scholarly journals The pregnancy microbiome and preterm birth

2020 ◽  
Vol 42 (4) ◽  
pp. 487-499 ◽  
Author(s):  
Erna Bayar ◽  
Phillip R. Bennett ◽  
Denise Chan ◽  
Lynne Sykes ◽  
David A. MacIntyre
Keyword(s):  
Preterm Birth ◽  
Global Health ◽  
Human Microbiome ◽  
Neonatal Morbidity ◽  
Neonatal Care ◽  
Morbidity And Mortality ◽  
Health Concern ◽  
Vaginal Microbiome ◽  
Complex Interplay ◽  
In Pregnancy

Abstract Preterm birth is a global health concern and continues to contribute to substantial neonatal morbidity and mortality despite advances in obstetric and neonatal care. The underlying aetiology is multi-factorial and remains incompletely understood. In this review, the complex interplay between the vaginal microbiome in pregnancy and its association with preterm birth is discussed in depth. Advances in the study of bacteriology and an improved understanding of the human microbiome have seen an improved awareness of the vaginal microbiota in both health and in disease.

Neonatal Morbidity and Mortality in the Neonatal Care Unit of Al-Gumhouri Teaching Hospital , Sana'a , Yemen

2013 ◽  
Vol 2 (2) ◽  
pp. 200-206
Author(s):  
Abdulla M. Bin Al-Zoa ◽  
Mabrook A. Bin Mohanna ◽  
Najla Al-Sonboli
Keyword(s):  
Teaching Hospital ◽  
Neonatal Morbidity ◽  
Neonatal Care ◽  
Morbidity And Mortality ◽  
Neonatal Care Unit

scholarly journals 17-Alpha-Hydroxyprogesterone vs. Placebo for Preventing of Recurrent Preterm Birth: A Systematic Review and Meta-Analysis of Randomized Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Abdulaali R. Almutairi ◽  
Hadir I. Aljohani ◽  
Nouf S. Al-fadel
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Meta Analysis ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Relative Risk Ratio ◽  
Analysis Model ◽  
Clinical Trial Registries

Background: Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality.Objective: To estimate the effect of 17-alpha-hydroxyprogesterone caproate (17-OHPC) compared to placebo in singleton gestations for reducing the risk of recurrent PTB and neonatal morbidity and mortality.Work Design: Systematic review and meta-analysis.Search Strategy: Searching MEDLINE, Embase, Web of Science, SCOPUS, Cochrane Library, and clinical trial registries.Selection Criteria: Randomized controlled trials of singleton gestations with a history of PTB and treated with a weekly intramuscular injection of 17-OHPC or placebo.Data Collection and Analysis: A random meta-analysis model was performed for the PTB outcomes (<32, <35, and <37 weeks) and neonatal outcomes (neonatal death, grade 3 or 4 intraventricular hemorrhage, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and sepsis). Effect estimates were measured by relative risk ratio (RR) with a 95% confidence interval (CI).Main Results: Six works were included. There were no statistically significant reductions in the PTB risk following the use of 17-OHPC at <32 weeks (RR = 0.61, 95% CI: 0.13–2.77, and I2 = 39%), <35weeks (RR = 0.60, 95% CI: 0.10–3.67, and I2 = 51%), and <37 weeks (RR = 0.68, 95% CI: 0.46–1, and I2 = 75%). Furthermore, all the neonatal outcomes were statistically similar between the two groups.Conclusion: Treatment with 17-OHPC is not associated with reducing the risk of PTB or neonatal outcomes compared to placebo.

scholarly journals UMA ANÁLISE INTEGRAL DO TRABALHO DE PARTO PREMATURO

2019 ◽  
Vol 6 (1) ◽  
pp. 54-57
Author(s):  
Renata dos Santos Oliveira ◽  
Maria Luiza Silva Brito ◽  
Delcides Bernardes da Costa Neto
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Early Diagnosis ◽  
Preterm Labor ◽  
Transvaginal Ultrasound ◽  
Treatment Options ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Fetal Fibronectin ◽  
Appropriate Treatment

