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Zhong Y, Lu H, Jiang Y, Rong M, Zhang X, Liabsuetrakul T. Effect of homemade peanut oil consumption during pregnancy on low birth weight and preterm birth outcomes: a cohort study in Southwestern China. Glob Health Action 2024; 17:2336312. [PMID: 38629142 PMCID: PMC11025407 DOI: 10.1080/16549716.2024.2336312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Homemade peanut oil is widely consumed in rural areas of Southwestern China, which is easily contaminated by aflatoxins (AFs) and associated with adverse birth outcomes. OBJECTIVE To identify the effect of exposure to homemade peanut oil consumption on low birth weight (LBW), preterm birth (PB) and other associated factors. METHODS A prospective cohort study was conducted among pregnant women in Guangxi province, Southwestern China. Information of all eligible women on homemade peanut oil consumption and potential factors associated with LBW and PB was collected, and all were followed up until delivery. The effect of homemade peanut oil exposure was analyzed using multiple logistic regression models using the directed acyclic graph (DAG) approach. RESULTS Of 1611 pregnant women, 1316 (81.7%) had consumed homemade peanut oil, and the rates of LBW and PB were 9.7% and 10.0%, respectively. Increased risks of LBW and PB in women with homemade peanut oil consumption were found with aORs of 1.9 (95% CI 1.1-3.2) and 1.8 (95% CI 1.1-3.0), respectively. Women with a history of PB or LBW were 3-5 times more likely to have higher rates of LBW or PB compared with those without this type of history. The odds of PB were approximately double in those taking medicine during pregnancy. Advanced maternal age, lack of physical exercise during pregnancy, passive smoking, or pregnancy complications were also more likely to have a higher risk of LBW. CONCLUSIONS Homemade peanut oil consumption was a potential risk factor for both LBW and PB, of which health authorities who are responsible for food safety of the country should pay more attention to providing recommendation for oil consumption during pregnancy.
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Affiliation(s)
- Yanxu Zhong
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, China
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Huan Lu
- Infectious Diseases Department, The Fourth People’s Hospital of Nanning, Nanning, China
| | - Yuyan Jiang
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, China
| | - Minyan Rong
- Infectious Disease Control and Prevention Department, Guiping Center for Disease Control and Prevention (Guiping CDC), Guigang, China
| | - Xiangming Zhang
- Maternity Department, Guiping People’s Hospital, Guigang, China
| | - Tippawan Liabsuetrakul
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Diamond-Smith N, Baer RJ, Jelliffe-Pawlowski L. Impact of being underweight before pregnancy on preterm birth by race/ethnicity and insurance status in California: an analysis of birth records. J Matern Fetal Neonatal Med 2024; 37:2321486. [PMID: 38433400 DOI: 10.1080/14767058.2024.2321486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND The US still has a high burden of preterm birth (PTB), with important disparities by race/ethnicity and poverty status. There is a large body of literature looking at the impact of pre-pregnancy obesity on PTB, but fewer studies have explored the association between underweight status on PTB, especially with a lens toward health disparities. Furthermore, little is known about how weight, specifically pre-pregnancy underweight status, and socio-economic-demographic factors such as race/ethnicity and insurance status, interact with each other to contribute to risks of PTB. OBJECTIVES The objective of this study was to measure the association between pre-pregnancy underweight and PTB and small for gestational age (SGA) among a large sample of births in the US. Our secondary objective was to see if underweight status and two markers of health disparities - race/ethnicity and insurance status (public vs. other) - on PTB. STUDY DESIGN We used data from all births in California from 2011 to 2017, which resulted in 3,070,241 singleton births with linked hospital discharge records. We ran regression models to estimate the relative risk of PTB by underweight status, by race/ethnicity, and by poverty (Medi-cal status). We then looked at the interaction between underweight status and race/ethnicity and underweight and poverty on PTB. RESULTS Black and Asian women were more likely to be underweight (aRR = 1.0, 95% CI: 1.01, 1.1 and aRR = 1.4, 95% CI: 1.4, 1.5, respectively), and Latina women were less likely to be underweight (aRR = 0.7, 95% CI: 0.7, 0.7). Being underweight was associated with increased odds of PTB (aRR = 1.3, 95% CI 1.3-1.3) and, after controlling for underweight, all nonwhite race/ethnic groups had increased odds of PTB compared to white women. In interaction models, the combined effect of being both underweight and Black, Indigenous and People of Color (BIPOC) statistically significantly reduced the relative risk of PTB (aRR = 0.9, 95% CI: 0.8, 0.9) and SGA (aRR = 1.0, 95% CI: 0.9, 1.0). The combined effect of being both underweight and on public insurance increased the relative risk of PTB (aRR = 1.1, 95% CI: 1.1, 1.2) but there was no additional effect of being both underweight and on public insurance on SGA (aRR = 1.0, 95% CI: 1.0, 1.0). CONCLUSIONS We confirm and build upon previous findings that being underweight preconception is associated with increased risk of PTB and SGA - a fact often overlooked in the focus on overweight and adverse birth outcomes. Additionally, our findings suggest that the effect of being underweight on PTB and SGA differs by race/ethnicity and by insurance status, emphasizing that other factors related to inequities in access to health care and poverty are contributing to disparities in PTB.
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Affiliation(s)
- Nadia Diamond-Smith
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
| | - Rebecca J Baer
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
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Hirst JE, Boniface JJ, Le DP, Polpitiya AD, Fox AC, Vu TTK, Dang TT, Fleischer TC, Bui NTH, Hickok DE, Kearney PE, Thwaites G, Kennedy SH, Kestelyn E, Le TQ. Validating the ratio of insulin like growth factor binding protein 4 to sex hormone binding globulin as a prognostic predictor of preterm birth in Viet Nam: a case-cohort study. J Matern Fetal Neonatal Med 2024; 37:2333923. [PMID: 38584143 DOI: 10.1080/14767058.2024.2333923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/13/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To validate a serum biomarker developed in the USA for preterm birth (PTB) risk stratification in Viet Nam. METHODS Women with singleton pregnancies (n = 5000) were recruited between 19+0-23+6 weeks' gestation at Tu Du Hospital, Ho Chi Minh City. Maternal serum was collected from 19+0-22+6 weeks' gestation and participants followed to neonatal discharge. Relative insulin-like growth factor binding protein 4 (IGFBP4) and sex hormone binding globulin (SHBG) abundances were measured by mass spectrometry and their ratio compared between PTB cases and term controls. Discrimination (area under the receiver operating characteristic curve, AUC) and calibration for PTB <37 and <34 weeks' gestation were tested, with model tuning using clinical factors. Measured outcomes included all PTBs (any birth ≤37 weeks' gestation) and spontaneous PTBs (birth ≤37 weeks' gestation with clinical signs of initiation of parturition). RESULTS Complete data were available for 4984 (99.7%) individuals. The cohort PTB rate was 6.7% (n = 335). We observed an inverse association between the IGFBP4/SHBG ratio and gestational age at birth (p = 0.017; AUC 0.60 [95% CI, 0.53-0.68]). Including previous PTB (for multiparous women) or prior miscarriage (for primiparous women) improved performance (AUC 0.65 and 0.70, respectively, for PTB <37 and <34 weeks' gestation). Optimal performance (AUC 0.74) was seen within 19-20 weeks' gestation, for BMI >21 kg/m2 and age 20-35 years. CONCLUSION We have validated a novel serum biomarker for PTB risk stratification in a very different setting to the original study. Further research is required to determine appropriate ratio thresholds based on the prevalence of risk factors and the availability of resources and preventative therapies.
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Affiliation(s)
- Jane E Hirst
- Department of Global Women's Health, The George Institute for Global Health, Imperial College London, London, UK
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford, UK
| | | | - Dung Puhong Le
- Department of Obstetrics and Gynaecology, Tu Du Hospital, Ho Chi Minh City, Viet Nam
| | | | - Angela C Fox
- Sera Prognostics, Inc, Salt Lake City, Utah, USA
| | - Thi Thai Kim Vu
- Clinical Trials Unit, Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | - Thuan Trong Dang
- Clinical Trials Unit, Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | | | - Nhu Thi Hong Bui
- Department of Obstetrics and Gynaecology, Tu Du Hospital, Ho Chi Minh City, Viet Nam
| | | | | | - Guy Thwaites
- Clinical Trials Unit, Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Stephen H Kennedy
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford, UK
| | - Evelyne Kestelyn
- Clinical Trials Unit, Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Thanh Quang Le
- Department of Obstetrics and Gynaecology, Tu Du Hospital, Ho Chi Minh City, Viet Nam
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Hong J, Crawford K, Cavanagh E, da Silva Costa F, Kumar S. Prediction of preterm birth in growth-restricted and appropriate-for-gestational-age infants using maternal PlGF and the sFlt-1/PlGF ratio-A prospective study. BJOG 2024; 131:1089-1101. [PMID: 38196326 DOI: 10.1111/1471-0528.17752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 12/15/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVE To assess the utility of placental growth factor (PlGF) levels and the soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio to predict preterm birth (PTB) for infants with fetal growth restriction (FGR) and those appropriate for gestational age (AGA). DESIGN Prospective, observational cohort study. SETTING Tertiary maternity hospital in Australia. POPULATION There were 320 singleton pregnancies: 141 (44.1%) AGA, 83 (25.9%) early FGR (<32+0 weeks) and 109 (30.0%) late FGR (≥32+0 weeks). METHODS Maternal serum PlGF and sFlt-1/PlGF ratio were measured at 4-weekly intervals from recruitment to delivery. Low maternal PlGF levels and elevated sFlt-1/PlGF ratio were defined as <100 ng/L and >5.78 if <28 weeks and >38 if ≥28 weeks respectively. Cox proportional hazards models were used. The analysis period was defined as the time from the first measurement of PlGF and sFlt-1/PlGF ratio to the time of birth or censoring. MAIN OUTCOME MEASURES The primary study outcome was overall PTB. The relative risks (RR) of birth within 1, 2 and 3 weeks and for medically indicated and spontaneous PTB were also ascertained. RESULTS The early FGR cohort had lower median PlGF levels (54 versus 229 ng/L, p < 0.001) and higher median sFlt-1 levels (2774 ng/L versus 2096 ng/L, p < 0.001) and sFlt-1/PlGF ratio higher (35 versus 10, p < 0.001). Both PlGF <100 ng/L and elevated sFlt-1/PlGF ratio were strongly predictive for PTB as well as PTB within 1, 2 and 3 weeks of diagnosis. For both FGR and AGA groups, PlGF <100 ng/L or raised sFlt-1/PlGF ratio were strongly associated with increased risk for medically indicated PTB. The highest RR was seen in the FGR cohort when PlGF was <100 ng/L (RR 35.20, 95% CI 11.48-175.46). CONCLUSIONS Low maternal PlGF levels and elevated sFlt-1/PlGF ratio are potentially useful to predict PTB in both FGR and AGA pregnancies.
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Affiliation(s)
- Jesrine Hong
- Mater Research Institute, University of Queensland, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Kylie Crawford
- Mater Research Institute, University of Queensland, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Erika Cavanagh
- Mater Research Institute, University of Queensland, South Brisbane, Queensland, Australia
| | - Fabricio da Silva Costa
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
- Maternal Fetal Medicine Unit, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Sailesh Kumar
- Mater Research Institute, University of Queensland, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- NHMRC Centre for Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
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Sun M, Luo M, Wang T, Zhong T, Chen Q, Liu H, Tang J, Li L, Qin J. Associations between maternal syphilis infection during pregnancy and low birth weight and preterm birth: a prospective cohort study. Arch Gynecol Obstet 2024; 310:203-211. [PMID: 38157028 DOI: 10.1007/s00404-023-07321-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/25/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND In recent years, syphilis is still the most common sexually transmitted disease worldwide. Pregnant women infected with syphilis can transmit it to the fetus in utero through mother-to-child transmission, which can directly lead to adverse pregnancy outcomes. The aim of this study was to investigate the associations between maternal syphilis infection and low birth weight and preterm birth in offspring. METHODS Multinomial logistic regression model was used to analyze the associations between maternal syphilis infection and low birth weight and preterm birth, and to explore its stability through subgroup analysis. RESULTS A total of 34,074 subjects were included in the study. After adjusting for potential confounders, maternal syphilis infection during pregnancy was associated with a 2.60-fold (95% CI 1.83-3.69) increased risk of low birth weight and a 1.91-fold (95% CI 1.35-2.69) increased risk of preterm birth. Subgroup analysis showed that the association was stable. CONCLUSION We found that maternal syphilis infection during pregnancy was significantly associated with an increased risk of low birth weight and preterm birth. The implementation of reasonable syphilis screening and standardized treatment and follow-up of pregnant syphilis may have important practical significance in reducing the low birth weight and preterm birth rate in offspring.
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Affiliation(s)
- Mengting Sun
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China
| | - Manjun Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Taowei Zhong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China
| | - Qian Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China
| | - Hanjun Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China
| | - Jiapeng Tang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China
| | - Liuxuan Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China.
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China.
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Hunan, China.
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Broekhuis A, Koenen SV, Broeren MAC, Krabbe JG, Pop VJM. High first trimester ferritin levels differ according to parity and are independently related to preterm birth: A prospective cohort study. Acta Obstet Gynecol Scand 2024; 103:1437-1443. [PMID: 38650165 PMCID: PMC11168274 DOI: 10.1111/aogs.14830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION A considerable amount of neonatal morbidity and mortality worldwide is caused by preterm birth. To date, the underlying etiology of preterm birth has not been fully clarified. Previous studies demonstrate that inflammation is one of the pathological factors that might cause preterm birth, and that there is a difference between primiparous and multiparous women in immune response to pregnancy. The objective of this prospective cohort study was to investigate the role of two inflammatory markers, ferritin and C-reactive protein (CRP) and preterm birth, in first trimester women, stratified for parity. In addition, a possible association between high ferritin and CRP, and a possible association between high ferritin and CRP and preterm birth were assessed. MATERIAL AND METHODS A total of 2044 healthy, low-risk pregnant women from primary obstetric care in the Netherlands participated in this study. Their ferritin and CRP levels were evaluated at 12 weeks' gestation. Levels above the parity specific 95th percentile were defined as high. The main outcome of this study was to assess the presence of a possible association between parity specific high ferritin and CRP, and preterm birth. The secondary outcomes were the ferritin and CRP levels of women, stratified for parity, and the possible association between high ferritin and CRP levels. Logistic regression analysis was performed with preterm birth as a dependent variable and parity specific high ferritin and CRP as an independent variable, adjusting for age and history of preterm birth. RESULTS Ferritin levels decreased with increasing parity. Ferritin and CRP levels at 12 weeks' gestation were significantly higher in women with preterm birth. In primiparous women, high ferritin levels (OR: 2.5, CI: 1.14-5.38) and high CRP levels (OR: 5.0, CI: 2.61-9.94) were independently associated with preterm birth. In multiparous women, high ferritin levels (OR: 6.0, CI: 2.28-16.67) were independently associated with preterm birth while high CRP levels were not. CONCLUSIONS First trimester parity specific ferritin and CRP levels could play a part in predictive models for preterm birth, and further research for their additive role in preterm birth is needed.
