المؤلفون: Jacobsson, Bo^1,2,3 (AUTHOR) bo.jacobsson@obgyn.gu.se, Simpson, Joe Leigh⁴ (AUTHOR), Norman, Jane (AUTHOR), Grobman, William (AUTHOR), Bianchi, Ana (AUTHOR), Munjanja, Stephen (AUTHOR), González, Catalina María Valencia (AUTHOR), Mol, Ben W. (AUTHOR), Shennan, Andrew (AUTHOR), FIGO Working Group for Preterm Birth (CORPORATE AUTHOR)

المصدر: International Journal of Gynecology & Obstetrics. Oct2021, Vol. 155 Issue 1, p1-4. 4p.

مصطلحات موضوعية: *CERVICAL cerclage, *PREMATURE labor, *CHILDBIRTH, *PLACENTA praevia, *INFERTILITY, *MULTIPLE pregnancy, *UMBILICAL cord clamping, *BEST practices, *PREMATURE infants

المؤلفون: Berezowsky, Alexandra¹ (AUTHOR), Mazkereth, Ram² (AUTHOR), Ashwal, Eran¹ (AUTHOR), Mazaki-Tovi, Shali¹ (AUTHOR), Schiff, Eyal¹ (AUTHOR), Weisz, Boaz¹ (AUTHOR), Lipitz, Shlomo¹ (AUTHOR), Yinon, Yoav¹ (AUTHOR) yoav.yinon27@gmail.com

المصدر: Journal of Maternal-Fetal & Neonatal Medicine. Apr2016, Vol. 29 Issue 8, p1252-1256. 5p.

مصطلحات موضوعية: *TWINS, *RISK factors in premature labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *DURATION of pregnancy, *GESTATIONAL age, *HOSPITAL admission & discharge, *HYPOTHERMIA, *PREMATURE infants, *NEONATAL jaundice, *LONGITUDINAL method, *MULTIPLE pregnancy, *NEONATAL intensive care, *OXYGEN therapy, *PATIENTS, *PHOTOTHERAPY, *RESPIRATORY distress syndrome, *NEONATAL intensive care units, *RETROSPECTIVE studies

مصطلحات جغرافية: ISRAEL

مستخلص: Objective: To determine the neonatal outcome at late prematurity of uncomplicated monochorionic (MC) twin pregnancies.Methods: A retrospective cohort study of 166 patients with uncomplicated MC diamniotic twins delivered between 34 and 37 weeks of gestation at a single tertiary center. The study population was classified into four groups according to the gestational age at delivery: (1) 34 weeks, (2) 35 weeks, (3) 36 weeks and (4) 37 weeks. Neonatal outcome measures were compared between the groups.Results: Neonatal morbidity was significantly higher at 34 weeks of gestation compared to the other three groups including respiratory distress syndrome, oxygen requirement, hypothermia and hyperbilirubinemia. Moreover, the rate of admission to the special care unit and need for phototherapy were significantly higher in newborns born at 36 weeks compared to 37 weeks of gestation (p = 0.02 and 0.03 respectively). Multiple regression analysis revealed that the risk for adverse neonatal outcome was significantly associated with gestational age at delivery. Of note, there were no fetal or neonatal deaths in our cohort.Conclusions: The risk of neonatal morbidity of uncomplicated MC twins delivered at 34-37 weeks of gestation significantly decreases with advanced gestation. Therefore, under close fetal surveillance, uncomplicated MC twin pregnancies should be delivered at 37 weeks of gestation. [ABSTRACT FROM AUTHOR]

المؤلفون: Passini Jr, Renato¹ passini@caism.unicamp.br, Cecatti, Jose G.^1,2, Lajos, Giuliane J.¹, Tedesco, Ricardo P.^1,3, Nomura, Marcelo L.¹, Dias, Tabata Z.¹, Haddad, Samira M.¹, Rehder, Patricia M.¹, Pacagnella, Rodolfo C.¹, Costa, Maria L.¹, Sousa, Maria H.²

المصدر: PLoS ONE. Oct2014, Vol. 9 Issue 10, p1-12. 12p.

