Prediction of severe adverse neonatal outcomes at the second stage of labor using machine learning: a retrospective cohort study

2021 ◽  
Author(s):  
Joshua Guedalia ◽  
Yishai Sompolinsky ◽  
Michal Novoselsky Persky ◽  
Sarah M. Cohen ◽  
Doron Kabiri ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Neonatal Outcomes ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Adverse Neonatal Outcomes

scholarly journals Oxygen Saturation Index in Neonates with a Congenital Diaphragmatic Hernia: A Retrospective Cohort Study

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Emily J.J. Horn-Oudshoorn ◽  
Marijn J. Vermeulen ◽  
Kelly J. Crossley ◽  
Suzan C.M. Cochius-den Otter ◽  
J. Marco Schnater ◽  
...  
Keyword(s):  
Cohort Study ◽  
Oxygen Saturation ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Saturation Index ◽  
Neonatal Outcomes ◽  
Predictive Values ◽  
Adverse Neonatal Outcomes

<b><i>Introduction:</i></b> The oxygenation index (OI) is a marker for respiratory disease severity and adverse neonatal outcomes. The oxygen saturation index (OSI) is an alternative that allows for continuous noninvasive monitoring, but evidence for clinical use in critically ill neonates is scarce. The aim of this study was to evaluate the OSI as compared to the OI in term neonates with a congenital diaphragmatic hernia (CDH). <b><i>Methods:</i></b> A single-center retrospective cohort study was conducted including all live-born infants with an isolated CDH between June 2017 and December 2020. Paired values of the OI and OSI in the first 24 h after birth were collected. The relation between OI and OSI measurements was assessed, taking into account arterial pH, body temperature, and preductal versus postductal location of oxygen saturation measurement or arterial blood sampling. The predictive values for pulmonary hypertension, need for extracorporeal membrane oxygenation therapy, and survival at discharge were evaluated. <b><i>Results:</i></b> Of 33 subjects included, 398 paired values of the OI (median 5.8 [3.3–17.2]) and OSI (median 7.3 [3.6–14.4]) were collected. The OI and OSI correlated strongly (<i>r</i> = 0.77, <i>p</i> &#x3c; 0.001). The OSI values corresponding to the clinically relevant OI values (10, 15, 20, and 40) were 8.9, 10.9, 12.9, and 20.9, respectively. The predictive values of the OI and OSI were comparable for all adverse neonatal outcomes. No difference was found in the area under the receiver operating characteristic curves for the OI and the OSI for adverse neonatal outcomes. <b><i>Conclusions:</i></b> The OSI could replace the OI in clinical practice in infants with a CDH.

scholarly journals Postpartum maternal codeine therapy and the risk of adverse neonatal outcomes: A retrospective cohort study

2012 ◽  
Vol 50 (5) ◽  
pp. 390-395 ◽  
Author(s):  
David N. Juurlink ◽  
Tara Gomes ◽  
Astrid Guttmann ◽  
Chelsea Hellings ◽  
Marco L. A. Sivilotti ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Neonatal Outcomes ◽  
Adverse Neonatal Outcomes

scholarly journals The influence of obesity on perinatal outcomes in pregnancies achieved with assisted reproductive technology: A population-based retrospective cohort study

2016 ◽  
Vol 9 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Amy M Valent ◽  
Eric S Hall ◽  
Emily A DeFranco
Keyword(s):  
Cohort Study ◽  
Assisted Reproductive Technology ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Population Based ◽  
Reproductive Technology ◽  
Neonatal Outcomes ◽  
Increased Risk ◽  
Adverse Neonatal Outcomes

Objective To determine the influence of obesity on neonatal outcomes of pregnancies resulting from assisted reproductive technology. Methods Population-based retrospective cohort study of all non-anomalous, live births in Ohio from 2007 to 2011, comparing differences in the frequency of adverse neonatal outcomes of women who conceived with assisted reproductive technology versus spontaneously conceived pregnancies and stratified by obesity status. Primary outcome was a composite of neonatal morbidities defined as ≥1 of the following: neonatal death, Apgar score of <7 at 5 min, assisted ventilation, neonatal intensive care unit admission, or transport to a tertiary care facility. Results Rates of adverse neonatal outcomes were significantly higher for assisted reproductive technology pregnancies than spontaneously conceived neonates; non-obese 25% versus 8% and obese 27% versus 10%, p < 0.001. Assisted reproductive technology was associated with a similar increased risk for adverse outcomes in both obese (adjusted odds ratio (aOR): 1.33, 95% confidence interval (CI): 1.11–1.59) and non-obese women (aOR: 1.34, 95% CI: 1.18–1.51) even after adjustment for coexisting risk factors. This increased risk was driven by higher preterm births in assisted reproductive technology pregnancies; obese (aOR: 1.06, 95% CI: 0.86–1.31) and non-obese (aOR: 1.15, 95% CI: 1.00–1.32). Discussion Assisted reproductive technology is associated with a higher risk of adverse neonatal outcomes. Obesity does not appear to adversely modify perinatal risks associated with assisted reproductive technology.

