scholarly journals Impact of clinical subtypes of preterm birth on child health and development

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Amy Metcalfe ◽  
Paul Brown ◽  
Carly McMorris ◽  
Kathleen Chaput ◽  
Maria Ospina ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Child Health ◽  
Health Outcomes ◽  
Neonatal Morbidity ◽  
Underlying Mechanism ◽  
Child Health Outcomes ◽  
Gestational Age At Delivery ◽  
Health And Development ◽  
Short And Long Term

IntroductionPreterm birth (birth <37 weeks of gestation) is common. While the clinical conditions leading to preterm birth are heterogeneous, most studies examining the short- and long-term consequences of preterm birth on child health and development, only consider the gestational age at delivery, and not the underlying mechanism of preterm birth. Objectives and ApproachMaternal hospitalization and perinatal data for deliveries occurring in Alberta, Canada in 2004, 2009, and 2014 were linked to identify underlying mechanisms for delivery (i.e., infection/inflammation (I/I), placental dysfunction (PD), both, or neither). Linked hospitalization, emergency department, and physician claims data were used to assess child health outcomes up to age 10. Chi-square tests were used to assess differences in the absolute rate of each outcome stratified by gestational age at delivery and underlying mechanism for delivery. Logistic regression was used to assess relative differences following adjustment for confounders compared to term infants without exposure to I/I or PD. ResultsA total of 134,424 children were included in the analysis. For preterm births occurring <32 weeks of gestation, no differences were observed in child health outcomes based on the underlying mechanism of preterm birth. However, infants born at 32-33 weeks following PD compared to I/I had significantly higher odds (PD:69.1%, OR=29.7, 95% CI:25.7-34.2 vs. I/I:47.2%, OR=18.7, 95% CI:16.8-20.9) of neonatal morbidity; while those born at 34-36 weeks had increased odds of neonatal morbidity (PD:21.1%, OR=5.1, 95% CI: 4.7-5.5 vs. I/I:16.2%, OR=3.7, 95% CI:3.4-3.9) and developmental disabilities (PD:3.3%, OR=2.2, 95% CI:1.8-2.6 vs. I/I:1.6%, OR=1.7, 95% CI:1.4-2.0). No differences were observed in mortality by sub-type of preterm birth; however, as expected perinatal mortality rates were significantly more common in preterm than term births. Conclusion/ImplicationsBoth the short- and long-term outcomes of preterm birth differ by the underlying mechanism leading to preterm delivery. Having a clearer prognosis for infants born preterm may promote the use of clinical interventions earlier for children at increased risk, leading to improved child health and development.

Optimum feeding and growth in preterm neonates

2013 ◽  
Vol 4 (3) ◽  
pp. 215-222 ◽  
Author(s):  
J. E. Harding ◽  
J. G. B. Derraik ◽  
M. J. Berry ◽  
A. L. Jaquiery ◽  
J. M. Alsweiler ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Later Life ◽  
Developed Countries ◽  
Postnatal Growth ◽  
Preterm Neonates ◽  
Intrauterine Environment ◽  
Neurological Outcomes ◽  
Health And Development ◽  
Short And Long Term

Approximately 10% of all babies worldwide are born preterm, and preterm birth is the leading cause of perinatal mortality in developed countries. Although preterm birth is associated with adverse short- and long-term health outcomes, it is not yet clear whether this relationship is causal. Rather, there is evidence that reduced foetal growth, preterm birth and the long-term health effects of both of these may all arise from a suboptimal intrauterine environment. Further, most infants born preterm also experience suboptimal postnatal growth, with potential adverse effects on long-term health and development. A number of interventions are used widely in the neonatal period to optimise postnatal growth and development. These commonly include supplementation with macronutrients and/or micronutrients, all of which have potential short-term risks and benefits for the preterm infant, whereas the long-term health consequences are largely unknown. Importantly, more rapid postnatal growth trajectory (and the interventions required to achieve this) may result in improved neurological outcomes at the expense of increased cardiovascular risk in later life.

scholarly journals In-utero exposure to antihypertensive medication and neonatal and child health outcomes

