scholarly journals Sex-specific differences in HPA axis activity in VLBW preterm newborns

2021 ◽  
Author(s):  
Britt J van Keulen ◽  
Michelle Romijn ◽  
Bibian van der Voorn ◽  
Marita de Waard ◽  
Michaela F. Hartmann ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Excretion Rate ◽  
Post Partum ◽  
Small Sample ◽  
Gas Chromatography Mass Spectrometry ◽  
Adrenocortical Function ◽  
Mortality And Morbidity ◽  
Cortisol Excretion

Objective Sex-specific differences in hypothalamic-pituitary-adrenal axis activity might explain why male preterm infants are at higher risk of neonatal mortality and morbidity than their female counterparts. We examined whether male and female preterm infants differed in cortisol production and metabolism at 10 days post-partum. Design and methods This prospective study included 36 preterm born infants (18 boys) with a very low birth weight (VLBW) (<1.500 gram). At 10 days postnatal age, urine was collected over a 4- to 6-hr period. Glucocorticoid metabolites were measured using gas chromatography-mass spectrometry. Main outcome measures were: (1) cortisol excretion rate, (2) sum of all glucocorticoid metabolites, as an index of corticosteroid excretion rate, and (3) ratio of 11-OH/11-OXO metabolites, as an estimate of 11β-hydroxysteroid dehydrogenase (11β-HSD) activity. Differences between sexes, including interaction with Score of Neonatal Acute Physiology Perinatal Extension-II (SNAPPE II), sepsis and bronchopulmonary dysplasia (BPD), were assessed. Results No differences between sexes were found for cortisol excretion rate, corticosteroid excretion rate or 11β-HSD activity. Interaction was observed between: sex and SNAPPE II score on 11β-HSD activity (p=0.04) and sex and BPD on cortisol excretion rate (p=0.04). Conclusion This study did not provide evidence for sex-specific differences in adrenocortical function in preterm VLBW infants on a group level. However, in an interaction model sex differences became manifest under stressful circumstances. These patterns might provide clues for the male disadvantage in neonatal mortality and morbidity following preterm birth. However, due to the small sample size, the data should be seen as hypothesis generating.

scholarly journals Temporal trends in neonatal mortality and morbidity following spontaneous and clinician-initiated preterm birth in Washington State, USA: a population-based study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023004 ◽  
Author(s):  
Lindsay L Richter ◽  
Joseph Ting ◽  
Giulia M Muraca ◽  
Anne Synnes ◽  
Kenneth I Lim ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Preterm Infants ◽  
Temporal Trends ◽  
Population Based ◽  
Washington State ◽  
Late Preterm ◽  
Population Based Study ◽  
Mortality And Morbidity ◽  
Late Preterm Infants ◽  
Spontaneous Labour

ObjectiveAfter a decade of increase, the preterm birth (PTB) rate has declined in the USA since 2006, with the largest decline at late preterm (34–36 weeks). We described concomitant changes in gestational age-specific rates of neonatal mortality and morbidity following spontaneous and clinician-initiated PTB among singleton infants.Design, setting and participantsThis retrospective population-based study included 754 763 singleton births in Washington State, USA, 2004–2013, using data from birth certificates and hospitalisation records. PTB subtypes included preterm premature rupture of membranes (PPROM), spontaneous onset of labour and clinician-initiated delivery.Outcome measuresThe primary outcomes were neonatal mortality and a composite outcome including death or severe neonatal morbidity. Temporal trends in the outcomes and individual morbidities were assessed by PTB subtype. Logistic regression yielded adjusted odds ratios (AOR) per 1 year change in outcome and 95% CI.ResultsThe rate of PTB following PPROM and spontaneous labour declined, while clinician-initiated PTB increased (all p<0.01). Overall neonatal mortality remained unchanged (1.3%; AOR 0.99, CI 0.95 to 1.02), though gestational age-specific mortality following clinician-initiated PTB declined at 32–33 weeks (AOR 0.85, CI 0.74 to 0.97) and increased at 34–36 weeks (AOR 1.10, CI 1.01 to 1.20). The overall rate of the composite outcome increased (from 7.9% to 11.9%; AOR 1.06, CI 1.05 to 1.08). Among late preterm infants, combined mortality or severe morbidity increased following PPROM (AOR 1.13, CI 1.08 to 1.18), spontaneous labour (AOR 1.09, CI 1.06 to 1.13) and clinician-initiated delivery (AOR 1.10, CI 1.07 to 1.13). Neonatal sepsis rates increased among all preterm infants (AOR 1.09, CI 1.08 to 1.11).ConclusionsTiming of obstetric interventions is associated with infant health outcomes at preterm. The temporal decline in late PTB among singleton infants was associated with increased mortality among late preterm infants born following clinician-initiated delivery and increased combined mortality or severe morbidity among all late preterm infants, mainly due to increased rate of sepsis.

scholarly journals The Potential Effects of Human Milk on Morbidity in Very-Low-Birth-Weight Preterm Infants

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1882
Author(s):  
Paola Roggero ◽  
Nadia Liotto ◽  
Orsola Amato ◽  
Fabio Mosca
Keyword(s):  
Quality Of Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Mortality And Morbidity ◽  
Vlbw Infants

Improvements in quality of care have led to a significant reduction in mortality and morbidity in preterm infants, especially very-low-birth-weight (VLBW) infants [...]

