Antenatal Azithromycin to Prevent Preterm Birth in Pregnant women with Vaginal Cerclage. A Randomized Controlled Trial

Abstract Background Preterm birth with its complications is one of the leading causes of perinatal morbidity and mortality, as well as maternal morbidity, especially in low and middle-income countries. Cervical cerclage is a well-established preventive tool in women at high risk of preterm birth; however, subclinical maternal infection might still cause failure of this method. Thus, adding prophylactic antibiotics, namely macrolides, could prevent preterm birth. Patients and methods This was a randomized controlled clinical trial involving two groups of women who underwent vaginal cerclage at Ain Shams University Maternity Hospital. One group received azithromycin 500mg one tablet orally once daily for 3 days every month from 14th week to 34th week gestation, in addition to routine antenatal care; while the other group received usual antenatal care without antibiotic prophylaxis after cerclage. Follow-up was done and we compared the outcomes in each group: gestational age at delivery, birth weight, mode of delivery, maternal complications, and perinatal complications. ClinicalTrials.gov Identifier NCT04278937. Results Gestational age at delivery was significantly higher in the azithromycin group (36.8weeks vs 34.1weeks; P = 0.017), with significant prolongation of gestation in the azithromycin group (23.7weeks vs 21.1weeks; P = 0.005). As regards birth weight, it was significantly higher in the azithromycin group (2932.6gm vs 2401.8gm; P = 0.006); however babies with low birth weight (birth weight <2500gm) were non-significantly less frequent in the azithromycin group (3cases vs 7cases; P = 0.165). There was no significant difference between the two groups as regards other outcomes (miscarriage, stillbirth, neonatal intensive care unit admission, antepartum hemorrhage, postpartum pyrexia, need for blood transfusion). Conclusion Adding azithromycin as antenatal prophylaxis in women undergoing vaginal cerclage prolongs pregnancy and reduces risk of PTB, with slight increase in birth weight. However, there was no clear effect on incidence of low birth weight, or perinatal morbidity/mortality.

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Synbiotics use for preventing sepsis and necrotizing enterocolitis in very low birth weight neonates: a randomized controlled trial

Clinical and Experimental Pediatrics ◽

10.3345/cep.2019.00381 ◽

2020 ◽

Vol 63 (6) ◽

pp. 226-231 ◽

Cited By ~ 1

Author(s):

Ozge Serce Pehlevan ◽

Derya Benzer ◽

Tugba Gursoy ◽

Guner Karatekin ◽

Fahri Ovali

Keyword(s):

Randomized Controlled Trial ◽

Birth Weight ◽

Low Birth Weight ◽

Necrotizing Enterocolitis ◽

Gestational Age ◽

Very Low Birth Weight ◽

Late Onset ◽

Controlled Trial ◽

Randomized Controlled ◽

Significant Difference

Background: Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone.Purpose: We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis in very low birth weight neonates.Methods: Neonates with a gestational age ≤32 weeks and birth weight ≤1,500 g were enrolled. The study group received a combination of synbiotics and lactoferrin, whereas the control group received 1 mL of distilled water as placebo starting with the first feed until discharge. The outcome measures were the incidence of NEC stage ≥2 or late-onset cultureproven sepsis and NEC stage ≥2 or death.Results: Mean birth weight and gestational age of the study (n=104) and the control (n=104) groups were 1,197±235 g vs. 1,151±269 g and 29±1.9 vs. 28±2.2 weeks, respectively (P>0.05). Neither the incidence of NEC stage ≥2 or death, nor the incidence of NEC stage ≥2 or late-onset culture-proven sepsis differed between the study and control groups (5.8% vs. 5.9%, P=1; 26% vs. 21.2%, P=0.51). The only significant difference was the incidence of all stages of NEC (1.9% vs. 10.6%, P=0.019).Conclusion: The combination of synbiotics and lactoferrin did not reduce NEC severity, sepsis, or mortality.

