor, *SLEEP apnea syndromes, *CHILDBIRTH, *GESTATIONAL age, *NEUROBEHAVIORAL disorders, *COMPARATIVE studies, *PREMATURE infants, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL cooperation, *RESEARCH, *RESEARCH funding, *EVALUATION research, *PROPORTIONAL hazards models

مصطلحات جغرافية: SWEDEN

مستخلص: Background: Preterm birth (gestational age <37 weeks) has previously been associated with cardiometabolic and neuropsychiatric disorders into adulthood, but has seldom been examined in relation to sleep disorders. We conducted the first population-based study of preterm birth in relation to sleep-disordered breathing (SDB) from childhood into mid-adulthood.Methods: A national cohort study was conducted of all 4 186 615 singleton live births in Sweden during 1973-2014, who were followed for SDB ascertained from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth in relation to SDB while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed for potential confounding by unmeasured shared familial factors.Results: There were 171 100 (4.1%) persons diagnosed with SDB in 86.0 million person-years of follow-up. Preterm birth was associated with increased risk of SDB from childhood into mid-adulthood, relative to full-term birth (39-41 weeks) [adjusted hazard ratio (aHR), ages 0-43 years: 1.43; 95% confidence interval (CI), 1.40, 1.46; P <0.001; ages 30-43 years: 1.40; 95% CI, 1.34, 1.47; P <0.001]. Persons born extremely preterm (<28 weeks) had more than 2-fold risks (aHR, ages 0-43 years: 2.63; 95% CI, 2.41, 2.87; P <0.001; ages 30-43 years: 2.22; 95% CI, 1.64, 3.01; P <0.001). These associations affected both males and females, but accounted for more SDB cases among males (additive interaction, P = 0.003). Co-sibling analyses suggested that these findings were only partly due to shared genetic or environmental factors in families.Conclusions: Preterm-born children and adults need long-term follow-up for anticipatory screening and potential treatment of SDB. [ABSTRACT FROM AUTHOR]

المؤلفون: Bertholdt, Charline^1,2 charline.bertholdt@gmail.com, Menard, Sophie¹, Delorme, Pierre^1,3, Lamau, Marie‐Charlotte¹, Goffinet, François^1,3, Le Ray, Camille^1,3, Lamau, Marie-Charlotte⁴ (AUTHOR)

المصدر: Acta Obstetricia et Gynecologica Scandinavica. May2018, Vol. 97 Issue 5, p608-614. 7p.

مصطلحات موضوعية: *CESAREAN section, *PREMATURE labor, *PREGNANCY complications, *GESTATIONAL age, *CHILDBIRTH, *COMPARATIVE studies, *PREMATURE infants, *RESEARCH methodology, *MEDICAL cooperation, *RESEARCH, *SURGICAL complications, *LOGISTIC regression analysis, *EVALUATION research, *RETROSPECTIVE studies

مستخلص: Introduction: At the same time as survival is increasing among premature babies born before 26 weeks of gestation, the rates of cesarean deliveries before 26 weeks is also rising. Our purpose was to compare the frequency of intraoperative adverse events during cesarean deliveries in two gestational age groups: 24-25 weeks and 26-27 weeks.Material and Methods: This single-center retrospective cohort study included all women with cesarean deliveries performed before 28+0 weeks from 2007 through 2015. It compared the frequency of intraoperative adverse events between two groups: those at 24-25 weeks of gestation and at 26-27 weeks. Intraoperative adverse events were a classical incision, transplacental incision, difficulty in fetal extraction (explicitly mentioned in the surgical report), postpartum hemorrhage (≥500 mL of blood loss), and injury to internal organs. A composite outcome including at least one of these events enabled us to analyze the risk factors for intraoperative adverse events with univariate and multivariable analysis. Stratified analyses by the indication for the cesarean were performed.Results: We compared 74 cesarean deliveries at 24-25 weeks of gestation and 214 at 26-27 weeks. Intraoperative adverse events occurred at higher rates in the 24-25-week group (63.5 vs. 30.8%, p < 0.001). After adjustment for confounding factors, this group remained at significantly higher risk of intraoperative adverse events [adjusted odds ratio 5.04 (2.67-9.50)], even after stratification by indication for the cesarean.Conclusion: These results should help obstetricians and women making decisions about cesarean deliveries at these extremely low gestational ages. [ABSTRACT FROM AUTHOR]