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Affiliation(s)
- Annabel Broekhuis
- Department of Obstetrics and GynecologyMeander Medical CenterAmersfoortThe Netherlands
| | - Steven V. Koenen
- Department of Obstetrics and GynecologyElisabeth‐TweeSteden ZiekenhuisTilburgThe Netherlands
| | | | - Johannes G. Krabbe
- Department of Clinical Chemistry and Laboratory MedicineMedisch Spectrum TwenteEnschedeThe Netherlands
| | - Victor J. M. Pop
- Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands
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Yi X, Zhang D, Yang J, Gao H, Cai H, Cong J, Lin C. Analysis of perinatal outcomes for emergency cervical cerclage in singleton pregnancies at 24-28 weeks of gestation. Arch Gynecol Obstet 2024; 310:229-235. [PMID: 38649500 PMCID: PMC11168987 DOI: 10.1007/s00404-024-07493-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/24/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Cervical cerclage is the only effective treatment for cervical insufficiency, effectively preventing late miscarriage and preterm birth. The effectiveness and safety of emergency cervical cerclage (ECC) as an emergency treatment when the cervix is already dilated or when there is protrusion of the fetal membranes into the vagina remain controversial, especially in pregnancies at 24-28 weeks when the fetus is viable. There is still no consensus on whether emergency cervical cerclage should be performed in such cases. PURPOSE To investigate the effectiveness and safety of emergency cervical cerclage in singleton pregnant women at 24-28 weeks of gestation. METHODS This study employed a single-center prospective cohort design, enrolling singleton pregnant women at 24-28 weeks of gestation with ultrasound or physical examination indicating cervical dilation or even membrane protrusion. Emergency cervical cerclage was compared with conservative treatment. The primary endpoints included a comprehensive assessment of perinatal pregnancy loss, significant neonatal morbidity, and adverse neonatal outcomes. Secondary endpoints included prolonged gestational age, preterm birth, neonatal hospitalization rate, premature rupture of membranes, and intrauterine infection/chorioamnionitis. RESULTS From June 2021 to March 2023, a total of 133 pregnant women participated in this study, with 125 completing the trial, and were allocated to either the Emergency Cervical Cerclage (ECC) group (72 cases) or the conservative treatment group (53 cases) based on informed consent from the pregnant women. The rate of adverse neonatal outcomes was 8.33% in the ECC group and 26.42% in the conservative treatment (CT) group, with a statistically significant difference (P = 0.06). There were no significant differences between the two groups in terms of perinatal pregnancy loss and significant neonatal morbidity. The conservative treatment group had a mean prolonged gestational age of 63.0 (23.0, 79.5) days, while the ECC group had 84.0 (72.5, 89.0) days, with a statistically significant difference between the two groups (P < 0.001). Compared with CT group, the ECC group showed a significantly reduced incidence of preterm birth before 28 weeks, 32 weeks, and 34 weeks, with statistical significance (P = 0.046, 0.007, 0.001), as well as a significantly decreased neonatal hospitalization rate (P = 0.013, 0.031). Additionally, ECC treatment did not increase the risk of preterm premature rupture of membranes or intrauterine infection/chorioamnionitis, with no statistically significant differences (P = 0.406, 0.397). CONCLUSION In singleton pregnant women with cervical insufficiency at 24-28 weeks of gestation, emergency cervical cerclage can reduce adverse neonatal pregnancy outcomes, effectively prolong gestational age, decrease preterm births before 28 weeks, 32 weeks, and 34 weeks, lower neonatal hospitalization rates, and does not increase the risk of preterm premature rupture of membranes or intrauterine infection/chorioamnionitis.
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Affiliation(s)
- Xiling Yi
- Department of Obstetrics and Gynaecology, Shenyang Women's and Children's Hospital, Shenyang, 110000, Liaoning, China
| | - Dan Zhang
- Department of Obstetrics and Gynaecology, Shenyang Women's and Children's Hospital, Shenyang, 110000, Liaoning, China
| | - Jing Yang
- Department of Obstetrics and Gynaecology, Shenyang Women's and Children's Hospital, Shenyang, 110000, Liaoning, China.
| | - Hongyan Gao
- Department of Obstetrics and Gynaecology, Shenyang Women's and Children's Hospital, Shenyang, 110000, Liaoning, China
| | - Hengyu Cai
- Department of Obstetrics and Gynaecology, Shenyang Women's and Children's Hospital, Shenyang, 110000, Liaoning, China
| | - Jianping Cong
- Department of Obstetrics and Gynaecology, Shenyang Women's and Children's Hospital, Shenyang, 110000, Liaoning, China
| | - Chengli Lin
- Department of Obstetrics and Gynaecology, Shenyang Women's and Children's Hospital, Shenyang, 110000, Liaoning, China
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Liza V, Ravikumar G. Placental correlates in categories of preterm births based on gestational age. Placenta 2024; 152:9-16. [PMID: 38744037 DOI: 10.1016/j.placenta.2024.05.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/03/2024] [Accepted: 05/05/2024] [Indexed: 05/16/2024]
Abstract
Placental abnormalities can precipitate preterm birth (PTB), a principal contributor to neonatal morbidity and mortality. This study targets understanding placental variations among different gestational age-based categories of PTB. METHODS A three-year retrospective study conducted a detailed clinicopathological analysis of PTB placentas categorized by gestational age: extremely preterm (EPTB,<28 weeks), very preterm (VPTB, 28 to 31 + 6 weeks), moderate preterm (MPTB, 32 to 33 + 6 weeks), and late preterm (LPTB, 34 to 36 + 6 weeks). Macroscopic parameters sourced from pathology records and microscopic examination assessed for maternal and fetal stromal-vascular lesions, inflammatory and hypoxic lesions and others. Stillbirths/intrauterine demise and multifetal gestation were excluded. Clinical data were gathered from medical records. RESULTS A total of 645 preterm placentas were received and 538 were included. The majority were LPTB(46.3 %), while EPTB, VPTB and MPTB accounted for 5.8 %, 28.4 % and 19.5 % respectively. Low birth weight and low Apgar were prevalent in EPTB(p < 0.001), while obstetric complications were higher in other PTB categories. Placental infarction was higher in VPTB and MPTB(p = 0.006). On microscopy, maternal (48.4 %), fetal (29 %) inflammatory response and villous edema (48.4 %) was higher in EPTB(p = 0.04 & p < 0.001 respectively), while maternal stromal-vascular lesions were higher in VPTB and MPTB(67.3 % & 64.8 %, p < 0.001). Delayed villous maturation (17.7 %,p = 0.02), chronic chorioamnionitis (11.3 %,p = 0.02), membrane hypoxia (38.6 %,p = 0.007), and massive fibrin deposition (10.8 %,p < 0.001) featured higher in LPTB. DISCUSSION Acute inflammatory pathology was common in EPTB, strongly suggesting inflammation in triggering parturition. Frequent obstetric complications and maternal stromal-vascular lesions in VPTB and MPTB may underscore maternal vascular compromise in this group. Villous maturation defects, chronic chorioamnionitis, massive fibrin deposition and membrane hypoxia in LPTB, likely contribute to long-term neonatal morbidity.
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Affiliation(s)
- Victoria Liza
- Department of Pathology, St. John's Medical College, Bangalore, India, 560076.
| | - Gayatri Ravikumar
- Department of Pathology, St. John's Medical College, Bangalore, India, 560076.
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Diao M, Tao Y, Liu Q, Huang L, Li H, Lin X. Rac1 promotes the lipopolysaccharide-induced inflammatory response and contraction-associated proteins (CAPs) expression in mouse uterine smooth muscle cells. Reprod Biol 2024; 24:100896. [PMID: 38833837 DOI: 10.1016/j.repbio.2024.100896] [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: 09/04/2023] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 06/06/2024]
Abstract
Activation of the maternal immune system leads to a downstream cascade of proinflammatory events that culminate in the activation of spontaneous uterine contractions, which is associated with preterm birth. Ras-related C3 botulinum toxin substrate 1 (Rac1) is a crucial protein related to cell contraction and inflammation. The main purpose of this study was to explore the role and function of Rac1's regulation of inflammation through in- vivo and in-vitro experiments. Rac1 inhibitor was used in animal model of preterm birth and cells isolated from the uterine tissues of pregnant mice on gestational day 16 were transfected with adenovirus to knockdown or overexpress Rac1 and treated with the Calcium-calmodulin-dependent protein kinase II (CaMKII) inhibitor KN93. The expression of Rac1, uterine contraction-associated proteins (CAPs) (COX-2 and Connexin43), and inflammatory cytokines, were assessed by Western blotting and RTPCR. LPS upregulated Rac1, COX-2 and Connexin43 expression in uterine smooth muscle cells (USMCs). The expression of inflammatory cytokines, COX-2, and Connexin43 was significantly decreased in shRac1-transfected cells compared with cells stimulated with LPS only. Rac1 overexpression led to an increase in the expression of inflammatory cytokines, COX-2, and Connexin43. Furthermore, after Rac1 overexpression, KN93 reduced the expression of uterine contraction-associated proteins and inflammatory cytokines. It is thought that the effect of Rac1 on inflammatory cytokine and contraction-associated protein expression in USMCs is mediated by CaMKII. Rac1 can modulate the expression of contraction-associated proteins and inflammatory cytokines through the CaMKII pathway. Rac1 could be an effective therapeutic target for improving the outcome of preterm birth.
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Affiliation(s)
- Min Diao
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Yunkai Tao
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Qian Liu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Lu Huang
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Hao Li
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Xuemei Lin
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China.
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10
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Elias DE, Santos MR, Campaña H, Poletta FA, Heisecke SL, Gili JA, Ratowiecki J, Cosentino V, Uranga R, Saleme C, Rittler M, Krupitzki HB, Lopez Camelo JS, Gimenez LG. Indirect Effects of Neighbourhood Socioeconomic Status on Preterm Birth Risk in an Argentine Population. Matern Child Health J 2024:10.1007/s10995-024-03951-1. [PMID: 38831170 DOI: 10.1007/s10995-024-03951-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Preterm birth (PTB) is the main condition related to perinatal morbimortality worldwide. The aim of this study was to determine the indirect effects of neighbourhood socioeconomic status (NSES) on the risk of spontaneous PTB. METHODS We carried out a retrospective case-control study including sociodemographic and obstetric data of multigravid women who gave birth at a maternity hospital in Tucumán, Argentina, between 2005 and 2010: 949 women without previous PTB nor pregnancy loss who delivered at term and 552 who had spontaneous PTB. NSES was estimated from the Unsatisfied Basic Needs index of census data. Variables selected through penalised regressions were used to create a data-driven Bayesian network; then, pathways were identified and mediation analyses performed. RESULTS Maternal age less than 20 years mediated part of the protective effect of high NSES on spontaneous PTB [natural indirect effect (NIE) -0.0125, 95% confidence interval (CI) (-0.0208, -0.0041)] and on few prenatal visits (< 5) [NIE - 0.0095, 95% CI (-0.0166, -0.0025)]. These pathways showed greater sensitivity to unobserved confounders that affect the variables mediator-outcome in the same direction, and exposure-mediator in the opposite direction. They did not show sensitivity to observed potential confounders, nor to the parameterization used to define NSES. Meanwhile, urinary tract infections showed a trend in mediating the effect of low NSES on spontaneous PTB [NIE 0.0044, 95% CI (-0.0006, 0.0093), P 0.0834]. CONCLUSIONS High NSES has protective indirect effects on spontaneous PTB risk, mainly associated with a lower frequency of teenage pregnancy.
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Affiliation(s)
- Dario E Elias
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina.
| | - Maria R Santos
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Comisión de Investigaciones Científicas, Buenos Aires, Argentina
- Instituto Multidisciplinario de Biología Celular, Buenos Aires, Argentina
| | - Hebe Campaña
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Comisión de Investigaciones Científicas, Buenos Aires, Argentina
| | - Fernando A Poletta
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Instituto Nacional de Genética Médica Populacional (INAGEMP), CEMIC-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvina L Heisecke
- Dirección de Investigación, CEMIC-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Juan A Gili
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Instituto Académico Pedagógico de Ciencias Humanas, Universidad Nacional de Villa María, Córdoba, Argentina
| | - Julia Ratowiecki
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
| | - Viviana Cosentino
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Hospital Interzonal General de Agudos Luisa C. de Gandulfo, Buenos Aires, Argentina
| | - Rocio Uranga
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Hospital San Juan de Dios, Buenos Aires, Argentina
| | - César Saleme
- Instituto de Maternidad y Ginecología Nuestra Señora de las Mercedes, Tucumán, Argentina
| | - Mónica Rittler
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Hospital Materno Infantil Ramón Sardá, Ciudad Autónoma de Buenos Aires, Argentina
| | - Hugo B Krupitzki
- Dirección de Investigación, CEMIC-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
- Instituto Universitario, Centro de Educación Médica e Investigaciones Clínicas (CEMIC-IUC), Ciudad Autónoma de Buenos Aires, Argentina
| | - Jorge S Lopez Camelo
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Instituto Nacional de Genética Médica Populacional (INAGEMP), CEMIC-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lucas G Gimenez
- Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Instituto Nacional de Genética Médica Populacional (INAGEMP), CEMIC-CONICET, Ciudad Autónoma de Buenos Aires, Argentina
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11
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Fu JY, Wang CA, Mead EC, Phung J, Makrides M, Pennell CE. The role of omega-3 polyunsaturated fatty acids in the prevention of preterm birth. Med J Aust 2024; 220:502-504. [PMID: 38714366 DOI: 10.5694/mja2.52301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/21/2023] [Indexed: 05/09/2024]
Affiliation(s)
| | - Carol A Wang
- University of Newcastle, Newcastle, NSW
- Mothers and Babies Research Program, Hunter Medical Research Institute, Newcastle, NSW
| | - Elyse C Mead
- University of Newcastle, Newcastle, NSW
- Hunter New England Local Health District, NSW Health, Newcastle, NSW
| | - Jason Phung
- University of Newcastle, Newcastle, NSW
- Mothers and Babies Research Program, Hunter Medical Research Institute, Newcastle, NSW
| | - Maria Makrides
- South Australian Health and Medical Research Institute, Adelaide, SA
| | - Craig E Pennell
- University of Newcastle, Newcastle, NSW
- Mothers and Babies Research Program, Hunter Medical Research Institute, Newcastle, NSW
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12
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Kohler C, Plaikner A, Siegler K, Hertel H, Hasenbein K, Petzel A, Schubert M, Blohmer JU, Böhmer G, Stolte C, Marnitz S, Mallmann-Gottschalk N, Oppelt P, Favero G, Westphalen S, Hagemann I, Martus P, Schneider A. Radical vaginal trachelectomy: long-term oncologic and fertility outcomes in patients with early cervical cancer. Int J Gynecol Cancer 2024; 34:799-805. [PMID: 38599782 DOI: 10.1136/ijgc-2024-005274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE Radical vaginal trachelectomy is a fertility-preserving treatment for patients with early cervical cancer. Despite encouraging oncologic and fertility outcomes, large studies on radical vaginal trachelectomy are lacking. METHOD Demographic, histological, fertility, and follow-up data of consecutive patients who underwent radical vaginal trachelectomy between March 1995 and August 2021 were prospectively recorded and retrospectively analyzed. RESULTS A total of 471 patients of median age 33 years (range 21-44) were included. 83% (n=390) were nulliparous women. Indications were International Federation of Gynecology and Oncology (FIGO, 2009) stages IA1 with lymphvascular space involvement (LVSI) in 43 (9%) patients, IA1 multifocal in 8 (2%), IA2 in 92 (20%), IB1 in 321 (68%), and IB2/IIA in 7 (1%) patients, respectively. LVSI was detected in 31% (n=146). Lymph node staging was performed in 151 patients (32%) by the sentinel node technique with a median of 7 (range 2-14) lymph nodes and in 320 (68%) by systematic lymphadenectomy with a median of 19 (range 10-59) lymph nodes harvested. Residual tumor was histologically confirmed in 29% (n=136). In total, 270 patients (62%) were seeking pregnancy of which 196 (73%) succeeded. There were 205 live births with a median fetal weight of 2345 g (range 680-4010 g). Pre-term delivery occurred in 94 pregnancies (46%). After a median follow-up of 159 months (range 2-312), recurrences were detected in 16 patients (3.4%) of which 43% occurred later than 5 years after radical vaginal trachelectomy. Ten patients (2.1%) died of disease (five more than 5 years after radical vaginal trachelectomy). Overall survival, disease-free survival, and cancer-specific survival were 97.5%, 96.2%, and 97.9%, respectively. CONCLUSION Our study confirms oncologic safety of radical vaginal trachelectomy associated with a high chance for childbearing. High rate of pre-term delivery may be due to cervical volume loss. Our long-term oncologic data can serve as a benchmark for future modifications of fertility-sparing surgery.
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Affiliation(s)
- Christhardt Kohler
- Department of Gynecology, Asklepios Clinic Altona, Hamburg, Germany
- Institute for Dysplasia and Cytology, MVZ Fürstenbergkarree, Berlin, Germny
| | - Andrea Plaikner
- Department of Gynecology, Asklepios Clinic Altona, Hamburg, Germany
| | - Kathrin Siegler
- Department of Gynecology, Asklepios Clinic Altona, Hamburg, Germany
| | - Hermann Hertel
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Kati Hasenbein
- Specialized Medical Practice for Gynecologic Oncology, Berlin-Spandau, Berlin, Germany
| | - Anja Petzel
- Institute for Dysplasia and Cytology, MVZ Kreuzberg, Berlin, Germany
| | - Melanie Schubert
- Gynecology and Obstetrics, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | | | - Gerd Böhmer
- Institute for Dysplasia and Cytology, IZD Hannover, Hannover, Germany
| | - Claudia Stolte
- Institute for Dysplasia and Cytology, IZD Hannover, Hannover, Germany
| | - Simone Marnitz
- Radiation Oncology Vosspalais, Private Clinic, Berlin, Germany
| | - Nina Mallmann-Gottschalk
- Department of Gynecology and Obstetrics, University Hospital of Cologne Medical Faculty, Cologne, Germany
| | - Peter Oppelt
- Department for Gynecology, Obstetrics and Gynecological Endocrinology, Johannes Kepler University Linz, Linz, Austria
| | - Giovanni Favero
- Department of Gynecology and Obstetrics, Asklepios Hospital Lich, Lich, Germany
| | - Silke Westphalen
- Specialized Medical Practice for Dysplasia and Cytology, Lüneburg, Germany
| | - Ingke Hagemann
- Specialized Medical Practice for Dysplasia and Cytology, Kronshagen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Biometry, Eberhard Karls University Tübingen Faculty of Medicine, Tubingen, Germany
| | - Achim Schneider
- Institute for Dysplasia and Cytology, MVZ Fürstenbergkarree, Berlin, Germny
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13
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Han M. Predicted brain age (PBA), promising surrogate indicator for neurodevelopment in preterm baby: how to predict accurately? Eur Radiol 2024; 34:3598-3600. [PMID: 38078998 DOI: 10.1007/s00330-023-10481-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/05/2023] [Accepted: 11/25/2023] [Indexed: 06/12/2024]
Affiliation(s)
- Miran Han
- Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, 164, World Cup-Ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea.