مصطلحات موضوعية: *PREMATURE infants, *PREMATURE labor, *CHILDBIRTH, *HEALTH facilities, *MULTIPLE pregnancy

مصطلحات جغرافية: BRAZIL

مستخلص: Background: Preterm birth rate is increasing and is currently a worldwide concern. The purpose of this study was to estimate the prevalence of preterm birth in a sample of health facilities in Brazil and to identify the main risk factors associated with spontaneous preterm births. Methods and Findings: This was a multicentre cross sectional study on preterm births in 20 referral obstetric hospitals with a case-control component to identify factors associated with spontaneous preterm birth. Surveillance was implemented at all centres to identify preterm births. For eligible consenting women, data were collected through a post-delivery questionnaire completed with information from all mother-newborn medical records until death or discharge or at a maximum of 60 days post-delivery, whichever came first. The risk of spontaneous preterm birth was estimated with OR and 95%CI for several predictors. A non-conditional logistic regression analysis was then performed to identify independently associated factors. The overall prevalence of preterm birth was 12.3%. Among them, 64.6% were spontaneous and 35.4% therapeutic. In the case-control component, 2,682 spontaneous preterm births were compared to a sample of 1,146 term births. Multivariate analyses identified the following as risk factors for spontaneous preterm birth among women with at least one previous birth: a previous preterm birth (ORadj = 3.19, 2.30–4.43), multiple pregnancy (ORadj = 29.06, 8.43–100.2), cervical insufficiency (ORadj = 2.93, 1.07–8.05), foetal malformation (ORadj = 2.63, 1.43–4.85), polyhydramnios (ORadj = 2.30, 1.17–4.54), vaginal bleeding (ORadj = 2.16, 1.50–3.11), and previous abortion (ORadj = 1.39, 1.08–1.78). High BMI (ORadj = 0.94, 0.91–0.97) and weight gain during gestation (ORadj = 0.92, 0.89–0.95) were found to be protective factors. Conclusions: The preterm birth rate in these health facilities in Brazil is high and spontaneous preterm births account for two thirds of them. A better understanding of the factors associated with spontaneous preterm birth is of utmost importance for planning effective measures to reduce the burden of its increasing rates. [ABSTRACT FROM AUTHOR]

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: Subbaraman, Meenakshi S., Roberts, Sarah C. M.

المصدر: PLoS ONE; 5/8/2019, Vol. 14 Issue 5, p1-7, 7p

مصطلحات موضوعية: ALCOHOL drinking, VITAL statistics, PREGNANCY, CHILDBIRTH, MULTIPLE pregnancy, PREMATURE labor

مصطلحات جغرافية: UNITED States

مستخلص: Background and objective: As of 2016, 43 US states have policies regarding alcohol use during pregnancy. A recent study found that out of eight state-level alcohol/pregnancy policies, six are significantly associated with poorer birth outcomes, and two are not associated with any outcomes. Here we estimate the excess numbers of low birthweight (LBW) and preterm births (PTB) related to these policies and their associated additional costs in the first year of life. Methods: Cost study using birth certificate data for 155,446,714 singleton live births in the United States between 1972–2015. Exposures were state- and month/year-specific indicators of having each of eight alcohol/pregnancy policies in place. Outcomes were excess numbers of LBW and PTB and associated costs in the first year of life. Fixed effects regressions with state-specific time trends were used for statistical analyses in 2018. Results: In 2015, policies mandating warning signs were associated with an excess of 7,375 LBW; policies defining alcohol use during pregnancy as child abuse/neglect were associated with an excess of 12,372 PTB; these excess adverse outcomes are associated with additional costs of $151,928,002 and $582,698,853 in the first year of life, respectively. Conclusions: Multiple state-level alcohol pregnancy policies lead to increased prevalence of LBW and PTB, which cost hundreds of millions of dollars annually. Policymakers should consider adverse public health impacts of alcohol/pregnancy policies before expanding extant policies to new substances or adopting existing policies in new states. [ABSTRACT FROM AUTHOR]

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المؤلفون: Blondel, B.¹ blondel@vjf.inserm.fr, MacFarlane, A.², Gissler, M.³, Breart, G.¹, Zeitlin, J.¹

المصدر: BJOG: An International Journal of Obstetrics & Gynaecology. May2006, Vol. 113 Issue 5, p528-535. 8p. 4 Charts, 1 Graph.

