Perinatal Outcome of Twins Compared to Singletons of the Same Gestational Age: A Case-Control Study

Our objective was to determine the perinatal outcome of first- and second-born twins compared to singletons, born at the same gestational age. To that end we conducted a case-control study in Flanders (Northern Belgium). During a 10-year period (01.01.1999–31.12.2008), the entire twin population — 11,154 first- and 11,118 second-born twins (cases) — was compared to 22,228 singletons (controls) with respect to fetal and neonatal (0–27 days) mortality. Only case and control infants of ≥ 500 grams were included, which explained the unequal number of first- and second-born twins. Mothers and their infants of cases and of controls were derived from the Flemish perinatal database and were matched for maternal age and parity, gestational age and gender of the offspring. The main outcome measures were fetal and neonatal mortality according to gestational age. The frequency of fetal death was statistically significantly less frequent in preterm born twins than in singletons, except at term where the reverse was seen in second-born twins compared to controls. After adjustment for congenital malformations, the results stayed unchanged. Below 28 weeks gestation, singletons had a significantly lower neonatal mortality rate than twins that persisted after adjustment for congenital malformations: the first-born twin versus singleton OR 1.71 (1.17–2.51) and second-born versus singleton OR 2.09 (1.43–3.05). Between 28 and 32 weeks, the second-born twin showed a survival advantage over the control singleton. Between 32 and 36 6/7 weeks both twins had a significantly higher survival rate than the corresponding singleton controls. However, after adjustment for congenital malformations, the aforementioned differences between 28 and 36 6/7 weeks disappeared. When at term, twins and singletons had a comparable, though very low, neonatal death rate. These results confirm previous published data. In conclusion, we demonstrated that the neonatal death rate was lower for twins between 32 and 36 weeks (from 28 weeks for the second born twin) when compared to a singleton of the same gestational age. After adjusting for congenital malformations, there was no statistical significant difference.

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Daylight Saving Time and Spontaneous Deliveries: A Case–Control Study in Italy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218091 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8091

Author(s):

Rosaria Cappadona ◽

Sara Puzzarini ◽

Vanessa Farinelli ◽

Piergiorgio Iannone ◽

Alfredo De Giorgi ◽

...

Keyword(s):

Gestational Age ◽

Case Control Study ◽

Case Control ◽

Chi Square ◽

Daylight Saving Time ◽

Daylight Saving ◽

Vaginal Deliveries ◽

Significant Difference ◽

Secondary Outcomes ◽

Control Study

(1) Background: Although the current literature shows that daylight saving time (DST) may play a role in human health and behavior, this topic has been poorly investigated with reference to Obstetrics. The aim of this case–control study was to evaluate whether DST may influence the number of spontaneous deliveries. (2) Methods: A low-risk pregnancy cohort with spontaneous onset of labor (n = 7415) was analyzed from a single Italian region for the period 2016–2018. Primary outcome was the number of spontaneous deliveries. Secondary outcomes were: gestational age at delivery, type and time of delivery, use of analgesia, birth weight, and 5-min Apgar at delivery. We compared the outcomes in the two weeks after DST (cases) to the two weeks before DST (controls). (3) Results: Data showed no significant difference between the number of deliveries occurring before and after DST (Chi-square = 0.546, p = 0.46). Vaginal deliveries at any gestational age showed no statistical difference between the two groups (Chi-square = 0.120, p = 0.73). There were no significant differences in the secondary outcomes, as well. (4) Conclusions: DST has neither a significant impact on the number of deliveries nor on the obstetric variables investigated by this study.

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Determinants of neonatal mortality in the largest international border of Brazil: a case-control study

BMC Public Health ◽

10.1186/s12889-019-7638-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Suzana de Souza ◽

Etienne Duim ◽

Fernando Kenji Nampo

Keyword(s):

Neonatal Mortality ◽

Neonatal Death ◽

Case Control Study ◽

Case Control ◽

High Rate ◽

Mortality Data ◽

Sociodemographic Characteristics ◽

Factors Associated ◽

International Border ◽

Control Study

Abstract Background Foz do Iguassu is a Brazilian municipality located in the most populous international border of the country and provides medical care to foreigners. Neonatal mortality in the city is higher than Brazil’s average and corresponds to 61% of all deaths in children under five. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. Methods In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. Results Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.49; CI 95% 7.44–67.95; p = < 0.001); low birth weight (OR 17.15; CI 95% 8.56–34.37; p = < 0.001), first minute Apgar score under 7 (OR 15.60; CI 95% 8.23–29.67; p = < 0.001); zero to 3 prenatal appointments (OR 3.34; CI 95% 1.28–8.73; p = 0.014) and prematurity (OR 3.60; CI 95% 1.87–7.11; p = < 0.001). Conclusion The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.

