Prediction of Perinatal Outcomes in Full-Term Fetuses Appropriates for Gestational Age by Evaluation of Cerebroplacental Ratio (Cpr) Before the Active Phase of Labor

Background: Objective of the current study was to determine the importance of Doppler screening (cerebroplacental ratio i.e. CPR) in antenatal mothers and its effect on perinatal outcome of the baby so that appropriate management can be planned effectively for a better reduction in perinatal mortality and morbidity.Methods: A prospective study conducted on hundred antenatal women in GMKMCH, Salem with gestational age >32 weeks, with singleton pregnancies. Doppler ultrasonogram of fetal middle cerebral artery and umbilical artery and thus CPR obtained.Results: 25 out of the 100 patients in the study had CPR<1. CPR was compared against factors such as maternal age, parity, associated risk factors, gestational age (GA) at diagnosis (LMP GA and scan GA), time duration to delivery from diagnosis, requiring neonatal intensive care unit (NICU) admission, duration of stay in NICU and perinatal mortality. The CPR≤1 has a good sensitivity of 68% but a very high specificity of around 98% in predicting neonatal complications which was found to be statistically significant with a p value <0.0001.Conclusions: Since CPR has a high negative predictive value, CPR>1 helps to rule out adverse perinatal outcomes. When CPR<1, it acts as an effective tool in helping the obstetrician to decide on the mode of delivery to ensure that the baby is delivered within 12 hours of diagnosis, to improve the perinatal outcome of the baby.

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The Use of Somatex Shunt for Fetal Pleural Effusion: A Cohort of 8 Procedures

Fetal Diagnosis and Therapy ◽

10.1159/000515849 ◽

2021 ◽

pp. 1-8

Author(s):

Man Yan Chung ◽

Wing Cheong Leung ◽

Wing Ting Tse ◽

Yuen Ha Ting ◽

Kwok Ming Law ◽

...

Keyword(s):

Pleural Effusion ◽

Gestational Age ◽

Single Case ◽

Perinatal Outcomes ◽

In Utero ◽

Good Survival ◽

Pleural Effusions ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Live Births

Introduction: Fetal pleural effusion may require in utero shunting which is associated with procedure-related complications. Objective: To evaluate the efficacy and complications of the newly designed Somatex shunt in treating fetal pleural effusion. Methods: Consecutive cases with primary fetal pleural effusion who were treated with the Somatex shunt between 2018 and 2019 were evaluated. Perinatal outcomes and complications were retrospectively analyzed. Results: There were 6 cases of unilateral and 1 case of bilateral pleural effusion, and hence a total of 8 pleuroamniotic shunting procedures were performed. The median gestational age at diagnosis and shunting was 20.7 and 22.6 weeks, respectively. All 8 procedures were successful, achieving complete in utero drainage. All but one were live births (85.7%) with a median gestational age of 38 weeks. The single case of in utero death occurred 4.7 weeks after successful shunting, and no cause could be identified after autopsy. The rates of preterm birth and premature rupture of membranes were 33.3% (2/6) and 16.7% (1/6), respectively. Four of the 8 procedures (50%) had minor shunt-related complications such as dislodgement and entrapment, occurring at a median of 7.7 weeks after shunting. None of the shunts became blocked. Conclusions: The Somatex shunt is effective in relieving fetal pleural effusions with good survival rate. Overall, it was a safe instrument, though minor shunt complications occurred.

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Perinatal outcomes in women affected by different types of headache disorders: A prospective cohort study

Cephalalgia ◽

10.1177/03331024211029236 ◽

2021 ◽

pp. 033310242110292

Author(s):

Isabella Neri ◽

Daniela Menichini ◽

Francesca Monari ◽

Ludovica Spanò Bascio ◽

Federico Banchelli ◽

...

Keyword(s):

