Factors Associated with Formula Feeding among Late Preterm Neonates

2020 ◽  
Vol 37 (14) ◽  
pp. 1393-1399
Author(s):  
Michal Fishel Bartal ◽  
Han-Yang Chen ◽  
Sean C. Blackwell ◽  
Suneet P. Chauhan ◽  
Baha M. Sibai
Keyword(s):  
Secondary Analysis ◽  
Preterm Births ◽  
Formula Feeding ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Chronic Hypertension ◽  
Antenatal Corticosteroids ◽  
Singleton Pregnancy ◽  
Factors Associated ◽  
Increased Risk

Objective Late preterm births (delivery at 34–36 weeks) account for nearly three quarters of the preterm births and among them there is a knowledge gap about an important aspect of infant care: breast versus formula feeding. The aim of this study was to assess factors associated with formula feeding in late preterm neonates. Study Design Secondary analysis of a multicenter randomized trial of antenatal corticosteroids for women at risk for late preterm birth. All women with a singleton pregnancy who delivered at 340/7 to 366/7 weeks were included. Women with no information on neonatal feeding or known fetal anomalies were excluded. The outcome evaluated was the type of neonatal feeding during hospital stay. Maternal and neonatal characteristics were compared among women who initiated breast versus formula feeding. Adjusted relative risks (aRRs) for formula feeding with 95% confidence intervals (CIs) were calculated. Results Of the 2,831 women in the parent trial, 2,329 (82%) women met inclusion criteria and among them, 696 (30%) were formula feeding. After multivariable regression, the following characteristics were associated with an increased risk of formula feeding: maternal age < 20 years (aRR: 1.47, 95% CI: 1.20–1.80) or ≥35 years (aRR: 1.19, 95% CI: 1.02–1.40), never married status (aRR: 1.39, 95% CI: 1.20–1.60), government-assisted insurance (aRR: 1.41, 95% CI: 1.16–1.70), chronic hypertension (aRR: 1.19, 95% CI: 1.01–1.40), smoking (aRR: 1.51, 95% CI: 1.31–1.74), cesarean delivery (aRR: 1.16, 95% CI: 1.03–1.32), and admission to neonatal intensive care unit (aRR: 1.31, 95% CI: 1.16–1.48). Hispanic ethnicity (aRR: 0.78, 95% CI: 0.64–0.94), education >12 years (aRR: 0.81, 95% CI 0.69–0.96), and nulliparity (aRR 0.71, 95% CI: 0.62–0.82) were associated with a reduced risk for formula feeding. Conclusion In this geographically diverse cohort of high-risk deliveries, 3 out 10 late preterm newborns were formula fed. Smoking cessation was a modifiable risk factor that may diminish the rate of formula feeding among late preterm births. Key Points

Antenatal corticosteroids and neurodevelopmental outcomes in late preterm births

2021 ◽  
pp. fetalneonatal-2021-322152
Author(s):  
Amir Aviram ◽  
Kellie Murphy ◽  
Sarah McDonald ◽  
Elizabeth Asztalos ◽  
Arthur Zaltz ◽  
...  
Keyword(s):  
Birth Weight ◽  
Neonatal Resuscitation ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Neurocognitive Disorder ◽  
Antenatal Corticosteroids ◽  
Neurodevelopmental Outcomes ◽  
Increased Risk ◽  
Visual Testing

ObjectivesAntenatal corticosteroids (ACS) decrease neonatal mortality and morbidity among preterm neonates, yet there has been concern regarding their long-term safety. We hypothesised that potential long-term adverse effects of ACS may be observed among infants born during the late preterm period (LPT, 340/7–366/7 weeks of gestation), when the benefits of ACS are subtle.DesignPopulation-based, retrospective cohort.SettingOntario, Canada, between 2006 and 2011.PatientsAll live singleton infants born during the LPT period with a minimum 5-year follow-up.InterventionsExposure to ACS prior to 340/7 weeks of gestation.Main outcome measuresSuspected neurocognitive disorder, audiometry testing or visual testing.ResultsOverall, 25 668 infants were eligible for analysis, of whom 2689 (10.5%) received ACS. Infants in the ACS group had lower mean birth weight and higher rates of birth weight <10th percentile, neonatal resuscitation and neonatal intensive care unit admission. At 5 years of age, ACS exposure was associated with an increased risk of suspected neurocognitive disorder (adjusted HR (aHR) 1.12, 95% CI 1.05 to 1.20), audiometry testing (aHR 1.20, 95% CI 1.10 to 1.31) and visual testing (aHR 1.06, 95% CI 1.01 to 1.11).ConclusionIn children born during the LPT period, exposure to ACS prior to 340/7 weeks of gestation is associated with an increased utilisation of the healthcare system related to audiometry and visual testing and suspected neurocognitive disorders by 5 years of age.