المؤلفون: van Zijl, Maud D.¹, Koullali, Bouchra¹, Oudijk, Martijn A.¹, Kazemier, Brenda M.¹, Pajkrt, Eva¹, Naaktgeboren, Christiana A.^1,2, Vollebregt, Karlijn C.³, Muller, Moira A.⁴, Bekker, Mireille N.⁵, Brons, Jozien T. J.⁶, Sueters, Marieke⁷, Langenveld, Josje⁸, Franssen, Maureen T.⁹, Schuitemaker, Nico W.¹⁰, van Beek, Erik¹¹, Scheepers, Hubertina C. J.¹², Schuit, Ewoud², de Boer, Karin¹³, Tepe, Eveline M.¹⁴, Huisjes, Anjoke J. M.¹⁵

المصدر: BMC Pregnancy & Childbirth. 9/4/2017, Vol. 17, p1-8. 8p.

مصطلحات موضوعية: *PREMATURE labor, *MULTIPLE birth, *CHILDBIRTH, *PROGESTERONE, *PROGESTERONE receptors, *CERVIX uteri, *CERVIX uteri diseases, *COMPARATIVE studies, *FETAL ultrasonic imaging, *PREMATURE infants, *RESEARCH methodology, *EVALUATION of medical care, *MEDICAL cooperation, *MEDICAL protocols, *PESSARIES, *PREGNANCY, *PROGESTATIONAL hormones, *RESEARCH, *VAGINAL medication, *EVALUATION research, *RANDOMIZED controlled trials, *TREATMENT effectiveness, *DISEASE complications, *PREVENTION

مستخلص: Background: Preterm birth is in quantity and in severity the most important topic in obstetric care in the developed world. Progestogens and cervical pessaries have been studied as potential preventive treatments with conflicting results. So far, no study has compared both treatments.Methods/design: The Quadruple P study aims to compare the efficacy of vaginal progesterone and cervical pessary in the prevention of adverse perinatal outcome associated with preterm birth in asymptomatic women with a short cervix, in singleton and multiple pregnancies separately. It is a nationwide open-label multicentre randomized clinical trial (RCT) with a superiority design and will be accompanied by an economic analysis. Pregnant women undergoing the routine anomaly scan will be offered cervical length measurement between 18 and 22 weeks in a singleton and at 16-22 weeks in a multiple pregnancy. Women with a short cervix, defined as less than, or equal to 35 mm in a singleton and less than 38 mm in a multiple pregnancy, will be invited to participate in the study. Eligible women will be randomly allocated to receive either progesterone or a cervical pessary. Following randomization, the silicone cervical pessary will be placed during vaginal examination or 200 mg progesterone capsules will be daily self-administered vaginally. Both interventions will be continued until 36 weeks gestation or until delivery, whichever comes first. Primary outcome will be composite adverse perinatal outcome of perinatal mortality and perinatal morbidity including bronchopulmonary dysplasia, intraventricular haemorrhage grade III and IV, periventricular leukomalacia higher than grade I, necrotizing enterocolitis higher than stage I, Retinopathy of prematurity (ROP) or culture proven sepsis. These outcomes will be measured up until 10 weeks after the expected due date. Secondary outcomes will be, among others, time to delivery, preterm birth rate before 28, 32, 34 and 37 weeks, admission to neonatal intensive care unit, maternal morbidity, maternal admission days for threatened preterm labour and costs.Discussion: This trial will provide evidence on whether vaginal progesterone or a cervical pessary is more effective in decreasing adverse perinatal outcome in both singletons and multiples.Trial Registration: Trial registration number: NTR 4414 . Date of registration January 29th 2014. [ABSTRACT FROM AUTHOR]

