Neonatal mortality and morbidity rates in term twins with advancing gestational age

2006 ◽  
Vol 195 (1) ◽  
pp. 172-177 ◽  
Author(s):  
Jennifer E. Soucie ◽  
Quiying Yang ◽  
Shi Wu Wen ◽  
Karen Fung Kee Fung ◽  
Mark Walker
Author(s):  
Salma Younes ◽  
Muthanna Samara ◽  
Rana Al-Jurf ◽  
Gheyath Nasrallah ◽  
Sawsan Al-Obaidly ◽  
...  

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar <7 at 1 and 5 minutes and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.


Author(s):  
Elizabeth B. Ausbeck ◽  
Phillip Hunter Allman ◽  
Jeff M. Szychowski ◽  
Akila Subramaniam ◽  
Anup Katheria

Objective The aim of the study is to describe the rates of neonatal death and severe neonatal morbidity in a contemporary cohort, as well as to evaluate the predictive value of birth gestational age (GA) and birth weight, independently and combined, for neonatal mortality and morbidity in the same contemporary cohort. Study Design We performed a secondary analysis of an international, multicenter randomized controlled trial of delayed umbilical cord clamping versus umbilical cord milking in preterm infants born at 23 0/7 to 31 6/7 weeks of gestation. The current analysis was restricted to infants delivered <28 weeks. The primary outcomes of this analysis were neonatal death and a composite of severe neonatal morbidity. Incidence of outcomes was compared by weeks of GA, with planned subanalysis comparing small for gestational age (SGA) versus non-SGA neonates. Multivariable logistic regression was then used to model these outcomes based on birth GA, birth weight, or a combination of both as primary independent predictors to determine which had superior ability to predict outcomes. Results Of 474 neonates in the original trial, 180 (38%) were included in this analysis. Overall, death occurred in 27 (15%) and severe morbidity in 139 (77%) neonates. Rates of mortality and morbidity declined with increasing GA (mortality 54% at 23 vs. 9% at 27 weeks). SGA infants (n = 25) had significantly higher mortality compared with non-SGA infants across all GAs (p < 0.01). There was no difference in the predictive value for neonatal death or severe morbidity between the three prediction options (GA, birth weight, or GA and birth weight). Conclusion Death and severe neonatal morbidity declined with advancing GA, with higher rates of death in SGA infants. Birth GA and birth weight were both good predictors of outcomes; however, combining the two was not more predictive, even in SGA infants. Key Points


2015 ◽  
Vol 212 (1) ◽  
pp. S351
Author(s):  
Elad Mei-Dan ◽  
Jyotsna Shah ◽  
Anne Synnes ◽  
Sandesh Shivananda ◽  
Greg Ryan ◽  
...  

PEDIATRICS ◽  
2009 ◽  
Vol 123 (6) ◽  
pp. e1064-e1071 ◽  
Author(s):  
R. De Luca ◽  
M. Boulvain ◽  
O. Irion ◽  
M. Berner ◽  
R. E. Pfister

PEDIATRICS ◽  
1967 ◽  
Vol 40 (5) ◽  
pp. 923-923
Author(s):  
JEROLD F. LUCEY ◽  
AUDREY K. BROWN ◽  
ALICE GAMBLE BEARD ◽  
MARVIN CORNBLATH ◽  
MOSES GROSSMAN ◽  
...  

THE physical design of and routine practices in neonatal units (especially nurseries for high-risk infants) are presently influenced almost entirely by considerations related to the risk of spreading infection in the nursery by fomites and personnel. The role of nursery design and specific routines in preventing epidemics is considered so important that the details are encoded in many local, state, and federal health laws or regulations. These are enforced by periodic inspections and conformity is made a prerequisite for official approval, allocation of funds, etc. Although there is little reason to doubt that these policies have had the effect of reducing the incidence of nursery epidemics, there is growing concern that official rigidity in these matters may interfere with optimal care of the very ill infant, as well as with research designed to improve care and find solutions to the overall problems of neonatal mortality and morbidity. Infections are an important and frequent cause of disease in the newborn. They are, however, clearly outdistanced by major non-infectious disorders that account for the majority of deaths and brain damage in the neonatal period (respiratory distress, asphyxia, acidosis, hypoglycemia, and hyperbilirubinemia). Some of the precautionary techniques used to reduce the risk of infections have the practical disadvantages of making it difficult (1) to approach the neonatal patient and (2) to apply modern diagnostic maneuvers and therapeutic aids in order to improve the neonatal patient's chances for intact survival. As a result the nursery-based infants in this country are, in general, quite well protected from the risks of nosocomial infections; but, they receive less than ideal management for cardiorespiratory disorders, a major cause of neonatal mortality. It is obvious that new solutions are required to solve the problem of hospital care of the sick neonate. Unfortunately, both the search for new approaches to neonatal care and the application of some newly established knowledge are now being impaired by rigid rules and construction codes which do not permit innovation. Although these rules cannot be completely abandoned until safe alternatives have been demonstrated, the Committee believes that public health administrators and hospital committees must permit cautious, responsible exploration and evaluation of new approaches to the multiple problems involved.


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