Do emissions from landfill fires affect pregnancy outcomes? A retrospective study after arson at a solid waste facility in Sicily

ObjectivesIn response to public health concern about effects of arson at solid waste management plants in July 2012, we analysed vital statistics data to evaluate any potential effect on pregnancies at different gestational ages of pollutants emitted from the landfill on fire.SettingA community living near the largest landfill plant in Sicily.ParticipantsThe study group comprised 551 births, live births and stillbirths from pregnancies of mothers residing in the extra-urban exposed area, conceived during a 40 week period during which the highest fire’s peak might have influenced pregnancy.Primary and secondary outcome measuresBirth outcomes (gestational age <37 and <32 weeks, low birth weight, very low birth weight and small for gestational age) in the study group were compared with the ones of a reference group of women residing in areas of Sicily with similarly low population density and industrial development.ResultsAmong singleton live births we observed a three-fold increase in risk of very preterm birth between the extra-urban area and the remaining low inhabitants density and unindustrialised areas for births whose pregnancies were in the third trimester (OR adjusted for maternal age and infant gender=3.41; 95% CI 1.04 to 11.16). There was an excess of very low birth weight singleton infants in the study group as compared with the reference group, which was limited to births to mothers exposed during periconception period (OR adjusted for maternal age and infant gender=4.64; 95% CI 1.04 to 20.6) and first trimester (OR adjusted for maternal age and infant gender=3.66; 95% CI 1.11 to 12.1). The association estimates were imprecise due to the small number of outcomes recorded.ConclusionsThe study documented an excess of very preterm and very low birth weight among infants born to mothers exposed to the landfill fire emissions during conception or early pregnancy.

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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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Impact of Lockdown Measures during COVID-19 Pandemic on Pregnancy and Preterm Birth

American Journal of Perinatology ◽

10.1055/s-0041-1739357 ◽

2021 ◽

Author(s):

Belal Alshaikh ◽

Po-Yin Cheung ◽

Nancy Soliman ◽

Marie-Anne Brundler ◽

Kamran Yusuf

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Pregnancy Outcomes ◽

Very Low Birth Weight ◽

Gestational Hypertension ◽

Cohort Analysis ◽

Preterm Births ◽

Live Births ◽

Very Preterm

Objective The objective of this study is to assess the effect of the lockdown measures during the coronavirus disease 2019 (COVID-19) pandemic on pregnancy outcomes of women who were not affected by severe acute respiratory syndrome coronavirus 2 infection. Study Design We used data from the perinatal health program and neonatal databases to conduct a cohort analysis of pregnancy outcomes during the COVID-19 lockdown in the Calgary region, Canada. Rates of preterm birth were compared between the lockdown period (March 16 to June 15, 2020) and the corresponding pre-COVID period of 2015 to 2019. We also compared maternal and neonatal characteristics of preterm infants admitted to neonatal intensive care units (NICUs) in Calgary between the two periods. Findings A total of 4,357 and 24,160 live births occurred in the lockdown and corresponding pre-COVID period, respectively. There were 366 (84.0 per 1,000 live births) and 2,240 (92.7 per 1,000 live births) preterm births in the lockdown and corresponding pre-COVID period, respectively (p = 0.07). Rates of very preterm and very-low-birth-weight births were lower in the lockdown period compared with the corresponding pre-COVID period (11.0 vs. 15.6 and 9.0 vs. 14.4 per 1,000 live births, p = 0.02 and p = 0.005, respectively). There was no difference in spontaneous stillbirth between the two periods (3.7 vs. 4.1 per 1,000 live birth, p = 0.71). During the lockdown period, the likelihood of multiple births was lower (risk ratio [RR] 0.73, 95% confidence interval [CI]: 0.60–0.88), while gestational hypertension and clinical chorioamnionitis increased (RR 1.24, 95%CI: 1.10–1.40; RR 1.33, 95%CI 1.10–1.61, respectively). Conclusion Observed rates of very preterm and very-low-birth-weight births decreased during the COVID-19 lockdown. Pregnant women who delivered during the lockdown period were diagnosed with gestational hypertension and chorioamnionitis more frequently than mothers in the corresponding pre-COVID period. Key Points

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Functional Outcomes and Participation in Young Adulthood for Very Preterm and Very Low Birth Weight Infants: The Dutch Project on Preterm and Small for Gestational Age Infants at 19 Years of Age

PEDIATRICS ◽

10.1542/peds.2006-2407 ◽

2007 ◽

Vol 120 (3) ◽

pp. e587-e595 ◽

Cited By ~ 118

Author(s):

E. T. M. Hille ◽

N. Weisglas-Kuperus ◽

J. B. van Goudoever ◽

G. W. Jacobusse ◽

M. H. Ens-Dokkum ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Young Adulthood ◽

Gestational Age ◽

Small For Gestational Age ◽

Functional Outcomes ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Very Preterm

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Survival rate of very low birth weight infants over a quarter century (1994 –2019): A single-institution experience