المؤلفون: Heiring, Christian, Verder, Henrik, Schousboe, Peter, Jessen, Torben E., Bender, Lars, Ebbesen, Finn, Dahl, Marianne, Eschen, Christian, Fenger‐Grøn, Jesper, Höskuldsson, Agnar, Matthews, Morgaine, Reinholdt, Jes, Scoutaris, Nikolaos, Smedegaard, Heidi, Fenger-Grøn, Jesper

المصدر: Acta Paediatrica; Feb2020, Vol. 109 Issue 2, p285-290, 6p

مصطلحات موضوعية: RESPIRATORY distress syndrome, CHILDBIRTH, PREMATURE infants, PULMONARY surfactant, PREMATURE labor, RESEARCH, RESEARCH methodology, MEDICAL cooperation, EVALUATION research, COMPARATIVE studies, RESEARCH funding, LECITHIN, SPECTRUM analysis

مستخلص: Aim: To evaluate the accuracy of our new rapid point-of-care (POC) test for lung maturity. The method as we describe in an accompanying article was developed with the purpose of improving the outcome from respiratory distress syndrome (RDS). The test enables the delivery of surfactant in infants with immature lungs already at birth and ensures that infants with mature lungs are not treated unnecessarily.Methods: Fresh gastric aspirate (GAS) was sampled at birth in a cohort of preterm infants with gestational ages ranging between 24 and 31 completed weeks for lung surfactant measurement as lecithin-sphingomyelin ratio (L/S). L/S was prospectively compared with RDS development. The clinical outcome was blinded for the investigators of L/S. The time for analysis was <15 minutes.Results: GAS was obtained from 72 infants. Forty-four (61%) developed RDS. The cut-off for L/S was 3.05; predicting RDS with a sensitivity of 91% and specificity of 79%.Conclusion: The new improved spectroscopic L/S method of lung maturity on GAS has high sensitivity. The method is designed for use as a POC test at birth, and a spectroscopic prototype has been developed for bedside use. Clinical trials with this new lung maturity test are planned. [ABSTRACT FROM AUTHOR]

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المؤلفون: Litwinska, E., Syngelaki, A., Cimpoca, B., Sapantzoglou, I., Nicolaides, K. H.

المصدر: Ultrasound in Obstetrics & Gynecology; Feb2020, Vol. 55 Issue 2, p189-197, 9p

مصطلحات موضوعية: PREGNANCY, LASER endoscopy, CHILDBIRTH, PREGNANCY tests, PREMATURE labor, RESEARCH, PREMATURE infants, RESEARCH methodology, FETAL development, TWINS, RETROSPECTIVE studies, GESTATIONAL age, MEDICAL cooperation, EVALUATION research, PREGNANCY outcomes, RISK assessment, PERINATAL death, COMPARATIVE studies, BIRTH weight, RESEARCH funding, MULTIPLE pregnancy, FETAL ultrasonic imaging, SMALL for gestational age, LONGITUDINAL method