- Department of Radiology, Graduate School of Kangwon National University, Chuncheon, Republic of Korea.
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14
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den Heijer AE, Jansen ASN, van Kersbergen M, van Dokkum NH, Reijneveld SA, Spikman JM, de Kroon MLA, Bos AF. Neurocognitive outcomes in moderately preterm born adolescents. Early Hum Dev 2024; 193:106020. [PMID: 38733834 DOI: 10.1016/j.earlhumdev.2024.106020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Early preterm (EP) born children are at risk of neurocognitive impairments persisting into adulthood. Less is known about moderately to late (MLP) preterm born children, especially after early childhood. The aim of this study was to assess neurocognitive functioning of MLP adolescents regarding intelligence, executive and attentional functioning, compared with EP and full-term (FT) adolescents. METHODS This study was part of the Longitudinal Preterm Outcome Project (LOLLIPOP), a large community-based observational cohort study. In total 294 children (81 EP, 130 MLP, and 83 FT) were tested at age 14 to 16 years, regarding intelligence, speed of processing, attention, and executive functions. We used the Dutch version of the Wechsler Intelligence Scale for Children-Third Edition-Dutch Version (WISC-III-NL), the Test of Everyday Attention for Children, and the Behavioural Assessment of the Dysexecutive Syndrome for Children. We assessed differences between preterm-born groups with the FT group as a reference. RESULTS Compared to the FT group, MLP adolescents scored significantly lower on two subtasks of the WISC-III-NL, i.e. Similarities and Symbol Search. EP adolescents performed significantly lower on all neuropsychological tests than their FT peers, except for the subtask Vocabulary. The MLP adolescents scored in between FT and EP adolescents on all tasks, except for three WISC-III-NL subtasks. CONCLUSIONS Neurocognitive outcomes of MLP adolescents fell mostly in between outcomes of their EP and FT peers. MLPs generally performed on a low-average to average level, and appeared susceptible to a variety of moderate neurodevelopmental problems at adolescent age, which deserves attention in clinical practice.
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Affiliation(s)
- A E den Heijer
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - A S N Jansen
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - M van Kersbergen
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - N H van Dokkum
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - S A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - J M Spikman
- Department of Neurology, Subdepartment of Clinical Neuropsychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - M L A de Kroon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Public Health and Primary Care, Centre Environment & Health, KU Leuven, Leuven, Belgium
| | - A F Bos
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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15
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Ward VC, Lee AC, Hawken S, Otieno NA, Mujuru HA, Chimhini G, Wilson K, Darmstadt GL. Overview of the Global and US Burden of Preterm Birth. Clin Perinatol 2024; 51:301-311. [PMID: 38705642 DOI: 10.1016/j.clp.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Preterm birth (PTB) is the leading cause of morbidity and mortality in children globally, yet its prevalence has been difficult to accurately estimate due to unreliable methods of gestational age dating, heterogeneity in counting, and insufficient data. The estimated global PTB rate in 2020 was 9.9% (95% confidence interval: 9.1, 11.2), which reflects no significant change from 2010, and 81% of prematurity-related deaths occurred in Africa and Asia. PTB prevalence in the United States in 2021 was 10.5%, yet with concerning racial disparities. Few effective solutions for prematurity prevention have been identified, highlighting the importance of further research.
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Affiliation(s)
- Victoria C Ward
- Department of Pediatrics, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA 94305, USA.
| | - Anne Cc Lee
- Department of Pediatrics, Global Advancement of Infants and Mothers, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
| | - Steven Hawken
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Center for Practice Changing Research, 501 Smyth Road, Box 201-B, Ottawa, Ontario K1H 8L6, Canada
| | - Nancy A Otieno
- Kenya Medical Research Institute (KEMRI), Centre for Global Health Research, Division of Global Health Protection, Box 1578 Kisumu 40100, Kenya
| | - Hilda A Mujuru
- Department of Child Adolescent and Women's Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, MP 167, Mount Pleasant, Harare, Zimbabwe
| | - Gwendoline Chimhini
- Department of Child Adolescent and Women's Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, MP 167, Mount Pleasant, Harare, Zimbabwe
| | - Kumanan Wilson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Center for Practice Changing Research, 501 Smyth Road, Box 201-B, Ottawa, Ontario K1H 8L6, Canada; Department of Medicine, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada; Bruyère Research Institute, 43 Bruyère Street, Ottawa, ON K1N 5C8, Canada
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, CA 94304, USA
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16
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Mata-Moreno G, Bernal-Silva S, García-Sepúlveda CA, González-Ortíz AM, Ochoa-Pérez UR, Medina-Serpa AU, Pérez-González LF, Noyola DE. Population-based Influenza and Respiratory Syncytial Virus Hospitalizations and In-hospital Mortality Rates Among Mexican Children Less Than Five Years of Age. Pediatr Infect Dis J 2024; 43:493-497. [PMID: 38359346 DOI: 10.1097/inf.0000000000004269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Population-based information regarding the impact of respiratory syncytial virus (RSV) and influenza on hospital admissions and mortality is scant for many countries. METHODS Prospective testing of RSV and influenza virus was undertaken in patients <5 years old admitted to hospital with acute respiratory infection (ARI) between July, 2014 and June, 2015, and mortality rates for children living in 3 municipalities in the state of San Luis Potosí were calculated. RESULTS During the 12-month study period, 790 children living in these municipalities were admitted with ARI. RSV was detected in 245 (31%) and influenza in 47 (5.9%). History of preterm birth was recorded for 112 children on admission. For children <5 years old, ARI-, RSV- and influenza-associated admission rates were 23.2, 7.2 and 1.4 (per 1000 population), respectively. The corresponding admission rates per 1000 infants <1 year old were 78, 25.2 and 4.4. Preterm infant admission rates were 2 times higher than those of term infants. Six children died; RSV was detected in 4 (66.6%) of the deceased, while no deaths were associated with influenza. ARI and RSV in-hospital mortality rates for children <5 years were 0.18 and 0.12 per 1000 population. ARI and RSV mortality rates in preterm infants were 7 and 14 times higher than in term infants, respectively. CONCLUSIONS RSV was associated with both high admission and in-hospital mortality rates in children <5 years old. Specific interventions, such as active or passive immunization, to prevent RSV infections are required to reduce ARI-associated infant mortality.
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Affiliation(s)
- Gabriel Mata-Moreno
- From the Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
- Centro de Investigación en Ciencias de la Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Sofía Bernal-Silva
- From the Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
- Centro de Investigación en Ciencias de la Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Christian A García-Sepúlveda
- Viral and Human Genomics Laboratory, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | | | - Uciel R Ochoa-Pérez
- From the Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | | | | | - Daniel E Noyola
- From the Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
- Centro de Investigación en Ciencias de la Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
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17
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Murillo C, Rueda C, Larroya M, Boada D, Grau L, Ponce J, Herranz A, Gómez O, Ferrero S, Andreu-Fernández V, Gratacós E, Crispi F, Palacio M, Cobo T. Intra-amniotic infection and/or inflammation is associated with fetal cardiac concentric hypertrophy and diastolic dysfunction in preterm labor and preterm prelabor rupture of membranes. Am J Obstet Gynecol 2024; 230:665.e1-665.e30. [PMID: 38290925 DOI: 10.1016/j.ajog.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Preterm delivery is associated with cardiovascular remodeling and dysfunction in children and adults. However, it is unknown whether these effects are caused by the neonatal consequences of preterm birth or if these are already present in utero. OBJECTIVE We evaluated fetal cardiac morphology and function in fetuses of mothers admitted for preterm labor or preterm prelabor rupture of membranes and the association of these changes with the presence of intra-amniotic infection and/or inflammation. STUDY DESIGN In this prospective cohort study, fetal echocardiography and amniocentesis were performed at admission in singleton pregnant women with preterm labor and/or preterm prelabor rupture of membranes between 24.0 and 34.0 weeks' gestation with (intra-amniotic infection and/or inflammation group, n=41) and without intra-amniotic infection and/or inflammation (non-intra-amniotic infection and/or inflammation, n=54). Controls (n=48) were outpatient pregnant women without preterm labor or preterm prelabor rupture of membranes. Intra-amniotic infection was defined by a positive amniotic fluid culture or positive 16S ribosomal RNA gene. Intra-amniotic inflammation was defined by using the amniotic fluid interleukin-6 cutoff levels previously reported by our group being >1.43 ng/mL in preterm prelabor rupture of membranes and >13.4 ng/mL in preterm labor. Fetal cardiac morphology and function was evaluated using echocardiography, and troponin-I and N-terminal pro-brain natriuretic peptide concentrations were measured in amniotic fluid from women with preterm labor or preterm prelabor rupture of membranes and compared with 20 amniotic fluid Biobank samples obtained for reasons other than preterm labor or preterm prelabor rupture of membranes or cardiac pathology. The data were adjusted for the estimated fetal weight below the 10th percentile and for preterm prelabor rupture of membranes at admission and also for gestational age at amniocentesis when amniotic fluid biomarkers were compared. RESULTS From 2018 to 2021, 143 fetuses were included; 95 fetuses were from mothers admitted with a diagnosis of preterm labor or preterm prelabor rupture of membranes, and among those, 41 (28.7%) were in the intra-amniotic infection and/or inflammation group and 54 (37.8%) were in the non-intra-amniotic infection and/or inflammation group. A total of 48 (33.6%) fetuses were included in the control group. Fetuses with preterm labor and/or preterm prelabor rupture of membranes had signs of subclinical cardiac concentric hypertrophy (median left wall thickness of 0.93 [interquartile range, 0.72-1.16] in the intra-amniotic infection and/or inflammation group; 0.79 [0.66-0.92] in the non-intra-amniotic infection and/or inflammation group; and 0.69 [0.56-0.83] in controls; P<.001) and diastolic dysfunction (tricuspid A duration 0.23 seconds [0.21-0.25], 0.24 [0.22-0.25], and 0.21 [0.2-0.23]; P=.007). Systolic function was similar among groups. Higher values of amniotic fluid troponin I (1413 pg/mL [927-2334], 1190 [829-1636], and 841 [671-959]; P<.001) and N-terminal pro-brain natriuretic peptide were detected (35.0%, 17%, and 0%; P=.005) in fetuses with preterm labor or preterm prelabor rupture of membranes when compared with the control group. The highest N-terminal pro-brain natriuretic peptide concentrations were found in the intra-amniotic infection and/or inflammation group. CONCLUSION Fetuses with preterm labor or preterm prelabor rupture of membranes showed signs of cardiac remodeling and subclinical dysfunction, which were more pronounced in those exposed to intra-amniotic infection and/or inflammation. These findings support that the cardiovascular effects observed in children and adults born preterm have, at least in part, a prenatal origin.
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Affiliation(s)
- Clara Murillo
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - Claudia Rueda
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - Marta Larroya
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - David Boada
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - Laia Grau
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - Júlia Ponce
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - Ana Herranz
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - Olga Gómez
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain; Center for Biomedical Research on Rare Diseases (CIBER-ER), Instituto Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Silvia Ferrero
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - Vicente Andreu-Fernández
- Biosanitary Research Institute, Valencian International University (VIU), Valencia, Spain. Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - Eduard Gratacós
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain; Center for Biomedical Research on Rare Diseases (CIBER-ER), Instituto Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Fàtima Crispi
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain; Center for Biomedical Research on Rare Diseases (CIBER-ER), Instituto Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Montse Palacio
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain; Center for Biomedical Research on Rare Diseases (CIBER-ER), Instituto Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Teresa Cobo
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinic and Hospital Sant Joan de Déu, Institut Clínic de Ginecología, Obstetrícia I Neonatología, Fetal i+D Fetal Medicine Research Center, Barcelona, Spain; Fundació de Recerca Clínica Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer (IIS-FRCB-IDIBAPS), Universitat de Barcelona. Barcelona, Spain; Center for Biomedical Research on Rare Diseases (CIBER-ER), Instituto Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
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Applegate JA, Islam MS, Khanam R, Roy AD, Chowdhury NH, Ahmed S, Mitra DK, Mahmud A, Islam MS, Saha SK, Baqui AH. Young Infant Mortality Associated with Preterm and Small-for-Gestational-Age Births in Rural Bangladesh: A Prospective Cohort Study. J Pediatr 2024; 269:114001. [PMID: 38432296 PMCID: PMC11155441 DOI: 10.1016/j.jpeds.2024.114001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/12/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To assess the relative risk of mortality in infants born preterm and small for gestational age (SGA) during the first and second months of life in rural Bangladesh. STUDY DESIGN We analyzed data from a cohort of pregnant women and their babies in Sylhet, Bangladesh, assembled between 2011 and 2014. Community health workers visited enrolled babies up to 10 times from birth to age 59 days. Survival status was recorded at each visit. Gestational age was estimated from mother's reported last menstrual period. Birth weights were measured within 72 hours of delivery. SGA was defined using the INTERGROWTH-21st standard. We estimated unadjusted and adjusted hazard ratios (HRs) and corresponding 95% CIs for babies born preterm and SGA separately for the first and second month of life using bivariate and multivariable weighted Cox regression models. RESULTS The analysis included 17 643 singleton live birth babies. Compared with infants born at term-appropriate for gestational age, in both unadjusted and adjusted analyses, infants born preterm-SGA had the greatest risk of death in the first (HR 13.25, 95% CI 8.65-20.31; adjusted HR 12.05, 95% CI 7.82-18.57) and second month of life (HR 4.65, 95% CI 1.93-11.23; adjusted HR 4.1, 95% CI 1.66-10.15), followed by infants born preterm-appropriate for gestational age and term-SGA. CONCLUSIONS The risk of mortality in infants born preterm and/or SGA is increased and extends through the second month of life. Appropriate interventions to prevent and manage complications caused by prematurity and SGA could improve survival during and beyond the neonatal period.
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Affiliation(s)
- Jennifer A Applegate
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
| | | | - Rasheda Khanam
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Arunangshu Dutta Roy
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | | | | | - Dipak K Mitra
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Arif Mahmud
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | | | - Samir K Saha
- Child Health Research Foundation, Dhaka, Bangladesh
| | - Abdullah H Baqui
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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Hong J, Crawford K, Cavanagh E, Clifton V, Kumar S. Prediction of preterm birth in women with fetal growth restriction - Is the weekly change in sFlt-1/PlGF ratio or PlGF levels useful? Acta Obstet Gynecol Scand 2024; 103:1112-1119. [PMID: 38483020 PMCID: PMC11103152 DOI: 10.1111/aogs.14831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION To assess the rate of change in soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio and PlGF levels per week compared to a single sFlt-1/PlGF ratio or PlGF level to predict preterm birth for pregnancies complicated by fetal growth restriction. MATERIAL AND METHODS A prospective cohort study of pregnancies complicated by isolated fetal growth restriction. Maternal serum PlGF levels and the sFlt-1/PlGF ratio were measured at 4-weekly intervals from recruitment to delivery. We investigated the utility of PlGF levels, sFlt-1/PlGF ratio, change in PlGF levels per week or sFlt-1/PlGF ratio per week. Cox-proportional hazard models and Harrell's C concordance statistic were used to evaluate the effect of biomarkers on time to preterm birth. RESULTS The total study cohort was 158 pregnancies comprising 91 (57.6%) with fetal growth restriction and 67 (42.4%) with appropriate for gestational age controls. In the fetal growth restriction cohort, sFlt-1/PlGF ratio and PlGF levels significantly affected time to preterm birth (Harrell's C: 0.85-0.76). The rate of increase per week of the sFlt-1/PlGF ratio (hazard ratio [HR] 3.91, 95% confidence interval [CI]: 1.39-10.99, p = 0.01, Harrell's C: 0.74) was positively associated with preterm birth but change in PlGF levels per week was not (HR 0.65, 95% CI: 0.25-1.67, p = 0.37, Harrell's C: 0.68). CONCLUSIONS Both a high sFlt-1/PlGF ratio and low PlGF levels are predictive of preterm birth in women with fetal growth restriction. Although the rate of increase of the sFlt-1/PlGF ratio predicts preterm birth, it is not superior to either a single elevated sFlt-1/PlGF ratio or low PlGF level.
