Mode of delivery for term breech fetuses and long-term pediatric respiratory morbidity of the offspring

In this review, the Paediatric Assembly of the European Respiratory Society (ERS) presents a summary of the highlights and most relevant findings in the field of paediatric respiratory medicine presented at the virtual ERS International Congress 2020. Early Career Members of the ERS and Chairs of the different Groups comprising the Paediatric Assembly discuss a selection of the presented research. These cover a wide range of research areas, including respiratory physiology and sleep, asthma and allergy, cystic fibrosis, respiratory infection and immunology, neonatology and intensive care, epidemiology, bronchology and lung and airway development. Specifically, we describe the long-term effect in lung function of premature birth, mode of delivery and chronic respiratory conditions such as cystic fibrosis. In paediatric asthma, we present risk factors, phenotypes and their progression with age, and the challenges in diagnosis. We confirm the value of the lung clearance index to detect early lung changes in cystic fibrosis. For bronchiectasis treatment, we highlight the importance of identifying treatable traits. The use of biomarkers and genotypes to identify infants at risk of long-term respiratory morbidity is also discussed. We present the long-term impact on respiratory health of early life and fetal exposures to maternal obesity and intrauterine hypoxia, mechanical ventilation hyperoxia, aeroallergens, air pollution, vitamin A deficient intake and bronchitis. Moreover, we report on the use of metabolomics and genetic analysis to understand the effect of these exposures on lung growth and alveolar development. Finally, we stress the need to establish multidisciplinary teams to treat complex airway pathologies.

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Spatio-temporal associations of air pollutant concentrations, GP respiratory consultations and respiratory inhaler prescriptions: a 5-year study of primary care in the borough of Lambeth, South London

Environmental Health ◽

10.1186/s12940-021-00730-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Mark Ashworth ◽

◽

Antonis Analitis ◽

David Whitney ◽

Evangelia Samoli ◽

...

Keyword(s):

Primary Care ◽

Negative Binomial ◽

Hospital Admissions ◽

Air Pollutant ◽

Respiratory Morbidity ◽

Short Term ◽

Short Term Exposure ◽

Short And Long Term ◽

Spatio Temporal

Abstract Background Although the associations of outdoor air pollution exposure with mortality and hospital admissions are well established, few previous studies have reported on primary care clinical and prescribing data. We assessed the associations of short and long-term pollutant exposures with General Practitioner respiratory consultations and inhaler prescriptions. Methods Daily primary care data, for 2009–2013, were obtained from Lambeth DataNet (LDN), an anonymised dataset containing coded data from all patients (1.2 million) registered at general practices in Lambeth, an inner-city south London borough. Counts of respiratory consultations and inhaler prescriptions by day and Lower Super Output Area (LSOA) of residence were constructed. We developed models for predicting daily PM2.5, PM10, NO2 and O3 per LSOA. We used spatio-temporal mixed effects zero inflated negative binomial models to investigate the simultaneous short- and long-term effects of exposure to pollutants on the number of events. Results The mean concentrations of NO2, PM10, PM2.5 and O3 over the study period were 50.7, 21.2, 15.6, and 49.9 μg/m3 respectively, with all pollutants except NO2 having much larger temporal rather than spatial variability. Following short-term exposure increases to PM10, NO2 and PM2.5 the number of consultations and inhaler prescriptions were found to increase, especially for PM10 exposure in children which was associated with increases in daily respiratory consultations of 3.4% and inhaler prescriptions of 0.8%, per PM10 interquartile range (IQR) increase. Associations further increased after adjustment for weekly average exposures, rising to 6.1 and 1.2%, respectively, for weekly average PM10 exposure. In contrast, a short-term increase in O3 exposure was associated with decreased number of respiratory consultations. No association was found between long-term exposures to PM10, PM2.5 and NO2 and number of respiratory consultations. Long-term exposure to NO2 was associated with an increase (8%) in preventer inhaler prescriptions only. Conclusions We found increases in the daily number of GP respiratory consultations and inhaler prescriptions following short-term increases in exposure to NO2, PM10 and PM2.5. These associations are more pronounced in children and persist for at least a week. The association with long term exposure to NO2 and preventer inhaler prescriptions indicates likely increased chronic respiratory morbidity.

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Mode of Delivery and Infant Respiratory Morbidity Among Infants Born to HIV-1-Infected Women

Obstetrics and Gynecology ◽

10.1097/aog.0b013e3181e8f38a ◽

2010 ◽

Vol 116 (2, Part 1) ◽

pp. 335-343 ◽

Cited By ~ 8

Author(s):

Elizabeth G. Livingston ◽

Yanling Huo ◽

Kunjal Patel ◽

Susan B. Brogly ◽

Ruth Tuomala ◽

...

