1
|
Jurgelėnė V, Kuzmickienė V, Stonienė D. The Role of Skin-to-Skin Contact and Breastfeeding in the First Hour Post Delivery in Reducing Excessive Weight Loss. CHILDREN (BASEL, SWITZERLAND) 2024; 11:232. [PMID: 38397344 PMCID: PMC10887814 DOI: 10.3390/children11020232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND AIMS An excessive weight loss (EWL) of >10% after birth is associated with serious health outcomes. The aim of this study was to determine factors that can reduce weight loss in full-term, exclusively breastfed infants after birth. METHODS This is a retrospective, observational, single-center study. We included 642 healthy, full-term, exclusively breastfed neonates born in 2019 in a baby-friendly hospital, and their healthy mothers. The exclusion criteria were as follows: supplementation with formula, multiple pregnancies, and neonates or mothers with health issues. RESULTS The mean percentage of neonatal weight loss after 24 h of life was 5.13%, and that after 48 h was 6.34%. Neonates delivered via a caesarean section lost more weight after 24 and 48 h of life than those delivered via vaginal delivery (p < 0.01). There is a noticeable pattern that neonates tend to lose more weight if they do not get skin-to-skin contact (SSC) and breastfeeding within the first hour after birth (p > 0.05). CONCLUSIONS Neonates born via a CS tend to lose more weight after 24 and 48 h of life. Immediate SSC and breastfeeding in the first hour after delivery may decrease the excessive weight loss.
Collapse
Affiliation(s)
- Valentina Jurgelėnė
- Department of Neonatology, Faculty of Medicine, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania; (V.J.); (V.K.)
- Department of Neonatology, Hospital of Lithuanian University of Health Sciences (LUHS) Kauno Klinikos, LT50161 Kaunas, Lithuania
| | - Vilma Kuzmickienė
- Department of Neonatology, Faculty of Medicine, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania; (V.J.); (V.K.)
- Department of Neonatology, Hospital of Lithuanian University of Health Sciences (LUHS) Kauno Klinikos, LT50161 Kaunas, Lithuania
| | - Dalia Stonienė
- Department of Neonatology, Faculty of Medicine, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania; (V.J.); (V.K.)
| |
Collapse
|
2
|
Mtove G, Abdul O, Kullberg F, Gesase S, Scheike T, Andersen FM, Madanitsa M, Ter Kuile FO, Alifrangis M, Lusingu JPA, Minja DTR, Schmiegelow C. Weight change during the first week of life and a new method for retrospective prediction of birthweight among exclusively breastfed newborns. Acta Obstet Gynecol Scand 2022; 101:293-302. [PMID: 35156190 DOI: 10.1111/aogs.14323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Identification of low birthweight and small for gestational age is pivotal in clinical management and many research studies, but in low-income countries, birthweight is often unavailable within 24 h of birth. Newborn weights measured within days after birth and knowledge of the growth patterns in the first week of life can help estimate the weight at birth retrospectively. This study aimed to generate sex-specific prediction maps and weight reference charts for the retrospective estimation of birthweight for exclusively breastfed newborns in a low-resource setting. MATERIAL AND METHODS This was a prospective cohort study nested in a clinical trial of intermittent preventive treatment in pregnancy for malaria with either dihydroartemisinin-piperaquine with/without azithromycin or sulfadoxine-pyrimethamine in Korogwe District, north-eastern Tanzania (Clinicaltrials.gov: NCT03208179). Newborns were weighed at birth or in the immediate hours after birth and then daily for 1 week. Reference charts, nadir, time to regain weight, and prediction maps were generated using nonlinear mixed-effects models fitted to the longitudinal data, incorporating interindividual variation as random effects. Predictions and prediction standard deviations were computed using a linear approximation approach. RESULTS Between March and December 2019, 513 live newborns with birthweights measured within 24 h of delivery were weighed daily for 1 week. Complete datasets were available from 476 exclusively breastfed newborns. There was a rapid decline in weight shortly after delivery. The average weight loss, time of nadir, and time to regain weight were 4.3% (95% confidence interval [CI] 3.8-4.9) at 27 h (95% CI 24-30) and 105 h (95% CI 91-120) in boys and 4.9% (95% CI 4.2-5.6) at 28 h (95% CI 23-33) and 114 h (95% CI 93-136) in girls, respectively. The data were used to generate prediction maps with 1-h time intervals and 0.05 kg weight increments showing the predicted birthweights and weight-for-age and weight-change-for-age reference charts depicting variation in weight loss from <1 to >10%. CONCLUSIONS The prediction maps and reference charts can be used by researchers in low-resource settings to retrospectively estimate birthweights using weights collected up to 168 h after delivery, thereby maximizing data utilization. Clinical practitioners can also use the prediction maps to retrospectively classify newborns as low birthweight or small for gestational age.
