Association of FQHC Expansion With Birth Weight Outcomes by Race and Neighborhood Segregation [07C]

2020 ◽  
Vol 135 ◽  
pp. 31s
Author(s):  
Michelle Debbink ◽  
Asha B. McClurg
Keyword(s):  
Birth Weight ◽  
Weight Outcomes ◽  
Neighborhood Segregation

Very Low Birth Weight Outcomes

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 357-357
Author(s):  
HELEN HARRISON
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Meta Analysis ◽  
Low Birth Weight Infants ◽  
Randomized Controlled Clinical Trials ◽  
Weight Outcomes ◽  
Term Evaluation

To the Editor.— The authors of the National Institute of Child Health and Human Development report on neonatal care1 found "important" variations among neonatal intensive care units in philosophies of treatment, methods of treatment, and short-term outcomes. In a recent meta-analysis of follow-up studies,2 researchers document a similarly haphazard approach to the long-term evaluation of very low birth weight survivors. Until randomized controlled clinical trials validate the safety and efficacy of neonatal therapies, and until long-term outcomes are assessed accurately, the treatment of very low birth weight infants should be declared experimental.

Very Low Birth Weight Outcomes

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 357-357
Author(s):  
WILLIAM TARNOW-MORDI ◽  
ANDREW WILKINSON
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Hospital Mortality ◽  
Very Low Birth Weight ◽  
Pediatric Intensive Care ◽  
Low Birth Weight Infants ◽  
Severity Of Disease ◽  
Weight Outcomes ◽  
Initial Severity

To the Editor.— In their valuable report1 Dr Hack and colleagues confirm large variations between centers in the perinatal histories, treatment, and outcomes of very low birth weight infants. Unfortunately, in contrast to earlier reports,2,3 they neglect to mention the need for measures of initial disease severity. This is an important omission. In a survey of nine pediatric intensive care centers Pollack et al4 showed that hospital mortality varied from 3.6% to 17%. This large variation was explained completely by differences between hospital populations in initial severity of disease, calculated from routine indices of physiologic stability on the day of admission.

Neonatology—Science or Art?

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 880-880
Keyword(s):  
Birth Weight ◽  
Child Health ◽  
Low Birth Weight ◽  
Human Development ◽  
Very Low Birth Weight ◽  
Research Network ◽  
Exact Science ◽  
Weight Outcomes

To the Editor.— The authors of the National Institute of Child Health and Human Development Neonatal Research network report1 of very low birth weight outcomes deserve a lot of praise for providing a survey of neonatal practices. But they are much too polite. In the discussion of "important intercenter variation as well as differences in the philosophy of care," the authors mildly note, "the practice of neonatal medicine remains in part an art rather than an exact science."

Very Low Birth Weight Outcomes of the National Institute of Child Health and Human Development Neonatal Network

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 587-597 ◽  
Author(s):  
Maureen Hack ◽  
Jeffrey D. Horbar ◽  
Michael H. Malloy ◽  
Linda Wright ◽  
Jon E. Tyson ◽  
...  
Keyword(s):  
Birth Weight ◽  
Child Health ◽  
Low Birth Weight ◽  
Human Development ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Weight Outcomes

This report describes the neonatal outcomes of 1765 very low birth weight (<1500 g) infants delivered from November 1987 through October 1988 at the seven participating centers of the National Institute of Child Health and Human Development Neonatal Intensive Care Network. Survival was 34% at <751 g birth weight (range between centers 20% to 55%), 66% at 751 through 1000 g (range 42% to 75%), 87% at 1001 through 1250 g (range 84% to 91%), and 93% at 1251 through 1500 g (range 89% to 98%). By obstetric measures of gestation, survival was 23% at 23 weeks (range 0% to 33%), 34% at 24 weeks (range 10% to 57%), and 54% at 25 weeks (range 30% to 72%). Neonatal morbidity included respiratory distress (67%), symptomatic patent ductus arteriosus (25%), necrotizing enterocolitis (6%), septicemia (17%), meningitis (2%), urinary tract infection (4%), and intraventricular hemorrhage (45%, 18% grade III and IV). Morbidity increased with decreasing birth weight. Oxygen was administered for ≥28 days to 79% of <751-g birth weight infants (range between centers 67% to 100%), 45% of 751-through 1000-g infants (range 20% to 68%), and 13% of 1001- through 1500-g infants (range 5% to 23%). Ventilator support for ≥28 days was given to 68% of infants at <751 g, 29% at 751 through 1000 g, and 4% at >1000 g. Hospital stay was 59 days for survivors vs 15 days for infants who died. Sixty-nine percent of survivors had subnormal (<10th percentile) weight at discharge. The data demonstrate important intercenter variation of current neonatal outcomes, as well as differences in philosophy of care and definition and prevalence of morbidity.