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Pregnancy Outcome during the First COVID 19 Lockdown in Vienna, Austria

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073782 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3782

Author(s):

Sylvia Kirchengast ◽

Beda Hartmann

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Pregnancy Outcome ◽

Gestational Age ◽

Very Low Birth Weight ◽

Extremely Low Birth Weight ◽

Negative Effects ◽

Gestational Length ◽

Live Births

The COVID 19 pandemic represents a major stress factor for non-infected pregnant women. Although maternal stress during pregnancy increases the risk of preterm birth and intrauterine growth restriction, an increasing number of studies yielded no negative effects of COVID 19 lockdowns on pregnancy outcome. The present study focused on pregnancy outcome during the first COVID 19 lockdown phase in Austria. In particular, it was hypothesized that the national lockdown had no negative effects on birth weight, low birth weight rate and preterm birth rate. In a retrospective medical record-based single center study, the outcome of 669 singleton live births in Vienna Austria during the lockdown phase between March and July 2020 was compared with the pregnancy outcome of 277 live births at the same hospital during the pre-lockdown months of January and February 2020 and, in addition, with the outcome of 28,807 live births between 2005 and 2019. The rate of very low gestational age was significantly lower during the lockdown phase than during the pre-lockdown phase. The rate of low gestational age, however, was slightly higher during the lockdown phase. Mean birth weight was significantly higher during the lockdown phase; the rates of low birth weight, very low birth weight and extremely low birth weight were significantly lower during the lockdown phase. In contrast, maternal gestational weight gain was significantly higher during the lockdown phase. The stressful lockdown phase in Austria seems to have no negative affect on gestational length and newborn weight among non-infected mothers.

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Bacterial vaginosis in early pregnancy is associated with low birth weight and small for gestational age, but not with spontaneous preterm birth: A population-based study on Danish women

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767050500361604 ◽

2006 ◽

Vol 19 (1) ◽

pp. 1-7 ◽

Cited By ~ 15

Author(s):

Poul Thorsen ◽

Ida Vogel ◽

Jørn Olsen ◽

Bernard Jeune ◽

Jes G. Westergaard ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Bacterial Vaginosis ◽

Early Pregnancy ◽

Gestational Age ◽

Small For Gestational Age ◽

Population Based ◽

Spontaneous Preterm Birth ◽

Population Based Study

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The Effectiveness of Auditory Stimuli from Murottal Quran to Improve Comfort and Weight in Low Birth Weight Infants: Randomized Controlled Trial

Jurnal NERS ◽

10.20473/jn.v13i2.14823 ◽

2019 ◽

Vol 14 (1) ◽

pp. 111

Author(s):

Desriati Devi ◽

Yeni Rustina ◽

Defi Efendi

Keyword(s):

Randomized Controlled Trial ◽

Birth Weight ◽

Low Birth Weight ◽

Controlled Trial ◽

Auditory Stimuli ◽

Control Groups ◽

Low Birth Weight Infants ◽

Randomized Controlled ◽

Significant Difference ◽

And Control

Introduction: Low birth weight (LBW) infants who have been hospitalized are exposed to various conditions that provoke discomfort, which could trigger a stress response and growth disorders. This study aimed to identify the effects of auditory stimuli from Murottal Quran when it comes to the comfort and weight of LBW infants.Methods: This study used a clinical randomized controlled trial design involving 52 low birth weight infants. The infants were randomly assigned to either the intervention group (n=26) or the control (n=26). The intervention of Murottal Quran was given using a speaker 4 times a day for 20 minutes every 3 hours. This intervention was conducted for three days.Results: The results of this study show that there is a significant difference in the comfort of low birth weight infants after Murottal Qur’an on the first, second, and third days between the intervention and control groups (p=0.014; <0.001; <0.001). There was no significant difference in the weight between the intervention and control groups in the first, second, and third days (p=0.481; 0.481; 0.464).Conclusion: The auditory stimuli of Murottal Quran can help to improve the comfort level of low birth weight infants during hospitalization. It can therefore be used as a supportive therapy to facilitate low birth weight infant and premature infant development.

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Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04050-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fahimeh Ranjbar ◽

Leila Allahqoli ◽

Soheila Ahmadi ◽

Robab Mousavi ◽

Maryam Gharacheh ◽

...