scholarly journals The impact of stage of labor on adverse maternal and neonatal outcomes in multiparous women: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Li Wang ◽  
Hongxia Wang ◽  
Lu Jia ◽  
Wenjie Qing ◽  
Fan Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adverse Outcome ◽  
Neonatal Resuscitation ◽  
Neonatal Outcomes ◽  
Second Stage ◽  
Multiparous Women ◽  
Maternal And Neonatal Outcomes ◽  
The Impact

Abstract Background The correlation between stage of labor and adverse delivery outcomes has been widely studied. Most of studies focused on nulliparous women, it was not very clear what impact the stage of labor duration had on multiparous women. Methods A retrospective cohort study was conducted among all the multiparous women of cephalic, term, singleton births, who planned vaginal delivery. The total stage of labor covered the first stage and the second stage in this study, and they were divided into subgroups. Adverse maternal outcomes were defined as referral cesarean delivery, instrumental delivery, postpartum hemorrhage, perineal laceration (III and IV degree), hospitalization stay ≥90th, and adverse neonatal outcomes as NICU, shoulder dystocia, Apgar score ≤ 7(5 min), neonatal resuscitation, assisted ventilation required immediately after delivery. Results There were 7109 parturients included in this study. The duration of first stage was 6.2(3.6–10.0) hours, the second stage was 0.3(0.2–0.7) hour, the total stage was 6.9(4.1–10.7) hours in multiparous women. At the first stage, the rates of overall adverse outcome were 21, 23.4, 28.8, 35.5, 38.4% in subgroups < 6 h, 6–11.9 h, 12–17.9 h, 18–23.9 h, ≥24 h, which increased significantly (X2 = 57.64, P < 0.001), and ARR (95% CI) were 1.10 (0.92,1.31), 1.33 (1.04,1.70), 1.80 (1.21,2.68), 2.57 (1.60,4.15) compared with subgroup < 6 h (ARR = 1); At the second stage, the rates of overall adverse outcome were 20.0, 30.7, 38.5, 61.2, 69.6% in subgroups < 1 h, 1–1.9 h, 2–2.9 h, 3–3.9 h, ≥4 h (X2 = 349.70, P < 0.001), and ARR (95% CI) were 1.89 (1.50, 2.39), 2.22 (1.55, 3.18), 10.64 (6.09, 18.59), 11.75 (6.55, 21.08) compared with subgroup < 1 h (ARR = 1)). At the total stage, the rates of overall adverse outcome were 21.5, 30.8, 42.4% in subgroups < 12 h, 12–23.9 h, ≥24 h (X2 = 84.90, P < 0.001), and ARR (95% CI) were 1.41 (1.16,1.72), 3.17 (2.10,4.80) compared with subgroup < 12 h (ARR = 1). Conclusions The prolonged stage of labor may lead to increased adverse outcomes in multiparous women, it was an independent risk factor of adverse maternal and neonatal outcomes.

scholarly journals The Impact of Labor Stage Duration on Adverse Maternal and Neonatal Outcomes in Multiparous Women: A Retrospective Cohort Study

2020 ◽  
Author(s):  
li wang ◽  
hongxia Wang ◽  
lu jia ◽  
wenjie qing ◽  
fan Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Stage Duration ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Multiparous Women ◽  
Maternal And Neonatal Outcomes ◽  
The Impact