A meta-analysis of neonatal health outcomes from oocyte donation

2015 ◽  
Vol 7 (3) ◽  
pp. 257-272 ◽  
Author(s):  
D. H. Adams ◽  
R. A. Clark ◽  
M. J. Davies ◽  
S. de Lacey
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Health Outcomes ◽  
Very Low Birth Weight ◽  
Meta Analysis ◽  
Oocyte Donation ◽  
Donor Oocyte ◽  
Cochrane Reviews ◽  
Increased Risk ◽  
Weight Outcomes

Donated oocytes are a treatment modality for female infertility which is also associated with increased risks of preeclampsia. Subsequently it is important to evaluate if there is concomitant increased risks for adverse neonatal events in donated oocyte neonates. A structured search of the literature using PubMed, EMBASE and Cochrane Reviews was performed to investigate the perinatal health outcomes of offspring conceived from donor oocytes compared with autologous oocytes. Meta-analysis was performed on comparable outcomes data. Twenty-eight studies were eligible and included in the review, and of these, 23 were included in a meta-analysis. Donor oocyte neonates are at increased risk of being born with low birth weight (<2500 g) [risk ratio (RR): 1.18, 95% confidence interval (CI): 1.14–1.22, P-value (P)<0.00001], very low birth weight (<1500 g) (RR: 1.24, CI: 1.15–1.35, P<0.00001), preterm (<37 weeks) (RR: 1.26, CI: 1.23–1.30, P<0.00001), of lower gestational age (mean difference −0.3 weeks, CI: −0.35 weeks to −0.25 weeks, P<0.00001), and preterm with low birth weight (RR: 1.24, CI: 1.19–1.29, P<0.00001), when compared with autologous oocyte neonates. Conversely, low birth weight outcomes were improved in term donor oocyte neonates (RR: 0.86, CI: 0.8–0.93, P=0.0003). These negative outcomes remained significant when controlling for multiple deliveries. The donor oocyte risk rates are higher than those found in general ART outcomes, are important considerations for the counselling of infertile patients and may also influence the long term health of the offspring.

scholarly journals Racial Disparities in Associations between Neighborhood Demographic Polarization and Birth Weight

2020 ◽  
Vol 17 (9) ◽  
pp. 3076
Author(s):  
Kelvin C. Fong ◽  
Maayan Yitshak-Sade ◽  
Kevin J. Lane ◽  
M. Patricia Fabian ◽  
Itai Kloog ◽  
...  
Keyword(s):  
Birth Weight ◽  
Social Dynamics ◽  
Population Group ◽  
Effect Modification ◽  
Black Mothers ◽  
Lower Odds ◽  
Weight Outcomes ◽  
White Mothers ◽  
Demographic Indices ◽  
Birth Records

Neighborhood demographic polarization, or the extent to which a privileged population group outnumbers a deprived group, can affect health by influencing social dynamics. While using birth records from 2001 to 2013 in Massachusetts (n = 629,675), we estimated the effect of two demographic indices, racial residential polarization (RRP) and economic residential polarization (ERP), on birth weight outcomes, which are established predictors of the newborn’s future morbidity and mortality risk. Higher RRP and ERP was each associated with higher continuous birth weight and lower odds for low birth weight and small for gestational age, with evidence for effect modification by maternal race. On average, per interquartile range increase in RRP, the birth weight was 10.0 g (95% confidence interval: 8.0, 12.0) higher among babies born to white mothers versus 6.9 g (95% CI: 4.8, 9.0) higher among those born to black mothers. For ERP, it was 18.6 g (95% CI: 15.7, 21.5) higher among those that were born to white mothers versus 1.8 g (95% CI: −4.2, 7.8) higher among those born to black mothers. Racial and economic polarization towards more privileged groups was associated with healthier birth weight outcomes, with greater estimated effects in babies that were born to white mothers than those born to black mothers.