مستخلص: Objective: To investigate the value of intertwin discordance in fetal crown-rump length (CRL) at the 11-13-week scan in the prediction of adverse outcome in dichorionic (DC), monochorionic diamniotic (MCDA) and monochorionic monoamniotic (MCMA) twin pregnancies.Methods: This was a retrospective analysis of prospectively collected data on twin pregnancies undergoing routine ultrasound examination at 11-13 weeks' gestation between 2002 and 2019. In pregnancies with no major abnormalities, we examined the value of intertwin discordance in fetal CRL in DC, MCDA and MCMA twins in the prediction of fetal loss at < 20 and < 24 weeks' gestation, perinatal death at ≥ 24 weeks, preterm delivery at < 32 and < 37 weeks, birth of at least one small-for-gestational-age (SGA) neonate with birth weight < 5th percentile and intertwin birth-weight discordance of ≥ 20% and ≥ 25%.Results: First, the study population of 6225 twin pregnancies included 4896 (78.7%) DC, 1274 (20.4%) MCDA and 55 (0.9%) MCMA twin pregnancies. Second, median CRL discordance in DC twin pregnancies (3.2%; interquartile range (IQR), 1.4-5.8%) was lower than in MCDA twins (3.6%; IQR, 1.6-6.2%; P = 0.0008), but was not significantly different from that in MCMA twins (2.9%; IQR, 1.2-5.1%; P = 0.269). Third, compared to CRL discordance in DC twin pregnancies with two non-SGA live births at ≥ 37 weeks' gestation, there was significantly larger CRL discordance in both DC and MCDA twin pregnancies complicated by fetal death at < 20 and < 24 weeks' gestation, perinatal death at ≥ 24 weeks, preterm birth at < 32 and < 37 weeks, birth of at least one SGA neonate and birth-weight discordance ≥ 20% and ≥ 25%, and in MCDA twin pregnancies undergoing endoscopic laser surgery. Fourth, the predictive performance of CRL discordance for each adverse pregnancy outcome was poor, with areas under the receiver-operating-characteristics curves ranging from 0.533 to 0.624. However, in both DC and MCDA twin pregnancies with large CRL discordance, there was a high risk of fetal loss. Fifth, in DC twin pregnancies, the overall rate of fetal loss at < 20 weeks' gestation was 1.3% but, in the small subgroup with CRL discordance of ≥ 15%, which constituted 1.9% of the total, the rate increased to 5.3%. Sixth, in MCDA twin pregnancies, the rate of fetal loss or endoscopic laser surgery at < 20 weeks was about 11%, but, in the small subgroups with CRL discordance of ≥ 10%, ≥ 15% and ≥ 20%, which constituted 9%, < 3% and < 1% of the total, the risk was increased to about 32%, 49% and 70%, respectively. Seventh, in MCMA twin pregnancies, there were no significant differences in CRL discordance for any of the adverse outcome measures, but this may be the consequence of the small number of cases in the study population.Conclusions: In both DC and MCDA twin pregnancies, increased CRL discordance is associated with an increased risk of fetal death at < 20 and < 24 weeks' gestation, perinatal death at ≥ 24 weeks, preterm birth at < 37 and < 32 weeks, birth of at least one SGA neonate and birth-weight discordance ≥ 20% and ≥ 25%, but CRL discordance is a poor screening test for adverse pregnancy outcome. However, in DC twins, CRL discordance of ≥ 15% is associated with an increased risk of fetal loss at < 20 and < 24 weeks' gestation and, in MCDA twins, CRL discordance of ≥ 10%, and more so discordance of ≥ 15% and ≥ 20%, is associated with a very high risk of fetal loss or endoscopic laser surgery at < 20 and < 24 weeks and this information is useful in counseling women and defining the timing for subsequent assessment and possible intervention. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

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المؤلفون: Barbuscia, Anna, Martikainen, Pekka, Myrskylä, Mikko, Remes, Hanna, Somigliana, Edgardo, Klemetti, Reija, Goisis, Alice

المصدر: Human Reproduction; Jan2020, Vol. 35 Issue 1, p212-220, 9p, 3 Charts, 2 Graphs

مصطلحات موضوعية: MATERNAL age, REPRODUCTIVE technology, PREMATURE labor, CHILDBIRTH, LOW birth weight, RESEARCH, PREMATURE infants, RESEARCH methodology, ACQUISITION of data, MEDICAL cooperation, EVALUATION research, COMPARATIVE studies