scholarly journals 312: Factors associated with formula feeding among late preterm neonates

2020 ◽  
Vol 222 (1) ◽  
pp. S209-S210
Author(s):  
Michal Fishel Bartal ◽  
Han-Yang Chen ◽  
Sean Blackwell ◽  
Suneet P. Chauhan ◽  
Baha M. Sibai
Keyword(s):  
Formula Feeding ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Factors Associated

A RETROSPECTIVE ANALYSIS OF MATERNALAND FETAL OUTCOMES OF PRETERM DELIVERIES IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA.

2021 ◽  
pp. 42-44
Author(s):  
Varsha Konyala ◽  
Poornima M ◽  
Suma K.B
Keyword(s):  
Preterm Delivery ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Preterm Births ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Maternal Complications ◽  
Record Keeping

Aim:To study preterm delivery outcomes in a tertiary care hospital in South India. Methods: The study was conducted for a 7 month period from July 1, 2020 to January 31, 2021at JSS Hospital, Mysuru. Relevant details of every pregnant woman who underwent a preterm delivery and the subsequent neonate born were collected and followed till discharge. Results: The prevalence rate of preterm births was 11.81%. There were 44 early preterm deliveries and 88 late preterm deliveries. The most common maternal complications that lead to preterm births PPROM and preeclampsia.36 early preterm and 29 late preterm neonates required an NICU admission. This included 7 pairs of twins in the early preterm and 1 pair of twins in the late preterm. In the NICU, the most common complications noted were RDS, and sepsis.4 neonates remained by mother's side soon after delivery in the early preterm subset, whereas 54 of late preterm neonates were kept by the mother's side soon after delivery. 31 of 40 early preterm, 86 of the 88 of late preterm neonates were healthy and t for discharge. Conclusion:The prevalence of preterm birth rate in our study stands comparable to the reported global average. Preterm births have a multifactorial etiology. Timely referral to higher centers, experienced obstetricians, and a good NICU facility proved helpful to both the mother and neonate. Thorough record keeping also allows a true picture of preterm prevalence on the basis of which, policies and decisions can be made to further improve preterm care.

scholarly journals Acquired infection during neonatal and pediatric extracorporeal membrane oxygenation

Perfusion ◽  
2018 ◽  
Vol 33 (6) ◽  
pp. 472-482 ◽  
Author(s):  
Katherine Cashen ◽  
Ron Reeder ◽  
Heidi J. Dalton ◽  
Robert A. Berg ◽  
Thomas P. Shanley ◽  
...  
Keyword(s):  
Viral Infections ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Secondary Analysis ◽  
Hazard Ratio ◽  
Research Network ◽  
Factors Associated ◽  
Increased Risk ◽  
Neonatal Icu ◽  
Pediatric Icu

Introduction: Our objectives are to (1) describe the pathogens, site, timing and risk factors for acquired infection during neonatal and pediatric ECMO and (2) explore the association between acquired infection and mortality. Methods: Secondary analysis of prospective data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. Clinical factors associated with acquired infection were assessed with multivariable Cox regression. Factors associated with mortality were assessed with logistic regression. Results: Of 481 patients, 247 (51.3%) were neonates and 400 (83.2%) received venoarterial ECMO. Eighty (16.6%) patients acquired one or more infections during ECMO; 60 (12.5%) patients had bacterial, 21 (4.4%) had fungal and 11 (2.3%) had viral infections. The site of infection included respiratory for 53 (11.0%) patients, bloodstream for 21 (4.4%), urine for 20 (4.2%) and other for 7 (1.5%). Candida species were most common. Median time to infection was 5.2 days (IQR 2.3, 9.6). On multivariable analysis, a greater number of procedures for ECMO cannula placement was independently associated with increased risk of acquired infection during ECMO (Hazard Ratio 2.13 (95% CI 1.22, 3.72), p<0.01) and receiving ECMO in a neonatal ICU compared to a pediatric or cardiac ICU was associated with decreased risk (Hazard Ratio pediatric ICU 4.25 (95% CI 2.20, 8.20), cardiac ICU 2.91 (95% CI 1.48, 5.71), neonatal ICU as reference, p<0.001). Acquired infection was not independently associated with mortality. Conclusion: ECMO procedures and location may contribute to acquired infection risk; however, acquired infection did not predict mortality in this study.

