scholarly journals Racial differences in gestational age–specific neonatal morbidity: further evidence for different gestational lengths

2012 ◽  
Vol 206 (3) ◽  
pp. 259.e1-259.e6 ◽  
Author(s):  
Ryan Loftin ◽  
Aimin Chen ◽  
Arthur Evans ◽  
Emily DeFranco
Keyword(s):  
Racial Differences ◽  
Gestational Age ◽  
Neonatal Morbidity

Neonatal Outcomes at Extreme Prematurity by Gestational Age Versus Birth Weight in a Contemporary Cohort

2021 ◽  
Author(s):  
Elizabeth B. Ausbeck ◽  
Phillip Hunter Allman ◽  
Jeff M. Szychowski ◽  
Akila Subramaniam ◽  
Anup Katheria
Keyword(s):  
Birth Weight ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Predictive Value ◽  
Neonatal Death ◽  
Controlled Trial ◽  
Neonatal Morbidity ◽  
Mortality And Morbidity ◽  
Severe Morbidity ◽  
Multicenter Randomized Controlled Trial

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

scholarly journals Pregnancy Outcome of Twin Pregnancy at Gandaki Medical College Teaching Hospital, Pokhara, Nepal

2018 ◽  
Vol 11 (02) ◽  
pp. 1-4
Author(s):  
M Tripathi ◽  
R Shrestha
Keyword(s):  
Preterm Delivery ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Twin Pregnancy ◽  
College Teaching ◽  
Neonatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Neonatal Complications ◽  
Twin Pregnancies

Objectives: To evaluate maternal and neonatal complications and pregnancy outcomes of twin pregnancies. Methods: The cross sectional study was conducted using retrospective data on the twin pregnancies with more than 28 weeks of gestational age. The study used data over a period of five years, from March 10, 2010 to March 9, 2015 in the Department of Obstetrics and Gynecology, GMC Teaching Hospital Pokhara. Results: Of the 50 twin pregnancies, the most common maternal complication was preterm delivery (40%). Other maternal complications were anemia (36%), pregnancy induced hypertension (14%), premature rupture of membranes (14%), postpartum hemorrhage (12%) and antepartum hemorrhage (6%). Median gestational age at delivery was 37 weeks. Most common route of delivery was cesarean section (66%). Most common neonatal complication was low birth weight (48%) births first twin and second twin 56%. Conclusion: Twin pregnancy has high maternal and neonatal complications, especially preterm delivery that increases the risk of significant neonatal morbidity and mortality.

Rates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003‐2016

2020 ◽  
Author(s):  
Ye’elah Berman ◽  
Ibinabo Ibiebele ◽  
Deborah Randall ◽  
Siranda Torvaldsen ◽  
Tanya A. Nippita ◽  
...  
Keyword(s):  
Gestational Age ◽  
New South ◽  
New South Wales ◽  
Neonatal Morbidity ◽  
South Wales

Neonatal Morbidity of Monoamniotic Twin Pregnancies: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Danilo Buca ◽  
Daniele Di Mascio ◽  
Asma Khalil ◽  
Ganesh Acharya ◽  
Tim Van Mieghem ◽  
...  
Keyword(s):  
Gestational Age ◽  
Primary Outcome ◽  
Random Effect ◽  
Neonatal Morbidity ◽  
Small Sample ◽  
Respiratory Morbidity ◽  
Infectious Morbidity ◽  
Neurological Morbidity ◽  
Twin Pregnancies ◽  
Type Of Management