Abstract Background The duration of first and second stages of labor was increased in the consensus that American College of Obstetricians and Gynecologists (ACOG) published 2014. Studies showed increased adverse maternal and neonatal outcomes in nulliparous women with prolonged second stage of labor. It is not very clear that the impact of labor stage duration on multiparous women.Methods A retrospective cohort study was performed. Cephalic, term, singleton multiparous women were included, who planned for vaginal delivery. Adverse maternal outcomes were defined as referral cesarean delivery, instrumental delivery, postpartum hemorrhage, perineal laceration (3rd and 4th degree), hospitalization stay ≥ 90%th, and adverse neonatal outcomes as NICU, shoulder dystocia, Apgar score ≤ 7(5 min), neonatal resuscitation, assisted ventilation required immediately after delivery. We defined the total stage included the first and second stage of labor.Results There were 7109 parturients included, The duration of first stage was 6.2(3.6–10.0) hours in multiparous women, the second stage was 0.3(0.2–0.7) hours, the total stage was 6.9(4.1–10.7) hours. In the first stage, the rate of overall adverse outcomes was 21%, 23.4%, 28.8%, 35.5%, 38.4% in < 6 h, 6-11.9 h, 12-17.9 h, 18-23.9 h, ≥ 24 h, increased significantly (X2 = 57.64, P๤0.001). Compared with < 6 h, ARR(95%CI) were 1.10(0.92,1.31), 1.33(1.04,1.70), 1.80(1.21,2.68), 2.57(1.60,4.15);In the second stage, the rate of overall adverse outcomes increased from 20.0%, 30.7%, 38.5%, to 61.2%, 69.6% in < 1 h, 1-1.9 h, 2-2.9 h, 3-3.9 h, ≥ 4 h (X2 = 349.70, P๤0.001). Compared with < 1 h, ARR (95% CI) were 1.89 (1.50, 2.39), 2.22 (1.55, 3.18), 10.64 (6.09, 18.59), 11.75 (6.55, 21.08); In the total stage, the rate of overall adverse outcomes were 21.5%, 30.8%, 42.4% in < 12 h, 12-23.9 h, ≥ 24 h (X2 = 84.90, P๤0.001). Compared with < 12 h, ARR (95% CI) were 1.41(1.16,1.72), 3.17 (2.10,4.80).Conclusions The prolonged labor stage may lead to increased adverse outcomes in multiparous women, even in the first stage. The duration of labor stage was an independent risk factor for adverse maternal and neonatal outcomes.

scholarly journals The Impact of Stage of Labor on Adverse Maternal and Neonatal Outcomes in Multiparous Women: A Retrospective Cohort Study

2020 ◽  
Author(s):  
li wang ◽  
hongxia Wang ◽  
lu jia ◽  
wenjie qing ◽  
fan Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adverse Outcome ◽  
Neonatal Resuscitation ◽  
Neonatal Outcomes ◽  
Second Stage ◽  
Multiparous Women ◽  
Maternal And Neonatal Outcomes ◽  
The Impact

Abstract Background: The correlation between stage of labor and adverse delivery outcomes has been widely studied. Most of studies focused on nulliparous women, it was not very clear what impact the stage of labor duration had on multiparous women.Methods: A retrospective cohort study was conducted among all the multiparous women of cephalic, term, singleton births, who planned vaginal delivery. The total stage of labor covered the first stage and the second stage in this study, and they were divided into subgroups. Adverse maternal outcomes were defined as referral cesarean delivery, instrumental delivery, postpartum hemorrhage, perineal laceration (III and IV degree), hospitalization stay ≥90th, and adverse neonatal outcomes as NICU, shoulder dystocia, Apgar score ≤7(5 min), neonatal resuscitation, assisted ventilation required immediately after delivery. Results: There were 7109 parturients included in this study. The duration of first stage was 6.2(3.6-10.0) hours, the second stage was 0.3(0.2-0.7) hour, the total stage was 6.9(4.1-10.7) hours in multiparous women. At the first stage, the rates of overall adverse outcome were 21%, 23.4%, 28.8%, 35.5%, 38.4% in subgroups <6h, 6-11.9h, 12-17.9h, 18-23.9h, ≥24h, which increased significantly (X2=57.64, P<0.001), and ARR (95% CI) were 1.10 (0.92,1.31), 1.33 (1.04,1.70), 1.80 (1.21,2.68), 2.57 (1.60,4.15) compared with subgroup <6h (ARR=1); At the second stage, the rates of overall adverse outcome were 20.0%, 30.7%, 38.5%, 61.2%, 69.6% in subgroups <1h, 1-1.9h, 2-2.9h, 3-3.9h, ≥4h (X2=349.70, P<0.001), and ARR (95% CI) were 1.89 (1.50, 2.39), 2.22 (1.55, 3.18), 10.64 (6.09, 18.59), 11.75 (6.55, 21.08) compared with subgroup <1h (ARR=1)). At the total stage, the rates of overall adverse outcome were 21.5%, 30.8%, 42.4% in subgroups <12h, 12-23.9h, ≥24h (X2=84.90, P<0.001), and ARR (95% CI) were 1.41 (1.16,1.72), 3.17 (2.10,4.80) compared with subgroup <12h (ARR=1).Conclusions: The prolonged stage of labor may lead to increased adverse outcomes in multiparous women, it was an independent risk factor of adverse maternal and neonatal outcomes.

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