Keyword(s):

Health Care ◽

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Health Care Services ◽

Mode Of Delivery ◽

Preterm Births ◽

Future Health ◽

Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

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Dengue during pregnancy and live birth outcomes: a cohort of linked data from Brazil

BMJ Open ◽

10.1136/bmjopen-2018-023529 ◽

2019 ◽

Vol 9 (7) ◽

pp. e023529 ◽

Cited By ~ 2

Author(s):

Enny S Paixão ◽

Oona M Campbell ◽

Maria Gloria Teixeira ◽

Maria CN Costa ◽

Katie Harron ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Birth Outcomes ◽

Live Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Severe Dengue ◽

Maternal Risk ◽

Increased Risk

ObjectivesDengue is the most common viral mosquito-borne disease, and women of reproductive age who live in or travel to endemic areas are at risk. Little is known about the effects of dengue during pregnancy on birth outcomes. The objective of this study is to examine the effect of maternal dengue severity on live birth outcomes.Design and settingWe conducted a population-based cohort study using routinely collected Brazilian data from 2006 to 2012.ParticipatingWe linked birth registration records and dengue registration records to identify women with and without dengue during pregnancy. Using multinomial logistic regression and Firth method, we estimated risk and ORs for preterm birth (<37 weeks’ gestation), low birth weight (<2500 g) and small for gestational age (<10thcentile). We also investigated the effect of time between the onset of the disease and each outcome.ResultsWe included 16 738 000 live births. Dengue haemorrhagic fever was associated with preterm birth (OR=2.4; 95% CI 1.3 to 4.4) and low birth weight (OR=2.1; 95% CI 1.1 to 4.0), but there was no evidence of effect for small for gestational age (OR=2.1; 95% CI 0.4 to 12.2). The magnitude of the effects was higher in the acute disease period.ConclusionThis study showed an increased risk of adverse birth outcomes in women with severe dengue during pregnancy. Medical intervention to mitigate maternal risk during severe acute dengue episodes may improve outcomes for infants born to exposed mothers.

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Differences in the pregnancy gestation period and mean birth weights in infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK: a retrospective analysis of routinely collected data

BMJ Open ◽

10.1136/bmjopen-2017-017139 ◽

2017 ◽

Vol 7 (8) ◽

pp. e017139 ◽

Cited By ~ 4

Author(s):

Rebecca Garcia ◽

Nasreen Ali ◽

Andy Guppy ◽

Malcolm Griffiths ◽

Gurch Randhawa

Keyword(s):

Birth Weight ◽

Retrospective Analysis ◽

Preterm Delivery ◽

Outcome Measures ◽

Gestational Age ◽

Secondary Data ◽

Significant Difference ◽

Singleton Birth ◽

Gestational Age At Delivery ◽

Indian Mothers

ObjectiveTo compare mean birth weights and gestational age at delivery of infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK.DesignRetrospective analysis using routinely recorded secondary data in Ciconia Maternity information System, between 2008 and 2013.SettingLuton, UK.ParticipantsMothers whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian and living in Luton, aged over 16, who had a live singleton birth over 24 weeks of gestation were included in the analysis (n=14 871).Outcome measuresPrimary outcome measures were mean birth weight and gestational age at delivery.ResultsAfter controlling for maternal age, smoking, diabetes, gestation age, parity and maternal height and body mass index at booking, a significant difference in infants’ mean birth weight was found between white British and Indian, Pakistani and Bangladeshi infants, F(3, 12 287)=300.32, p<0.0001. The partial Eta-squared for maternal ethnicity was η2=0.067. The adjusted mean birth weight for white British infants was found to be 3377.89 g (95% CI 3365.34 to 3390.44); Indian infants, 3033.09 g (95% CI 3038.63 to 3103.55); Pakistani infants, 3129.49 g (95% CI 3114.5 to 3144.48); and Bangladeshi infants, 3064.21 g (95% CI 3041.36 to 3087.06). There was a significant association in preterm delivery found in primipara Indian mothers, compared with Indian mothers (Wald=8.192, df 1, p<0.005).ConclusionsResults show important differences in adjusted mean birth weight between Indian, Pakistani, Bangladeshi and white British women. Moreover, an association was found between primipara Indian mothers and preterm delivery, when compared with Pakistani, Bangladeshi and white British women.

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