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.

scholarly journals Prevalence of Preterm Birth Rate During COVID-19 Lockdown in a Tertiary Care Hospital, Riyadh

Cureus ◽  
2021 ◽  
Author(s):  
Roya Huseynova ◽  
Latifa Bin Mahmoud ◽  
Adli Abdelrahim ◽  
Morabet Al Hemaid ◽  
Muath S Almuhaini ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Birth Rate ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Preterm Birth Rate

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 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 Preterm birth, stillbirth and early neonatal mortality during the Danish COVID-19 lockdown

2021 ◽  
Author(s):  
Paula L. Hedley ◽  
Gitte Hedermann ◽  
Christian M. Hagen ◽  
Marie Bækvad-Hansen ◽  
Henrik Hjalgrim ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Perinatal Mortality ◽  
Birth Rate ◽  
Preterm Births ◽  
Extended Period ◽  
Stillbirth Rate ◽  
Early Neonatal Mortality ◽  
Extremely Preterm ◽  
Preterm Birth Rate ◽  
Extremely Preterm Birth

AbstractUsing provisional or opportunistic data, three nationwide studies (The Netherlands, the USA and Denmark) have identified a reduction in preterm or extremely preterm births during periods of COVID-19 restrictions. However, none of the studies accounted for perinatal deaths. To determine whether the reduction in extremely preterm births, observed in Denmark during the COVID-19 lockdown, could be the result of an increase in perinatal deaths and to assess the impact of extended COVID-19 restrictions, we performed a nationwide Danish register-based prevalence proportion study. We examined all singleton pregnancies delivered in Denmark during the COVID-19 strict lockdown calendar periods (March 12–April 14, 2015-2020, N = 31,164 births) and the extended calendar periods of COVID-19 restrictions (February 27–September 30, 2015-2020, N = 214,862 births). The extremely preterm birth rate was reduced (OR 0.27, 95% CI 0.07 to 0.86) during the strict lockdown period in 2020, while perinatal mortality was not significantly different. During the extended period of restrictions in 2020, the extremely preterm birth rate was marginally reduced, and a significant reduction in the stillbirth rate (OR 0.69, 0.50 to 0.95) was observed. No changes in early neonatal mortality rates were found.Conclusion: Stillbirth and extremely preterm birth rates were reduced in Denmark during the period of COVID-19 restrictions and lockdown, respectively, suggesting that aspects of these containment and control measures confer an element of protection. The present observational study does not allow for causal inference; however, the results support the design of studies to ascertain whether behavioural or social changes for pregnant women may improve pregnancy outcomes. What is Known:• The aetiologies of preterm birth and stillbirth are multifaceted and linked to a wide range of socio-demographic, medical, obstetric, foetal, psychosocial and environmental factors.• The COVID-19 lockdown saw a reduction in extremely preterm births in Denmark and other high-income countries. An urgent question is whether this reduction can be explained by increased perinatal mortality. What is New:• The reduction in extremely preterm births during the Danish COVID-19 lockdown was not a consequence of increased perinatal mortality, which remained unchanged during this period.• The stillbirth rate was reduced throughout the extended period of COVID-19 restrictions.

scholarly journals A study of etiology and outcome of preterm birth at a tertiary care centre

2017 ◽  
Vol 6 (10) ◽  
pp. 4488
Author(s):  
Shaveta Garg ◽  
Tajinder Kaur ◽  
Ajayveer Singh Saran ◽  
Monu Yadav
Keyword(s):  
Preterm Birth ◽  
Tertiary Care ◽  
Preterm Births ◽  
Active Phase ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
High Incidence ◽  
History Of ◽  
Tract Infections

Background: Preterm births are still the leading cause of perinatal mortality and morbidity. It is a major challenge in the obstetrical health care.Methods: This study was conducted over a period of eight months from September 2016 till April 2017 at a tertiary care hospital. All patients who delivered a live baby before 37 weeks of gestation were included in the study.Results: Present study was conducted on 100 eligible women out of which 7 delivered before 30 weeks but majority of them (55%) delivered after 34 weeks of gestation. In our study, most of the patients (66%) presented in active phase of labor which resulted in preterm birth of baby. The most common risk factor of preterm labor was genitourinary tract infections (34%) followed by Preterm Premature rupture of membranes (22%). Past obstetric history of preterm delivery and abortions also had a significant impact on the present pregnancy outcome.Conclusions: Preterm labour and birth still have a high incidence causing significant neonatal mortality and morbidity as well as economic burden on family and hospital. The causes of preterm birth are multifactorial and modifiable. This incidence can be reduced by early identification of established risk factors, as revisited and reemphasized in our study, with the help of universal and proper antenatal care.

scholarly journals Outcome of moderate preterm and term babies at tertiary care centre

2018 ◽  
Vol 5 (6) ◽  
pp. 2222
Author(s):  
Shaitan Singh Balai ◽  
Durgavati Katara ◽  
Vivek Arora
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Preterm Births ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Major Morbidity ◽  
Mortality And Morbidity ◽  
Maternal Risk ◽  
Maternal Hypertension