scholarly journals Morbidity profile and immediate outcome of late preterm neonates compared to term neonates in a rural tertiary care hospital of Gujarat

2017 ◽  
Vol 4 (4) ◽  
pp. 1329 ◽  
Author(s):  
Manish Rasania ◽  
Prasad Muley
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Preterm Births ◽  
Full Term ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Term Infants ◽  
Term Neonates ◽  
Late Preterm Infants

Background: Late premature infants are born near term, but are immature. As a consequence, late preterm infants are at higher risk than term infants to develop morbidities. Although late preterm infants are the largest subgroup of preterm infants, there is a very limited data available on problems regarding late preterm infants in rural India.Methods: This is a retrospective cohort study using previously collected data from neonates born at Dhiraj Hospital and neonates who were born outside but admitted at SNCU of Dhiraj Hospital, Piparia, Vadodara district, Gujarat, India between January 2015 to December 2015.Results: 168 late preterm infants and 1025 term infants were included in this study. The need for SNCU admission is significantly higher in late preterm compared to full term (41.07% vs 2.04%). Morbidities were higher in late preterm neonates compared to full term neonates. Sepsis (4.76% vs 1.07%), TTN (10.11% vs 2.04%), hyperbilirubinemia (19.04% vs 9.36%), RDS (1.78% vs 0.09%), hypoglycemia (1.78% vs 0.29%), PDA (1.78% vs 0.58%), risk of major congenital malformation (2.38% vs 0.58%). Need for respiratory support was 5.95% in late preterm vs 2.04% in full term neonates. Immediate neonatal outcome in terms of death and DAMA (non-salvageable) cases was poor in late preterm neonates compared to full term neonates (1.19% vs 0.78%).Conclusions: Late preterm neonates are at higher risk of morbidities and mortalities. They require special care. Judicious obstetric decisions are required to prevent late preterm births. 

scholarly journals Perinatal and Maternal Outcomes in Two Groups of Normal and At the Risk of Borderline Oligohydramnios in Late Preterm Pregnancy

2020 ◽  
Vol 8 (1) ◽  
pp. 29-32
Author(s):  
Saddiqa Hassan ◽  
Sana Ali ◽  
Sajid Hussain Sherazi
Keyword(s):  
Perinatal Outcomes ◽  
Late Preterm ◽  
Maternal Outcomes ◽  
Singleton Pregnancy ◽  
Apgar Scores ◽  
Border Line ◽  
Increased Risk ◽  
Borderline Patients ◽  
Group 2

Background: Pregnancy outcomes of a borderline oligohydramnios versus normal relatively comes to be slightly increasing meconium‐stained fluid, low Apgar scores and hyper bilirubinemia on follow up as perinatal outcomes and increased risk of C section as maternal outcome. There is currently insufficient evidence to recommend additional perinatal and maternal testing based on a borderline oligohydramnios. Clinical determination is considered in evaluating meconium‐stained fluid, low Apgar scores and hyper bilirubinemia. Objective: The purpose of this study is to determine the adverse perinatal and maternal outcomes in uncomplicated late preterm pregnancies with borderline oligohydramnios. Setting: A total of 38 patients were studied, 19 were with normal AFI and 19 patients were of borderline AFI. Patients with normal AFI were referred as Group 1 and the other as Group 2. This study was conducted at Niazi Medical and Dental College, Sargodha. Population: Pregnant women with normal AFI at term and borderline patients with late preterm pregnancy and borderline oligohydramnios. Methods: This descriptive study was conducted at Niazi Medical and Dental College, Sargodha. This study comprised of 38 patients with normal AFI and border line AFI. Data of 19 patients with normal AFI and 19 patients with border line AFI was collected. The Inclusion Criteria was 19 singleton pregnancies of 36+6 weeks, with AFI ≤ 8 cm and 19 singleton pregnancy 37+ weeks with upto 24 cm AFI. In both groups, Maternal and perinatal outcomes were assessed. The results of both groups were compared in the end. Conclusion: The results of this study indicated that borderline AFI was not a risk for adverse perinatal and maternal outcomes in uncomplicated, late preterm pregnancies.    Int. J. Appl. Sci. Biotechnol. Vol 8(1): 29-32