Objective This study was aimed to report the incidence of neonatal morbidity in monochorionic monoamniotic (MCMA) twin pregnancies according to gestational age at birth and type of management adopted (inpatient or outpatient). Study Design Medline and Embase databases were searched. Inclusion criteria were nonanomalous MCMA twins. The primary outcome was a composite score of neonatal morbidity, defined as the occurrence of at least one of the following outcomes: respiratory morbidity, overall neurological morbidity, severe neurological morbidity, and infectious morbidity, necrotizing enterocolitis at different gestational age windows (24–30, 31–32, 33–34, and 35–36 weeks). Secondary outcomes were the individual components of the primary outcome and admission to neonatal intensive care unit (NICU). Subanalysis according to the type of surveillance strategy (inpatient compared with outpatient) was also performed. Random effect meta-analyses were used to analyze the data. Results A total of 14 studies including 685 MCMA twin pregnancies without fetal anomalies were included. At 24 to 30, 31 to 32, 33 to 34, and 35 to 36 weeks of gestation, the rate of composite morbidity was 75.4, 65.5, 37.6, and 18.5%, respectively, the rate of respiratory morbidity was 74.2, 59.1, 35.5, and 12.2%, respectively, while overall neurological morbidity occurred in 15.3, 10.2, 4.3, and 0% of the cases, respectively. Infectious morbidity complicated 13, 4.2, 3.1, and 0% of newborns while 92.1, 81.6, 58.7, and 0% of cases required admission to NICU. Morbidity in pregnancies delivered between 35 and 36 weeks of gestation was affected by the very small sample size of cases included. When comparing the occurrence of overall morbidity according to the type of management (inpatient or outpatient), there was no difference between the two surveillance strategies (p = 0.114). Conclusion MCMA pregnancies are at high risk of composite neonatal morbidity, mainly respiratory morbidity that gradually decreases with increasing gestational age at delivery with a significant reduction for pregnancies delivered between 33 and 34 weeks. We found no difference in the occurrence of neonatal morbidity between pregnancies managed as inpatient or outpatient. Key Points

Correlation between Clinical, Placental Histology and Microbiological Findings in Spontaneous Preterm Births

2015 ◽  
Vol 40 (2) ◽  
pp. 141-149 ◽  
Author(s):  
Gali Garmi ◽  
Marina Okopnik ◽  
Yoram Keness ◽  
Noah Zafran ◽  
Elad Berkowitz ◽  
...  
Keyword(s):  
Gestational Age ◽  
Neonatal Outcome ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
Spontaneous Preterm Birth ◽  
Retrospective Case ◽  
Delivery Methods ◽  
Main Determinant ◽  
Gestational Age At Delivery ◽  
The Impact

Aims: To examine the occurrence of chorioamnionitis and abruption among women who had a spontaneous preterm birth (SPTB), the correlation between clinical and placental findings, and the impact of these complications on neonatal outcome after delivery. Methods: This was a retrospective case-control study conducted between 2008 and 2012 at a single teaching hospital. The study group included all women who had an SPTB (23-36 weeks). Placentas were cultured and underwent histological examination. Results: A total of 478 women were included. The mean gestational age at delivery was 32.6 ± 3.1 weeks. Overall, 260 (54.4%) women had either clinical and/or histological abruption or chorioamnionitis. Clinical chorioamnionitis was diagnosed before birth in 14 (2.9%) women, while histological chorioamnionitis (HCA) in 84 (17.4%). Overall, 38 neonates had infection. Placental cultures were negative in 65.8% (25/38) of these neonates, and in 77.1% (27/38), HCA was ruled out. Logistic regression analysis revealed that neonatal morbidity and mortality were correlated with gestational age at delivery (p = 0.02), not with placental pathology (p = 0.08). Conclusions: Half of the women with PTB had clinical or histological abruption, chorioamnionitis or both. A partial correlation was found between clinical and placental findings. The main determinant of neonatal outcome was gestational age at delivery and not placental findings.

scholarly journals Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

2016 ◽  
Vol 10 ◽  
pp. CMPed.S40070 ◽  
Author(s):  
Deepak Sharma ◽  
Sweta Shastri ◽  
Pradeep Sharma
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Perinatal Asphyxia ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Growth Potential ◽  
Intrauterine Growth ◽  
Health And Disease ◽  
Neonatal Problems

Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR.

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