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Affiliation(s)
- Jesrine Hong
- Mater Research InstituteUniversity of QueenslandSouth BrisbaneQueenslandAustralia
- Faculty of MedicineThe University of QueenslandHerstonQueenslandAustralia
- Department of Obstetrics and Gynecology, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Kylie Crawford
- Mater Research InstituteUniversity of QueenslandSouth BrisbaneQueenslandAustralia
- Faculty of MedicineThe University of QueenslandHerstonQueenslandAustralia
| | - Erika Cavanagh
- Mater Research InstituteUniversity of QueenslandSouth BrisbaneQueenslandAustralia
| | - Vicki Clifton
- Mater Research InstituteUniversity of QueenslandSouth BrisbaneQueenslandAustralia
| | - Sailesh Kumar
- Mater Research InstituteUniversity of QueenslandSouth BrisbaneQueenslandAustralia
- Faculty of MedicineThe University of QueenslandHerstonQueenslandAustralia
- NHMRC Centre for Research Excellence in Stillbirth, Mater Research InstituteUniversity of QueenslandBrisbaneQueenslandAustralia
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20
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Hall M, Valencia CM, Soma-Pillay P, Luyt K, Jacobsson B, Shennan A. Effective and simple interventions to improve outcomes for preterm infants worldwide: The FIGO PremPrep-5 initiative. Int J Gynaecol Obstet 2024; 165:929-935. [PMID: 38264849 DOI: 10.1002/ijgo.15269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 01/25/2024]
Abstract
Preterm birth remains the leading cause of mortality among under-5's and is a major contributor to the reduction in quality-of-life adjusted years and reduction in human capital. Globally, there are many interventions and care bundles that aim to reduce the impact of preterm birth once preterm labor has ensued and into the neonatal period; not all of these are applicable in all settings. Here, we introduce the FIGO PremPrep-5 initiative, which aims to disseminate key information on the most simple and effective interventions with the aim of increasing implementation globally. Before delivery, we recommend a course of antenatal corticosteroids, and intrapartum magnesium sulfate. At delivery, we recommend delayed cord clamping. Postnatally, we recommend early feeding with breast milk and immediate kangaroo care. While there are many other interventions that may improve outcomes at the time of labor and after preterm birth, these are clinically effective and relatively inexpensive options that can be practiced in most settings and supplemented with more advanced care. We include examples of a training video and infographics that will be used for dissemination.
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Affiliation(s)
- Megan Hall
- Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, UK
| | - Catalina M Valencia
- Department of Obstetrics and Gynecology, Universidad CES, Medellín, Colombia
- Maternal Fetal Medicine Unit, Clinica del Prado, Medellín, Colombia
| | - Priya Soma-Pillay
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Steve Biko Academic Hospital, Pretoria, South Africa
| | - Karen Luyt
- Bristol Medical School, University of Bristol, Bristol, UK
- Neonatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway
| | - Andrew Shennan
- Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, UK
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21
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Nguyen-Hoang L, Chaemsaithong P, Cheng YKY, Feng Q, Fung J, Duan H, Chong MKC, Leung TY, Poon LC. Longitudinal evaluation of cervical length and shear wave elastography in women with spontaneous preterm birth. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 63:789-797. [PMID: 38354177 DOI: 10.1002/uog.27614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE To evaluate longitudinal changes in cervical length (CL) and mean cervical shear wave elastography (CSWE) score in women with a singleton or twin pregnancy who undergo spontaneous preterm birth (sPTB) compared with those who deliver at term. METHODS This was a prospective longitudinal study of unselected women with a singleton or twin pregnancy attending a dedicated research clinic for screening for sPTB at four timepoints during pregnancy: 11 + 0 to 15 + 6 weeks, 16 + 0 to 20 + 6 weeks, 21 + 0 to 24 + 6 weeks and 28 + 0 to 32 + 6 weeks. At each visit, a transvaginal ultrasound scan was conducted to measure the CL and the CSWE scores in six regions of interest (ROI) (inner, middle and external parts of anterior and posterior cervical lips). The mean CSWE score from the six ROIs was calculated for analysis. Log10 transformation was applied to data to produce a Gaussian distribution prior to statistical analysis. A multilevel mixed-effects analysis was performed to compare longitudinally CL and CSWE between the sPTB and term-delivery groups. RESULTS The final cohort consisted of 1264 women, including 1143 singleton pregnancies, of which 57 (5.0%) were complicated by sPTB, and 121 twin pregnancies, of which 33 (27.3%) were complicated by sPTB. Compared to those who delivered at term, women with sPTB had a lower CL across gestation when controlling for history of cervical surgery, number of fetuses, gestational age (GA) at cervical assessment and the interaction between GA at cervical assessment and sPTB (P < 0.001). Specifically, CL in the sPTB group was significantly lower at 21 + 0 to 24 + 6 weeks (P = 0.039) and 28 + 0 to 32 + 6 weeks (P < 0.001). Twin pregnancies had significantly greater CL throughout pregnancy compared with singleton pregnancies (regression coefficient, 0.01864; P < 0.001). After adjusting for maternal age, weight, height, body mass index and GA at cervical assessment, CSWE score in the sPTB group was significantly lower compared with that in the term-delivery group across gestation (P = 0.013). However, on analysis of individual visits, CSWE score in the sPTB group was significantly lower than that in the term-delivery group only at 11 + 0 to 15 + 6 weeks (P = 0.036). There was no difference in CSWE score between singleton and twin pregnancies throughout gestation (regression coefficient, -0.00128; P = 0.937). CONCLUSIONS Women with sPTB have a shorter and softer cervix across gestation compared with those who deliver at term. A shorter cervix in the sPTB group is observed from the late second trimester onwards, while lower cervical stiffness in the sPTB group is observed primarily in the first trimester. CL is significantly lower in singleton pregnancies compared with twin pregnancies, while cervical stiffness does not differ between the two. Our findings indicate that the cervix tends to undergo a softening process prior to shortening in sPTB cases. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- L Nguyen-Hoang
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - P Chaemsaithong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Y K Y Cheng
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Q Feng
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China
| | - J Fung
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - H Duan
- Department of Obstetrics and Gynecology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - M K C Chong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - T Y Leung
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - L C Poon
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
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Coyne R, Hughes W, Purtill H, McGrath D, Dunne CP, Philip RK. Influence of an Early Human Milk Diet on the Duration of Parenteral Nutrition and Incidence of Late-Onset Sepsis in Very Low Birthweight (VLBW) Infants: A Systematic Review. Breastfeed Med 2024; 19:425-434. [PMID: 38651604 DOI: 10.1089/bfm.2023.0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Introduction: Human milk is the preferred source of enteral nutrition for very low birthweight (VLBW) infants, and it possibly decreases dependence on parenteral nutrition (PN) and reduces incidence of late-onset sepsis (LOS). No systematic review to date has specifically addressed the value of early versus late introduction of human milk diet (HMD) on duration of PN and incidence of LOS among VLBW infants. Objective: To review the evidence for an early versus late introduction of HMD on duration of PN and incidence of LOS in VLBW infants. Method: Preferred reporting items for systematic reviews and meta-analysis-guided search of EMBASE and PubMed/Medline databases was conducted for this systematic review using phrases addressing population, intervention, comparator, and outcome framework to identify articles published over the past two decades without language restrictions. Full-text articles (both observational and randomized) that studied an early versus late initiation of HMD were included. Mean difference (MD) and relative risk (RR) with 95% confidence intervals (CIs) were calculated for PN and LOS. Quality of evidence was analyzed using UK National Service Framework and the risk-of-bias was assessed using Robvis®. Results: One randomized controlled trial (RCT) and two observational studies (two English and one Chinese) recruited 474 VLBW infants (455 analyzed). Among an intrauterine growth-restricted cohort enrolled in the RCT (n = 72), early HMD resulted in statistically significant reduction in PN dependence. However, no statistically significant difference was found in LOS. Two observational studies found similar reductions in PN duration and LOS incidence among the early HMD cohort. One observational study reported significant PN reduction; however, the incidence of LOS did not reach statistical significance in either case. Conclusion: An early HMD may reduce the duration of PN for a growth-restricted VLBW cohort. Observational studies suggesting reduced PN and LOS from early HMD endorse the need for bioactivity-focused human milk research. Variations in feeding guidelines among VLBW infants have the potential to influence neonatal outcomes significantly.
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Affiliation(s)
- Roisin Coyne
- Division of Neonatology, Department of Paediatrics, University Maternity Hospital Limerick (UMHL), Limerick, Ireland
| | - William Hughes
- Department of Sports and Health Sciences, Technological University of the Shannon: Midlands Midwest Athlone, Athlone, Ireland
| | - Helen Purtill
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Deirdre McGrath
- Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Colum P Dunne
- University of Limerick School of Medicine, Limerick, Ireland
- Centre for Interventions in Infection, Inflammation, and Immunity (4i), University of Limerick, Limerick, Ireland
| | - Roy K Philip
- Division of Neonatology, Department of Paediatrics, University Maternity Hospital Limerick (UMHL), Limerick, Ireland
- University of Limerick School of Medicine, Limerick, Ireland
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Powell AM, Ali Khan FZ, Ravel J, Elovitz MA. Untangling Associations of Microbiomes of Pregnancy and Preterm Birth. Clin Perinatol 2024; 51:425-439. [PMID: 38705650 PMCID: PMC11070640 DOI: 10.1016/j.clp.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
This review illuminates the complex interplay between various maternal microbiomes and their influence on preterm birth (PTB), a driving and persistent contributor to neonatal morbidity and mortality. Here, we examine the dynamics of oral, gastrointestinal (gut), placental, and vaginal microbiomes, dissecting their roles in the pathogenesis of PTB. Importantly, focusing on the vaginal microbiome and PTB, the review highlights (1) a protective role of Lactobacillus species; (2) an increased risk with select anaerobes; and (3) the influence of social health determinants on the composition of vaginal microbial communities.
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Affiliation(s)
- Anna Maya Powell
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 249, Baltimore, MD 21287, USA
| | - Fouzia Zahid Ali Khan
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 249, Baltimore, MD 21287, USA
| | - Jacques Ravel
- Department of Microbiology and Immunology, Institute for Genome Sciences, 670 West Baltimore Street, 3rd Floor, Room 3173, Baltimore, MD 21201, USA
| | - Michal A Elovitz
- Department of Obstetrics and Gynecology, Women's Health Research, Icahn School of Medicine at Mount Sinai, Women's Biomedical Research Institute, 1468 Madison Avenue, New York, NY 10029, USA.
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De Pieri C, Fauroux B, Khirani S, Thierry B, Delacourt C, Cogo P, Amaddeo A. Respiratory polygraphy in children with bronchopulmonary dysplasia: a retrospective study. Minerva Pediatr (Torino) 2024; 76:350-356. [PMID: 33305917 DOI: 10.23736/s2724-5276.20.06088-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND Periodic assessment of the need for oxygen supplementation and/or mechanical ventilation in children with severe bronchopulmonary dysplasia (BPD) is crucial. The aim of the study was to analyze the indications and results of respiratory polygraphies (RP) performed in preterm infants with BPD followed at a tertiary university hospital. METHODS All subjects <5-year-old with BPD who had a RP between September and February 2018 were included. The indications and results of RP and consequent medical management were analyzed. RESULTS Fourteen infants (9 females, mean gestational age 27.6±3.3 weeks) underwent a RP at mean age of 26.4±19.4 months. Five subjects were evaluated for the need of long-term respiratory support (RS), 3 started continuous positive airway pressure (CPAP), 2 were weaned from RS. Four subjects underwent RP for suspected obstructive sleep apnea (OSA), one started on CPAP. Central apnea syndrome (CSA) was confirmed in 2 subjects and one was started on non-invasive ventilation. RP allowed safe tracheostomy decannulation in 2 subjects. Finally, RP was normal in one subject who had a brief resolved unexplained event. CONCLUSIONS RP represents an important tool for the evaluation of children with BPD and leads to important therapeutic decisions.
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Affiliation(s)
- Carlo De Pieri
- Unit of Pediatric and Non-invasive Ventilation and Sleep, Necker-Enfants Malades Hospital, Paris, France
- Division of Pediatrics, Department of Medicine, University Hospital of Udine, Udine, Italy
| | - Brigitte Fauroux
- Unit of Pediatric and Non-invasive Ventilation and Sleep, Necker-Enfants Malades Hospital, Paris, France
- University of Paris, VIFASOM, Paris, France
| | - Sonia Khirani
- Unit of Pediatric and Non-invasive Ventilation and Sleep, Necker-Enfants Malades Hospital, Paris, France
- ASV Santé, Gennevilliers, France
| | - Briac Thierry
- Pediatric ENT Department, Necker-Enfants Malades Hospital, Paris, France
| | - Christophe Delacourt
- Department of Pediatric Pulmonology and Allergy, Necker-Enfants Malades Hospital, Paris, France
| | - Paola Cogo
- Division of Pediatrics, Department of Medicine, University Hospital of Udine, Udine, Italy
| | - Alessandro Amaddeo
- Unit of Pediatric and Non-invasive Ventilation and Sleep, Necker-Enfants Malades Hospital, Paris, France -
- University of Paris, VIFASOM, Paris, France
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25
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Zheng C, Martin-Herz SP, Abath CB, Scharf RJ. Motor Impairment Referrals to an International Child Development Clinic: It is Not Always Cerebral Palsy. Pediatr Neurol 2024; 155:167-170. [PMID: 38663153 DOI: 10.1016/j.pediatrneurol.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/21/2023] [Accepted: 02/10/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND The majority of the estimated 50 to 100 million children living with disability worldwide reside in low- or middle-income countries. As families migrate to avoid humanitarian crises, children with developmental disability and delay warrant particular attention in refugee and international health settings. During transitions, medical documentation may be lost and diagnoses may not be fully understood, contributing to the challenges of determining etiologies of motor impairment. METHODS Of the first 100 refugee children who were referred to the Child Development Clinic, we identified a subset of children referred for motor impairment or cerebral palsy. Data on their presentation, diagnoses following evaluation, and therapeutic services required was collected by retrospective chart review. RESULTS Twenty children were referred for motor impairment and cerebral palsy. Average age was 8.9 years; 45% were female. Eight children were eventually diagnosed with cerebral palsy, and 12 had alternate or inconclusive diagnoses. Microcephaly was more common in children diagnosed with cerebral palsy. CONCLUSIONS The frequent differences between referral and final diagnoses in refugee children referred for cerebral palsy highlights the need for pediatricians' careful examination and diagnostic reasoning upon initial presentation.
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Affiliation(s)
- Christie Zheng
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Susanne P Martin-Herz
- Department of Pediatrics, University of California San Francisco, San Francisco, California
| | | | - Rebecca J Scharf
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
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26
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Safarzadeh M, Richardson LS, Kammala AK, Mosebarger A, Bettayeb M, Kim S, Lam PY, Radnaa E, Han A, Menon R. A multi-organ, feto-maternal interface organ-on-chip, models pregnancy pathology and is a useful preclinical extracellular vesicle drug trial platform. EXTRACELLULAR VESICLE 2024; 3:100035. [PMID: 38872854 PMCID: PMC11175617 DOI: 10.1016/j.vesic.2024.100035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Pregnant women and their fetuses are often excluded from clinical trials due to missing drug-related pre-clinical trial information at the human feto-maternal interface (FMi). The two interfaces-placenta/decidua and fetal membranes/decidua are gatekeepers of drug transport; however, testing their functions is impractical during pregnancy. Limitations of current in-vivo/in-vitro models have hampered drug development and testing during pregnancy. Hence, major complications like preterm births and maternal and neonatal mortalities remain high. Advancements in organ-on-chip (OOC) platforms to test drug kinetics and efficacy and novel extracellular vesicle-based fetal drug delivery are expected to accelerate preclinical trials related to pregnancy complications. Here we report the development and testing of a humanized multi-organ fetal membrane/placenta (fetal)-decidua (maternal) interface OOC (FMi-PLA-OOC) that contains seven cell types interconnected through microchannels to maintain intercellular interactions as seen in-utero. Cytotoxicity, propagation, mechanism of action, and efficacy of engineered extracellular vesicles containing anti-inflammatory interleukin (IL)-10 (eIL-10) were evaluated to reduce FMi inflammation associated with preterm birth. A healthy and disease model (lipopolysaccharide-infectious inflammation) of the FMi-PLA-OOC was created and co-treated with eIL-10. eIL-10 propagated from the maternal to fetal side within 72-hours, localized in all cell types, showed no cytotoxicity, activated IL-10 signaling pathways, and reduced lipopolysaccharide-induced inflammation (minimized NF-kB activation and proinflammatory cytokine production). These data recapitulated eIL-10s' ability to reduce inflammation and delay infection-associated preterm birth in mouse models, suggesting FMi-PLA-OOC as an alternative approach to using animal models. Additionally, we report the utility of eIL-10 that can traverse through FMis to reduce inflammation-associated pregnancy complications.