Keyword(s):

Mode Of Delivery ◽

Respiratory Morbidity ◽

Hiv 1

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Respiratory morbidity in twins by birth order, gestational age and mode of delivery

Journal of Perinatal Medicine ◽

10.1515/jpm-2015-0404 ◽

2016 ◽

Vol 44 (8) ◽

Cited By ~ 7

Author(s):

Katja Bricelj ◽

Natasa Tul ◽

Mateja Lasic ◽

Andreja Trojner Bregar ◽

Ivan Verdenik ◽

...

Keyword(s):

Birth Order ◽

Cesarean Delivery ◽

Gestational Age ◽

Mode Of Delivery ◽

Age Groups ◽

Assisted Ventilation ◽

Vaginal Birth ◽

National Database ◽

Respiratory Morbidity ◽

Cesarean Birth

AbstractObjective:To evaluate the relationship between respiratory morbidity in twins by gestational age, birth order and mode of delivery.Methods:All twin deliveries at <37 weeks, registered in a national database, in the period 2003–2012 were classified into four gestational age groups: 33–36, 30–32, 28–29, and <28 weeks. Outcome variables included transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS) and need for assisted ventilation.Results:A total of 1836 twins were born vaginally, and 2142 twins were born by cesarean delivery, for a grand total of 3978 twins. TTN did not appear to be related to birth order and to the mode of delivery. In contrast, RDS was more frequent among the second born twins in the vaginal birth groups born at 30–36 weeks [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.2–5.1 and OR 2.0, 95% CI 1.2–3.5 for 33–36 weeks and 30–32 weeks, respectively], whereas this trend was seen in the cesarean birth groups born earlier (OR 3.8, 95% CI 1.1–13.0 for 28–29 weeks). Cesarean delivery significantly increased the frequency of RDS in twin A as well as in twin B compared with vaginal birth, but only at gestational ages <30 weeks.Conclusion:Mode of delivery and birth order have a gestational age dependent effect on the incidence of RDS.

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181: Mode of delivery and neonatal respiratory morbidity in near-term preterm births

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2008.09.208 ◽

2008 ◽

Vol 199 (6) ◽

pp. S62

Author(s):

Caitlin Saint-Aubin ◽

Sarah Hopkins ◽

Deborah Feldman ◽

Victor Fang ◽

Charles Ingardia ◽

...

Keyword(s):

Mode Of Delivery ◽

Preterm Births ◽

Respiratory Morbidity ◽

Near Term

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204: Maternal history of recurrent pregnancy loss increases the risk for long-term pediatric respiratory morbidity of the offspring

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.10.081 ◽

2018 ◽

Vol 218 (1) ◽

pp. S135

Author(s):

Sharon Davidesko ◽

Asnat Walfisch ◽

Tamar Wainstock ◽

Daniella Landau ◽

Eyal Sheiner

Keyword(s):

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Respiratory Morbidity ◽

Maternal History ◽

History Of

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Effect of Antenatal Administration of Betamethasone on Hospital Costs and Survival of Premature Infants

PEDIATRICS ◽

10.1542/peds.68.5.633 ◽

1981 ◽

Vol 68 (5) ◽

pp. 633-637 ◽

Cited By ~ 1

Author(s):

Dana E. Johnson ◽

David P. Munson ◽

Theodore R. Thompson

Keyword(s):

Premature Infants ◽

Distress Syndrome ◽

Hospital Costs ◽

Glucocorticoid Therapy ◽

Hospital Charges ◽

Respiratory Morbidity ◽

University Of Minnesota ◽

Long Term Effects ◽

The University

Prenatal administration of glucocorticoids has been shown to decrease the incidence and severity of respiratory distress syndrome in premature infants, but little is known regarding the immediate economic impact of this reduction in respiratory morbidity. This study retrospectively examined 342 infants born during 1978 and 1979 and hospitalized in the University of Minnesota Hospitals. Comparison of survival and the hospital charges for infants whose mothers had or had not received prenatal glucocorticoid therapy showed that administration of glucocorticoids had a significant effect in lowering mortality in infants with birth weights between 750 and 1,249 gm (27 to 29 weeks' gestation). Glucocorticoid therapy was also effective in decreasing morbidity as reflected by hospital charges of surviving infants with birth weights between 1,250 and 1,749 gm (30 to 32 weeks' gestation). In both steroid-treated and nontreated mothers, prolongation of gestation decreases hospital charges in a linear fashion. The noted decrease in hospital costs should not justify prenatal glucocorticoid administration but should stimulate examination of long-term effects of the drug on surviving infants.

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