Background: To study the maternal risk factors, morbidity, mortality of moderate preterm in comparison to term neonates.Methods: This Cohort study involved two hundred fifty consecutively born moderate preterm and equal number of term newborns delivered in a tertiary care hospital. They were followed till discharge for morbidities and mortality. Detailed maternal and neonatal factors were studied and compared between the two groups.Results: Moderate preterm babies constituted 55% of all live preterm births during the study period. The odds of babies developing major morbidity was significantly more in those whose mothers had hypertension and infections (OR 2.69 95% CI: 1.55, 4.68 and 2.08, 95% CI: 1.6, 2.71 respectively). In the study group, 42.4% and 20.8% babies suffered major and minor morbidity compared to 8.4% and 6.8% of term controls respectively. moderate preterm neonates had significantly higher odds of developing morbidity like respiratory distress (12.4% vs. 5.6%, OR 2.21, 95%CI 1.21,4.11), need for non-invasive(17.3% vs. 5.7%, OR 3.05 95% CI 1.69, 5.47) and invasive ventilation (14.6% vs. 1.7%, OR 8.62, 95% CI 3.09, 24.04), sepsis (20.8% vs. 5.2%, OR 5.20, 95% CI 2.71, 9.99), seizures (22.8% vs. 4.8%, OR 4.75 95%CI 2.61, 8.63), shock (17.6% vs. 4.4%, OR 4.00 95% CI 2.12,7.56), and jaundice (26% vs. 6%, OR 4.33 95%CI 2.54, 7.39). By logistic regression, the odds of developing major morbidity decreased with increasing gestational age (aOR 0.28 95% CI 0.18, 0.45; p<0.001) and increased with hypertensive disease of pregnancy (aOR 2.16 95% CI 1.09, 4.260; p00.026).Conclusions: Moderate preterm neonates have significantly more mortality and morbidity compared to term controls. Maternal hypertension and lower gestational age are the strongest predictors of morbidity.

scholarly journals Effect of Periodontal Treatment on Preterm Birth Rate: Meta-analysis

2013 ◽  
Vol 4 (4) ◽  
pp. 256-261
Author(s):  
Adel S Alobaid
Keyword(s):  
Preterm Birth ◽  
Treatment Group ◽  
Periodontal Disease ◽  
Birth Rate ◽  
Meta Analysis ◽  
Periodontal Treatment ◽  
Control Group ◽  
Increased Risk ◽  
Significant Difference ◽  
Preterm Birth Rate

ABSTRACT Introduction During pregnancy, the prevalence and severity of gingivitis have been reported to be elevated. Studies suggest that periodontitis is associated with an increased risk of preterm birth (PTB), as well as low birth weight (LBW) and pre-eclampsia. The purpose of this meta-analysis is to determine whether the treatment of periodontal disease by mechanical debridement and oral hygiene instructions during pregnancy will reduce the incidence of PTB < 37 weeks. Materials and methods Literature search was conducted for all clinical trials that related to periodontal disease and PTB from 2005 to 2012. Five were selected based no randomization technique, sample size and treatment approach. There were 2,767 patients randomly assigned to treatment group, in these trials, and 2,592 subjects randomly assigned to control group. Results There were 276 (9.98%) PTBs in treatment group vs 270 (10.42%) in control group. A total of 216 (8%) LBW were seen in experimental groups and 193 (7.5%) in control group. Our results showed no significant difference in the incidence of PTB with or without received periodontal treatment during pregnancy. Risk ratio (RR) was 0.99 (95% CI: 0.74-1.33) (p = 0.97) with moderate heterogeneity 12.33. df = 4 (p = 0.02) with I2= 68%. Experimental groups showed better periodontal health after delivery. Conclusion Periodontal treatment may improve the oral health during pregnancy without affecting the pregnancy outcome however; it did not reduce the incidence of PTB and LBW. Larger meta-analysis with less heterogeneity is needed. How to cite this article Alobaid AS. Effect of Periodontal Treatment on Preterm Birth Rate: Meta-analysis. World J Dent 2013;4(4):256-261.

scholarly journals A prospective study comparing the morbidities of late preterm and term infants in the neonatal period in a tertiary care hospital

2021 ◽  
Vol 8 (5) ◽  
pp. 803
Author(s):  
Sirajuddin Nazeer ◽  
Sivagurunathan Panchanathan ◽  
Karthikeyan Soundararajan
Keyword(s):  
Preterm Birth ◽  
Prospective Study ◽  
Preterm Infants ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Late Preterm ◽  
Care Hospital ◽  
Term Infants ◽  
Late Preterm Infants ◽  
Increased Risk