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Affiliation(s)
- Melody Safarzadeh
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
- Division of Maternal-Fetal Medicine and Perinatal Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Lauren S. Richardson
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Ananth Kumar Kammala
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Angela Mosebarger
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Mohamed Bettayeb
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Sungjin Kim
- Department of Biomedical Engineering and Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Po Yi Lam
- Department of Biomedical Engineering and Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Enkhtuya Radnaa
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Arum Han
- Department of Biomedical Engineering and Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Ramkumar Menon
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
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27
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Bai J, Lu Y, Liu H, He F, Guo X. Editorial: New technologies improve maternal and newborn safety. FRONTIERS IN MEDICAL TECHNOLOGY 2024; 6:1372358. [PMID: 38872737 PMCID: PMC11169838 DOI: 10.3389/fmedt.2024.1372358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/17/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Jieyun Bai
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Information Technology, Jinan University, Guangzhou, China
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Yaosheng Lu
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Information Technology, Jinan University, Guangzhou, China
| | - Huishu Liu
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Fang He
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaohui Guo
- Department of Obstetrics, Shenzhen People’s Hospital, Shenzhen, China
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28
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Komatsu R, Nakamura H, Hosono T, Masuda T, Jones CJP, Aplin JD, Mimura K, Endo M, Kimura T. Local vaginal bioelectrical impedance can predict preterm delivery in mice. Mol Hum Reprod 2024; 30:gaae021. [PMID: 38830032 DOI: 10.1093/molehr/gaae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/26/2024] [Indexed: 06/05/2024] Open
Abstract
Preterm birth is a serious pregnancy complication that affects neonatal mortality, morbidity, and long-term neurological prognosis. Predicting spontaneous preterm delivery (PTD) is important for its management. While excluding the risk of PTD is important, identifying women at high risk of PTD is imperative for medical intervention. Currently used PTD prediction parameters in clinical practice have shown high negative predictive values, but low positive predictive values. We focused on sulfated and sialylated glycocalyx changes in the uterus and vagina prior to the onset of parturition and explored the potential of electrophysiological detection of these changes as a PTD prediction parameter with a high positive predictive value. In vivo local vaginal bioelectrical impedance (VZ) was measured using two different mouse PTD models. PTD was induced in ICR mice through the subcutaneous injection of mifepristone or local intrauterine injection of lipopolysaccharide (LPS). The PTD rates were 100% and 60% post-administration of mifepristone (16-20 h, n = 4) and LPS (12-24 h, n = 20), respectively. The local VZ values (15 and 10 h after mifepristone or LPS treatment, respectively) were significantly lower in the PTD group than in the non-PTD group. Receiver operator characteristic (ROC) curve analysis of VZ at 125 kHz as a predictor of PTD showed an area under the ROC curve of 1.00 and 0.77 and positive predictive values of 1.00 and 0.86, for the mifepristone and LPS models, respectively, suggesting that local VZ value can predict PTD. Histological examination of the LPS-treated model 6 h post-treatment revealed increased expression of sulfomucins and/or sulfated proteoglycans and sialomucins in the cervical epithelium, cervical stroma and vaginal stroma. In conclusion, local VZ values can determine sulfated and sialylated glycocalyx alterations within the uterus and vagina and might be a useful PTD prediction parameter.
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Affiliation(s)
- Reina Komatsu
- Department of Obstetrics and Gynaecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hitomi Nakamura
- Department of Obstetrics and Gynaecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takayoshi Hosono
- Graduate School of Biomedical Engineering, Osaka Electro-Communication University, Shijyo-nawate, Japan
| | - Tatsuo Masuda
- Department of Obstetrics and Gynaecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Carolyn J P Jones
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, St Mary's Hospital, Manchester, UK
- Maternal and Fetal Health Research Centre, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - John D Aplin
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, St Mary's Hospital, Manchester, UK
- Maternal and Fetal Health Research Centre, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Kazuya Mimura
- Department of Obstetrics and Gynaecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masayuki Endo
- Department of Obstetrics and Gynaecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynaecology, Osaka University Graduate School of Medicine, Suita, Japan
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29
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Peng T, Cui J, Ni Z, Tang Y, Cao X, Li S, Cheng X, Huang J. Methyl-CpG-binding protein 2 regulates CYP27A1-induced myometrial contraction during preterm labor. Mol Hum Reprod 2024; 30:gaae016. [PMID: 38704863 DOI: 10.1093/molehr/gaae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 03/25/2024] [Indexed: 05/07/2024] Open
Abstract
Persistent and intense uterine contraction is a risk factor for preterm labor. We previously found that methyl-CpG-binding protein 2 (MeCP2), as a target of infection-related microRNA miR-212-3p, may play an inhibitory role in regulating myometrium contraction. However, the molecular mechanisms by which MeCP2 regulates myometrial contraction are still unknown. In this study, we found that MeCP2 protein expression was lower in myometrial specimens obtained from preterm labor cases, compared to those obtained from term labor cases. Herein, using RNA sequence analysis of global gene expression in human uterine smooth muscle cells (HUSMCs) following siMeCP2, we show that MeCP2 silencing caused dysregulation of the cholesterol metabolism pathway. Notably, MeCP2 silencing resulted in the upregulation of CYP27A1, the key enzyme involved in regulating cholesterol homeostasis, in HUSMCs. Methylation-specific PCR, chromatin immunoprecipitation, and dual luciferase reporter gene technology indicated that MeCP2 could bind to the methylated CYP27A1 promoter region and repress its transcription. Administration of siCYP27A1 in a lipopolysaccharide (LPS)-induced preterm labor mouse model delayed the onset of preterm labor. Human preterm myometrium and the LPS-induced preterm labor mouse model both showed lower expression of MeCP2 and increased expression of CYP27A1. These results demonstrated that aberrant upregulation of CYP27A1 induced by MeCP2 silencing is one of the mechanisms facilitating inappropriate myometrial contraction. CYP27A1 could be exploited as a novel therapeutic target for preterm birth.
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Affiliation(s)
- Ting Peng
- Department of Obstetrics, Changning Maternity & Infant Health Hospital, East China Normal University, Shanghai, China
- Department of Obstetrics, Shanghai Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jiayan Cui
- Department of Pharmaceutical Sciences,Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, Shanghai, China
| | - Ziyun Ni
- Department of Pharmaceutical Sciences,Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, Shanghai, China
| | - Yao Tang
- Department of Obstetrics, Shanghai Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaojing Cao
- Department of Pharmaceutical Sciences,Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, Shanghai, China
| | - Sihan Li
- Department of Pharmaceutical Sciences,Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, Shanghai, China
| | - Xixi Cheng
- Department of Obstetrics, Shanghai Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jin Huang
- Department of Pharmaceutical Sciences,Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, Shanghai, China
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30
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Künstle N, Gorlanova O, Marten A, Müller L, Sharma P, Röösli M, Sinues P, Schär P, Schürmann D, Rüttimann C, Da Silva Sena CR, Nahum U, Usemann J, Steinberg R, Yammine S, Schulzke S, Latzin P, Frey U. Differences in autophagy marker levels at birth in preterm vs. term infants. Pediatr Res 2024:10.1038/s41390-024-03273-6. [PMID: 38811718 DOI: 10.1038/s41390-024-03273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/04/2024] [Accepted: 04/22/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Preterm infants are susceptible to oxidative stress and prone to respiratory diseases. Autophagy is an important defense mechanism against oxidative-stress-induced cell damage and involved in lung development and respiratory morbidity. We hypothesized that autophagy marker levels differ between preterm and term infants. METHODS In the prospective Basel-Bern Infant Lung Development (BILD) birth cohort we compared cord blood levels of macroautophagy (Beclin-1, LC3B), selective autophagy (p62) and regulation of autophagy (SIRT1) in 64 preterm and 453 term infants. RESULTS Beclin-1 and LC3B did not differ between preterm and term infants. However, p62 was higher (0.37, 95% confidence interval (CI) 0.05;0.69 in log2-transformed level, p = 0.025, padj = 0.050) and SIRT1 lower in preterm infants (-0.55, 95% CI -0.78;-0.31 in log2-transformed level, padj < 0.001). Furthermore, p62 decreased (padj-value for smoothing function was 0.018) and SIRT1 increased (0.10, 95% CI 0.07;0.13 in log2-transformed level, padj < 0.001) with increasing gestational age. CONCLUSION Our findings suggest differential levels of key autophagy markers between preterm and term infants. This adds to the knowledge of the sparsely studied field of autophagy mechanisms in preterm infants and might be linked to impaired oxidative stress response, preterm birth, impaired lung development and higher susceptibility to respiratory morbidity in preterm infants. IMPACT To the best of our knowledge, this is the first study to investigate autophagy marker levels between human preterm and term infants in a large population-based sample in cord blood plasma This study demonstrates differential levels of key autophagy markers in preterm compared to term infants and an association with gestational age This may be linked to impaired oxidative stress response or developmental aspects and provide bases for future studies investigating the association with respiratory morbidity.
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Affiliation(s)
- Noëmi Künstle
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Andrea Marten
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Loretta Müller
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pawan Sharma
- Center for Translational Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Jane & Leonard Korman Respiratory Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland and University of Basel, Basel, Switzerland
| | - Pablo Sinues
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Primo Schär
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - David Schürmann
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Céline Rüttimann
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carla Rebeca Da Silva Sena
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Priority Research Centre GrowUpWell® and Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Uri Nahum
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ruth Steinberg
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sven Schulzke
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Philipp Latzin
- Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Urs Frey
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland.
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31
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Bergeron J, Avraam D, Calas L, Fraser W, Harris JR, Heude B, Mandhane P, Moraes TJ, Muckle G, Nader J, Séguin JR, Simons E, Subbarao P, Swertz MA, Tough S, Turvey SE, Fortier I, Rod NH, Andersen AMN. Stress and anxiety during pregnancy and length of gestation: a federated study using data from five Canadian and European birth cohorts. Eur J Epidemiol 2024:10.1007/s10654-024-01126-4. [PMID: 38805076 DOI: 10.1007/s10654-024-01126-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 04/14/2024] [Indexed: 05/29/2024]
Abstract
While its etiology is not fully elucidated, preterm birth represents a major public health concern as it is the leading cause of child mortality and morbidity. Stress is one of the most common perinatal conditions and may increase the risk of preterm birth. In this paper we aimed to investigate the association of maternal perceived stress and anxiety with length of gestation. We used harmonized data from five birth cohorts from Canada, France, and Norway. A total of 5297 pregnancies of singletons were included in the analysis of perceived stress and gestational duration, and 55,775 pregnancies for anxiety. Federated analyses were performed through the DataSHIELD platform using Cox regression models within intervals of gestational age. The models were fit for each cohort separately, and the cohort-specific results were combined using random effects study-level meta-analysis. Moderate and high levels of perceived stress during pregnancy were associated with a shorter length of gestation in the very/moderately preterm interval [moderate: hazard ratio (HR) 1.92 (95%CI 0.83, 4.48); high: 2.04 (95%CI 0.77, 5.37)], albeit not statistically significant. No association was found for the other intervals. Anxiety was associated with gestational duration in the very/moderately preterm interval [1.66 (95%CI 1.32, 2.08)], and in the early term interval [1.15 (95%CI 1.08, 1.23)]. Our findings suggest that perceived stress and anxiety are associated with an increased risk of earlier birth, but only in the earliest gestational ages. We also found an association in the early term period for anxiety, but the result was only driven by the largest cohort, which collected information the latest in pregnancy. This raised a potential issue of reverse causality as anxiety later in pregnancy could be due to concerns about early signs of a possible preterm birth.
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Affiliation(s)
- Julie Bergeron
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
- Research Institute of the McGill University Health Center, Montreal, Canada.
| | - Demetris Avraam
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Lucinda Calas
- Centre for Research in Epidemiology and Statistics, INSERM, Paris, France
| | - William Fraser
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrook, Canada
| | - Jennifer R Harris
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, Norway
| | - Barbara Heude
- Centre for Research in Epidemiology and Statistics, INSERM, Paris, France
| | - Piush Mandhane
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Theo J Moraes
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Gina Muckle
- School of Psychology, Université Laval, Quebec, Canada
| | - Johanna Nader
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, Norway
| | - Jean R Séguin
- Department of Psychiatry and Addictology, Université de Montréal and CHU Ste-Justine Research Center, Montreal, Canada
| | - Elinor Simons
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Padmaja Subbarao
- Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Morris A Swertz
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Suzanne Tough
- Department of Paediatrics, University of Calgary, Calgary, Canada
| | - Stuart E Turvey
- Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, Canada
| | - Isabel Fortier
- Research Institute of the McGill University Health Center, Montreal, Canada
| | - Naja Hulvej Rod
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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32
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Mulinganya MG, De Keyser K, Mongane IJ, Kampara MF, De Vulder A, Boelens J, Duyvejonck H, Hendwa E, Kujirakwinja BY, Bisimwa BG, Rodriguez A, Vaneechoutte M, Callens S, Cools P. Second trimester vaginal Candida colonization among pregnant women attending antenatal care in Bukavu, Democratic Republic of the Congo: prevalence, clinical correlates, risk factors and pregnancy outcomes. Front Glob Womens Health 2024; 5:1339821. [PMID: 38847001 PMCID: PMC11153668 DOI: 10.3389/fgwh.2024.1339821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/29/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Vaginal Candida colonization (CC) can lead to vulvovaginal candidiasis, the second most prevalent vaginal condition worldwide, and has been associated with adverse birth outcomes. However, no data on CC in the Democratic Republic of the Congo are available. We investigated the prevalence, Candida species, clinical correlates, risk factors and pregnancy outcomes in women with CC in the second trimester of pregnancy. Material and methods In Bukavu, the Democratic Republic of the Congo, pregnant women were recruited during antenatal care between 16 and 20 weeks of gestation from January 2017 to October 2017 and followed until delivery. Sociodemographics, sexual behavioral, hygienic and clinical characteristics, microbiological data and pregnancy outcomes were collected. Candida detection and speciation was performed with microscopy (Gram-stained smears and wet-mount) and/or quantitative PCR. Multivariate regression models were used to estimate the different associations with CC. Results The prevalence of CC by wet mount, microscopy of Gram-stain smears and qPCR was 27.9%, 28.1% and 38.2%, respectively. C. albicans was the most prevalent Candida species (91.0%). Previous genital infections, an intermediate vaginal microbiota, bacterial vaginosis, and the use of pit toilets were risk factors for CC. Clinically, CC was associated with itching only. Women with CC had twice the odds for preterm birth, if Candida concentration was high, the odds were four times higher. Conclusions In Bukavu, the Democratic Republic of the Congo, the prevalence of CC was high and associated with microbiological and modifiable risk factors. Screening and treatment for CC during antenatal care should be investigated as a possible strategy to reduce preterm birth.
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Affiliation(s)
- Mulumeoderhwa Guy Mulinganya
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Karen De Keyser
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Irenge Jules Mongane
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Mirindi Freddy Kampara
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Annelies De Vulder
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jerina Boelens
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Hans Duyvejonck
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Erick Hendwa
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Bisimwa Yvette Kujirakwinja
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | | | - Antonio Rodriguez
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Mario Vaneechoutte
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Steven Callens
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Piet Cools
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Kudo R, Iwama N, Hamada H, Tomita H, Tagami K, Kumagai N, Sato N, Izumi S, Sakurai K, Watanabe Z, Ishikuro M, Obara T, Tatsuta N, Hoshiai T, Metoki H, Saito M, Sugawara J, Kuriyama S, Arima T, Yaegashi N. Maternal birth weight is an indicator of preterm delivery: the Japan environment and children's study. J Dev Orig Health Dis 2024; 15:e11. [PMID: 38773803 DOI: 10.1017/s2040174424000126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
This study aimed to investigate the association between maternal birth weight (MBW) with preterm delivery (PTD) in the Japanese population. To this end, a total of 78,972 Japanese pregnant women were included in a prospective birth cohort study. Multiple logistic regression and multinominal logistic regression models were applied to investigate the associations of MBW with PTD (delivery from 22 to < 37 weeks of gestation), early PTD (delivery from 22 to < 34 weeks), and late PTD (delivery from 34 to < 37 weeks). The results showed that MBW was inversely associated with PTD, early PTD, and late PTD (p-for-trend < 0.0001, 0.0014, and < 0.0001, respectively). The adjusted odds ratios per each 500 g of MBW decrease were 1.167 (95% confidence interval [CI]: 1.118-1.218) for PTD, 1.174 (95% CI: 1.070-1.287) for early PTD and 1.151 (95% CI: 1.098-1.206) for late PTD. The effect size of the association of MBW with early PTD was similar to that with late PTD. This study demonstrated for the first time an association of a low MBW with PTD, early PTD, and late PTD in a Japanese nationwide cohort.