scholarly journals Dietary patterns before and during pregnancy and birth outcomes: a systematic review

2019 ◽  
Vol 109 (Supplement_1) ◽  
pp. 729S-756S ◽  
Author(s):  
Ramkripa Raghavan ◽  
Carol Dreibelbis ◽  
Brittany L Kingshipp ◽  
Yat Ping Wong ◽  
Barbara Abrams ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Dietary Patterns ◽  
Access To Health Care ◽  
Spontaneous Preterm Birth ◽  
Weight Outcomes ◽  
Age And Sex ◽  
Pregnancy And Birth

ABSTRACTBackgroundMaternal diet before and during pregnancy could influence fetal growth and birth outcomes.ObjectiveTwo systematic reviews aimed to assess the relationships between dietary patterns before and during pregnancy and 1) gestational age at birth and 2) gestational age- and sex-specific birth weight.MethodsLiterature was searched from January, 1980 to January, 2017 in 9 databases including PubMed, Embase, and Cochrane. Two analysts independently screened articles using predetermined inclusion and exclusion criteria. Data were extracted from included articles and risk of bias was assessed. Data were synthesized qualitatively, a conclusion statement was drafted for each question, and evidence supporting each conclusion was graded.ResultsOf the 9103 studies identified, 11 [representing 7 cohorts and 1 randomized controlled trial (RCT)] were included for gestational age and 21 (representing 19 cohorts and 2 RCTs) were included for birth weight. Limited but consistent evidence suggests that certain dietary patterns during pregnancy are associated with a lower risk of preterm birth and spontaneous preterm birth. These protective dietary patterns are higher in vegetables; fruits; whole grains; nuts, legumes, and seeds; and seafood (preterm birth, only), and lower in red and processed meats, and fried foods. Most of the research was conducted in healthy Caucasian women with access to health care. No conclusion can be drawn on the association between dietary patterns during pregnancy and birth weight outcomes. Although research is available, the ability to draw a conclusion is restricted by inconsistency in study findings, inadequate adjustment of birth weight for gestational age and sex, and variation in study design, dietary assessment methodology, and adjustment for key confounding factors. Insufficient evidence exists regarding dietary patterns before pregnancy for both outcomes.ConclusionsMaternal dietary patterns may be associated with a lower preterm and spontaneous preterm birth risk. The association is unclear for birth weight outcomes.

scholarly journals Antiepileptic Drug Exposure during Pregnancy and Neonatal Birth Weight Outcomes: Protocol for a Systematic Review and Meta-analysis.

2020 ◽  
Author(s):  
Alekhya Lavu ◽  
Christine Vaccaro ◽  
Walid Shouman ◽  
Silvia Alessi-Severini ◽  
Sherif Eltonsy
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Antiepileptic Drug ◽  
Drug Exposure ◽  
Meta Analysis ◽  
Grey Literature ◽  
Cochrane Library ◽  
Neonatal Birth Weight ◽  
Weight Outcomes ◽  
In Pregnancy

Abstract Background: The prevalence of epilepsy in pregnant women is estimated at 0.3- 1%. Antiepileptic drug (AED) exposure in-utero has been associated with various adverse health outcomes in neonates including adverse birth weight outcomes. Methods: To summarize the evidence on the association between AED exposure in pregnancy and adverse birthweight outcomes. Studies assessing AED exposure in pregnancy and neonatal birth weight outcome including small for gestational age (SGA), low birth weight (LBW), birth weight (BW), length head circumference and cephalization index will be identified in MEDLINE, EMBASE, Cochrane Library, Scopus, CINAHL, IPA, and Global Health. Open grey, Theses Canada and ProQuest Dissertations will be used to locate grey literature. Eligible study designs include experimental and observational studies. Studies will be assessed for risk of bias using the Newcastle-Ottawa Scale and Meta-analysis will be conducted using a random-effects model. Discussion: The results from this review could improve clinicians’ prescribing decisions by highlighting the safest AEDs for women who are pregnant or planning to conceive based on the best evidence currently available. Systematic review registration: submitted (19/08/2020))

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