661: The impact of cervical screening on preterm birth: a decision analysis

Preterm birth and stillbirth are important global perinatal health indicators. Definitions of these indicators can differ between countries, affecting comparability of preterm birth and stillbirth rates across countries. This study aimed to document national-level adherence to World Health Organization (WHO) definitions of preterm birth and stillbirth in the WHO Western Pacific region. A systematic search of government health websites and 4 electronic databases was conducted. Any official report or published study describing the national definition of preterm birth or stillbirth published between 2000 and 2020 was eligible for inclusion. A total of 58 data sources from 21 countries were identified. There was considerable variation in how preterm birth and stillbirth was defined across the region. The most frequently used lower gestational age threshold for viability of preterm birth was 28 weeks gestation (range 20-28 weeks), and stillbirth was most frequently classified from 20 weeks gestation (range 12-28 weeks). High-income countries more frequently used earlier gestational ages for preterm birth and stillbirth compared with low- to middle-income countries. The findings highlight the importance of clear, standardized, internationally comparable definitions for perinatal indicators. Further research is needed to determine the impact on regional preterm birth and stillbirth rates.

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Cervical pap smears and pandemics: The effect of COVID-19 on screening uptake & opportunities to improve

Women s Health ◽

10.1177/17455065211017070 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110170

Author(s):

Hannah Masson

Keyword(s):

Human Papilloma Virus ◽

Cervical Screening ◽

High Sensitivity ◽

Health Board ◽

Pap Smears ◽

Local Health ◽

Papilloma Virus ◽

Face To Face ◽

Screening Uptake ◽

The Impact

Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented upheaval within global healthcare systems and resulted in the temporary pausing of the National Health Service (NHS) Scotland Cervical Screening Programme. With several months of backlogs in appointments, there has not only been a reduction in primary samples being taken for human papilloma virus (HPV) testing but there have also been fewer women referred to colposcopy for investigation and treatment of precancerous or cancerous changes as a result. Encouraging uptake for cervical screening was always a priority before the pandemic, but it is even more important now, considering that the fears and barriers to screening that women may have are now exacerbated by COVID-19. Objectives: This article explores the impact of the pandemic on the uptake of cervical screening within NHS Ayrshire & Arran and evaluates potential strategies to improve uptake now and in future such as self-sampling and telemedicine. Methods: This article presents evidence-based literature and local health board data relating to cervical screening during the pandemic. Results: Human papilloma virus self-sampling carried out by the woman in her home has been shown to improve uptake, especially in non-attenders, whilst maintaining a high sensitivity and, crucially, reducing the need for face-to-face contact. Increased education is key to overcoming barriers women have to screening and telemedicine can strengthen engagement with women during this time. Conclusion: There are lessons to be learned from the pandemic, and we must use this opportunity to improve cervical screening uptake for the future.

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Relationship between preterm birth and air pollution in Santos, Sao Paulo, Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.111 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M E L Brandao ◽

B A L F Braga ◽

M L C Martins ◽

P L A A Pereira

Keyword(s):

