524: Preterm birth occurrence among Asian women relative to their place of birth

Extreme preterm birth is a major precursor to mortality and disability. Survival is improved in babies born in specialist centres but for multiple reasons this frequently does not occur. In the Thames Valley region of the UK in 2012–2014, covering 27 000 births per annum, about 50% of extremely premature babies were born in a specialist centre. Audit showed a number of potential areas for improvement. We used regional place of birth data and compared the place of birth of extremely premature babies for 2 years before our intervention and for 4 years (2014–2018) after we started. We aimed to improve the proportion of neonates born in a specialist centre with three interventions: increasing awareness and education across the region, by improving and simplifying the referral pathway to the local specialised centre, and by developing region-wide guidelines on the principal precursors to preterm birth: preterm labour and expedited delivery for fetal growth restriction. There were 147 eligible neonates born within the network in the 2 years before the intervention and 80 (54.4%) were inborn in a specialised centre. In the 4 years of and following the intervention, there were 334 neonates of whom 255 were inborn (76.3%) (relative risk of non-transfer 0.50 (95% CI 0.39 to 0.65), p<0.001). Rates showed a sustained improvement. The proportion of extremely premature babies born in specialist centres can be significantly improved by a region-wide quality improvement programme. The interventions and lessons could be used for other areas and specialties.

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The relationship between preterm birth and underweight in Asian women

Reproductive Toxicology ◽

10.1016/j.reprotox.2015.07.045 ◽

2015 ◽

Vol 56 ◽

pp. 20

Author(s):

Yasmin H. Neggers

Keyword(s):

Preterm Birth ◽

Asian Women ◽

The Relationship

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The relationship between preterm birth and underweight in Asian women

Reproductive Toxicology ◽

10.1016/j.reprotox.2015.03.005 ◽

2015 ◽

Vol 56 ◽

pp. 170-174 ◽

Cited By ~ 5

Author(s):

Yasmin H. Neggers

Keyword(s):

Preterm Birth ◽

Asian Women ◽

The Relationship

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A Meta-Analysis for Prevalence of Cesarean Section, Preterm Birth, Stillbirth, and Low Birth Weight Deliveries in Infected Pregnant Women with COVID-19

World Journal of Peri & Neonatology ◽

10.18502/wjpn.v4i1.7542 ◽

2021 ◽

Author(s):

Mojgan Karimi-Zarchi ◽

David A. Schwartz ◽

Seyed Alireza Dastgheib ◽

Reza Bahrami ◽

Atiyeh Javaheri ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Cesarean Section ◽

Pregnant Women ◽

Meta Analysis ◽

Asian Women ◽

Pooled Data ◽

Stratified Analysis ◽

Combined Data

Background: The aim of this meta-analysis was to estimate the prevalence of cesarean section (CS), preterm birth, stillbirth, and low birth weight deliveries (LBWD) in pregnant women with SARS-COV-2 infection. Methods: All relevant studies were searched up to 30 February 2021. Results: A total of 47 studies with 5970 infected pregnant women were included. There were 1010 CS, 55 stillbirths, 524 preterm birth, and 82 with LBWD. Pooled data showed that the prevalence of CS, preterm birth, stillbirth, and LBWD among women with SARS-COV-2 infection was 29.6% (95% CI 0.081-0.160), 2.1% (95% CI 0.081-0.160), 11.5% (95% CI 0.081-0.160), and 2.1% (95% CI 0.081-0.160), respectively. Stratified analysis revealed that these pregnancy outcomes among Asian women were higher than Caucasians. Conclusion: Our combined data revealed that the CS prevalence (29.6%) was the highest followed by preterm birth (11.5%), stillbirth (2.1%), and LBWD (2.1%) among women with COVID-19.

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Vaginal Microbiota and Cytokine Levels Predict Preterm Delivery in Asian Women

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.639665 ◽

2021 ◽

Vol 11 ◽

Author(s):

Manoj Kumar ◽

Selvasankar Murugesan ◽

Parul Singh ◽

Marwa Saadaoui ◽

Duaa Ahmed Elhag ◽

...

Keyword(s):

Preterm Birth ◽

Minority Groups ◽

Neonatal Morbidity ◽

First Trimester ◽

Adverse Outcomes ◽

Vaginal Microbiota ◽

Asian Women ◽

Vaginal Microbiome ◽

High Resource ◽

Cytokine Levels

Preterm birth (PTB) is the most common cause of neonatal morbidity and mortality worldwide. Approximately half of PTBs is linked with microbial etiologies, including pathologic changes to the vaginal microbiota, which vary according to ethnicity. Globally more than 50% of PTBs occur in Asia, but studies of the vaginal microbiome and its association with pregnancy outcomes in Asian women are lacking. This study aimed to longitudinally analyzed the vaginal microbiome and cytokine environment of 18 Karen and Burman pregnant women who delivered preterm and 36 matched controls delivering at full term. Using 16S ribosomal RNA gene sequencing we identified a predictive vaginal microbiota signature for PTB that was detectable as early as the first trimester of pregnancy, characterized by higher levels of Prevotella buccalis, and lower levels of Lactobacillus crispatus and Finegoldia, accompanied by decreased levels of cytokines including IFNγ, IL-4, and TNFα. Differences in the vaginal microbial diversity and local vaginal immune environment were associated with greater risk of preterm birth. Our findings highlight new opportunities to predict PTB in Asian women in low-resource settings who are at highest risk of adverse outcomes from unexpected PTB, as well as in Burman/Karen ethnic minority groups in high-resource regions.

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Place of birth- why we need to improve

10.22541/au.160590963.34285437/v1 ◽

2020 ◽

Author(s):

CATH HARRISON ◽

Lizzy Bonney

Keyword(s):

Preterm Birth ◽

High Activity ◽

In Utero ◽

Place Of Birth ◽

Tertiary Centre ◽

Extremely Preterm ◽

Working Together ◽

Preterm Babies ◽

The Right

7.9% babies are born preterm per year. It is well described that extremely preterm babies born in a high activity tertiary centre with a NICU have a better outcome but despite this only 72% babies are born in “the right place”. There are challenges in both maternity and neonatal services due to problems accepting women for in utero transfer, prediction of preterm birth and neonatal cot capacity. This article describes these challenges and how we can resolve them by working together as perinatal teams.

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