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Determinants Of Neonatal Mortality In The Largest International Border Of Brazil: A Case-Control Study

10.21203/rs.2.10817/v3 ◽

2019 ◽

Author(s):

Suzana de Souza ◽

Etienne Larissa Duim ◽

Fernando Kenji Nampo

Keyword(s):

Neonatal Mortality ◽

Neonatal Death ◽

Case Control Study ◽

Case Control ◽

High Rate ◽

Mortality Data ◽

Sociodemographic Characteristics ◽

Factors Associated ◽

International Border ◽

Control Study

Abstract BACKGROUND: Foz do Iguassu is a Brazilian municipality located in the most populous international border of the country and provides medical care to foreigners. Neonatal mortality in the city is higher than Brazil’s average and corresponds to 61% of all deaths in children under five. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. METHODS: In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. RESULTS : Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.49; CI 95% 7.44-67.95; p = <0.001); low birth weight (OR 17.15; CI 95% 8.56-34.37; p = <0.001), first minute Apgar score under 7 (OR 15.60; CI 95% 8.23- 29.67; p = <0.001); zero to 3 prenatal appointments (OR 3.34; CI 95% 1.28-8.73; p = 0.014) and prematurity (OR 3.60; CI 95% 1.87‑7.11; p = <0.001). CONCLUSION : The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.

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DETERMINANTS OF NEONATAL MORTALITY IN THE LARGEST INTERNATIONAL BORDER OF BRAZIL: A CASE CONTROL STUDY

10.21203/rs.2.10817/v1 ◽

2019 ◽

Author(s):

Suzana de Souza ◽

Etienne Larissa Duim ◽

Fernando Kenji Nampo

Keyword(s):

Neonatal Mortality ◽

Neonatal Death ◽

Case Control Study ◽

Case Control ◽

Sociodemographic Characteristics ◽

Neonatal Deaths ◽

Live Births ◽

Factors Associated ◽

International Border ◽

Control Study

Abstract BACKGROUND: Neonatal deaths correspond to 44% of the deaths in children under five globally. The most populous international border of Brazil includes Foz do Iguassu (Brazil), Puerto Iguazu (Argentina) and Ciudad del Este (Paraguay). Similarly to any other Brazilian city, the public health services located in Foz do Iguassu provide medical care to foreigners, including pregnant women who go to Brazil to deliver. Although the international importance of Foz do Iguassu in terms of healthcare, neonatal mortality in the city (15.3/1,000 live births) is higher than Brazil’s average (13.8/1,000 live births) and corresponds to 61% of all deaths in children under five. Unfortunately, the causes of the neonatal deaths in Foz do Iguassu remain unclear, which make it more difficult to manage the problem. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. METHODS: In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. RESULTS: Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.4; CI 95% 7.41-67.76; p = <0.001); low birth weight (OR 17.4; CI 95% 8.70-35.17; p = <0.001), first minute Apgar score under 7 (OR 15.4; CI 95% 8.11- 29.24; p = <0.001); zero to 3 prenatal appointments (OR 3.3; CI 95% 1.28-8.70; p = 0.014) and prematurity (OR 3.5; CI 95% 1.79 6.92; p = <0.001). CONCLUSION: The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.