Neonatal mortality in very low birth weight and very preterm infants

1985 ◽  
Vol 153 (8) ◽  
pp. 929-930 ◽  
Author(s):  
S.Pauline Verloove-Vanhorick ◽  
Robert A. Verwey ◽  
Marc J.N.C. Keirse
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Very Preterm Infants ◽  
Very Preterm

Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity

2016 ◽  
Vol 175 ◽  
pp. 61-67.e4 ◽  
Author(s):  
Emilija Wilson ◽  
Rolf F. Maier ◽  
Mikael Norman ◽  
Bjoern Misselwitz ◽  
Elizabeth A. Howell ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Preterm Infants ◽  
Very Preterm Infants ◽  
Mortality And Morbidity ◽  
Very Preterm

Association of antenatal steroids with neonatal mortality and morbidity in preterm infants born to mothers with diabetes mellitus and hypertension

2021 ◽  
Author(s):  
Heather M. Weydig ◽  
Charles R. Rosenfeld ◽  
Mambarambath A. Jaleel ◽  
Patti J. Burchfield ◽  
Mackenzie S. Frost ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Neonatal Mortality ◽  
Preterm Infants ◽  
Mortality And Morbidity ◽  
Antenatal Steroids

scholarly journals OUTCOME OF PRETERM INFANTS AFTER DELIVERY ROOM CARDIOPULMONARY RESUSCITATION. A RETROSPECTIVE OBSERVATIONAL STUDY

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e19-e19
Author(s):  
Bishal Gautam ◽  
Sarah McKnight ◽  
Michael Miller ◽  
Bryan Richardson ◽  
Abrar Ahmed ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Preterm Infants ◽  
Chest Compression ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Delivery Room ◽  
Bivariate Analysis ◽  
Care Hospital ◽  
Mortality And Morbidity

Abstract BACKGROUND Chest compression in the delivery room (CPR-DR) during neonatal resuscitation is considered as an extreme measure. When respiratory support alone is unable to establish circulatory transition, chest compression with or without epinephrine is necessary. The results of earlier studies have shown varied results in mortality and morbidity of preterm infants who received CPR-DR. OBJECTIVES To examine the relationship between need of CPR-DR in infants born between 23 and 32 weeks gestation and neonatal mortality and morbidity. DESIGN/METHODS This was a population-based cohort study of 23 0/7 to 32 6/7 weeks gestational age infants born at a Canadian tertiary care hospital between January 1, 2007 and December 31, 2016. Data were retrieved from the Neonatal-Perinatal database. Neonatal mortality and morbidities were examined between infants who did and did not need CPR-DR. RESULTS Of 1443 newborns meeting study criteria, 55 (3.8%) received CPR-DR. On bivariate analysis, outcome of infants requiring CPR-DR was associated with higher mortality (40% vs. 5.8%, p <0.001), intraventricular hemorrhage grade 3 or 4 (21.8% vs. 6.1%, p <0.001), patent ductus arteriosus (54.5% vs. 27.7%, p<0.001), bronchopulmonary dysplasia (35.4% vs. 19.6%, p=0.007), need of mechanical ventilation (90.9% vs. 61.1%, p<0.001) and sepsis (23.6% vs. 13.5%, p=0.034). However, in a multivariable logistic regression analysis controlling for predictor variables, CPR-DR was only associated with increased neonatal mortality (aOR=4.41 p<0.001, 95%CI [2.18, 8.92]). CONCLUSION While CPR-DR is associated with a high mortality rate in infants less than 32 weeks gestation, associated morbidities are largely predicted by other risk factors.

Neonatal mortality and morbidity in preterm infants born from assisted reproductive technologies

2012 ◽  
Vol 101 (8) ◽  
pp. 846-851 ◽  
Author(s):  
JC Picaud ◽  
S Chalies ◽  
C Combes ◽  
G Mercier ◽  
H Dechaud ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Preterm Infants ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Mortality And Morbidity

Neurodevelopmental assessment of very low birth weight preterm infants at corrected age of 18-24 months by Bayley III scales

2012 ◽  
Author(s):  
Luciana Volpiano Fernandes ◽  
Ana Lucia Goulart ◽  
Amélia Miyashiro Nunes dos Santos ◽  
Marina Carvalho de Moraes Barros ◽  
Camila Campos Guerra ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Very Low Birth Weight
Sign in / Sign up

Export Citation Format

Share Document