Collapse
Affiliation(s)
- George Mtove
- National Institute for Medical Research, Tanga Medical Research Centre, Tanga, Tanzania
| | - Omari Abdul
- National Institute for Medical Research, Tanga Medical Research Centre, Tanga, Tanzania
| | - Fanny Kullberg
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Samwel Gesase
- National Institute for Medical Research, Tanga Medical Research Centre, Tanga, Tanzania
| | - Thomas Scheike
- Department of Biostatistics, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Feiko O Ter Kuile
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Michael Alifrangis
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - John P A Lusingu
- National Institute for Medical Research, Tanga Medical Research Centre, Tanga, Tanzania.,Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Daniel T R Minja
- National Institute for Medical Research, Tanga Medical Research Centre, Tanga, Tanzania
| | - Christentze Schmiegelow
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| |
Collapse
|
3
|
Humbert G. [Impact of mode of delivery on the weight kinetics of the breastfed infant]. SOINS. PÉDIATRIE, PUÉRICULTURE 2021; 42:40-46. [PMID: 34489081 DOI: 10.1016/j.spp.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In various studies, the introduction of infant formulas during the stay in the maternity ward has been shown to increase the risk of breastfeeding failure and the development of cow's milk protein allergy. How can they be avoided when the infant loses weight in an "abnormal" way? A team from the Polyclinique Majorelle, in Nancy, studied the impact of the mode of delivery on the weight of the newborn in order to improve its accompaniment while respecting the real needs and rhythms of each child.
Collapse
Affiliation(s)
- Gwénaëlle Humbert
- Maternité de la polyclinique Majorelle, 95 rue Ambroise-Paré, 54000 Nancy, France.
| |
Collapse
|
4
|
Jayaraj D, Rao S, Balachander B. Predisposing factors for excessive loss of weight in exclusively breastfed term and late preterm neonates - a case control study. J Matern Fetal Neonatal Med 2020; 35:3083-3088. [PMID: 32862736 DOI: 10.1080/14767058.2020.1808617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Exclusively breastfed healthy neonates can lose weight excessively due to poor milk production, inadequate enteral intake or due to poor milk transfer. The studies assessing risk factors for infants to lose weight excessively are diverse and results are highly varied. OBJECTIVES We aimed to determine the risk factors for weight loss of over 10% in term and late preterm newborns who were exclusively breastfed. METHODS This was a case-control study which was conducted in a tertiary care hospital. Exclusively breastfed neonates of ≥34 weeks having weight loss of >10% in the first 14 days of life comprised the study group with gestational age and weight-matched neonates without significant weight loss forming the control group. Demographic details, LATCH score, maternal EPDS (Edinburg postpartum depression score) and neonatal morbidities were assessed. RESULTS Of the 53 mother-infant dyad in each group, baseline characteristics were similar. Gestational Diabetes Mellitus (GDM), Lower segment Caesarean section (LSCS) delivery, higher EPDS score, low LATCH score, absence of immediate skin to skin contact were associated with excessive weight loss and was found to be significant statistically. Babies in the study group had higher incidence of jaundice and hypernatremia and had longer duration of stay in hospital. CONCLUSION Lack of early skin to skin contact, higher EPDS scores and lower LATCH scores are predisposing factors for exclusively breastfed infants to lose weight excessively.
