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Preterm AND Quality Of Life

Rebekah J Mccurdy, Jason K Baxter
BACKGROUND: Preterm birth is a leading cause of neonatal morbidity and mortality worldwide; evidence-based strategies to decrease preterm birth are desperately needed. OBJECTIVE: The purpose of this study was to estimate which of three strategies for screening for shortened cervix in asymptomatic low risk women is the most cost-effective in terms of prevention of preterm birth and associated morbidity. STUDY DESIGN: A decision analysis model was developed from available published evidence comparing three strategies in screening asymptomatic low-risk women for shortened cervix: (1) cervicometer with subsequent referral for transvaginal ultrasound, (2) transvaginal ultrasound screening, and (3) no screening...
February 13, 2019: Journal of Maternal-fetal & Neonatal Medicine
Siddarth Ramji, Ashish Jain
RMNCH+A is a platform for delivering adolescent, maternal, newborn and child health in an integrated manner using a life cycle approach. The new initiatives under this strategy that would impact newborn health include antenatal corticosteroids in preterm labor, delayed clamping of cord at birth, skin-to-skin contact at birth and Kangaroo mother care, Family participatory care, Lactation management centers and care beyond newborn survival under the Rashtriya Bal Swasthya Karyakram. Even though the coverage of many of the existing initiatives has been moderately high, there are concerns about the quality of delivery of these interventions and slow progress in the roll out of the newer interventions...
February 8, 2019: Indian Journal of Pediatrics
Mariola Bidzan, Karolina Lutkiewicz
The aim of the study was to identify whether perceived stress and significant life changes are related with partnership relation quality in mothers of preterm-born children. The study group consisted of 260 women, who gave a preterm birth. In most cases the delivery took place in the 34⁻36th week of pregnancy. The research consisted of two phases. Phase 1 was carried out in the Department of Obstetrics at the Medical University of Gdansk in the neonatal period (2⁻3 days after birth). Phase 2 was carried out in the place of residence of the mother and child during early childhood (24⁻30th month of the child's life)...
January 27, 2019: International Journal of Environmental Research and Public Health
Redoy Ranjan, Dipannita Adhikary, Sanjoy Kumar Saha, Sabita Mandal, Kamrul Hasan, Asit Baran Adhikary
BACKGROUND: This study evaluated pregnancy outcome in women with a prosthetic heart valve, especially with the oral anticoagulation therapy that must be weighed against the risk of intracardiac thrombosis. METHODS: This multicenter, retrospective, cohort study was undertaken between January 2012 and June 2017. The principal maternal outcome variables included bleeding and thromboembolic complications, infective endocarditis, prosthetic valve thrombosis and heart failure...
January 9, 2019: Perfusion
Kristina N Heye, Walter Knirsch, Ianina Scheer, Ingrid Beck, Kristina Wetterling, Andreas Hahn, Karoline Hofmann, Beatrice Latal, Bettina Reich, Markus A Landolt
BACKGROUND: Little is known about health-related quality of life in young children undergoing staged palliation for single-ventricle CHD. The aim of this study was to assess the impact of CHD on daily life in pre-schoolers with single-ventricle CHD and to identify determinants of health-related quality of life. METHOD: Prospective two-centre cohort study assessing health-related quality of life using the Preschool Paediatric Cardiac Quality of Life Inventory in 46 children at a mean age of 38 months and 3 weeks...
January 2, 2019: Cardiology in the Young
Jina J Kim, Daniel A Axelrad, Chris Dockins
Preterm birth (PTB) is a predictor of infant mortality and later-life morbidity. Despite recent declines, PTB rates remain high in the United States. Growing research suggests a possible relationship between a mother's exposure to common air pollutants, including fine particulate matter (PM2.5 ), and PTB of her baby. Many policy actions to reduce exposure to common air pollutants require benefit-cost analysis (BCA), and it's possible that PTB will need to be included in BCA in the future. However, an estimate of the willingness to pay (WTP) to avoid PTB risk is not available, and a comprehensive alternative valuation of the health benefits of reducing pollutant-related PTB currently does not exist...
December 7, 2018: Environmental Research
José Granero-Molina, Isabel María Fernández Medina, Cayetano Fernández-Sola, José Manuel Hernández-Padilla, María Del Mar Jiménez Lasserrotte, María Del Mar López Rodríguez
PURPOSE: The purpose of this study was to describe and understand the experiences of mothers of extremely preterm infants during the first twelve months at home following discharge from a neonatal intensive care unit. DESIGN AND METHODS: A qualitative, interpretative approach using Gadamer's philosophical hermeneutics was carried out. One focus group and fifteen in-depth, semi-structured interviews were conducted twelve months after hospital discharge. Responses were recorded, transcribed and analyzed using computer-assisted qualitative data analysis...
