scholarly journals The risks of advancing parental age on neonatal morbidity and mortality are U- or J-shaped for both maternal and paternal ages

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
James A. Thompson
Keyword(s):  
United States ◽  
Maternal Age ◽  
Neonatal Intensive Care ◽  
Neonatal Morbidity ◽  
The United States ◽  
Paternal Age ◽  
Morbidity And Mortality ◽  
Hospital Death ◽  
Very Preterm ◽  
Prolonged Ventilation

Abstract Background The biologic implications of delayed parenthood have been blamed for a major public health crisis in the United States, that includes high rates of neonatal morbidity and mortality (NMM). The objective of this study was to evaluate the risk of parent age on NMM and to provide results that can serve as a starting point for more specific mediation modeling. Methods Data containing approximately 15,000,000 birth records were obtained from the United States Natality database for the years 2014 to 2018. A Bayesian modeling approach was used to estimate the both the total effect and the risk adjusted for confounding between parent ages and for mediation by chromosomal disorders including Down syndrome. Outcomes included intra-hospital death and nine measures of neonatal morbidity. Results For paternal age, seven NMM (preterm birth, very preterm birth, low Apgar score, treatment with antibiotics, treatment with surfactant, prolonged ventilation, intra-hospital death) had U-shaped risk patterns, two NMM (small for gestational age, admission to neonatal intensive care) had J-shaped risk patterns, one NMM (seizures) was not significantly related to paternal age. For maternal age, three NMM (low Apgar score, treatment with antibiotics and intra-hospital death) had U-shaped risk patterns, four NMM (preterm delivery, very preterm delivery, admission to neonatal intensive care, treatment with surfactant) had J-shaped risk patterns, one NMM (small for gestational age) had a risk declining with age, one NMM (prolonged ventilation) had a risk increasing with age and one NMM (seizures) was not significantly related to maternal age. Conclusions Both advancing maternal and paternal ages had U- or J-shaped risk patterns for neonatal morbidity and mortality.

scholarly journals The Risks of Advancing Parental Age on Neonatal Morbidity and Mortality are U- or J-Shaped for Both Maternal and Paternal Ages.

2020 ◽  
Author(s):  
James Thompson
Keyword(s):  
United States ◽  
Neonatal Mortality ◽  
Maternal Age ◽  
Neonatal Intensive Care ◽  
Neonatal Morbidity ◽  
The United States ◽  
Paternal Age ◽  
Morbidity And Mortality ◽  
Very Preterm ◽  
Prolonged Ventilation

Abstract Background: The biologic implications of delayed parenthood have been blamed for a major public health crisis in the United States, that includes high rates of neonatal morbidity and mortality (NMM). The objective of this study was to evaluate the risk of parent age on NMM and to provide results that can serve as a starting point for more specific mediation modeling. Methods: Data containing approximately 15,000,000 birth records were obtained from the United States Natality database for the years 2014 to 2017. A Bayesian modeling approach was used to estimate the both the total effect and the risk adjusted for confounding between parent ages and for mediation by chromosomal disorders including Down syndrome. Outcomes included neonatal mortality and nine measures of neonatal morbidity.Results: For paternal age, seven NMM (preterm birth, very preterm birth, low Apgar score, treatment with antibiotics, treatment with surfactant, prolonged ventilation, neonatal mortality) had U-shaped risk patterns, two NMM (small for gestational age, admission to neonatal intensive care) had J-shaped risk patterns, one NMM (seizures) was not significantly related to paternal age. For maternal age, three NMM (low Apgar score, treatment with antibiotics and neonatal mortality) had U-shaped risk patterns, four NMM (preterm delivery, very preterm delivery, admission to neonatal intensive care, treatment with surfactant) had J-shaped risk patterns, one NMM (small for gestational age) had a risk declining with age, one NMM (prolonged ventilation) had a risk increasing with age and one NMM (seizures) was not significantly related to maternal age. Conclusions. Under the assumptions of a specific causal model, both advancing maternal and paternal ages had U- or J-shaped risk patterns for neonatal morbidity and mortality.

scholarly journals Neonatal Morbidity and Mortality in Advanced Aged Mothers—Maternal Age Is Not an Independent Risk Factor for Infants Born Very Preterm

2021 ◽  
Vol 9 ◽  
Author(s):  
Nasenien Nourkami-Tutdibi ◽  
Erol Tutdibi ◽  
Theresa Faas ◽  
Gudrun Wagenpfeil ◽  
Elizabeth S. Draper ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Maternal Age ◽  
Periventricular Leukomalacia ◽  
Developed Countries ◽  
Morbidity And Mortality ◽  
Pediatric Care ◽  
Secondary Outcome ◽  
Hospital Death ◽  
Very Preterm ◽  
Significant Difference