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Affiliation(s)
- Rie Kudo
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirotaka Hamada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hasumi Tomita
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuma Tagami
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Natsumi Kumagai
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naoto Sato
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Seiya Izumi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kasumi Sakurai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Zen Watanabe
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mami Ishikuro
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Obara
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nozomi Tatsuta
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tetsuro Hoshiai
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Maternal and Fetal Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Junichi Sugawara
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Shinichi Kuriyama
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
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Giannini F, Hogan AB, Sarna M, Glass K, Moore HC. Modelling respiratory syncytial virus age-specific risk of hospitalisation in term and preterm infants. BMC Infect Dis 2024; 24:510. [PMID: 38773455 PMCID: PMC11110433 DOI: 10.1186/s12879-024-09400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infections in children worldwide. The highest incidence of severe disease is in the first 6 months of life, with infants born preterm at greatest risk for severe RSV infections. The licensure of new RSV therapeutics (a long-acting monoclonal antibody and a maternal vaccine) in Europe, USA, UK and most recently in Australia, has driven the need for strategic decision making on the implementation of RSV immunisation programs. Data driven approaches, considering the local RSV epidemiology, are critical to advise on the optimal use of these therapeutics for effective RSV control. METHODS We developed a dynamic compartmental model of RSV transmission fitted to individually-linked population-based laboratory, perinatal and hospitalisation data for 2000-2012 from metropolitan Western Australia (WA), stratified by age and prior exposure. We account for the differential risk of RSV-hospitalisation in full-term and preterm infants (defined as < 37 weeks gestation). We formulated a function relating age, RSV exposure history, and preterm status to the risk of RSV-hospitalisation given infection. RESULTS The age-to-risk function shows that risk of hospitalisation, given RSV infection, declines quickly in the first 12 months of life for all infants and is 2.6 times higher in preterm compared with term infants. The hospitalisation risk, given infection, declines to < 10% of the risk at birth by age 7 months for term infants and by 9 months for preterm infants. CONCLUSIONS The dynamic model, using the age-to-risk function, characterises RSV epidemiology for metropolitan WA and can now be extended to predict the impact of prevention measures. The stratification of the model by preterm status will enable the comparative assessment of potential strategies in the extended model that target this RSV risk group relative to all-population approaches. Furthermore, the age-to-risk function developed in this work has wider relevance to the epidemiological characterisation of RSV.
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Affiliation(s)
- Fiona Giannini
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, 15 Hospital Ave, Nedlands, WA, 6009, Australia.
| | - Alexandra B Hogan
- School of Population Health, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - Mohinder Sarna
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, 15 Hospital Ave, Nedlands, WA, 6009, Australia
- School of Population Health, Curtin University, Perth, WA, 6002, Australia
| | - Kathryn Glass
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, 15 Hospital Ave, Nedlands, WA, 6009, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, 62 Mills Rd, Acton ACT, 2601, Australia
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, 15 Hospital Ave, Nedlands, WA, 6009, Australia
- School of Population Health, Curtin University, Perth, WA, 6002, Australia
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Rent S, Gaffur R, Nkini G, Sengoka EG, Mlay P, Moyer CA, Lemmon M, Docherty SL, Mmbaga BT, Staton CA, Shayo A. Perinatal loss in Tanzania: Perspectives of maternal-child healthcare providers. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003227. [PMID: 38768103 PMCID: PMC11104680 DOI: 10.1371/journal.pgph.0003227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/19/2024] [Indexed: 05/22/2024]
Abstract
Over 98% of stillbirths and neonatal deaths occur in Low- and Middle-Income Countries, such as Tanzania. Despite the profound burden of perinatal loss in these regions, access to facility or community-based palliative and psychosocial care is poor and understudied. In this study we explore perinatal loss through the lens of front-line healthcare providers, to better understand the knowledge and beliefs that guide their engagement with bereaved families. A Knowledge Attitudes and Practices survey addressing perinatal loss in Tanzania was developed, translated into Swahili, and administered over a 4-month period to healthcare professionals working at the Kilimanjaro Christian Medical Center (KCMC). Results were entered into REDCap and analyzed in R Studio. 74 providers completed the survey. Pediatric providers saw a yearly average of 5 stillbirths and 32.7 neonatal deaths. Obstetric providers saw an average of 11.5 stillbirths and 13.12 neonatal deaths. Most providers would provide resuscitation beginning at 28 weeks gestational age. Respondents estimated that a 50% chance of survival for a newborn occurred at 28 weeks both nationally and at KCMC. Most providers felt that stillbirth and neonatal mortality were not the mother's fault (78.4% and 81.1%). However, nearly half (44.6%) felt that stillbirth reflects negatively on the woman and 62.2% agreed that women are at higher risk of abuse or abandonment after stillbirth. A majority perceived that women wanted hold their child after stillbirth (63.0%) or neonatal death (70.3%). Overall, this study found that providers at KCMC perceived that women are at greater risk of psychosocial or physical harm following perinatal loss. How women can best be supported by both the health system and their community remains unclear. More research on perinatal loss and bereavement in LMICs is needed to inform patient-level and health-systems interventions addressing care gaps unique to resource-limited or non-western settings.
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Affiliation(s)
- Sharla Rent
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Global Health Institute, Durham, North Carolina, United States of America
| | - Raziya Gaffur
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Center, Moshi, Tanzania
| | - Getrude Nkini
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Center, Moshi, Tanzania
| | - Enna Geofrey Sengoka
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Center, Moshi, Tanzania
| | - Pendo Mlay
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Cheryl A. Moyer
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Monica Lemmon
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, United States of America
- Department of Population Health Sciences, Duke University, Durham, North Carolina, United States of America
| | - Sharron L. Docherty
- School of Nursing, Duke University, Durham, North Carolina, United States of America
| | - Blandina T. Mmbaga
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Catherine A. Staton
- Duke Global Health Institute, Durham, North Carolina, United States of America
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Aisa Shayo
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Lafeber AH, de Jong RC, Bosch M, van de Lagemaat M, van Veenendaal NR, Aarnoudse-Moens CSH, Boersma B, van Goudoever JB, de Groof F. Nutritional intake and growth until two years of age in moderate and late preterms. Pediatr Res 2024:10.1038/s41390-024-03231-2. [PMID: 38769401 DOI: 10.1038/s41390-024-03231-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND AND AIM Moderate and late preterm infants (MLPTI) (gestational age 32 0/7-36 6/7 weeks), are at risk for suboptimal growth. This study evaluated adherence to nutritional recommendations until 6 months corrected age (CA), growth until 2 years CA, and associations between nutritional intake and growth until 2 years CA. METHODS We prospectively collected nutritional intakes from 100 MLPTI during the first week of life and at 6 weeks, 3 months, and 6 months CA. Anthropometry was assessed at birth, discharge, term age, and at 6 weeks, 3 months, 6 months, 1 year, and 2 years CA. RESULTS On day 7, <40% reached nutritional recommendations. Thereafter, >80% reached protein recommendations until 6 months of life, but <60% reached energy recommendations. Weight z-scores increased from -0.44 at term-age to 0.59 at 3 months CA, but declined to -0.53 at 2 years CA on the TNO curves. No significant associations were found between nutritional intake and growth until 2 years CA. CONCLUSION No associations were demonstrated between nutritional intakes and growth until 2 years CA, despite not reaching recommended intakes. Despite high efforts to optimize growth, MLPTI find their own growth curve in the first 2 years of life. IMPACT This research is pioneering in identifying how nutrition influences growth in moderate and late preterm infants (MLPTI) up to 2 years corrected age (CA). MLPTI often do not meet the recommended protein and energy intake in their first week of life, suggesting that current guidelines might be too high. No association was demonstrated between nutritional intake and growth of MLPTI in the first 2 years of life. Initially, MLPTI show an increase in weight z-scores from term age up to 3 months CA but experience a decline in weight z-scores at 2 years CA, according to TNO growth charts.
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Affiliation(s)
- Anne H Lafeber
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands
| | - Roxanne C de Jong
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands
| | - Mark Bosch
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands
| | - Monique van de Lagemaat
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development (AR&D), Research Institute, Amsterdam, The Netherlands
| | - Nicole R van Veenendaal
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands
| | - Cornelieke S H Aarnoudse-Moens
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bart Boersma
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands
| | - Johannes B van Goudoever
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development (AR&D), Research Institute, Amsterdam, The Netherlands
| | - Femke de Groof
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands.
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Chen JJ, Chen XJ, She QM, Li JX, Luo QH. Clinical risk factors for preterm birth and evaluating maternal psychology in the postpartum period. World J Psychiatry 2024; 14:661-669. [PMID: 38808088 PMCID: PMC11129159 DOI: 10.5498/wjp.v14.i5.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/26/2024] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Although the specific pathogenesis of preterm birth (PTB) has not been thoroughly clarified, it is known to be related to various factors, such as pregnancy complications, maternal socioeconomic factors, lifestyle habits, reproductive history, environmental and psychological factors, prenatal care, and nutritional status. PTB has serious implications for newborns and families and is associated with high mortality and complications. Therefore, the prediction of PTB risk can facilitate early intervention and reduce its resultant adverse consequences. AIM To analyze the risk factors for PTB to establish a PTB risk prediction model and to assess postpartum anxiety and depression in mothers. METHODS A retrospective analysis of 648 consecutive parturients who delivered at Shenzhen Bao'an District Songgang People's Hospital between January 2019 and January 2022 was performed. According to the diagnostic criteria for premature infants, the parturients were divided into a PTB group (n = 60) and a full-term (FT) group (n = 588). Puerperae were assessed by the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS), based on which the mothers with anxiety and depression symptoms were screened for further analysis. The factors affecting PTB were analyzed by univariate analysis, and the related risk factors were identified by logistic regression. RESULTS According to univariate analysis, the PTB group was older than the FT group, with a smaller weight change and greater proportions of women who underwent artificial insemination and had gestational diabetes mellitus (P < 0.05). In addition, greater proportions of women with reproductive tract infections and greater white blood cell (WBC) counts (P < 0.05), shorter cervical lengths in the second trimester and lower neutrophil percentages (P < 0.001) were detected in the PTB group than in the FT group. The PTB group exhibited higher postpartum SAS and SDS scores than did the FT group (P < 0.0001), with a higher number of mothers experiencing anxiety and depression (P < 0.001). Multivariate logistic regression analysis revealed that a greater maternal weight change, the presence of gestational diabetes mellitus, a shorter cervical length in the second trimester, a greater WBC count, and the presence of maternal anxiety and depression were risk factors for PTB (P < 0.01). Moreover, the risk score of the FT group was lower than that of the PTB group, and the area under the curve of the risk score for predicting PTB was greater than 0.9. CONCLUSION This study highlights the complex interplay between postpartum anxiety and PTB, where maternal anxiety may be a potential risk factor for PTB, with PTB potentially increasing the incidence of postpartum anxiety in mothers. In addition, a greater maternal weight change, the presence of gestational diabetes mellitus, a shorter cervical length, a greater WBC count, and postpartum anxiety and depression were identified as risk factors for PTB.
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Affiliation(s)
- Jia-Jun Chen
- Department of Clinical Laboratory, Shenzhen Bao’an District Songgang People’s Hospital, Shenzhen 518000, Guangdong Province, China
| | - Xue-Jin Chen
- Department of Otolaryngology Head and Neck Surgery Outpatient, Shenzhen Children’s Hospital, Shenzhen 518000, Guangdong Province, China
| | - Qiu-Min She
- Department of Clinical Laboratory, Shenzhen Bao’an District Songgang People’s Hospital, Shenzhen 518000, Guangdong Province, China
| | - Jie-Xi Li
- Department of Prevention and Health Care, Shenzhen Bao’an District Songgang People’s Hospital, Shenzhen 518000, Guangdong Province, China
| | - Qiu-Hong Luo
- Department of Obstetrics, Shenzhen Bao’an District Songgang People’s Hospital, Shenzhen 518000, Guangdong Province, China
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Song Y, Yang C. Mechanistic advances of hyperoxia-induced immature brain injury. Heliyon 2024; 10:e30005. [PMID: 38694048 PMCID: PMC11058899 DOI: 10.1016/j.heliyon.2024.e30005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/11/2024] [Accepted: 04/18/2024] [Indexed: 05/03/2024] Open
Abstract
The impact of hyperoxia-induced brain injury in preterm infants is being increasingly investigated. However, the parameters and protocols used to study this condition in animal models lack consistency. Research is further hampered by the fact that hyperoxia exerts both direct and indirect effects on oligodendrocytes and neurons, with the precise underlying mechanisms remaining unclear. In this article, we aim to provide a comprehensive overview of the conditions used to induce hyperoxia in animal models of immature brain injury. We discuss what is known regarding the mechanisms underlying hyperoxia-induced immature brain injury, focusing on the effects on oligodendrocytes and neurons, and briefly describe therapies that may counteract the effects of hyperoxia. We also identify further studies required to fully elucidate the effects of hyperoxia on the immature brain as well as discuss the leading therapeutic options.
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Affiliation(s)
- Yue Song
- Department of Pediatrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan Province, China
- Department of Clinical Medicine, The Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Changqiang Yang
- Department of Cardiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan Province, China
- Department of Clinical Medicine, The Chengdu Medical College, Chengdu 610500, Sichuan Province, China
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Rao T, Zhou Y, Chen C, Chen J, Zhang J, Lin W, Jia D. Recent progress in neonatal hyperoxic lung injury. Pediatr Pulmonol 2024. [PMID: 38742254 DOI: 10.1002/ppul.27062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/28/2024] [Accepted: 05/04/2024] [Indexed: 05/16/2024]
Abstract
With the progress in neonatal intensive care, there has been an increase in the survival rates of premature infants. However, this has also led to an increased incidence of neonatal hyperoxia lung injury and bronchopulmonary dysplasia (BPD), whose pathogenesis is believed to be influenced by various prenatal and postnatal factors, although the exact mechanisms remain unclear. Recent studies suggest that multiple mechanisms might be involved in neonatal hyperoxic lung injury and BPD, with sex also possibly playing an important role, and numerous drugs have been proposed and shown promise for improving the treatment outcomes of hyperoxic lung injury. Therefore, this paper aims to analyze and summarize sex differences in neonatal hyperoxic lung injury, potential pathogenesis and treatment progress to provide new ideas for basic and clinical research in this field.
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Affiliation(s)
- Tian Rao
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yiyang Zhou
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chizhang Chen
- Department of Clinical Medicine, Chinese Medicine Hospital of Pingyang, Wenzhou, Zhejiang, China
| | - Jiayi Chen
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jie Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wei Lin
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Danyun Jia
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China
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You Z, Mei H, Zhang Y, Song D, Zhang Y, Liu C. The effect of vitamin D deficiency during pregnancy on adverse birth outcomes in neonates: a systematic review and meta-analysis. Front Pediatr 2024; 12:1399615. [PMID: 38808102 PMCID: PMC11130944 DOI: 10.3389/fped.2024.1399615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/01/2024] [Indexed: 05/30/2024] Open
Abstract
Objective To systematically evaluate the effect of vitamin D deficiency during pregnancy on neonatal adverse outcomes, such as preterm infants, low birth weight infants (LBWI), and small for gestational age (SGA) infants. Methods A comprehensive literature search was conducted across multiple databases including PubMed, Embase, Cochrane Library, SinoMed, Wanfang Data Knowledge Service Platform, China National Knowledge Internet (CNKI), and VIP Chinese Science and Technology Journal Database (VIP). Following predefined inclusion and exclusion criteria, two researchers independently screened, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4 and Stata 14 software to synthesize the findings. Results This study incorporated 13 cohort studies from 8 different countries and regions, encompassing a total of 55,162 pregnant women, among whom 28,155 were identified as having vitamin D deficiency. The Newcastle-Ottawa Scale (NOS) score ranged from 7-9 points. Meta-analysis results indicated a higher incidence of LBWI (OR = 5.52, 95% CI = 1.31-23.22. P = 0.02) in the group of pregnant women with vitamin D deficiency compared to those with adequate levels. However, there was no statistically significant difference in the likelihood of premature birth (OR = 1.25, 95% CI = 0.78-1.99. P = 0.36) or SGA (OR = 1.47, 95% CI = 0.81-2.68. P = 0.21) among newborns born to mothers with vitamin D deficiency vs. those with sufficient levels of vitamin D. Subgroup analysis based on the timing of maternal blood collection revealed that there was no statistically significant association between vitamin D levels during pregnancy and the incidence of preterm birth across all stages of pregnancy. Furthermore, vitamin D deficiency throughout the entire pregnancy was associated with an increased incidence of neonatal LBWI, whereas vitamin D levels during the first, second, and third trimesters did not demonstrate statistically differences on LBWI. Neonates born to mothers with vitamin D deficiency throughout pregnancy were found to have a higher likelihood of developing SGA. However, there was no statistically significant association between vitamin D levels and the development of SGA during the first and second trimesters. Conclusions Adequate levels of vitamin D during pregnancy may decrease the incidence of LBWI, although further research is needed to determine its impact on the occurrence of preterm birth and SGA. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024535950, Identifier: (CRD42024535950).