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Determinants Of Neonatal Mortality In The Largest International Border Of Brazil: A Case-Control Study

10.21203/rs.2.10817/v2 ◽

2019 ◽

Author(s):

Suzana de Souza ◽

Etienne Larissa Duim ◽

Fernando Kenji Nampo

Keyword(s):

Neonatal Mortality ◽

Neonatal Death ◽

Case Control Study ◽

Case Control ◽

High Rate ◽

Mortality Data ◽

Sociodemographic Characteristics ◽

Factors Associated ◽

International Border ◽

Control Study

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Does Placental Weight Affects Perinatal Outcome? A Prospective Case-control Study

Current Women s Health Reviews ◽

10.2174/1573404815666191113111447 ◽

2020 ◽

Vol 16 (1) ◽

pp. 52-59

Author(s):

Naina Kumar ◽

Himani Agarwal

Keyword(s):

Birth Weight ◽

High Risk ◽

Perinatal Outcome ◽

Case Control Study ◽

Neonatal Outcome ◽

Case Control ◽

Placental Weight ◽

Tertiary Center ◽

Control Study ◽

Prospective Case Control Study

Background: Placenta plays a very important role in the growth and development of fetus. Objective: To know the correlation between placental weight and perinatal outcome in term antenatal women. Methods: Present prospective case-control study was conducted in the rural tertiary center of Northern India over one year (January-December 2018) on 1,118 term (≥37-≤42 weeks) antenatal women with singleton pregnancy fulfilling inclusion criteria with 559 women with high-risk pregnancy as cases and 559 low-risk pregnant women as controls. Placental weight, birth weight was measured immediately after delivery and compared between the two groups along with gestation, parity, fetal gender, and neonatal outcome. Statistical analysis was done using SPSS 22 version. Results: Mean placental weight [481.98±67.83 gm vs. 499.47±59.59 gm (p=.000)] and birth weight [2.68±0.53 Kg vs. 2.88±0.4 Kg (p=.000)] was significantly lower in high risk as compared to lowrisk participants, whereas placental birth weight ratio was higher in high-risk cases [18.35±2.37 vs. 17.41±1.38 (p=.000)] respectively. Placental weight was positively correlated with birth weight and placental weight and birth weight increased with increasing gestation in both cases and controls. Male neonates had higher placental weight [492.74±68.24 gm vs. 488±58.8 gm (p=0.224)] and birth weight [2.81±0.5 Kg vs. 2.74±0.45 Kg (p=0.033)] as compared to females. Neonatal Intensive Care Unit admission was significantly associated with low placental and birth weight (p=.000). Conclusion: There is a significant correlation between placental weight, birth weight and neonatal outcome, hence placental weight can be used as an indirect indicator of intrauterine fetal growth.

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Risk factors associated with subacromial pain in young athletes: A case control study

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-191683 ◽

2021 ◽

pp. 1-9

Author(s):

Zoran Z. Sarcevic ◽

Andreja P. Tepavcevic

Keyword(s):

Logistic Regression ◽

Case Control Study ◽

Case Control ◽

Sternoclavicular Joint ◽

Pectoralis Major ◽

Young Athletes ◽

Serratus Anterior ◽

Significant Difference ◽

Lower Trapezius ◽

Control Study

BACKGROUND: Subacromial pain (SAP) is a common complaint of young athletes, independently of the sport engaged. The prevalence of SAP in some sports is up to 50%. OBJECTIVE: The study was aimed to investigate some new factors possibly associated to subacromial pain in young athletes. The factors considered were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. METHODS: This case-control study included 82 young athletes 9–15 years, 41 with the symptoms of SAP and 41 controls. All participants self-reported whether they had subacromial pain. In addition, Hawkins–Kennedy Test was performed to all the participants to evaluate the subacromial pressure. Main outcome measures were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. The grade of tightness of the clavicular portion of the pectoralis major and the dysfunction of the sternoclavicular joint were measured with an inclinometer. Serratus anterior and lower trapezius strength were measured by a handheld dynamometer with external belt-fixation. The data were analyzed using t-test for independent samples, Mann-Whitney U test, contingency coefficients and a stepwise binary logistic regression. RESULTS: Significant statistical difference was observed in the grade of tightness of the clavicular portion of the pectoralis major and in the variable representing the physiological functioning of the sternoclavicular joint, between the cases and the controls. There was no significant difference in serratus anterior and lower trapezius strength between the cases and the controls. Logistic regression analysis showed that the variable representing the physiological functioning of the sternoclavicular joint and the grade of shortening of the clavicular portion of the pectoralis major were good predictors for presence of SAP. CONCLUSIONS: A strong association was determined between subacromial pain in young athletes, clavicular portion of pectoralis major tightness and the dysfunction of the sternoclavicular joint.