2017 ◽  
Vol 35 (11) ◽  
pp. 2123-2137 ◽  
Author(s):  
Catherine A. Fitton ◽  
Markus F.C. Steiner ◽  
Lorna Aucott ◽  
Jill P. Pell ◽  
Daniel F. Mackay ◽  
...  
Keyword(s):  
Child Health ◽  
Health Outcomes ◽  
Antihypertensive Medication ◽  
In Utero ◽  
In Utero Exposure ◽  
Child Health Outcomes ◽  
And Child Health

scholarly journals Maternal Iron Status in Pregnancy and Child Health Outcomes after Birth: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2221
Author(s):  
Hugo G. Quezada-Pinedo ◽  
Florian Cassel ◽  
Liesbeth Duijts ◽  
Martina U. Muckenthaler ◽  
Max Gassmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Iron Deficiency ◽  
Child Health ◽  
Methodological Quality ◽  
Iron Status ◽  
Meta Analysis ◽  
Child Health Outcomes ◽  
Maternal Iron ◽  
In Pregnancy

In pregnancy, iron deficiency and iron overload increase the risk for adverse pregnancy outcomes, but the effects of maternal iron status on long-term child health are poorly understood. The aim of the study was to systematically review and analyze the literature on maternal iron status in pregnancy and long-term outcomes in the offspring after birth. We report a systematic review on maternal iron status during pregnancy in relation to child health outcomes after birth, from database inception until 21 January 2021, with methodological quality rating (Newcastle-Ottawa tool) and random-effect meta-analysis. (PROSPERO, CRD42020162202). The search identified 8139 studies, of which 44 were included, describing 12,7849 mother–child pairs. Heterogeneity amongst the studies was strong. Methodological quality was predominantly moderate to high. Iron status was measured usually late in pregnancy. The majority of studies compared categories based on maternal ferritin, however, definitions of iron deficiency differed across studies. The follow-up period was predominantly limited to infancy. Fifteen studies reported outcomes on child iron status or hemoglobin, 20 on neurodevelopmental outcomes, and the remainder on a variety of other outcomes. In half of the studies, low maternal iron status or iron deficiency was associated with adverse outcomes in children. Meta-analyses showed an association of maternal ferritin with child soluble transferrin receptor concentrations, though child ferritin, transferrin saturation, or hemoglobin values showed no consistent association. Studies on maternal iron status above normal, or iron excess, suggest deleterious effects on infant growth, cognition, and childhood Type 1 diabetes. Maternal iron status in pregnancy was not consistently associated with child iron status after birth. The very heterogeneous set of studies suggests detrimental effects of iron deficiency, and possibly also of overload, on other outcomes including child neurodevelopment. Studies are needed to determine clinically meaningful definitions of iron deficiency and overload in pregnancy.

Liberalising Health-seeking Behaviour of the Johanne Marange Apostolic Sect in Manicaland, Zimbabwe

2021 ◽  
pp. 097206342110652
Author(s):  
Steven Masvaure
Keyword(s):  
Child Health ◽  
Health Outcomes ◽  
Conventional Medicine ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Child Health Outcomes ◽  
Women And Children ◽  
Religious Sects ◽  
And Child Health ◽  
Apostolic Church

Religious rights as enshrined in the Zimbabwean constitution are sacrosanct, however, when church doctrine bars followers from seeking modern medical care, they start infringing on health rights especially of the ‘lesser beings’ the women and children who are members of these religious sects. The ‘lesser beings’ are bearing the brunt of high maternal and neonatal mortality as they depend on unsafe traditional birth attendants and unconventional medicine. This study is ethnographic and presents lessons learnt from a programme aiming to improve maternal, newborn and child health outcomes among the Apostolic Church of Johanne Marange members in Manicaland province, Zimbabwe. The findings show that despite the stringent doctrine and barriers placed on apostolic members who want to access conventional medicine, the women and children are using clandestine approaches to circumvent the doctrine and barriers. This article argues that a barrage of unconventional and conventional approaches can lead to changes in health-seeking behaviour of the apostolic church and ultimately maternal and child health outcomes. The article argues that the intransigence of the apostolic can only be overcome by covert approaches to providing health services and save lives.

Sign in / Sign up

Export Citation Format

Share Document