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Affiliation(s)
| | - Hua Mei
- Department of Neonatology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Yayu Zhang
- Department of Neonatology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
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Getaneh FB, Mohammed A, Belete AG, Muche A, Ayres A, Asmamaw Y, Mengesha Z, Dimtse A, Misganaw NM, Mihretie DB, Bitew ZW, Mengstu M, Molla A. Effect of topical emollient oil application on weight of preterm newborns: A systematic review and meta-analysis. PLoS One 2024; 19:e0302969. [PMID: 38743769 PMCID: PMC11093394 DOI: 10.1371/journal.pone.0302969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Synthesizing current evidence on interventions to improve survival outcomes in preterm infants is crucial for informing programs and policies. The objective of this study is to investigate the impact of topical emollient oil application on the weight of preterm infants. METHODS A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. To identify relevant studies, comprehensive searches were conducted across multiple databases, including PubMed, Cochrane, Scopus, Clinical trials, ProQuest Central, Epistemonikos, and gray literature sources. The inclusion criteria were based on the PICO (Population, Intervention, Comparison, and Outcomes) format. Study quality was assessed using the Cochrane risk of bias tool for randomized trials (RoB 2.0). Data analysis was performed using StataCrop MP V.17 software, which included evaluating heterogeneity, conducting subgroup analysis, sensitivity analysis, and meta-regression. The findings were reported in accordance with the PRISMA checklist, and the review was registered with PROSPERO (CRD42023413770). RESULTS Out of the initial pool of 2734 articles, a total of 18 studies involving 1454 preterm neonates were included in the final analysis. Fourteen of these studies provided data that contributed to the calculation of the pooled difference in mean weight gain in preterm neonates. The random effects meta-analysis revealed a significant pooled difference in mean weight gain of 52.15 grams (95% CI: 45.96, 58.35), albeit with high heterogeneity (I2 > 93.24%, p 0.000). Subgroup analyses were conducted, revealing that preterm infants who received massages three times daily with either sunflower oil or coconut oil exhibited greater mean differences in weight gain. Meta-regression analysis indicated that the type of emollient oil, duration of therapy, and frequency of application significantly contributed to the observed heterogeneity. A sensitivity analysis was performed, excluding two outlier studies, resulting in a pooled mean weight difference of 78.57grams (95% CI: 52.46, 104.68). Among the nine studies that reported adverse events, only two mentioned occurrences of rash and accidental slippage in the intervention groups. CONCLUSION The available evidence suggests that the application of topical emollient oil in preterm neonates is likely to be effective in promoting weight gain, with a moderate-to-high level of certainty. Based on these findings, it is recommended that local policymakers and health planners prioritize the routine use of emollient oils in newborn care for preterm infants. By incorporating emollient oils into standard care protocols, healthcare providers can provide additional support to promote optimal growth and development in preterm infants.
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Affiliation(s)
| | - Anissa Mohammed
- College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | | | - Amare Muche
- College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Aznamariyam Ayres
- College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yibeltal Asmamaw
- College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zemen Mengesha
- College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Asrat Dimtse
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Zebenay Workneh Bitew
- College of Health Sciences, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Meaza Mengstu
- College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Asressie Molla
- College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Mitchell EJ, Aluvaala J, Bradshaw L, Daniels JP, Emadau C, Muthumbi B, Nabwera H, Ojee E, Opira J, Pallotti P, Qureshi Z, Sigei M, Su Y, Swinden R, Were F, Ojha S. A mixed-methods study to investigate feasibility and acceptability of an early warning score for preterm infants in neonatal units in Kenya: results of the NEWS-K study : Neonatal early warning scores in Kenya. BMC Pediatr 2024; 24:326. [PMID: 38734617 PMCID: PMC11088162 DOI: 10.1186/s12887-024-04778-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
Preterm birth (< 37 weeks gestation) complications are the leading cause of neonatal mortality. Early-warning scores (EWS) are charts where vital signs (e.g., temperature, heart rate, respiratory rate) are recorded, triggering action. To evaluate whether a neonatal EWS improves clinical outcomes in low-middle income countries, a randomised trial is needed. Determining whether the use of a neonatal EWS is feasible and acceptable in newborn units, is a prerequisite to conducting a trial. We implemented a neonatal EWS in three newborn units in Kenya. Staff were asked to record infants' vital signs on the EWS during the study, triggering additional interventions as per existing local guidelines. No other aspects of care were altered. Feasibility criteria were pre-specified. We also interviewed health professionals (n = 28) and parents/family members (n = 42) to hear their opinions of the EWS. Data were collected on 465 preterm and/or low birthweight (< 2.5 kg) infants. In addition to qualitative study participants, 45 health professionals in participating hospitals also completed an online survey to share their views on the EWS. 94% of infants had the EWS completed at least once during their newborn unit admission. EWS completion was highest on the day of admission (93%). Completion rates were similar across shifts. 15% of vital signs triggered escalation to a more senior member of staff. Health professionals reported liking the EWS, though recognised the biggest barrier to implementation was poor staffing. Newborn unit infant to staff ratios varied between 10 and 53 staff per 1 infant, depending upon time of shift and staff type. A randomised trial of neonatal EWS in Kenya is possible and acceptable, though adaptations are required to the form before implementation.
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Affiliation(s)
- Eleanor J Mitchell
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Jalemba Aluvaala
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | - Lucy Bradshaw
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jane P Daniels
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Caren Emadau
- Department of Paediatrics, Pumwani Maternity Hospital, PO Box 42849, Nairobi, 00100, Kenya
| | - Bernadine Muthumbi
- Department of Paediatrics, Thika Level 5 Hospital, PO Box 227, Thika, 001000, Kenya
| | - Helen Nabwera
- Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Ednah Ojee
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | | | - Phoebe Pallotti
- Maternal Health and Wellbeing Research Group, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Zahida Qureshi
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - Mark Sigei
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - Yuanfei Su
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Richard Swinden
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Fredrick Were
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | - Shalini Ojha
- Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
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Hong S, Jiang N, Lin G, Wang Q, Xu X, Shi X, Zhou Y, Wen X, Sun B, Wang H, Huang M, Wang J, Wang N, Chen Y, Jiang Q. Association of maternal mineral status with the risk of preterm birth: a retrospective cohort study. Front Nutr 2024; 11:1329720. [PMID: 38798772 PMCID: PMC11122899 DOI: 10.3389/fnut.2024.1329720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
Background There has been a gradual increase in the proportion of preterm birth in China during the past several decades. Maternal malnutrition is a significant determinant for preterm birth. Nevertheless, comprehensive studies investigating serum mineral levels during pregnancy associated with preterm birth remain scarce. This study aims to assess the associations between maternal serum mineral levels and the risk of preterm birth. Methods This retrospective cohort study of 18,048 pregnant women used data from a tertiary hospital in China from January 2016 to December 2022. Demographic data and serum mineral concentrations in the second and third trimesters of mothers were collected from the hospital information system. Analysis was performed using restricted cubic splines and logistic regression models. Results The proportion of preterm birth in this study was 6.01%. Phosphorus [P for overall = 0.005; P for nonlinear = 0.490; OR (95%CI) = 1.11 (1.04, 1.18)] and chlorine [P for overall = 0.002; P for nonlinear = 0.058; OR (95%CI) = 1.11 (1.03, 1.19)] showed a significant positive correlation with preterm birth in a linear fashion. Furthermore, serum levels of potassium (P for nonlinear <0.001), sodium (P for nonlinear = 0.004), and magnesium (P for nonlinear <0.001) exhibited non-linear relationships with the risk of preterm birth. Conclusion Serum levels of some minerals during pregnancy were associated with the risk of preterm birth among pregnant women. In addition to commonly recognized micronutrients such as folic acid, iron, and vitamin D, healthcare providers should also pay attention to the levels of these minerals during pregnancy.
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Affiliation(s)
- Sumiao Hong
- Department of the Obstetrics, The People's Hospital of Pingyang, Wenzhou, China
| | - Nan Jiang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Guankai Lin
- Wenzhou Center for Disease Control and Prevention, Wenzhou, China
| | - Quqing Wang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Xiaoyang Xu
- Department of the Obstetrics, The People's Hospital of Pingyang, Wenzhou, China
| | - Xinrui Shi
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - You Zhou
- Department of the Obstetrics, The People's Hospital of Pingyang, Wenzhou, China
| | - Xiaoting Wen
- Department of the Obstetrics, The People's Hospital of Pingyang, Wenzhou, China
| | - Baochang Sun
- Wenzhou Center for Disease Control and Prevention, Wenzhou, China
| | - Hexing Wang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Min Huang
- Department of the Obstetrics, The People's Hospital of Pingyang, Wenzhou, China
| | - Jiwei Wang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Na Wang
- Department of the Obstetrics, The People's Hospital of Pingyang, Wenzhou, China
| | - Yue Chen
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Qingwu Jiang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
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Govindaraj D, Jensen GB, Rahman Qazi K, Sverremark‐Ekström E, Abrahamsson T, Jenmalm MC. Effects of extremely preterm birth on cytokine and chemokine responses induced by T-cell activation during infancy. Clin Transl Immunology 2024; 13:e1510. [PMID: 38737447 PMCID: PMC11087183 DOI: 10.1002/cti2.1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/14/2024] Open
Abstract
Objectives Extremely preterm (EPT; gestational week < 28 + 0, < 1000 g) neonates are vulnerable to infections and necrotising enterocolitis, important contributors to mortality and morbidity. However, knowledge regarding their immune maturation remains limited. We here investigated the longitudinal development of functional T-cell capacity in EPT infants. Methods Peripheral blood mononuclear cells were isolated at 14th and 28th day (D) and at gestational week 36 + 0 (Gw36) from EPT infants, participated in a randomised, double-blind, placebo-controlled study of Lactobacillus reuteri DSM 17938 probiotic supplementation. Blood collected from 25 full-term (FT) infants at D14 was used as control. The secretion of immune mediators was determined through comprehensive Luminex panels after stimulation with human T-cell activator CD3/CD28 beads. Results The levels of many mediators were low in EPT infants at D14, whereas the secretion of several chemokines was higher in EPT than in FT infants. Furthermore, Th2:Th1 cytokine ratios were higher in EPT than in FT infants. Progressively elevated secretion of, for example, IFN-γ, TNF and IL-17A in EPT infants was observed from D14 to D28 and then at Gw36. Elevated levels were observed for many proinflammatory mediators at D28. Probiotic supplementation or perinatal factors (e.g. clinical chorioamnionitis, preeclampsia and delivery mode) did not influence the cytokine and chemokine responses. Conclusions Immune mediators induced by T-cell activation in EPT infants were mainly reduced at D14 and Th2 skewed compared to those in FT infants, but mostly recovered at Gw36, indicating immune maturation. Increased proinflammatory responses at D28 may be related to the heightened risk of severe immune-associated complications seen in EPT infants.
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Affiliation(s)
- Dhanapal Govindaraj
- Division of Inflammation and Infection (II), Department of Biomedical and Clinical Sciences (BKV)Linköping UniversityLinköpingSweden
| | - Georg Bach Jensen
- Division of Inflammation and Infection (II), Department of Biomedical and Clinical Sciences (BKV)Linköping UniversityLinköpingSweden
- Crown Princess Victoria Children's HospitalLinköpingCounty of ÖstergötlandSweden
| | - Khaleda Rahman Qazi
- Department of Molecular Biosciences, The Wenner‐Gren InstituteStockholm UniversityStockholmSweden
| | - Eva Sverremark‐Ekström
- Department of Molecular Biosciences, The Wenner‐Gren InstituteStockholm UniversityStockholmSweden
| | - Thomas Abrahamsson
- Division of Inflammation and Infection (II), Department of Biomedical and Clinical Sciences (BKV)Linköping UniversityLinköpingSweden
- Crown Princess Victoria Children's HospitalLinköpingCounty of ÖstergötlandSweden
| | - Maria C Jenmalm
- Division of Inflammation and Infection (II), Department of Biomedical and Clinical Sciences (BKV)Linköping UniversityLinköpingSweden
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Wang YS, Su XT, Ke L, He QH, Chang D, Nie J, Luo X, Chen F, Xu J, Zhang C, Zhang S, Zhang S, An H, Guo R, Yue S, Duan W, Jia S, Yang S, Yu Y, Zhao Y, Zhou Y, Chen LZ, Fan XR, Gao P, Lv C, Wu Z, Zhao Y, Quan X, Zhao F, Mu Y, Yan Y, Xu W, Liu J, Xing L, Chen X, Wu X, Zhao L, Huang Z, Ren Y, Hao H, Li H, Wang J, Dong Q, Chen L, Huang R, Liu S, Wang Y, Dong Q, Zuo XN. Initiating PeriCBD to probe perinatal influences on neurodevelopment during 3-10 years in China. Sci Data 2024; 11:463. [PMID: 38714688 PMCID: PMC11076487 DOI: 10.1038/s41597-024-03211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/02/2024] [Indexed: 05/10/2024] Open
Abstract
Adverse perinatal factors can interfere with the normal development of the brain, potentially resulting in long-term effects on the comprehensive development of children. Presently, the understanding of cognitive and neurodevelopmental processes under conditions of adverse perinatal factors is substantially limited. There is a critical need for an open resource that integrates various perinatal factors with the development of the brain and mental health to facilitate a deeper understanding of these developmental trajectories. In this Data Descriptor, we introduce a multicenter database containing information on perinatal factors that can potentially influence children's brain-mind development, namely, periCBD, that combines neuroimaging and behavioural phenotypes with perinatal factors at county/region/central district hospitals. PeriCBD was designed to establish a platform for the investigation of individual differences in brain-mind development associated with perinatal factors among children aged 3-10 years. Ultimately, our goal is to help understand how different adverse perinatal factors specifically impact cognitive development and neurodevelopment. Herein, we provide a systematic overview of the data acquisition/cleaning/quality control/sharing, processes of periCBD.
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Affiliation(s)
- Yin-Shan Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Developmental Population Neuroscience Research Center, International Data Group/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Xue-Ting Su
- Department of Military Operational Medical Protection, Chinese PLA Center for Disease Control and Prevention, Beijing, 100850, China
| | - Li Ke
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China.
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, 100875, China.