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Neonatal Outcomes of Premature Infants Born to Women with the Novel Coronavirus (SARS-CoV-2) Infection: A Case Control Study

American Journal of Perinatology ◽

10.1055/s-0041-1740177 ◽

2021 ◽

Author(s):

Beril Yasa ◽

Seyma Memur ◽

Dilek Y. Ozturk ◽

Onur Bagci ◽

Sait I. Uslu ◽

...

Keyword(s):

Vertical Transmission ◽

Premature Infants ◽

Gestational Age ◽

Case Control Study ◽

Case Control ◽

Neonatal Outcomes ◽

Study Group ◽

Novel Coronavirus ◽

Historical Controls ◽

Control Study

Objective Novel coronavirus disease 2019 (COVID-19) is a disease associated with atypical pneumonia caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The first cases of COVID-19 were reported in Wuhan at the end of 2019. Transmission usually occurs via infected droplets and close personal contact; the possibility of vertical transmission is still under debate. This retrospective study aimed to analyze clinical characteristics of premature infants born to mothers with symptomatic COVID-19 disease. Study Design This case control study compared the clinical and laboratory data of 20 premature infants born to mothers infected with SARS-CoV-2 with sex and gestational age–matched historical controls. Results The median gestational age and birth weight in both groups were similar. Respiratory distress developed in 11 (55.5%) infants in study group and 19 (47.5%) infants in control group. Mechanical ventilation and endotracheal surfactant administration rates were similar. Median duration of hospitalization was 8.5 (2–76) days in study group and 12 days in historical controls. Real-time reverse-transcription polymerase chain reaction tests (RT-PCR) of nasopharyngeal swab samples for SARS-CoV-2 were found to be negative twice, in the first 24 hours and later at 24 to 48 hours of life. No neutropenia or thrombocytopenia was detected in the study group. Patent ductus arteriosus, bronchopulmonary dysplasia, and necrotizing enterocolitis rates were similar between groups. No mortality was observed in both groups. Conclusion To the best of our knowledge, this is one of the few studies evaluating the clinical outcomes of premature infants born to SARS-CoV-2 infected mothers. There was no evidence of vertical transmission of SARS-CoV-2 from symptomatic SARS-CoV-2-infected women to the neonate in our cohort. The neonatal outcomes also seem to be favorable with no mortality in preterm infants. Key Points

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First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies

Journal of Perinatal Medicine ◽

10.1515/jpm-2013-0260 ◽

2015 ◽

Vol 43 (6) ◽

Cited By ~ 1

Author(s):

Tanya Maric ◽

Natasha Singh ◽

Keith Duncan ◽

Guy J. Thorpe-Beeston ◽

Makrina D. Savvidou

Keyword(s):

Fetal Growth ◽

Case Control Study ◽

Subsequent Development ◽

First Trimester ◽

Case Control ◽

Retrospective Case ◽

Crown Rump Length ◽

Significant Difference ◽

Twin Pregnancies ◽

Control Study

AbstractTo investigate the relation between first-trimester fetal growth discrepancy, as assessed by crown-rump length (CRL) at 11+0 to 13+6 weeks of gestation, and subsequent development of preeclampsia (PE) in dichorionic diamniotic (DCDA) twin pregnancies. The association between inter-twin CRL and birth weight (BW) discrepancy was also investigated.This was a retrospective, case-control study of DCDA twin pregnancies. Inter-twin CRL discrepancy was calculated as 100×(larger CRL–smaller CRL)/larger CRL. BW discordance was calculated as 100×(larger BW–smaller BW)/larger BW.The study included 299 DCDA pregnancies that remained normotensive and 35 that subsequently developed PE. There was no significant difference in the inter-twin CRL discrepancy between pregnancies complicated by PE and those that were not [3.2%, interquartile range (IQR): 0.5–4.5% vs. 3.3%, IQR: 1.4–5.5%; P=0.17]. There was a positive correlation between inter-twin CRL and BW discrepancy but only in pregnancies that remained normotensive (P<0.001). In women that subsequently developed PE, there was no association between inter-twin CRL and BW discordance (P=0.54).In unselected DCDA twins, first-trimester CRL discrepancy is not different between pregnancies that subsequently develop PE and those that remain normotensive. Furthermore, in pregnancies that are complicated by PE, the association between inter-twin CRL and BW discrepancy appears to be lost.

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