Birth weight and intra-amniotic inflammatory and infection-related complications in pregnancies with preterm prelabor rupture of membranes: a retrospective cohort study

Author(s):  
Jana Matulova ◽  
Marian Kacerovsky ◽  
Radka Bolehovska ◽  
Jaroslav Stranik ◽  
Richard Spacek ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Zeng ◽  
Erica Erwin ◽  
Wendy Wen ◽  
Daniel J. Corsi ◽  
Shi Wu Wen ◽  
...  

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.


2016 ◽  
Vol 31 (suppl_1) ◽  
pp. i328-i328
Author(s):  
Maki Shinzawa ◽  
Shiro Tanaka ◽  
Hironobu Tokumasu ◽  
Daisuke Takada ◽  
Tatsuo Tsukamoto ◽  
...  

2020 ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75 %). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7 %.Conclusions: The mortality rate of ELBW infants with AKI treated with PD is quite high because their organ system is not completely developed. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation.


2020 ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. There were two patients who had severe perinatal asphyxia (5-min Apgar score ≤3). The most important indication for starting PD was AKI due to sepsis. The average duration of PD was 9.4 (±7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (±4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75%). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7%.Conclusions: The mortality rate of ELBW infants with AKI treated with PD is quite high because their organ system is not completely developed. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI.


2020 ◽  
Author(s):  
Li Yu ◽  
Hai-Jin Ke ◽  
Di Che ◽  
Yong Guo ◽  
Jie-Ling Wu

Abstract Background: The effect of maternal vitamin D status on the birth weight of offspring is controversial as the results are inconsistent between different populations. This large retrospective cohort study aimed to assess the relationship between maternal vitamin D levels and birth weight of neonate. Methods: Serum samples were collected from 10,586 Chinese women in the 2 nd trimester of pregnancy, and the 25-hydroxyvitamin D [25(OH)D] level of the participants was assessed. Using the INTERGROWTH-21st standards, the offsprings were classified into three groups based on their gestational age and birth weight, which were as follows: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Results: The average maternal vitamin D concentration was 61.1 nmol/L. The 25(OH)D concentrations were <75.0, <50.0, and <25.0 nmol/L in 76.6%, 31.1%, and 1.6% of the participants, respectively. Approximately 6.4%, 86.4%, and 7.2% of women delivered SGA, AGA, and LGA infants, respectively. No significant differences were observed in vitamin D levels between the three groups (P = 0.562). With the increase in 25(OH)D levels, the risk of SGA and LGA tended to increase and decrease, respectively. However, the results were not precise. AGA was not affected by 25(OH)D levels. The results of the curve fitting and threshold effect analyses did not support the correlation between vitamin D levels and SGA or LGA. Based on the univariate prediction model and the model that adjusted for the risk factors, the area under the curve was extremely small. Thus, 25(OH)D level is not an effective predictor of SGA and LGA. Conclusions: Low maternal vitamin D levels were not associated with SGA or LGA.


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