Background: As childbearing is postponed in developed countries, maternal age (MA) has increased over decades with an increasing number of pregnancies between age 35–39 and beyond. The aim of the study was to determine the influence of advanced (AMA) and very advanced maternal age (vAMA) on morbidity and mortality of very preterm (VPT) infants.Methods: This was a population-based cohort study including infants from the “Effective Perinatal Intensive Care in Europe” (EPICE) cohort. The EPICE database contains data of 10329 VPT infants of 8,928 mothers, including stillbirths and terminations of pregnancy. Births occurred in 19 regions in 11 European countries. The study included 7,607 live born infants without severe congenital anomalies. The principal exposure variable was MA at delivery. Infants were divided into three groups [reference 18–34 years, AMA 35–39 years and very(v) AMA ≥40 years]. Infant mortality was defined as in-hospital death before discharge home or into long-term pediatric care. The secondary outcome included a composite of mortality and/or any one of the following major neonatal morbidities: (1) moderate-to-severe bronchopulmonary dysplasia; (2) severe brain injury defined as intraventricular hemorrhage and/or cystic periventricular leukomalacia; (3) severe retinopathy of prematurity; and (4) severe necrotizing enterocolitis.Results: There was no significant difference between MA groups regarding the use of surfactant therapy, postnatal corticosteroids, rate of neonatal sepsis or PDA that needed pharmacological or surgical intervention. Infants of AMA/vAMA mothers required significantly less mechanical ventilation during NICU stay than infants born to non-AMA mothers, but there was no significant difference in length of mechanical ventilation and after stratification by gestational age group. Adverse neonatal outcomes in VPT infants born to AMA/vAMA mothers did not differ from infants born to mothers below the age of 35. Maternal age showed no influence on mortality in live-born VPT infants.Conclusion: Although AMA/vAMA mothers encountered greater pregnancy risk, the mortality and morbidity of VPT infants was independent of maternal age.

scholarly journals Racial and Economic Neighborhood Segregation, Site of Delivery, and Very Preterm Neonatal Morbidity and Mortality

2021 ◽  
Author(s):  
Teresa Janevic ◽  
Jennifer Zeitlin ◽  
Natalia N. Egorova ◽  
Paul Hebert ◽  
Amy Balbierz ◽  
...  
Keyword(s):  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Very Preterm ◽  
Neighborhood Segregation

scholarly journals Severe Maternal Morbidity and Mortality Among Indigenous Women in the United States

2020 ◽  
Vol 135 (2) ◽  
pp. 294-300 ◽  
Author(s):  
Katy B. Kozhimannil ◽  
Julia D. Interrante ◽  
Alena N. Tofte ◽  
Lindsay K. Admon
Keyword(s):  
United States ◽  
Maternal Morbidity ◽  
The United States ◽  
Indigenous Women ◽  
Morbidity And Mortality ◽  
Severe Maternal Morbidity ◽  
Maternal Morbidity And Mortality

scholarly journals Healthcare-Associated Infections among Patients in a Large Burn Intensive Care Unit: Incidence and Pathogens, 2008–2012

2014 ◽  
Vol 35 (10) ◽  
pp. 1304-1306 ◽  
Author(s):  
David J. Weber ◽  
David van Duin ◽  
Lauren M. DiBiase ◽  
Charles Scott Hultman ◽  
Samuel W. Jones ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
The United States ◽  
Burn Injuries ◽  
Morbidity And Mortality ◽  
Common Source ◽  
Healthcare Associated Infections ◽  
Burn Patients ◽  
Healthcare Associated

Burn injuries are a common source of morbidity and mortality in the United States, with an estimated 450,000 burn injuries requiring medical treatment, 40,000 requiring hospitalization, and 3,400 deaths from burns annually in the United States. Patients with severe burns are at high risk for local and systemic infections. Furthermore, burn patients are immunosuppressed, as thermal injury results in less phagocytic activity and lymphokine production by macrophages. In recent years, multidrug-resistant (MDR) pathogens have become major contributors to morbidity and mortality in burn patients.Since only limited data are available on the incidence of both device- and nondevice-associated healthcare-associated infections (HAIs) in burn patients, we undertook this retrospective cohort analysis of patients admitted to our burn intensive care unit (ICU) from 2008 to 2012.

Contribution of Maternal Age and Pregnancy Checkbox on Maternal Mortality Ratios in the United States, 1978-2012

2018 ◽  
Vol 38 (2) ◽  
pp. 69-70
Author(s):  
N.L. Davis ◽  
D.L. Hoyert ◽  
D.A. Goodman ◽  
A.H. Hirai ◽  
W.M. Callaghan
Keyword(s):  
United States ◽  
Maternal Mortality ◽  
Maternal Age ◽  
The United States

Severity of Bronchopulmonary Dysplasia Among Very Preterm Infants in the United States

PEDIATRICS ◽  
2021 ◽  
pp. e2020030007
Author(s):  
Erik A. Jensen ◽  
Erika M. Edwards ◽  
Lucy T. Greenberg ◽  
Roger F. Soll ◽  
Danielle E.Y. Ehret ◽  
...  
Keyword(s):  
United States ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
The United States ◽  
Very Preterm Infants ◽  
Very Preterm

Narrowing the mindware gap in medicine

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Pat Croskerry
Keyword(s):  
United States ◽  
Cognitive Performance ◽  
Clinical Reasoning ◽  
Medical Errors ◽  
Medical Error ◽  
Causes Of Death ◽  
The United States ◽  
Morbidity And Mortality ◽  
Medical Educators ◽  
High Degree

Abstract Medical error is now recognized as one of the leading causes of death in the United States. Of the medical errors, diagnostic failure appears to be the dominant contributor, failing in a significant number of cases, and associated with a high degree of morbidity and mortality. One of the significant contributors to diagnostic failure is the cognitive performance of the provider, how they think and decide about the process of diagnosis. This thinking deficit in clinical reasoning, referred to as a mindware gap, deserves the attention of medical educators. A variety of specific approaches are outlined here that have the potential to close the gap.

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