December 21, 2018: Journal of Pediatric Nursing
Lin Xu, Ming-Yan Li, Yue-Liang Shen
Iron deficiency (ID) is the most common micronutrient deficiency in children. Due to insufficient iron storage at birth and rapid catch-up growth after birth, preterm infants tend to have a high incidence rate of ID. During the critical period of brain development, ID alters iron-dependent neurometabolism, neurochemistry, neuroanatomy, and gene/protein profiles. This affects the central nervous system and causes the change in neurocognitive and behavioral development. Iron supplementation in infancy cannot reverse neurodevelopmental impairment caused by perinatal ID...
December 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Xinye Fang, Guannan Bai, Dafna A Windhorst, David Feeny, Saroj Saigal, Liesbeth Duijts, Vincent W V Jaddoe, Shanlian Hu, Chunlin Jin, Hein Raat
OBJECTIVES: To evaluate the feasibility, discriminant validity and concurrent validity of the Health Status Classification System-Preschool (HSCS-PS) in children aged 3 years in a large community sample in the Netherlands. DESIGN/SETTING: A prospective population-based cohort in Rotterdam, the Netherlands. PARTICIPANTS: A questionnaire was administrated to a sample of parents of 4546 children (36.7±1.5 months). OUTCOME MEASURES: Health-related quality of life (HRQOL) of children was measured by HSCS-PS...
December 18, 2018: BMJ Open
Pauline Berneau, Trang Nguyen Phuc Thu, Patrick Pladys, Alain Beuchée
INTRODUCTION: Most infants born before 30 weeks gestational age (GA) develop respiratory distress syndrome soon after birth. Methods of surfactant administration that avoid ventilation have been recently introduced. The aim of this study was to evaluate the impact of implementing a new procedure of less invasive surfactant administration (LISA) and determine whether it is associated with an improvement in respiratory outcome. METHODS: This single center cohort quality improvement study analyzed preterm infants born before 30 weeks GA between May 2010 and April 2016...
2018: PloS One
Malini Anand Nijagal, Stephanie Wissig, Caleb Stowell, Elizabeth Olson, Isis Amer-Wahlin, Gouke Bonsel, Allyson Brooks, Matthew Coleman, Shamala Devi Karalasingam, James M N Duffy, Tracy Flanagan, Stefan Gebhardt, Meridith E Greene, Floris Groenendaal, J Ravichandran R Jeganathan, Tessa Kowaliw, Marije Lamain-de-Ruiter, Elliott Main, Michelle Owens, Rod Petersen, Irwin Reiss, Carol Sakala, Anna Maria Speciale, Rachel Thompson, Oluwakemi Okunade, Arie Franx
BACKGROUND: Value-based health care aims to optimize the balance of patient outcomes and health care costs. To improve value in perinatal care using this strategy, standard outcomes must first be defined. The objective of this work was to define a minimum, internationally appropriate set of outcome measures for evaluating and improving perinatal care with a focus on outcomes that matter to women and their families. METHODS: An interdisciplinary and international Working Group was assembled...
December 11, 2018: BMC Health Services Research
Leyin Zhou, Heng Li, Chong Li, Guohong Li
AIM: Infantile cerebral palsy (CP) severely affects the survival and quality of life of infants. CP is typically caused by multiple factors, leading to causal uncertainty of the role of medical errors in CP and resulting in frequent medical disputes. No relevant research exists on risk management and malpractice liabilities in CP, including in China. METHOD: A retrospective analysis of 400 CP malpractice litigation cases from 18th June 1999 to 23rd November 2017, collected from China Judgments Online, included basic case information, CP risk factors, medical errors, medical malpractice liability determination, and compensation...
November 25, 2018: Journal of Forensic and Legal Medicine
Cecilia Malmsten, Pär Hellberg, Karin Bergmark, Pernilla Dahm-Kähler
PURPOSE: Our aim was to evaluate fertility-sparing surgery of early stage cervical cancer after the introduction of vaginal trachelectomy (VT) and pelvic lymph node dissection (PLND). The objectives were to assess surgical, long-term oncological, fertility, and obstetric outcomes together with self-assessed quality of life (QoL). METHODS: All women ≤ 40 years diagnosed with early stage cervical cancers IA1-IB1 and ≤ 2 cm treated by VT and PLND between 2000 and 2014 were included...