A prematuridade é um dos mais significativos desafios da obstetrícia, constituindo a principal causa de morbimortalidade neonatal. A presença de fatores de risco, tanto maternos quanto fetais, geram maior vigilância durante o decorrer da gestação, entretanto cada gravidez ocorre de forma singular e seus fatores devem ser analisados individualmente, motivo que nos leva ao estudo profundo e integral de cada um deles. O diagnóstico do trabalho de parto prematuro é eminentemente clínico e, muitas vezes, de difícil estabelecimento precoce. Para auxiliar na obtenção de um diagnóstico em estágio inicial, tem-se empregado métodos complementares, como o ultrassom transvaginal e a fibronectina fetal. Existem várias opções de tratamento com suas particularidades para a indicação, porém a escolha deve ser feita prontamente a fim de prolongar a gestação, evitando os desfechos desfavoráveis do parto prematuro. Palavras-chave: trabalho de parto prematuro; diagnóstico precoce; tratamento adequado ABSTRACT Prematurity is one of the most significant challenges of obstetrics, being the main cause of neonatal morbidity and mortality. The presence of risk factors, both maternal and fetal, generate greater vigilance during the course of gestation, however each pregnancy occurs in a singular way and its factors must be analyzed individually, reason that leads us to the deep and integral study of each one of them. The diagnosis of preterm labor is eminently clinical and often difficult to establish early. To assist in obtaining an early diagnosis, complementary methods have been employed, such as transvaginal ultrasound and fetal fibronectin. There are several treatment options with their particularities for the indication, but the choice must be made promptly in order to prolong the gestation, avoiding the unfavorable outcomes of the preterm birth. Keywords: preterm labor; early diagnosis; appropriate treatment.

PROLONG Clinical Study Protocol: Hydroxyprogesterone Caproate to Reduce Recurrent Preterm Birth

2018 ◽  
Vol 35 (12) ◽  
pp. 1228-1234 ◽  
Author(s):  
Cynthia Gyamfi-Bannerman ◽  
Joseph Biggio ◽  
Suneet Chauhan ◽  
Brenna Hughes ◽  
Judette Louis ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Sample Size ◽  
Neonatal Morbidity ◽  
Total Sample ◽  
Morbidity And Mortality ◽  
Safety And Efficacy ◽  
Mortality Index ◽  
Hydroxyprogesterone Caproate ◽  
Secondary Outcomes

AbstractThe objective of this commentary is to describe the background, rationale, and methods of the PROLONG (Progestin's Role in Optimizing Neonatal Gestation) trial, which is a multicenter, multinational, placebo-controlled, randomized clinical trial (RCT) designed to assess the safety and efficacy of Makena (hydroxyprogesterone caproate injection, 250 mg/mL) in reducing the risk of preterm birth (PTB) and neonatal morbidity/mortality in women pregnant with a singleton gestation who had a previous singleton spontaneous PTB. The total sample size of the RCT will include 1,707 women. The trial has two coprimary outcomes: PTB less than 35 weeks and a composite neonatal morbidity and mortality index. This study sample size will provide 90% power to assess for a 35% reduction in neonatal morbidity and mortality. Secondary outcomes will include 2-year follow-up of infants. The trial is ongoing and targeted to complete recruitment in 2018.

scholarly journals Neonatal Outcomes from Mothers with Hypertension Disorders of Pregnancy: A Retrospective Study at a Referral Hospital in Rwanda

2020 ◽  
Vol 3 (2) ◽  
pp. 193-203
Author(s):  
Phoibe Uwizeyimana ◽  
Emerthe Musabyemariya ◽  
Olive Tengera ◽  
Anita Collins
Keyword(s):  
Retrospective Study ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
University Teaching ◽  
Delivery Mode ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Maternal Hypertension ◽  
In Pregnancy

Background Globally, maternal hypertensive disorders in pregnancy significantly increase both maternal and perinatal morbidity and mortality. Maternal hypertension affects 14 percent of pregnancies. Eearly detection and management are critical for improving the health outcomes of both mother and neonate. Objective To assess the association between maternal hypertension disorders in pregnancy and immediate neonatal outcomes at a University Teaching Hospital in Rwanda. Methods A retrospective study of maternal files with hypertension disorders was conducted from January 1, 2016, to March 31, 2019. A census sample of 114 records and pretested checklist was used to collect data. Descriptive statistics were used to analyze associations between maternal factors and immediate neonatal outcomes. Results Neonatal outcomes included low birth weight (75.4%), prematurity (59.6%), admission to neonatal intensive care unit (50.4%), intrauterine growth restriction (32.4%), and neonatal death (22.8%). Nearly two-thirds (62%) of mothers had preeclampsia. Significant associations with immediate neonatal outcomes included gestational age, medical history, delivery mode, maternal referral status, preterm birth, prematurity, and abortion. Conclusion Maternal hypertensive disorders were significantly associated with adverse neonatal outcomes in our study population in Rwanda. Improving early detection, health education, and management of hypertensive disorders in pregnancy is critical to reduce maternal and neonatal morbidity and mortality. Rwanda J Med Health Sci 2020;3(2):193-203