مصطلحات موضوعية: *PREMATURE labor, *MULTIPLE pregnancy, *CHILDBIRTH, *CESAREAN section, *DELIVERY (Obstetrics)

مستخلص: Objective To compare rates of preterm birth among multiple births in European countries, to estimate their contribution to overall preterm birth rates and to explore factors which could explain differences between preterm birth rates. Design Analyses of data from vital statistics, birth registers or national samples of births. Setting Eleven member states of the European Union. Population All live births or representative samples of births at national or regional level for the year 2000 or most recent year. Methods Description of rates of preterm birth before 37 and 32 weeks, estimation of population attributable risks (PAR), study of associations between preterm birth rates in multiples and singletons and nonspontaneous labour using Spearman's rank correlation coefficient. Main outcome measures Preterm birth rates, PAR, proportions of deliveries with nonspontaneous onset (caesarean sections before labour or induction of labour). Results The proportion of multiple births before 37 weeks varied from 68.4% in Austria to 42.2% in the Republic of Ireland. In half of the countries, over 20% of all preterm births were attributable to multiple births. A strong association was found between the proportions of births before 37 weeks among multiple and singleton births ( r= 0.81; P < 0.001). An association was observed between the rates of preterm birth and the proportions of deliveries with nonspontaneous onset among twins. Conclusions Wide variations in rates of preterm births and deliveries with nonspontaneous onset were found between countries, suggesting marked differences in clinical practice which could have long-term implications for the health of children from multiple births. [ABSTRACT FROM AUTHOR]

المؤلفون: Gilbert, Clare E., Dawes, Lisa, Wise, Michelle, Darlow, Brian A.

المصدر: Acta Obstetricia et Gynecologica Scandinavica; Dec2019, Vol. 98 Issue 12, p1497-1499, 3p

مصطلحات موضوعية: CERVICAL cerclage, UMBILICAL cord clamping, PREMATURE infants, NEONATAL mortality, RETROLENTAL fibroplasia, BIRTHING centers, PREMATURE labor, MULTIPLE pregnancy, CHILDBIRTH

مستخلص: Retinopathy of prematurity (ROP) is a potentially blinding condition of preterm infants who have received neonatal care.[1] The blindness is usually bilateral and irreversible. Blindness from ROP is now largely controlled in highly resourced countries where neonatal care is generally of high quality, and preterm infants are screened for ROP and treated if necessary. [Extracted from the article]

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المؤلفون: Fuchs, Florent, Monet, Barbara, Ducruet, Thierry, Chaillet, Nils, Audibert, Francois

المصدر: PLoS ONE; 1/31/2018, Vol. 13 Issue 1, p1-10, 10p

مصطلحات موضوعية: MATERNAL age, PREGNANCY, PREMATURE labor, CHILDBIRTH, MULTIPLE pregnancy, PREGNANCY complications

مستخلص: Background: Maternal age at pregnancy is increasing worldwide as well as preterm birth. However, the association between prematurity and advanced maternal age remains controversial. Objective: To evaluate the impact of maternal age on the occurrence of preterm birth after controlling for multiple known confounders in a large birth cohort. Study design: Retrospective cohort study using data from the QUARISMA study, a large Canadian randomized controlled trial, which collected data from 184,000 births in 32 hospitals. Inclusion criteria were maternal age over 20 years. Exclusion criteria were multiple pregnancy, fetal malformation and intra-uterine fetal death. Five maternal age categories were defined and compared for maternal characteristics, gestational and obstetric complications, and risk factors for prematurity. Risk factors for preterm birth <37 weeks, either spontaneous or iatrogenic, were evaluated for different age groups using multivariate logistic regression. Results: 165,282 births were included in the study. Chronic hypertension, assisted reproduction techniques, pre-gestational diabetes, invasive procedure in pregnancy, gestational diabetes and placenta praevia were linearly associated with increasing maternal age whereas hypertensive disorders of pregnancy followed a “U” shaped distribution according to maternal age. Crude rates of preterm birth before 37 weeks followed a “U” shaped curve with a nadir at 5.7% for the group of 30–34 years. In multivariate analysis, the adjusted odds ratio (aOR) of prematurity stratified by age group followed a “U” shaped distribution with an aOR of 1.08 (95%CI; 1.01–1.15) for 20–24 years, and 1.20 (95% CI; 1.06–1.36) for 40 years and older. Confounders found to have the greatest impact were placenta praevia, hypertensive complications, and maternal medical history. Conclusion: Even after adjustment for confounders, advanced maternal age (40 years and over) was associated with preterm birth. A maternal age of 30–34 years was associated with the lowest risk of prematurity. [ABSTRACT FROM AUTHOR]