Collapse
Affiliation(s)
- Dhanya Jayaraj
- Department of Neonatology, St. John's Medical College Hospital, Bengaluru, India
| | - Suman Rao
- Department of Neonatology, St. John's Medical College Hospital, Bengaluru, India
| | - Bharathi Balachander
- Department of Neonatology, St. John's Medical College Hospital, Bengaluru, India
| |
Collapse
|
5
|
Miyoshi Y, Suenaga H, Aoki M, Tanaka S. Determinants of excessive weight loss in breastfed full-term newborns at a baby-friendly hospital: a retrospective cohort study. Int Breastfeed J 2020; 15:19. [PMID: 32209129 PMCID: PMC7092579 DOI: 10.1186/s13006-020-00263-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/17/2020] [Indexed: 01/29/2023] Open
Abstract
Background Excessive weight loss in newborns is associated with neonatal complications such as jaundice and dehydration, which cause renal failure, thrombosis, hypovolemic shock, and seizures. The identification of the risk factors for excessive weight loss will help to discover preventive measures. The aim of this study was to determine the factors associated with excessive weight loss, defined as weight loss of ≥10%, in breastfed full-term newborns in Japan. Methods The present retrospective study, which was performed in a tertiary perinatal center accredited as a Baby-Friendly Hospital, included neonates who were born alive with a gestational age of ≥37 weeks. Cases of multiple births, admission to the neonatal intensive care unit (NICU), referral to another facility, or exclusive formula feeding were excluded. Multivariate logistic regression analyses were performed to assess the association between maternal or neonatal characteristics and excessive weight loss. Results We studied 399 newborns, of whom 164 (41%) had excessive weight loss. According to the adjusted multiple regression analysis, the factors associated with excessive weight loss were an older maternal age, primiparity, and antepartum Caesarean section, with adjusted odds ratios (95% Confidence Intervals [CIs]) of 1.07 (1.02, 1.11), 2.72 (1.69, 4.38), and 2.00 (1.09, 3.65), respectively. Conclusions Close monitoring of infants born to older mothers, primiparous mothers, or infants delivered by antepartum Cesarean section is recommended, and earlier supplementation with artificial milk may be considered.
Collapse
Affiliation(s)
- Yasuhiro Miyoshi
- Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
| | - Hideyo Suenaga
- Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Mikihiro Aoki
- Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Shigeki Tanaka
- Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| |
Collapse
|
6
|
Kelly NM, Keane JV, Gallimore RB, Bick D, Tribe RM. Neonatal weight loss and gain patterns in caesarean section born infants: integrative systematic review. MATERNAL AND CHILD NUTRITION 2019; 16:e12914. [PMID: 31777183 PMCID: PMC7083401 DOI: 10.1111/mcn.12914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/25/2019] [Accepted: 10/30/2019] [Indexed: 11/29/2022]
Abstract
There is evidence that caesarean section delivery can impact on neonatal weight loss and weight gain patterns in the first 5 days of life. We conducted an integrative systematic review to examine the association of mode of delivery on early neonatal weight loss. Pubmed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpta Medica dataBASE, and Medical Literature Analysis and Retrieval System Online were searched for relevant papers published before June 2019. Reference lists from the relevant papers were then backwards and forwards searched. As neonatal weight loss was reported in different formats, a meta‐analysis could not be carried out. Most studies did not distinguish between elective and emergency caesarean sections or instrumental and nonassisted vaginal deliveries. Seven papers were included. All papers except one found that caesarean section was associated with higher weight loss in the early days of life. Two papers presented data from studies on babies followed up to 1 month. One study found that on day 25, babies born by caesarean section had significantly higher weight gain than those born vaginally, while another found that by day 28, babies born vaginally gained more weight per day (11.9 g/kg/day) than those born by caesarean section (10.9 g/kg/day; p = .02). Overall, infants born by caesarean section lost more weight than those born vaginally, but due to the small number of studies included, more are needed to look at this difference and why it may occur. This discrepancy in weight between the two groups may be corrected over time, but future studies will need larger sample sizes and longer follow‐up periods to examine this.