| | - Qing-Hua He
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Da Chang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Developmental Population Neuroscience Research Center, International Data Group/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - JingJing Nie
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Developmental Population Neuroscience Research Center, International Data Group/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - XinLi Luo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Developmental Population Neuroscience Research Center, International Data Group/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Fumei Chen
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, 100875, China
| | - Jihong Xu
- National Research Institute for Health Commission, Beijing, 100081, China
| | - Cai Zhang
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, 100875, China
| | - Shudong Zhang
- Faculty of Education, Beijing Normal University, Beijing, 100875, China
| | - Shuyue Zhang
- Department of Psychology, Faculty of Education, Guangxi Normal University, Guilin, 541001, China
| | - Huiping An
- Anyang Maternal and Child Health Care Hospital, Anyang, 455000, China
| | - Rui Guo
- People's Hospital of Liangping District, Chongqing, 405200, China
| | - Suping Yue
- Anyang Preschool Education College, Anyang, 456150, China
| | - Wen Duan
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, 100875, China
| | - Shichao Jia
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, 100875, China
| | - Sijia Yang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, 100875, China
| | - Yankun Yu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
| | - Yang Zhao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, 100875, China
| | - Yang Zhou
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
| | - Li-Zhen Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Developmental Population Neuroscience Research Center, International Data Group/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Xue-Ru Fan
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Developmental Population Neuroscience Research Center, International Data Group/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Peng Gao
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, 030024, China
| | - Chenyu Lv
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Ziyun Wu
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Yunyan Zhao
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, 100875, China
| | - Xi Quan
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, 100875, China
| | - Feng Zhao
- Department of Psychology, Faculty of Education, Guangxi Normal University, Guilin, 541001, China
| | - Yanchao Mu
- Anyang Maternal and Child Health Care Hospital, Anyang, 455000, China
| | - Yu Yan
- Anyang Maternal and Child Health Care Hospital, Anyang, 455000, China
| | - Wenchao Xu
- Anyang Maternal and Child Health Care Hospital, Anyang, 455000, China
| | - Jie Liu
- Anyang Maternal and Child Health Care Hospital, Anyang, 455000, China
| | - Lixia Xing
- Anyang Maternal and Child Health Care Hospital, Anyang, 455000, China
| | - Xiaoqin Chen
- People's Hospital of Liangping District, Chongqing, 405200, China
| | - Xiang Wu
- People's Hospital of Liangping District, Chongqing, 405200, China
| | - Lanfeng Zhao
- People's Hospital of Liangping District, Chongqing, 405200, China
| | - Zhijuan Huang
- People's Hospital of Liangping District, Chongqing, 405200, China
| | - Yanzhou Ren
- Anyang Preschool Education College, Anyang, 456150, China
| | - Hongyan Hao
- Anyang Preschool Education College, Anyang, 456150, China
| | - Hui Li
- Anyang Preschool Education College, Anyang, 456150, China
| | - Jing Wang
- Anyang Preschool Education College, Anyang, 456150, China
| | - Qing Dong
- Anyang Preschool Education College, Anyang, 456150, China
| | - Liyan Chen
- Anyang Preschool Education College, Anyang, 456150, China
| | - Ruiwang Huang
- School of Psychology, South China Normal University, Guangzhou, 510631, China
| | - Siman Liu
- School of Humanities and Social Sciences, Beijing Institute of Technology, Beijing, 100081, China
| | - Yun Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
| | - Qi Dong
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
| | - Xi-Nian Zuo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Developmental Population Neuroscience Research Center, International Data Group/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
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Martínez-Zamora MD, Martín-Martínez C, Martínez-de-Quel Ó, Valenzuela PL. Influence of Preterm Birth and Low Birthweight on Physical Fitness: A Systematic Review, Meta-Analysis, and Meta-Regression. Sports Med 2024:10.1007/s40279-024-02026-z. [PMID: 38709451 DOI: 10.1007/s40279-024-02026-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Preterm birth and low birthweight (LBW) might be associated with reduced physical fitness, although evidence remains inconclusive. OBJECTIVE To examine the influence of preterm birth and LBW on physical fitness, as well as to assess whether variables such as gestational age, birthweight, or age at assessment moderate these effects. METHODS PubMed, Scopus, and PsycINFO were systematically searched from inception to 7 December 2023 for case-control and cohort studies analyzing the association between preterm birth or LBW (or gestational age or birthweight as continuous variables) with at least one physical fitness-related outcome (i.e., cardiorespiratory fitness (CRF), muscle strength, flexibility, speed, agility). Random-effects meta-analysis and meta-regression models were used to estimate the pooled effect size, as well as to examine potential associations between the magnitude of the effect and gestational age, birthweight, or age at assessment. RESULTS Fifty-two studies (n = 920,603 participants, average age ranging from 4.7 to 34.4 years) were included. Preterm birth was associated with reduced CRF (standardized mean difference (SMD) = -0.38, 95% confidence interval (CI) = -0.51 to -0.25) and muscle strength (SMD = -0.44, 95% CI = -0.79 to -0.08). LBW was associated with reduced CRF (SMD = -0.40, 95% CI = -0.64 to -0.17), muscle strength (SMD = -0.18, 95% CI = -0.24 to -0.13), flexibility (SMD = -0.11, 95% CI = -0.22 to -0.01), and agility (SMD = -0.99, 95% CI = -1.91 to -0.07). Meta-regression analyses showed that a lower gestational age or birthweight were associated with larger reductions in physical fitness, whereas no consistent association was found for the age at assessment. CONCLUSION Both preterm birth and LBW seem associated with reduced physical fitness regardless of age, with larger reductions overall observed in individuals with lower gestational age or birthweight. These findings might support the implementation of preventive strategies (e.g., fitness monitoring and physical exercise interventions) in these populations through the life course. PROSPERO registration: CRD42021231845.
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Affiliation(s)
| | | | - Óscar Martínez-de-Quel
- Faculty of Education, Complutense University of Madrid, Madrid, Spain.
- Faculty of Sciences for Physical Activity and Sport (INEF), Polytechnic University of Madrid, C/Martín Fierro, 7, 28040, Madrid, Spain.
| | - Pedro L Valenzuela
- Department of Systems Biology, University of Alcalá, Madrid, Spain.
- Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Hospital 12 de Octubre ('imas12'), Centro de Actividades Ambulatorias, 7ª Planta, Bloque D, Av. de Córdoba s/n, 28041, Madrid, Spain.
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Yuan H, Chen S, Duncan MR, de Rivero Vaccari JP, Keane RW, Dalton Dietrich W, Chou TH, Benny M, Schmidt AF, Young K, Park KK, Porciatti V, Elizabeth Hartnett M, Wu S. IC100, a humanized therapeutic monoclonal anti-ASC antibody alleviates oxygen-induced retinopathy in mice. Angiogenesis 2024:10.1007/s10456-024-09917-9. [PMID: 38709389 DOI: 10.1007/s10456-024-09917-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/28/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Retinopathy of prematurity (ROP), which often presents with bronchopulmonary dysplasia (BPD), is among the most common morbidities affecting extremely premature infants and is a leading cause of severe vision impairment in children worldwide. Activations of the inflammasome cascade and microglia have been implicated in playing a role in the development of both ROP and BPD. Apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) is pivotal in inflammasome assembly. Utilizing mouse models of both oxygen-induced retinopathy (OIR) and BPD, this study was designed to test the hypothesis that hyperoxia induces ASC speck formation, which leads to microglial activation and retinopathy, and that inhibition of ASC speck formation by a humanized monoclonal antibody, IC100, directed against ASC, will ameliorate microglial activation and abnormal retinal vascular formation. METHODS We first tested ASC speck formation in the retina of ASC-citrine reporter mice expressing ASC fusion protein with a C-terminal citrine (fluorescent GFP isoform) using a BPD model that causes both lung and eye injury by exposing newborn mice to room air (RA) or 85% O2 from postnatal day (P) 1 to P14. The retinas were dissected on P14 and retinal flat mounts were used to detect vascular endothelium with AF-594-conjugated isolectin B4 (IB4) and citrine-tagged ASC specks. To assess the effects of IC100 on an OIR model, newborn ASC citrine reporter mice and wildtype mice (C57BL/6 J) were exposed to RA from P1 to P6, then 75% O2 from P7 to P11, and then to RA from P12 to P18. At P12 mice were randomized to the following groups: RA with placebo PBS (RA-PBS), O2 with PBS (O2-PBS), O2 + IC100 intravitreal injection (O2-IC100-IVT), and O2 + IC100 intraperitoneal injection (O2-IC100-IP). Retinal vascularization was evaluated by flat mount staining with IB4. Microglial activation was detected by immunofluorescence staining for allograft inflammatory factor 1 (AIF-1) and CD206. Retinal structure was analyzed on H&E-stained sections, and function was analyzed by pattern electroretinography (PERG). RNA-sequencing (RNA-seq) of the retinas was performed to determine the transcriptional effects of IC100 treatment in OIR. RESULTS ASC specks were significantly increased in the retinas by hyperoxia exposure and colocalized with the abnormal vasculature in both BPD and OIR models, and this was associated with increased microglial activation. Treatment with IC100-IVT or IC100-IP significantly reduced vaso-obliteration and intravitreal neovascularization. IC100-IVT treatment also reduced retinal microglial activation, restored retinal structure, and improved retinal function. RNA-seq showed that IC100 treatment corrected the induction of genes associated with angiogenesis, leukocyte migration, and VEGF signaling caused by O2. IC100 also corrected the suppression of genes associated with cell junction assembly, neuron projection, and neuron recognition caused by O2. CONCLUSION These data demonstrate the crucial role of ASC in the pathogenesis of OIR and the efficacy of a humanized therapeutic anti-ASC antibody in treating OIR mice. Thus, this anti-ASC antibody may potentially be considered in diseases associated with oxygen stresses and retinopathy, such as ROP.
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Affiliation(s)
- Huijun Yuan
- Department of Pediatrics/Division of Neonatology, Batchelor Children's Research Institute and Holtz Children's Hospital, University of Miami Miller School of Medicine, P. O. Box 016960, Miami, FL, 33101, USA
| | - Shaoyi Chen
- Department of Pediatrics/Division of Neonatology, Batchelor Children's Research Institute and Holtz Children's Hospital, University of Miami Miller School of Medicine, P. O. Box 016960, Miami, FL, 33101, USA
| | - Matthew R Duncan
- Department of Pediatrics/Division of Neonatology, Batchelor Children's Research Institute and Holtz Children's Hospital, University of Miami Miller School of Medicine, P. O. Box 016960, Miami, FL, 33101, USA
| | - Juan Pablo de Rivero Vaccari
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert W Keane
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - W Dalton Dietrich
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tsung-Han Chou
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Merline Benny
- Department of Pediatrics/Division of Neonatology, Batchelor Children's Research Institute and Holtz Children's Hospital, University of Miami Miller School of Medicine, P. O. Box 016960, Miami, FL, 33101, USA
| | - Augusto F Schmidt
- Department of Pediatrics/Division of Neonatology, Batchelor Children's Research Institute and Holtz Children's Hospital, University of Miami Miller School of Medicine, P. O. Box 016960, Miami, FL, 33101, USA
| | - Karen Young
- Department of Pediatrics/Division of Neonatology, Batchelor Children's Research Institute and Holtz Children's Hospital, University of Miami Miller School of Medicine, P. O. Box 016960, Miami, FL, 33101, USA
| | - Kevin K Park
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Vittorio Porciatti
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Shu Wu
- Department of Pediatrics/Division of Neonatology, Batchelor Children's Research Institute and Holtz Children's Hospital, University of Miami Miller School of Medicine, P. O. Box 016960, Miami, FL, 33101, USA.
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van de Lagemaat M, Ruys CA, Muts J, Finken MJ, Rotteveel J, van Goudoever JB, Lafeber HN, van den Akker CH, Schrijver-Levie NS, Boonstra V, von Lindern JS, de Winter P, van Brakel MJ, Drewes AJ, Westra M. Growth and body composition of infants born moderate-to-late preterm fed a protein- and mineral-enriched postdischarge formula compared with a standard term formula until 6 months corrected age, a randomized controlled trial. Am J Clin Nutr 2024:S0002-9165(24)00461-1. [PMID: 38719093 DOI: 10.1016/j.ajcnut.2024.04.035] [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: 12/04/2023] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Infants born moderate-to-late preterm (i.e., 32 wk-35 wk 6 d gestation) are, analogous to those born very preterm, at risk of later obesity, hypertension, and diabetes. Appropriate early life nutrition is key for ensuring optimal growth and body composition, thereby mitigating potential cardiometabolic risks. OBJECTIVES We aimed to compare growth and body composition between infants born moderate-to-late preterm fed isocaloric but protein- and mineral-enriched postdischarge formula (PDF) or standard term formula (STF) until 6 mo corrected age (CA; i.e., after term equivalent age [TEA]). METHODS After enrollment (≤7 d postpartum), infants received PDF if (fortified) mother's own milk (MOM) was insufficient. At TEA, those receiving >25% of intake as formula were randomized to either continue the same PDF (n = 47) or switch to STF (n = 50); those receiving ≥75% of intake as MOM (n = 60) served as references. At TEA and 6 mo CA, we assessed anthropometry and body composition using both dual-energy x-ray absorptiometry (DXA) and air displacement plethysmography (ADP). RESULTS Feeding groups had similar gestational age (median [25th percentile;75th percentile]: 34.3 [33.5; 35.1] wk), birthweight (mean ± standard deviation [SD]: 2175 ± 412 g), anthropometry, and body composition at TEA. At 6 mo CA, infants fed PDF had slightly, but significantly, greater length (67.6 ± 2.5 and 66.9 ± 2.6 cm, P < 0.05) and larger head circumference (43.9 ± 1.3 and 43.4 ± 1.5 cm, P < 0.05) compared to infants fed STF. Also, infants fed PDF had higher lean mass (LM) and bone mineral content estimated by DXA (4772 ± 675 and 4502 ± 741 g; 140 ± 20 and 131 ± 23 g, respectively; P < 0.05). ADP estimates, however, were not statistically different between feeding groups. CONCLUSIONS Infants born moderate-to-late preterm demonstrated modest increases in length, head circumference, LM, and bone mineral content when fed PDF compared to STF for 6 mo after TEA. This trial was registered at the International Clinical Trial Registry Platform as NTR5117 and NTR NL4979.
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Affiliation(s)
- Monique van de Lagemaat
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.
| | - Charlotte A Ruys
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Jacqueline Muts
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Martijn Jj Finken
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands; Department of Pediatric Endocrinology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Joost Rotteveel
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands; Department of Pediatric Endocrinology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes B van Goudoever
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Harrie N Lafeber
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Chris Hp van den Akker
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
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Shittu KA, Ahmed B, Rabiu KA, Akinlusi F, Akinola OI. Does the use of antenatal corticosteroids reduce respiratory morbidity in babies born in late preterm period? BMC Pregnancy Childbirth 2024; 24:334. [PMID: 38698318 PMCID: PMC11064281 DOI: 10.1186/s12884-024-06304-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 01/29/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The aim of this study is to determine the effectiveness of antenatal corticosteroid in reducing respiratory morbidity in babies born in the late preterm period. METHODS Two hundred and eighty-six pregnant women at risk of having a late preterm delivery were studied. One hundred and forty-three (143) served as the cases and were given 2 doses of 12 mg intramuscular dexamethasone 12 h apart, while 143 served as the controls and were given a similar quantity of placebo. The women were followed up prospectively and data were collected on the pregnant women and their newborns on a standardized form. The neonates were assessed for acute respiratory distress syndrome and transient tachypnea of the newborn based on clinical signs, symptoms, and chest x-ray results (when indicated). The primary outcome was the occurrence of neonatal respiratory morbidity. RESULTS The primary outcome occurred in 5 out of 130 infants (3.8%) in the dexamethasone group and 31 out of 122 (25.4%) in the placebo group (P value = 0.000003). Birth asphyxia, neonatal intensive care admission and need for active resuscitation at birth also occurred significantly less frequently in the dexamethasone group (P value 0.004, 0.009, 0.014 respectively). There were no significant group differences in the incidence of neonatal sepsis, neonatal jaundice, hypoglycemia and feeding difficulties. CONCLUSIONS Administration of dexamethasone to women at risk for late preterm delivery significantly reduced the rate of neonatal respiratory complications, neonatal intensive care unit admission, and need for active resuscitation at birth. TRIAL REGISTRATION PACTR ( www.pactr.org ) Registration Number: PACTR202304579281358. The study was retrospectively registered on April 19, 2023.
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Affiliation(s)
- Khadijah A Shittu
- Department of Obstetrics & Gynaecology, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Bolaji Ahmed
- Programme Department, Damien Foundation Belgium (Nigeria Project), Lagos, Nigeria.
| | - Kabiru Afolarin Rabiu
- Department of Obstetrics & Gynaecology, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Fatimat Akinlusi
- Department of Obstetrics & Gynaecology, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Oluwarotimi I Akinola
- Department of Obstetrics & Gynaecology, Lagos State University Teaching Hospital, Lagos, Nigeria
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Shin JE, Lee SM, Lee MJ, Han J, Lim J, Jang H, Eun HS, Park MS, Kim SY, Sohn MH, Jung JY, Kim KW. Oligohydramnios affects pulmonary functional/structural abnormalities in school-aged children with bronchopulmonary dysplasia. Clin Exp Pediatr 2024; 67:257-266. [PMID: 38623024 PMCID: PMC11065638 DOI: 10.3345/cep.2023.01053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/09/2023] [Accepted: 02/01/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The relationship between early life factors and childhood pulmonary function and structure in preterm infants remains unclear. PURPOSE This study investigated the impact of bronchopulmonary dysplasia (BPD) and perinatal factors on childhood pulmonary function and structure. METHODS This longitudinal cohort study included preterm participants aged ≥5 years born between 2005 and 2015. The children were grouped by BPD severity according to National Institutes of Health criteria. Pulmonary function tests (PFTs) were performed using spirometry. Chest computed tomography (CT) scans were obtained and scored for hyperaeration or parenchymal lesions. PFT results and chest CT scores were analyzed with perinatal factors. RESULTS A total 150 children (66 females) aged 7.7 years (6.4-9.9 years) were categorized into non/mild BPD (n=68), moderate BPD (n=39), and severe BPD (n=43) groups. The median z score for forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced midexpiratory flow (FEF25%-75%) were significantly lower in the severe versus non/mild BPD group (-1.24 vs. -0.18, -0.22 vs. 0.41, -1.80 vs. -1.12, and -1.88 vs. -1.00, respectively; all P<0.05). The median z scores of FEV1, FEV1/ FVC, and FEF25%-75% among asymptomatic patients were also significantly lower in the severe versus non/mild BPD group (-0.82 vs. 0.09, -1.68 vs. -0.87, -1.59 vs. -0.61, respectively; all P<0.05). The severe BPD group had a higher median (range) CT score than the non/mild BPD group (6 [0-12] vs. 1 [0-10], P<0.001). Prenatal oligohydramnios was strongly associated with both low pulmonary function (FEV1/FVC CONCLUSION School-aged children with severe BPD showed airflow limitations and structural abnormalities despite no subjective respiratory symptoms. These results suggest that patients with a history of prenatal oligohydramnios or prolonged mechanical ventilation require extended follow-up.
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Affiliation(s)
- Jeong Eun Shin
- Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Gangnam Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Mi-Jung Lee
- Department of Radiology, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jungho Han
- Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Joohee Lim
- Department of Pediatrics, Gangnam Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Haerin Jang
- Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Seon Eun
- Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Soo Park
- Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Yeon Kim
- Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Hyun Sohn
- Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Ye Jung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea
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