Background: In obstetric practice, 34 completed weeks is considered as maturational milestone for the fetus. Despite relatively large size and apparent functional maturity, late preterm infants are at increased risk for neonatal morbidity compared with full term infants. Aim of the study was to study the incidence of late preterm births in a tertiary care hospital in Trichy, Tamil Nadu and to study the pattern of neonatal morbidities in late preterm infants and to compare it with term infants.Methods: Hospital based prospective study was conducted from April 2019 to March 2020. Total 470 late preterm infants were included in our study. All infants enrolled in the study were followed up daily till discharge and after discharge, all infants were than reviewed at 15 and 28 days in a well-baby clinic.Results: There were a total of 1941 live births during the study period. Of these, 470 (24.2%) were late preterm and 1263 (65%) were term births. Late preterm infants accounted for 71.1% of preterm birth. Late preterm infants were at significantly higher risk for overall morbidity due to any cause, respiratory 22.1%, neonatal jaundice 62%, sepsis 4%, hypoglycemia 8.9%, hospital readmission 8.1%. 63% of late preterm infants were readmitted for jaundice.Conclusions: The incidence of late preterm birth was 24%. Late preterm infants had a higher incidence of jaundice, sepsis and respiratory morbidities. Late preterm infants had a longer hospital stay. They were also more likely to get readmitted in the hospital when compared to term infants.

The contribution of twins conceived by in vitro fertilization to preterm birth rate: observations from a quarter of century

2020 ◽  
Vol 48 (4) ◽  
pp. 411-415
Author(s):  
Jelena Ivandić ◽  
Isaac Blickstein ◽  
Ana-Maria Šopić Rahelić ◽  
Eduard Eškinja ◽  
Tea Štimac
Keyword(s):  
Preterm Birth ◽  
In Vitro Fertilization ◽  
Birth Rate ◽  
Significant Risk ◽  
Preterm Births ◽  
Vitro Fertilization ◽  
Preterm Birth Rate ◽  
Perinatal Center ◽  
Over Time

AbstractObjectiveLittle information exists related to the contribution of assisted reproductive technology (ART) twins to the preterm and very preterm birth rate. We sought to examine this contribution over a period of more than two decades in a tertiary perinatal center.MethodsWe identified all preterm births from 1993 to 2017, born at <37 or <32 weeks’ gestation, by mode of conception [in vitro fertilization (IVF) vs. non-IVF pregnancies]. We generated trend lines of the annual change of the dependent variable (% preterm birth).ResultsWe evaluated 74,299 births, including 3934 (5.3%) preterm births at <37 and 826 (1.1%) at <32 weeks’ gestation. In this period, 1019 (1.4%) twin pairs were born including 475 (46.6%) and 80 (7.8%) at <37 and <32 weeks, respectively. There were 213 (5.4%) IVF pregnancies among the preterm births at <37 weeks, including 88 (41.3%) twins. Fifteen (1.8%) births of all IVF gestations were at <32 weeks, and all were twins. Whereas the annual rate of spontaneous twins did not change, a significant increase over time exists for IVF twins (P < 0.05, R2 = 0.6). We demonstrated an increase in IVF twin births at <37 weeks but not for spontaneously conceived twins. Whereas the twin birth rate at <32 weeks did not change over time, all preterm births at <32 weeks following IVF were twins.ConclusionThe risk of twins after ART increasingly contributes to preterm births at <37 weeks and ART twins are at significant risk for preterm births at <32 weeks.

Changes in incidence of iatrogenic and spontaneous preterm births over time: a population-based study

2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Miha Lucovnik ◽  
Andreja Trojner Bregar ◽  
Lili Steblovnik ◽  
Ivan Verdenik ◽  
Ksenija Gersak ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Birth Rate ◽  
Preterm Births ◽  
Population Based ◽  
Spontaneous Preterm Birth ◽  
Birth Rates ◽  
Population Based Study ◽  
Preterm Birth Rate ◽  
Iatrogenic Preterm Delivery ◽  
Over Time

AbstractTo examine the proportion of iatrogenic births among all preterm births over a 26-year period.A registry-based survey of preterm deliveries between 1987 and 2012 analyzed by the onset of labor: spontaneous with intact membranes, preterm premature rupture of membranes (PPROM) or iatrogenic. Stratification into categories by gestation (22 weeks to 27 weeks and 6 days, 28 weeks to 31 weeks and 6 days, 32 weeks to 33 weeks and 6 days, 34 weeks to 36 weeks and 6 days) was performed. Preterm birth rates were analyzed using the Mantel-Haenszel linear-by-linear associationOverall preterm birth rate was 5.9% (31328 deliveries) including 2358 (0.4%) before 28 completed weeks, 3388 (0.6%) between 28 weeks and 31 weeks 6 days, 3970 (0.8%) between 32 weeks and 33 weeks and 6 days, and 21611 (4.1%) between 34 weeks and 36 weeks and 6 days There was an increase in overall preterm birth rate (P<0.001). The rate of iatrogenic preterm births and PPROM increased over time (P<0.001 and P<0.014, respectively). Rates of spontaneous preterm birth decreased (P<0.001). After accounting for potential confounders, year of birth remained an independent risk factor for iatrogenic preterm delivery in all four gestational age categories (P<0.001).The incidence of iatrogenic preterm birth is increasing with a concomitant decrease in the incidence of spontaneous preterm birth. Attempts to analyze, interpret and decrease preterm birth rates should consider spontaneous and iatrogenic preterm births separately.

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