Assessment of risk factors associated with pre-term labour in Tertiary care Hospitals, Lahore

2021 ◽  
Vol 15 (1) ◽  
pp. 13-17
Author(s):  
Tanzeela Zafar ◽  
Iram Manzoor ◽  
Fariha Farooq
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Cesarean Section ◽  
Preterm Births ◽  
Intrauterine Death ◽  
Singleton Pregnancy ◽  
Factors Associated ◽  
History Of ◽  
Tract Infections ◽  
Inter Pregnancy Interval

Background: Pakistan has one of the highest rates of preterm births, nearly 16 for every 100 babies born. Around 4% of these premature babies, are at highest likelihood of death. The objective of this study was to assess association of multiple risk factors with preterm birth in Pakistani women. Patients and methods:  An analytical cross-sectional study was carried out in Obstetrics and Gynecology Department of Akhtar Saeed Trust Hospital and Farooq Hospital, West Wood Branch, Lahore from October 2018 to December 2019. Total 116 pregnant females who gave birth to preterm babies with gestational age between 20-37 weeks were included. Data about patients’ socio-demographic profile, previous obstetric history and current gestational profile was collected using closed ended structured questionnaire. Variables were presented in the form of frequency tables. Chi-square and Fisher exact test were applied to establish association of various risk factors and preterm presentation of patients’ in hospital. A p-value ≤ 0.05 was taken as significant. Results: Out of 116 participants, 49 (42.2%) were aged between 20-25 years, 47 (40.5%) were illiterate. Of the total sample 60 (51.7 %) participants were obese (BMI >30). Eighty-two (70.7%) patients were multigravida and 65 (56.1%) gave the history of previous cesarean section. Significant association was found between preterm birth and multi-parity (p=0.001), previous history of abortion (p=0.000), intrauterine death (p=0.001), infertility (p=0.04), cesarean-section (p=0.000), and inter-pregnancy interval of less than 24 months (p=0.007). Other significant factors associated with preterm labour were urinary tract infections (p=0.001), documented fever more than 101oF (p=0.000), anemia (p=0.000), singleton pregnancy (p=0.000) and cephalic fetal presentation (p=0.002), during current pregnancy. Conclusion: Multi-gravidity, history of abortion, intrauterine death, previous infertility, cesarean-section, inter-pregnancy interval of less than 24 months, UTI, genital tract infection, anemia, singleton pregnancy and cephalic fetal presentation during current pregnancy were observed to be significantly associated with preterm births.

scholarly journals Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries—A systematic review and meta-analysis of RCTs

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248774
Author(s):  
Mangesh Deshmukh ◽  
Sanjay Patole
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Neonatal Resuscitation ◽  
Late Preterm ◽  
Respiratory Support ◽  
Preterm Neonates ◽  
Antenatal Corticosteroids ◽  
Neurodevelopmental Outcomes ◽  
Level Of Evidence

Background Administration of antenatal corticosteroids (ANC) for impending preterm delivery beyond 34 weeks of gestation continues to be a controversial issue despite various guidelines for obstetricians and gynaecologists. Objective To compare outcomes following exposure to ANC for infants born between 34–36+6 weeks’ gestation. Methods A systematic review of randomised controlled trials (RCT) reporting neonatal outcomes after ANC exposure between 34–36+6 weeks’ gestation using Cochrane methodology. Databases including PubMed, Embase, Emcare, Cochrane Central library and Google Scholar were searched in May 2020. Primary outcomes: (1) Need for respiratory support (Mechanical ventilation, CPAP, high flow) or oxygen (2) Hypoglycemia. Secondary outcomes included respiratory distress syndrome (RDS), transient tachypnoea of newborn (TTN), need for neonatal resuscitation at birth [only in the delivery room immediately after birth (not in neonatal intensive care unit (NICU)], admission to NICU, mortality and developmental follow up. Level of evidence (LOE) was summarised by GRADE guidelines. Main results Seven RCTs (N = 4144) with low to high risk of bias were included. Only one RCT was from high income countries, Meta-analysis (random-effects model) showed (1) reduced need for respiratory support [5 RCTs (N = 3844); RR = 0.68 (0.47–0.98), p = 0.04; I2 = 55%; LOE: Moderate] and (2) higher risk of neonatal hypoglycaemia [4 RCTs (N = 3604); RR = 1.61(1.38–1.87), p<0.00001; I2 = 0%; LOE: High] after ANC exposure. Neonates exposed to ANC had reduced need for resuscitation at birth. The incidence of RDS, TTN and surfactant therapy did not differ significantly. None of the included studies reported long-term developmental follow up. Conclusions Moderate quality evidence indicates that ANC exposure reduced need for respiratory support, and increased the risk of hypoglycaemia in late preterm neonates. Large definitive trials with adequate follow up for neurodevelopmental outcomes are required to assess benefits and risks of ANC in this population.