Vaccines and pregnancy

2021 ◽  
pp. 175573802110517
Author(s):  
Ibidolapo Afuwape ◽  
Joanne Parsons ◽  
Debra Bick ◽  
Jeremy Dale ◽  
Sarah C. Hillman
Keyword(s):  
Global Health ◽  
Infectious Diseases ◽  
Pregnant Women ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Factors Affecting ◽  
Maternal Immunisation ◽  
In Pregnancy

The development of vaccines has been one of the major interventions in global health. Since they were first developed over two centuries ago, vaccines have played a prominent role in reducing morbidity and mortality from infectious diseases, including in pregnant women. The development of the coronavirus disease 2019 (COVID-19) vaccines has brought with it the possibility of reducing the high morbidity and mortality caused by this virus. This article focuses on the use of vaccines in pregnancy and discusses the benefits of maternal immunisation, recommended vaccines in pregnancy, the factors affecting uptake of vaccines, and COVID-19 vaccination in pregnancy.

Efetividade do Método Canguru em Relação à Redução da Mortalidade e Morbidade Neonatal

2018 ◽  
Vol 22 (3) ◽  
pp. 186
Author(s):  
Dayane Cristina Da Silva Santos ◽  
Mirian Dos Santos Pereira
Keyword(s):  
Low Income ◽  
Neonatal Morbidity ◽  
Neonatal Care ◽  
Morbidity And Mortality ◽  
Low Income Countries ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Premature Newborn ◽  
Middle Income Countries ◽  
Low Weight

O Método Mãe Canguru (MC) é destinado ao atendimento do recém-nascido prematuro de baixo peso, e visa fortalecer o vínculo mãe-filho, aumentar a competência e a confiança dos pais no cuidado do bebê e incentivar a prática da amamentação. O objetivo do estudo foi demonstrar as evidências que apontam o uso de Método Canguru (MC) como uma alternativa aos cuidados neonatais, enfocando seus benefícios e avaliando se o método reduz a morbidade e mortalidade em neonatos de baixo peso. Trata-se de uma pesquisa descritiva, realizada a partir de um levantamento bibliográfico nas bases de dados BDEnf, Lilacs, SciELO e BIREME, considerando o período de 2000 a 2016. Foram analisados artigos sobre o Método Canguru (MC) e a redução da morbimortalidade neonatal. O estudo evidenciou que o Método Mãe Canguru (MC) reduz as taxas tanto de mortalidade como morbidade neonatal, porém demonstrou que existem poucos estudos referentes a este tema. O Método Mãe Canguru (MC) demonstrou ser mais que uma alternativa para países de baixa renda, nos quais faltam incubadoras ou salas de atendimento neonatal, constituindo-se, também, uma estratégia com múltiplas vantagens para o recém-nascido, tanto o prematuro quanto o nascido a termo. Destacou-se a eficácia do método na diminuição da morbimortalidade do neonato com baixo peso. Os estudos sobre mortalidade e morbidade do Método Mãe-Canguru (MC), em países de baixa e média renda, concluíram que o Método Mãe Canguru (MC) reduz, substancialmente, a mortalidade neonatal em bebês nascidos antes do termo com baixo peso em hospitais. Palavras-chave: Morbimortalidade Neonatal. Método Canguru. Recém-Nascido de Baixo Peso. Abstract: The Kangaroo Mother Method is intended for the care of the low weight premature newborn and aims to strengthen the mother-child bond, increase the parents’ competence and trust in the baby care and encourage the breastfeeding practice. The objective was  demonstrating the evidence supporting the use of KMM as an alternative to neonatal care, focusing on its benefits and evaluating whether the method reduces morbidity and mortality in low weight premature newborn. This is a descriptive research, based on a bibliographic survey in the databases BDEnf, Lilacs, SciELO and BIREME, considering the period from 2000 to 2016.  Articles were analyzed on the Kangaroo Method and the reduction of neonatal morbidity and mortality, the study showed that the Kangaroo Mother Method reduces the rates of both mortality and neonatal morbidity, but has shown that there are few studies related to this topic. The Kangaroo Mother Method has proven to be more than an alternative for low-income countries, where incubators or neonatal care rooms are lacking. It is also a strategy with multiple advantages for the newborn, both premature and full-term. The method efficacy in reducing neonatal morbidity and mortality and low weight was emphasized. Mortality and morbidity studies of the Kangaroo Method in low- and middle-income countries have concluded that the Kangaroo Mother Method substantially reduces neonatal mortality in preterm infants in hospitals and underweight. Keywords: Morbidity and Mortality Neonatal. Kangaroo Method. Low Birth Newborn. 

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