مصطلحات جغرافية: FINLAND

مستخلص: Study Question: Does the risk of low birth weight and premature birth increase with age among mothers who conceive through medically assisted reproduction (MAR)?Summary Answer: Among MAR mothers, the risk of poorer birth outcomes does not increase with maternal age at birth except at very advanced maternal ages (40+).What Is Known Already: The use of MAR treatments has been increasing over the last few decades and is especially diffused among women who conceive at older ages. Although advanced maternal age is a well-known risk factor for adverse birth outcomes in natural pregnancies, only a few studies have directly analysed the maternal age gradient in birth outcomes for MAR mothers.Study Design, Size, Duration: The base dataset was a 20% random sample of households with at least one child aged 0-14 at the end of 2000, drawn from the Finnish population register and other administrative registers. This study included children who were born in 1995-2000, because the information on whether a child was conceived through MAR or naturally was available only from 1995 onwards.Participants/materials, Setting, Methods: The outcome measures were whether the child had low birth weight (LBW, <2500 g at birth) and whether the child was delivered preterm (<37 weeks of gestation). Conceptions through MAR were identified by examining data on purchases of prescription medication from the National Prescription Register. Linear probability models were used to analyse and compare the maternal age gradients in birth outcomes of mothers who conceived through MAR or naturally before and after adjustment for maternal characteristics (i.e. whether the mother suffered from acute/chronic conditions before the pregnancy, household income and whether the mother smoked during pregnancy).Main Results and the Role Of Chance: A total of 56 026 children, 2624 of whom were conceived through MAR treatments, were included in the study. Among the mothers who used MAR to conceive, maternal age was not associated with an increased risk of LBW (the overall prevalence was 12.6%) at ages 25-39. For example, compared to the risk of LBW at ages 30-34, the risk was 0.22 percentage points lower (95% CI: -3.2, 2.8) at ages 25-29 and was 1.34 percentage points lower (95% CI: -4.5, 1.0) at ages 35-39. The risk of LBW was increased only at maternal ages ≥40 (six percentage points, 95% CI: 0.2, 12). Adjustment for maternal characteristics only marginally attenuated these associations. In contrast, among the mothers who conceived naturally, the results showed a clear age gradient. For example, compared to the risk of LBW (the overall prevalence was 3.3%) at maternal ages 30-34, the risk was 1.1 percentage points higher (95% CI: 0.6, 1.6) at ages 35-39 and was 1.5 percentage points higher (95% CI: 0.5, 2.6) at ages ≥40. The results were similar for preterm births.Limitations, Reason For Caution: A limited number of confounders were included in the study because of the administrative nature of the data used. Our ability to reliably distinguish mothers based on MAR treatment type was also limited.Wider Implications Of the Findings: This is the first study to analyse the maternal age gradient in the risk of adverse birth outcomes among children conceived through MAR using data from a nationally representative sample and controlling for important maternal health and socio-economic characteristics. This topic is of considerable importance in light of the widespread and increasing use of MAR treatments.Study Funding/competing Interest(s): Funding for this project was provided by the European Research Council (grant no. 803959 MARTE to Alice Goisis and grant no. 336475 COSTPOST to Mikko Myrskylä). E.S. reports personal fees from Theramex, personal fees from Merck Serono, personal fees from Health Reimbursement Arrangement, non-financial support from Merck Serono and grants from Ferring, grants from Theramex, outside the submitted work. The remaining authors have no competing interests.Trial Registrtion Number: N/A. [ABSTRACT FROM AUTHOR]

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المؤلفون: Shachar, BZ, Mayo, JA, Lyell, DJ, Baer, RJ, Jeliffe‐Pawlowski, LL, Stevenson, DK, Shaw, GM

المصدر: BJOG: An International Journal of Obstetrics & Gynaecology; Nov2016, Vol. 123 Issue 12, p2009-2017, 9p

مصطلحات موضوعية: PREGNANCY, PREGNANCY complications, CHILDBIRTH, MOTHER-child relationship, PREMATURE labor, ABORTION, BIRTH intervals, COMPARATIVE studies, GESTATIONAL age, PREMATURE infants, INFANT mortality, LONGITUDINAL method, MATERNAL age, RESEARCH methodology, EVALUATION of medical care, MEDICAL cooperation, OBESITY, PERINATAL death, RESEARCH, EVALUATION research, BODY mass index, DISEASE incidence, RETROSPECTIVE studies