Air Pollution ◽

Preterm Birth ◽

Air Pollutants ◽

First Trimester ◽

Sao Paulo ◽

São Paulo ◽

Air Humidity ◽

Relative Air Humidity ◽

The Impact ◽

Fourth Quartile

Abstract Santos is a seaboard Brazilian city recognized by its port activity where the road and rail infrastructure along with the large transportation operation, displays an important factor to contribute with all kinds of toxic and air pollutants. Recent studies have suggested associations between air pollution and various birth outcomes. Pollutant gases such as NOx, O3 and particulate matter PM2,5, PM10 have been cited as factors involved in such outcomes. The present study aims to assess the relationship between atmospheric pollutants and perinatal outcomes in the city of Santos from Jan. 2012 to Dec. 2015. Cross-sectional study that analyzed 10.319 singleton births in an area set with 2 km radius of the monitoring stations. Birth weight and information on mother and pregnancy were obtained at the Brazilian “Born Alive National Information System”. Daily records of air pollutants (PM10, PM2.5, NO2 and O3), temperature and relative air humidity, for the study period, were obtained from São Paulo State Environmental Agency (CETESB). Associations between preterm birth and air pollutants mean levels at each gestational trimester were investigated using multiple logistic regression model controlled by the variables: infant sex, type of delivery, maternal education. prenatal care, and number of previous live births, temperature and relative air humidity. NO2 e PM2,5 was not associated with preterm birth. O3 was significantly associated in the first trimester in the fourth quartile (OR = 1,47 CI 95% 1,05; 2,07). PM10 was significantly associated in the first trimester for the fourth quartile (OR = 1,28 CI 95% 1,00; 1,64), second trimester for the second quartile (OR = 1,37 CI 95% 1,07; 1,77). Conclusions the results shows evidence that maternal exposure to air pollution especially during the first trimester of pregnancy may contribute to preterm birth. Further actions are needed towards controlling air pollution are strongly recommended for promoting early-life health. Key messages This is the first research of this kind that was made in Santos. It brings important evidence of the impact in the life of the population, especially those whose is not even born yet. It can be used as a resource to guide public policies in health, especially the guidelines that dictate the concentration of air pollutants and air quality.

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The impact of changes in preterm birth among twins on stillbirth and infant mortality in the United States

Journal of Perinatology ◽

10.1038/jp.2014.119 ◽

2014 ◽

Vol 34 (11) ◽

pp. 823-829 ◽

Cited By ~ 7

Author(s):

D Getahun ◽

K Demissie ◽

S W Marcella ◽

G G Rhoads

Keyword(s):

United States ◽

Preterm Birth ◽

Infant Mortality ◽

The United States ◽

The Impact

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Vaccination against HPV: indications for women and the impact on the cervical screening programme

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2008.01779.x ◽

2008 ◽

Vol 115 (8) ◽

pp. 938-946 ◽

Cited By ~ 12

Author(s):

DAM Heideman ◽

PJF Snijders ◽

J Berkhof ◽

RHM Verheijen ◽

TJM Helmerhorst ◽

...

Keyword(s):

Screening Programme ◽

Cervical Screening ◽

The Impact

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The impact of vaginal microbiome composition, race, and immunological factors on preterm birth

Reviews in Medical Microbiology ◽

10.1097/mrm.0000000000000292 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Roxana Nouri-Nikbakht ◽

Erin S. Honsa

Keyword(s):

Preterm Birth ◽

Vaginal Microbiome ◽

Microbiome Composition ◽

Immunological Factors ◽

The Impact

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The Compliance of Prescribed Activity Restriction in Women at High Risk for Preterm Birth

American Journal of Perinatology ◽

10.1055/s-0040-1714358 ◽

2020 ◽

Author(s):

Ghamar Bitar ◽

Anthony Sciscione

Keyword(s):

Preterm Birth ◽

High Risk ◽

Medical Center ◽

Compliance Rate ◽

Tertiary Care ◽

Prescribing Patterns ◽

Categorical Variables ◽

Continuous Variables ◽

Activity Restriction ◽

The Impact

Objective Despite lack of evidence to support efficacy, activity restriction is one of the most commonly prescribed interventions used for the prevention of preterm birth. We have a departmental policy against the use of activity restriction but many practitioners still prescribe it in an effort to prevent preterm birth. We sought to evaluate the rate and compliance of women who are prescribed activity restriction during pregnancy to prevent preterm birth. Study Design This was a single-site retrospective questionnaire study at a tertiary care, academic affiliated medical center. Women with a history of preterm delivery or short cervix were included. Once patients were identified, each patient was contacted and administered a questionnaire. We assessed the rates of activity restriction prescription and compliance. Secondary outcomes included details regarding activity restriction and treatment in pregnancy. Continuous variables were compared with t-test and categorical variables with Chi-square test. The value p < 0.05 was considered significant. Results Among the 52 women who responded to the questionnaire, 18 reported being placed on activity restriction by a physician, with 1 self-prescribing activity restriction, giving a rate of our primary outcome of 19 of 52 (36.5%). All women reported compliance with prescribed activity restriction (100%). Gestational age at delivery was not different in women placed on activity restriction. Conclusion This questionnaire suggests that approximately one in three high-risk women were placed on activity restriction during their pregnancy despite a departmental policy against its use. The 100% compliance rate in patients placed on activity restriction is a strong reminder of the impact prescribing patterns of physicians can have on patients. Key Points

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