Collapse
Affiliation(s)
- Niamh M Kelly
- Dept. of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, St Thomas' Hospital Campus, King's College London, London, UK
| | - Jessica V Keane
- Dept. of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, St Thomas' Hospital Campus, King's College London, London, UK
| | | | - Debra Bick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rachel M Tribe
- Dept. of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, St Thomas' Hospital Campus, King's College London, London, UK
| |
Collapse
|
7
|
Systematic Review of Expected Weight Changes After Birth for Full-Term, Breastfed Newborns. J Obstet Gynecol Neonatal Nurs 2019; 48:593-603. [DOI: 10.1016/j.jogn.2019.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2019] [Indexed: 11/20/2022] Open
|
8
|
Zia MTK, Golombek S, Lemon L, Nitkowski Keever S, Paudel U. The influence of time of birth and seasonal variations on weight loss in breastfeeding neonates. J Neonatal Perinatal Med 2019; 12:189-194. [PMID: 30714975 DOI: 10.3233/npm-17137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Breastfeeding (BF) neonates generally lose weight after birth. Neonatal factors like gestational age, birth weight and mode of delivery can affect the neonatal weight loss after birth. Similarly, maternal age, parity and illness may contribute to newborn weight loss. However, influence of the time of birth and season on changes in weight is not well elucidated. OBJECTIVE The aim of this study is to determine the effect of birth time and the seasonal variations on weight loss in BF newborns. METHODS In this retrospective study of a prospectively maintained database of two sets of groups, from January 2013 to October 2016, were evaluated- Birth time group and Seasonal group; Birth time of the groups was: night time 7pm to 7am and day time 7am to 7pm; and the seasonal variations groups studies were summer, fall, winter and spring. Weight loss of >5%, 7%, and 10% at <24 hours (h), 48 h and 72 h of birth, respectively, were considered as a significant weight loss. Preterm, exclusively formula fed and neonates admitted to NICU were excluded. RESULTS A total of 2044 newborns were analyzed. In the birth time group, babies born during the night time had significantly lost >5% of birth weight at <24 h (p < 0.01) and >7% birth weight at <48 h of life (p < 0.02). Weight loss >10% at <72 h was similar in both birth time cohorts. C-section, prolonged rupture of membrane, and maternal pre-delivery hospital stay for >12 h were significant contributing factors. Whereas, seasonal variations were not associated with weight loss in neonates. CONCLUSION BF babies born at night time lose significantly more weight during the first two days of life and seasonal association was not found to affect weight loss in the neonates.
Collapse
Affiliation(s)
- M T K Zia
- Department of Pediatrics, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA
- Department of Pediatrics, New York-Presbyterian/Hudson Valley Hospital, Cortlandt Manor, NY, USA
| | - S Golombek
- Department of Pediatrics, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA
| | - L Lemon
- Department of Pediatrics, New York-Presbyterian/Hudson Valley Hospital, Cortlandt Manor, NY, USA
| | - S Nitkowski Keever
- Department of Pediatrics, New York-Presbyterian/Hudson Valley Hospital, Cortlandt Manor, NY, USA
| | - U Paudel
- Department of Pediatrics, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA
- Department of Pediatrics, New York-Presbyterian/Hudson Valley Hospital, Cortlandt Manor, NY, USA
| |
Collapse
|
9
|
Verd S, de Sotto D, Fernández C, Gutiérrez A. Impact of in-hospital birth weight loss on short and medium term breastfeeding outcomes. Int Breastfeed J 2018; 13:25. [PMID: 29988668 PMCID: PMC6029158 DOI: 10.1186/s13006-018-0169-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/11/2018] [Indexed: 01/24/2023] Open
Abstract
Background The definition for lower limit of safe birthweight loss among exclusively breastfed neonates is arbitrary. Despite this, in cases of great in-hospital weight loss, breastfeeding adequacy is immediately questioned. The aim of this study was to examine the relationship between weight loss at discharge from hospital, when babies are ready to go home, and eventual cessation of exclusive breastfeeding since birth. Methods This is a secondary analysis of a cohort study. Study participants were 788 full term, breastfed and stable babies, born in 2007–2012 consecutively enrolled to primary care pediatric clinics in Majorca, Spain. Data were collected by chart review. The main predictor was birthweight loss at discharge. Extreme weight loss was defined as the 90th and 95th centiles of birthweight loss for babies who were delivered by vaginal delivery and by cesarean section. Main outcomes were cessation of exclusive breastfeeding by 7, 15, 30 and 100 days of life. Multivariate regression analysis was performed to study the relationship of selected variables with exclusive breastfeeding cessation since birth. Results We observed a median weight loss of 6%. In bivariate analysis, quartiles of birthweight loss at discharge were predictive of exclusive breastfeeding cessation at 15, 30 and 100 days postpartum. In multivariate analysis: in-hospital weight loss above the median did predict exclusive breastfeeding cessation by 15, 30 and 100 days of life, Adjusted Odds Ratios (AORs) (95% Confidence Intervals [CIs]): 1.57 (1.12, 2.19), 1.73 (1.26, 2.38) and 1.69 (1.25, 2.29), respectively. In contrast, we did not find that newborn extreme weight losses were associated with exclusive breastfeeding cessation. Conclusions We report that extreme birthweight loss does not trigger immediate formula supplementation. We do not identify any cut-off values to be used as predictors for the initiation of supplementary feeding, this research question remains unanswered.