Hypertensive Disorders of Pregnancy and Preterm Birth Rates among Black Women

2018 ◽  
Vol 36 (02) ◽  
pp. 148-154 ◽  
Author(s):  
Rebecca Baer ◽  
Laura Jelliffe-Pawlowski ◽  
Mary Norton ◽  
Ashish Premkumar
Keyword(s):  
Preterm Birth ◽  
Black Women ◽  
Gestational Hypertension ◽  
Chronic Hypertension ◽  
Inclusion Criteria ◽  
Maternal Factors ◽  
Factors Associated ◽  
Relative Risks ◽  
Increased Risk

Objective The objective of this study was to investigate the role of gestational hypertension (gHTN) and chronic hypertension (cHTN) on rates of preterm birth (PTB) among black women. Study Design Singleton live births between 20 and 44 weeks' gestation among black women in California from 2007 to 2012 were used for analysis. Risk of PTB by subtype and gestational age among women with cHTN or gHTN, including preeclampsia, was calculated via Poisson's logistic regression modeling. Risks were adjusted for maternal factors associated with increased risk of PTB. Results A total of 154,950 women met the inclusion criteria. Of the 5,948 women in the sample with cHTN, 26.2% delivered preterm; for the 11,728 women with gHTN, 21.6% delivered preterm. Women with gHTN or cHTN had a higher risk of medically indicated and spontaneous PTB, both at less than 32 and 32 to 36 weeks, when compared with nonhypertensive women (adjusted relative risks [aRRs]: 3.4–11.6). Women with superimposed preeclampsia had higher risks of spontaneous (aRR: 2.8, 95% confidence interval [CI]: 2.3–3.4) and medically indicated PTB (aRR: 2.8, 95% CI: 2.0–3.8), especially PTB < 32 weeks, when compared with women with preeclampsia. Conclusion Among black women, superimposed preeclampsia increased the risk for spontaneous and medically indicated PTB, especially PTB < 32 weeks.

Prevalence and Outcome of Preterm Births in the National Referral Hospital in Bhutan: An Observational Study

2019 ◽  
Vol 66 (2) ◽  
pp. 163-170
Author(s):  
Dinesh Pradhan ◽  
Yoriko Nishizawa ◽  
Hari P Chhetri
Keyword(s):  
Preterm Birth ◽  
Birth Rate ◽  
Tertiary Care ◽  
Preterm Births ◽  
Referral Hospital ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Increased Risk ◽  
Preterm Birth Rate ◽  
National Referral Hospital

Abstract Introduction Preterm birth-related complications are the leading cause of under-5 mortality globally. Bhutan does not have a reliable preterm birth rate or data regarding outcome of preterm babies. Aim To determine the preterm birth rate at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu, Bhutan, and assess their outcomes. Methods All live preterm births at JDWNRH from 1 January 2017 to 31 December 2017 were followed from birth till hospital discharge. Maternal demographic data, pregnancy details and delivery details were collected. Morbidity and mortality information as well as discharge outcome were collected on babies admitted to neonatal intensive care unit (NICU). Results Preterm birth rate among live births was 6.4%. Most mothers were younger than 30 years, housewives and had secondary education. Pregnancy registration rate and adequacy of antenatal visits were high. Most preterm births were singleton and the predominant mode of delivery was cesarean section. More than half of the births were initiated spontaneously, and the male:female ratio was 1.2:1. Most babies were late preterm and low birth weight. Half of them required NICU admission. Overall mortality rate was 11% and 21.6% for admitted preterm neonates. Preterm small-for-gestational-age neonates, and those born after provider-initiated preterm birth had significantly increased risk of mortality. Most preterm neonates were discharged without complications. The rate of extrauterine growth restriction was high. Conclusion This is the first study on the prevalence of preterm births and their outcomes in the largest tertiary-care hospital in Bhutan.

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