مصطلحات جغرافية: CALIFORNIA

مستخلص: Objectives: We assessed whether interpregnancy interval (IPI) length after live birth and after pregnancy termination was associated with preterm birth (PTB).Design: Multiyear birth cohort.Settings: Fetal death, birth and infant death certificates in California merged with Office of Statewide Health Planning and Development.Population: One million California live births (2007-10) after live birth and after pregnancy termination.Methods: Logistic regression was used to estimate odds ratios (ORs) of PTB of 20-36 weeks of gestation and its subcategories for IPIs after a live birth and after a pregnancy termination. We used conditional logistic regression (two IPIs/mother) to investigate associations within mothers.Main Outcome Measure: PTB relative to gestations of ≥ 37 weeks.Results: Analyses included 971 211 women with IPI after live birth, and 138 405 women with IPI after pregnancy termination with 30.6% and 74.6% having intervals of <18 months, respectively. IPIs of <6 months or 6-11 months after live birth showed increased odds of PTB adjusted ORs for PTB of 1.71 (95% CI 1.65-1.78) and 1.20 (95% CI 1.16-1.24), respectively compared with intervals of 18-23 months. An IPI >36 months (versus 18-23 months) was associated with increased odds for PTB. Short IPI after pregnancy termination showed a decreased OR of 0.87 (95% CI 0.81-0.94). The within-mother analysis showed the association of increased odds of PTB for short IPI, but not for long IPI.Conclusions: Women with IPI <1 or >3 years after a live birth were at increased odds of PTB-an important group for intervention to reduce PTB. Short IPI after pregnancy termination was associated with reduced odds for PTB and needs to be further explored.Tweetable Abstract: Short and long IPI after live birth, but not after pregnancy termination, showed increased odds for PTB. [ABSTRACT FROM AUTHOR]

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المؤلفون: Buil, Aude¹ (AUTHOR) audebuil11@gmail.com, Sankey, Carole¹ (AUTHOR) csankey@gmail.com, Caeymaex, Laurence² (AUTHOR) laurence.caeymaex@chicreteil.fr, Apter, Gisèle³ (AUTHOR) gisele.apter@gmail.com, Gratier, Maya⁴ (AUTHOR) gratier@gmail.com, Devouche, Emmanuel^1,3 (AUTHOR) devouche7@gmail.com

المصدر: Early Human Development. Feb2020, Vol. 141, pN.PAG-N.PAG. 1p.

مصطلحات موضوعية: *PREMATURE infants, *PREMATURE labor, *MOTHER-infant relationship, *INFANTS, *CHILDBIRTH, *MOTHERS, *RETROLENTAL fibroplasia, *RESEARCH, *NONVERBAL communication, *EYE movements, *HUMAN voice, *RESEARCH methodology, *MEDICAL cooperation, *EVALUATION research, *COMPARATIVE studies, *PSYCHOSOCIAL factors, *POSTNATAL care, *MOTHER-child relationship, *FOSTER home care

مستخلص: Background: Skin-to-skin contact (SSC) has been widely studied in NICU and several meta-analyses have looked at its benefits both for the baby and the parent. Very few studies however have investigated benefit for communication.Aims: Investigate the immediate benefits of Supported Diagonal Flexion (SDF) positioning during SSC on the quality of mother - very-preterm infant communication and to gain insight into how mothers' and very-preterm infants' communicative behaviours are coordinated in time just a few days after birth.Subjects and Study Design: Monocentric prospective matched-pair case-control study. Thirty-four mothers and their very preterm infants (27 to 31 + 6 weeks GA; mean age at birth 30: weeks GA) were assigned to one of the two SSC positioning, either the Vertical Control (n = 17) or the SDF Intervention positioning (n = 17). Mother and infant were filmed during the first 5 min of SSC, 15 days after the very first SSC (i.e. 18 days after very premature birth, i.e. on average 32.4 weeks GA).Outcome Measures: Infants' state of consciousness according to the Assessment of Preterm Infants' Behavior scale. Onset and duration of infants' and mothers' smiles, gazes and vocalizations, and their temporal proximity inside a 1-sec time-window.Results: In the SDF Intervention Group, very preterm infants vocalized three times more and mothers vocalized, gazed at their baby's face, and smiled more than in the Vertical Control Group. Moreover, in a one-second time-frame, temporal proximity of mother-infant behaviours was greater in the SDF Intervention Group.Conclusions: Our study shows that SDF positioning creates more opportunities for mother-infant communication during SSC. SDF positioning fosters a greater multimodal temporal proximity thus supporting a more qualitative mother-infant communication. [ABSTRACT FROM AUTHOR]