Collapse
Affiliation(s)
- Sergio Verd
- Department of Primary Care, Balearic Health Authority, 07003 Palma de Mallorca, Spain
| | - Diego de Sotto
- 2Endocrinology Unit. Department of Paediatrics, Son Espases University Hospital, Valldemossa Road, 79, 07010 Palma de Mallorca, Spain
| | - Consuelo Fernández
- Department of Primary Care, Balearic Health Authority, 07003 Palma de Mallorca, Spain
| | - Antonio Gutiérrez
- 3Molecular Biology Unit, Division of Hematology, Son Espases University Hospital, Valldemossa Road, 79, 07010 Palma de Mallorca, Spain
| |
Collapse
|
10
|
Eltonsy S, Blinn A, Sonier B, DeRoche S, Mulaja A, Hynes W, Barrieau A, Belanger M. Intrapartum intravenous fluids for caesarean delivery and newborn weight loss: a retrospective cohort study. BMJ Paediatr Open 2017; 1:e000070. [PMID: 29637114 PMCID: PMC5862158 DOI: 10.1136/bmjpo-2017-000070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/11/2017] [Accepted: 07/12/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine weight loss (WL) and excess weight loss (EWL) among newborns of caesarean delivery, comparing colloids plus crystalloids versus crystalloids only. Also, to examine different doses of intrapartum intravenous fluids on WL and EWL. DESIGN Comparative safety retrospective cohort study. SETTING University Teaching Hospital, Moncton, Canada. PATIENTS Mothers exposed to intravenous fluids with caesarean delivery between 2008 and 2016. INTERVENTIONS Exposure to colloids plus crystalloids was compared with crystalloids only, and dose-response analyses were performed for colloids, crystalloids and total intravenous fluids doses. Linear and logistic regression models were used, adjusting for potential confounders. MAIN OUTCOME MEASURES Infants' WL was measured at days 1, 2 and 3 post partum, and EWL defined as loss of >7% of birth weight. RESULTS From 801 mother-infant pairs, 176 were exposed to colloids plus crystalloids and 625 were exposed to crystalloids only (overall mean birth weight=3416 g, EWL=2%, 41.4% and 55.5% on days 1, 2 and 3, respectively). No significant difference in newborns' WL was observed on any of the days assessed. Adjusted OR (95% CI) of EWL was 1.0 (0.3 to 3.3) at 24 hours, 1.0 (0.7 to 1.5) at 48 hours and 1.4 (0.9 to 2.2) at 72 hours. No dose-response relationship was detected with type-specific and total intravenous fluids exposures. CONCLUSIONS The risk of EWL was similar with colloids plus crystalloids and crystalloids only, suggesting that both therapeutic options can be considered during caesarean delivery. The absence of dose-response relationships adds confirmatory evidence to the intravenous fluids safety profiles.
Collapse
Affiliation(s)
- Sherif Eltonsy
- Centre de formation médicale du Nouveau-Brunswick, Moncton, Canada.,The Maritime SPOR SUPPORT Unit (MSSU), Moncton, Canada
| | - Alain Blinn
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada.,Dieppe Family Medicine Unit, Dieppe, Canada
| | | | - Steven DeRoche
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada.,Dieppe Family Medicine Unit, Dieppe, Canada
| | - Aubin Mulaja
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada.,Dieppe Family Medicine Unit, Dieppe, Canada
| | - William Hynes
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada.,Dieppe Family Medicine Unit, Dieppe, Canada
| | - André Barrieau
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada.,Dieppe Family Medicine Unit, Dieppe, Canada
| | - Mathieu Belanger
- Centre de formation médicale du Nouveau-Brunswick, Moncton, Canada.,Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Canada.,Dieppe Family Medicine Unit, Dieppe, Canada.,Research Centre, Vitalité Health Network, Moncton, Canada
| |
Collapse
|