November 28, 2018: Archives of Gynecology and Obstetrics
Karen M Frank
Advances made in the last several decades in the care of the fetus and newborn have had a significant impact on morbidity and mortality. Delayed umbilical cord clamping in the preterm newborn results in fewer transfusions for anemia, decreased intraventricular hemorrhage, and decreased necrotizing enterocolitis. Because of advances made in fetal ultrasound diagnosis and technological advances, fetal surgeries to treat congenital diaphragmatic hernia, myelomeningocele, twin-to-twin transfusion syndrome, fetal lower urinary tract obstructions, amniotic band syndrome, and congenital cystic adenoid malformation or congenital pulmonary airway malformations have improved the quality of life and survival for these patients...
December 2018: Critical Care Nursing Clinics of North America
Ignatia F Reijnders, Annemarie G M G J Mulders, Melissa van der Windt, Eric A P Steegers, Régine P M Steegers-Theunissen
BACKGROUND: Worldwide, placenta-related complications contribute to adverse pregnancy outcomes, such as pre-eclampsia, fetal growth restriction and preterm birth, with implications for the future health of mothers and offspring. The placenta develops in the periconception period and forms the interface between mother and embryo/fetus. An unhealthy periconceptional maternal lifestyle, such as smoking, alcohol and under- and over-nutrition, can detrimentally influence placental development and function...
November 8, 2018: Human Reproduction Update
Jennifer M Brady, Huayan Zhang, Haresh Kirpalani, Sara B DeMauro
OBJECTIVE: To assess parents' views of their children's health-related quality of life (HRQoL) and the association between neonatal morbidities and HRQoL in children with severe bronchopulmonary dysplasia (BPD) who survived to 18-36 months of corrected age. STUDY DESIGN: Study population included infants born <32 weeks of gestational age with severe BPD. At 18-36 months of corrected age, parents of children with severe BPD completed age appropriate validated Pediatric Quality of Life Inventory assessing parental views of their child's physical (PHY-QoL) and psychosocial HRQoL (PS-QoL)...
November 5, 2018: Journal of Pediatrics
Vesara Ardhe Gatera, Rizky Abdulah, Ida Musfiroh, Raden Tina Dewi Judistiani, Budi Setiabudiawan
To update the guidelines regarding vitamin D status in respiratory distress syndrome, we reviewed recent human and animal studies on the benefits of vitamin D in respiratory distress. We searched PubMed and ProQuest for studies on the use of vitamin D from 2009 to 2017. The common parameters in these studies included the use of lung tissue, phospholipids, blood, and plasma to assess the effects of vitamin D on respiratory syndrome. The metabolized form of vitamin D used in these studies was 1,25(OH)2 D3 in animal studies and 25(OH)D in human studies...
2018: Advances in Pharmacological Sciences
Joshua I Rosenbloom, Adam K Lewkowitz, Kristina E Sondgeroth, Jessica L Hudson, George A Macones, Alison G Cahill, Methodius G Tuuli, Su-Hsin Chang
OBJECTIVE: To evaluate whether administration of antenatal late-preterm betamethasone is cost-effective in the immediate neonatal period. STUDY DESIGN: Cost-effectiveness analysis of late-preterm betamethasone administration with a time horizon of 7.5 days was conducted using a health-system perspective. Data for neonatal outcomes, including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), and hypoglycemia, were from the Antenatal Betamethasone for Women at Risk for Late-Preterm Delivery trial...
November 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
Mikko Hallman, Antti Haapalainen, Johanna M Huusko, Minna K Karjalainen, Ge Zhang, Louis J Muglia, Mika Rämet
Spontaneous preterm birth is a serious and common pregnancy complication associated with hormonal dysregulation, infection, inflammation, immunity, rupture of fetal membranes, stress, bleeding, and uterine distention. Heredity is 25-40% and mostly involves the maternal genome, with contribution of the fetal genome. Significant discoveries of candidate genes by genome-wide studies and confirmation in independent replicate populations serve as signposts for further research. The main task is to define the candidate genes, their roles, localization, regulation, and the associated pathways that influence the onset of human labor...
September 18, 2018: Pediatric Research
Sindhu Sivanandan, Tavpritesh Sethi, Rakesh Lodha, Anu Thukral, M Jeeva Sankar, Ramesh Agarwal, Vinod K Paul, Ashok K Deorari
OBJECTIVE: To avoid excessive oxygen exposure and achieve target oxygen saturation (SpO2) within intended range of 88%-95% among preterm neonates on oxygen therapy. METHODS: 20 preterm neonates receiving supplemental oxygen in the first week of life were enrolled. The percentage of time per epoch (a consecutive time interval of 10 hours/day) spent by them within the target SpO2 range was measured in phase 1 followed by implementation of a unit policy on oxygen administration and targeting in phase 2...
September 15, 2018: Indian Pediatrics
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