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العنوان البديل: Procena rizika od cerebralne paralize kod dece začete vantelesnim oplođenjem – uloga višestruke trudnoće i prevremenog rođenja. (Romanian)

المؤلفون: Milićević, Milena, Potić, Srećko

المصدر: Acta Facultatis Medicae Naissensis; Jun2015, Vol. 32 Issue 2, p101-113, 13p

مصطلحات موضوعية: CEREBRAL palsy, MULTIPLE pregnancy, HEALTH risk assessment, PREMATURE labor, CHILDBIRTH, INFERTILITY treatment

الملخص (بالإنجليزية): For more than three decades, assisted reproductive techniques (ART) have been used as effective treatments to overcome infertility. Since then, numerous studies have been focused on different aspects of long-term health and development of children born after assisted conception. The aim of this paper is to summarize new data on multiple pregnancy and preterm delivery as one of the risk factors which might increase the risk of developing cerebral palsy (CP) in children born after assisted conception. A comprehensive search of eight databases retrieved 108 papers, 10 of which met inclusion criteria and were relevant for this review. Despite the dissimilarities in methodological and analytic approaches in the selected studies, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are generally considered safe, still there is an ongoing discussion whether multiple pregnancy and preterm delivery increase or do not increase the risk of CP in children born after assisted conception. All information about possible adverse maternal and/or infant outcomes should be made available to the couples seeking ART treatment. [ABSTRACT FROM AUTHOR]

Abstract (Romanian): Postupci biomedicinski potpomognutog oplođenja efikasno se primenjuju u lečenju neplodnosti već više od tri decenije. Od tada su objavljena brojna istraživanja različitih aspekata dugoročnog zdravlja i razvoja dece rođene iz trudnoća začetih ovim postupcima. Cilj ovog rada bio je da se sumiraju novi podaci o višestrukim trudnoćama i prevremenom rađanju koji mogu da povećaju rizik od razvijanja kliničke slike cerebralne paralize (CP) kod dece rođene iz trudnoća začetih postupcima vantelesnog oplođenja. Sveobuhvatnom pretragom osam baza podataka preuzeto je 108 radova, od kojih je 10 ispunilo kriterijume za uključivanje i bilo relevantno za ovaj pregled. Uprkos metodološkim i analitičkim razlikama prisutnim u odabranim studijama, fertilizacija in vitro (IVF) i intracitoplazmatsko ubrizgavanje spermatozoida (ICSI) generalno se smatraju bezbednim. Ipak, glavno pitanje koje i dalje preovladava u naučnim diskusijama jeste da li višestruke trudnoće i prevremeno rođenje povećavaju ili ne povećavaju rizik od CP kod ove dece. Potrebno je da sve informacije o mogućim neželjenim ishodima po majku i/ili dete budu dostupne parovima uključenim u program vantelesne oplodnje. [ABSTRACT FROM AUTHOR]

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المؤلفون: Bryan, Elizabeth

المصدر: BJOG: An International Journal of Obstetrics & Gynaecology; Apr2003 Supplement 1, Vol. 110, p24, 5p

مصطلحات موضوعية: MULTIPLE pregnancy, CHILDBIRTH, MENSTRUAL cycle, PREMATURE infants, PREMATURE labor

مستخلص: Multiple births are important contributors to the preterm and low birthweight population and the numbers of twin births have been steadily rising since the early 1980s in all developed countries. This is largely due to the increased use of ovulation induction and multi-embryo transfer in the treatment of subfertility. Parents of preterm twins have been shown to be less responsive to their infants than those with singletons. Parental stress with twins has also been demonstrated by the higher incidence of maternal depression and of child abuse in multiple birth families. Furthermore, siblings of twins are more likely to have behaviour problems. Mortality and long-term morbidity rates are greatly increased amongst multiple birth children. The problems of the single surviving twin and the unaffected co-twin of a disabled child are often underestimated as is the complexity of the bereavement of parents who still have surviving multiples. Addressing the cause of the epidemic of iatrogenic multiple births is likely to be the single most effective way to reduce the number of preterm infants and the long-term problems to which they are prone. [Copyright &y& Elsevier]

: Copyright of BJOG: An International Journal of Obstetrics & Gynaecology is the property of Wiley-Blackwell 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.)