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200595 ◽

2020 ◽

pp. 1-8

Author(s):

M.A. AlQurashi

Keyword(s):

Birth Weight ◽

Survival Rate ◽

Low Birth Weight ◽

Gestational Age ◽

Very Low Birth Weight ◽

Improvement Rate ◽

Quarter Century ◽

Vlbw Infants ◽

Live Births ◽

The Past

BACKGROUND: Newborn infants with birth weight less than 1500 grams defining very low birth weight (VLBW) constitute 1.2–1.5% of total live births and 15–20% of all admissions to neonatal units. Advances in antenatal care, care at delivery, and neonatal practice over the past few decades, have substantially improved outcomes in VLBW infants, and reduced neonatal mortality. METHODS: A retrospective single tertiary care center cohort study of VLBW infants with gestational age between 23–33 weeks admitted to the neonatal intensive care unit (NICU) in King Abdulaziz Medical City, Jeddah (KAMC-J) between January 1, 1994, and December 31, 2019 (26 years). The trends of survival of VLBW infants and major changes in clinical practice of premature care over a period of 26 years were evaluated. RESULTS: Over a period of 26 years, 1,247 VLBW infants were admitted to the NICU that represents 1.43% (1.25–1.83%) of total live births. 50.80% (n = 634) were male, whereas the 49.2% (n = 613) were female. Among them, 1013 (81.2%) were discharged home alive. There was a significant and progressive improvement in the survival rate of VLBW infants over a 26-year period from 66.83% in period 1 (1994 –1998) to 90.0 % in period 5 (2014 –2019), which represents a 34.67% total improvement rate. The improvement in survival rates was observed in all gestational ages between 23–33 weeks, particularly in infants weighing ≤750 grams and ≤1000 grams, and with gestational age between 23–27 weeks. Infants with a gestational age of ≤26 weeks and birth weight ≤750 grams delivered by cesarean section had a higher survival rate. Moreover, female infants with a gestational age of ≤26 weeks and birth weight ≤750 grams had a higher survival rate compared to males but not statistically significant. CONCLUSIONS: The survival rate of VLBW infants had improved significantly over the past 26 years (1994 –2019). This is attributed mainly to the improved survival of ELBW infants (<1000 grams) and gestational age of ≤26 weeks.

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PREDICTOR VARIABLES OF NEONATAL MORTALITY IN VERY-LOW-BIRTH-WEIGHT INFANTS

International Journal of Advanced Research ◽

10.21474/ijar01/12997 ◽

2021 ◽

Vol 9 (06) ◽

pp. 163-171

Author(s):

Cristina Amaral Calixto ◽

◽

Nathalia Macedo Marteletto ◽

Priscila da Silva Azevedo Leite ◽

Paulo Sergio Leite ◽

...

Keyword(s):

Logistic Regression ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Apgar Score ◽

Maternal Age ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Kaplan Meier ◽

Type Of Delivery

The aim of this study is to investigate the mortality profile in very-low-birth-weight infants, as well as model the association of some variables with neonatal mortality, in order to detect possible preventable causes of death. This retrospective cross-sectional study included a total of 109 Very-Low-Weight-Infants admitted to a Neonatal Intensive Care Unit in a municipality in Minas Gerais, Brazil, between January 2012 and December 2016. The neonates were divided into two groups: death and non-death. Frequency distributions were constructed for the variables maternal age, sex, birth weight, gestational age, type of delivery, asphyxia (Apgar at five minutes), administration of antenatal corticosteroids, hypothermia, twinning, and amniotic membrane rupture. The survival curve was plotted using the Kaplan-Meier non-parametric estimator, and theassociation between death and the observed explanatory variables was modeled via Logistic Regression. In the survivor group, most infants exhibited normothermia and weight â‰¥1,000g. As for the death group, weight below 1,000g and hypothermic infants were predominant. In both groups, maternal age between 18 and 35 years prevailed, as well as the male sex, gestational age of 224 days, cesarean delivery, and fifth minute Apgar scores â‰¥7. The survival rate, estimated using the Kaplan-Meier method, showed a decrease from 1.0 to 0.55 at the beginning of the observation period. The adjusted logistic regression model included fetal weight and the fifth minute Apgar score. No significant relationship was found between death and the variables type of delivery, hypothermia, and antenatal corticosteroid use.Logistic regression indicated a high probability of death associated with birth weight and the Apgar score at five minutes. The low association with the other variables may be related to the good quality of prenatal, intrapartum, and postpartum care provided in the region and the analyzed hospital.

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Single-course antenatal corticosteroids is related to faster growth in very-low-birth-weight infant

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03510-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiajia Jing ◽

Yiheng Dai ◽

Yanqi Li ◽

Ping Zhou ◽

Xiaodong Li ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Very Low Birth Weight ◽

Postnatal Growth ◽

Weight Increase ◽

Antenatal Corticosteroids ◽

Lung Maturation ◽

Growth Outcomes

Abstract Background Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants. Methods A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes. Results A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed. Conclusions Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.

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