Migraine With Aura ◽

Gestational Age ◽

Small For Gestational Age ◽

Migraine Without Aura ◽

Perinatal Outcomes ◽

First Trimester ◽

Tension Type Headache ◽

Headache Disorders ◽

Aneuploidy Screening ◽

Type Headache

Objective This study aims to investigate pregnancy and perinatal outcomes in women with tension-type headache, migraine without aura and migraine with aura by comparing them to women without any headache disorders. Study design Prospective cohort study including singleton pregnancies attending the first trimester aneuploidy screening at the University Hospital of Modena, in Northern Italy, between June 2018 and December 2019. Results A total of 515 consecutive women were included and headache disorders were reported in 43.5% of them (224/515). Tension-type headache was diagnosed in 24.3% of the cases, while 14% suffered from migraine without aura and 5.2% from migraine with aura. Birthweight was significantly lower in women affected by migraine with aura respective to other groups, and a significantly higher rate of small for gestational age infants was found in tension-type headache (10.4%) and in migraine with aura (24.9%) groups respective to the others (p < 0.001). Moreover, the admission to the neonatal intensive care unit was significantly higher in all the headache groups (p = 0.012). Multivariate analysis showed that women presenting tension-type headache (OR 4.19, p = 0.004), migraine with aura (OR 5.37, p = 0.02), a uterine artery pulsatility index >90th centile (OR 3.66, p = 0.01), low multiple of the median (MoM) of Pregnancy-associated plasma protein-A (PAPP-A) (OR 0.48, p = 0.05) and high MoM of Inhibin-A (OR 3.24, p = 0.03) at first trimester, are independently associated with the delivery of small for gestational age infants when compared to women without headache disorders. Conclusion Migraine with aura and tension type headache expose women to an increased risk of delivering small for gestational age infants, in association with some utero-placenta markers evaluated at first trimester. These women with headache disorders have an additional indication to undergo first trimester aneuploidy screening and would possibly benefit from specific interventions.

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Prevalence of Language Delay among Healthy Preterm Children, Language Outcomes and Predictive Factors

Children ◽

10.3390/children8040282 ◽

2021 ◽

Vol 8 (4) ◽

pp. 282

Author(s):

Miguel Pérez-Pereira

Keyword(s):

Gestational Age ◽

Language Impairment ◽

Maternal Education ◽

Longitudinal Design ◽

Age Groups ◽

Full Term ◽

Language Delay ◽

Preterm Children ◽

General Terms ◽

Extremely Preterm

Language delay (LD) and its relationship with later language impairment in preterm children is a topic of major concern. Previous studies comparing LD in preterm (PT) and full-term (FT) children were mainly carried out with samples of extremely preterm and very preterm children (sometimes with additional medical problems). Very few of them were longitudinal studies, which is essential to understand developmental relationships between LD and later language impairment. In this study, we compare the prevalence of LD in low-risk preterm children to that of FT children in a longitudinal design ranging from 10 to 60 months of age. We also analyze which variables are related to a higher risk of LD at 22, 30 and 60 months of age. Different language tests were administered to three groups of preterm children of different gestational ages and to one group of full-term children from the ages of 10 to 60 months. ANOVA comparisons between groups and logistic regression analyses to identify possible predictors of language delay at 22, 30 and 60 months of age were performed. The results found indicate that there were practically no differences between gestational age groups. Healthy PT children, therefore, do not have, in general terms, a higher risk of language delay than FT children. Previous language delay and cognitive delay are the strongest and longest-lasting predictors of later language impairment. Other factors, such as a scarce use of gestures at 10 months or male gender, affect early LD at 22 months of age, although their effect disappears as children grow older. Low maternal education appears to have a late effect. Gestational age does not have any significant effect on the appearance of LD.

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Characteristics and adverse outcomes of Chinese adolescent pregnancies between 2012 and 2019

Scientific Reports ◽

10.1038/s41598-021-92037-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yanxia Xie ◽

Xiaodong Wang ◽

Yi Mu ◽

Zheng Liu ◽

Yanping Wang ◽

...

Keyword(s):

Adolescent Pregnancy ◽

Gestational Age ◽

Rural Areas ◽

Reference Group ◽

Perinatal Outcomes ◽

Severe Anaemia ◽

Adverse Outcomes ◽

Near Miss ◽

Adolescent Women ◽

Adolescent Pregnancies

AbstractWe aimed to describe the characteristics of adolescent pregnancy, determine its effect on adverse maternal and perinatal outcomes and explore whether that association varies with gestational age with the goal of proposing specific recommendations for adolescent health in China. This study included 2,366,559 women aged 10–24 years who had singleton pregnancies between 2012 and 2019 at 438 hospitals. Adolescent pregnancy was defined as younger than 20 years of age. We used multivariable logistic regression to estimate the effects. Women aged 20–24 years served as the reference group in all analyses. The proportion of rural girls with adolescent pregnancies rebounded after 2015 even though common-law marriage in rural areas decreased. Higher risks of eclampsia (adjusted odds ratio (aOR) 1.87, 95% confidence interval (CI) 1.57 ~ 2.23), severe anaemia (aOR 1.18, 95% CI 1.09 ~ 1.28), maternal near miss (MNM; aOR 1.24, 95% CI 1.12 ~ 1.37), and small for gestational age (SGA; aOR 1.30, 95% CI 1.28 ~ 1.33) were observed when gestational age was > 37 weeks. Adolescent pregnancy was independently associated with increased risks of other perinatal outcomes. Further implementation of pregnancy prevention strategies and improved health care interventions are needed to reduce adolescent pregnancies and prevent adverse fertility outcomes among adolescent women in China at a time when adolescent fertility rate is rebounding.

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Comparison of adverse perinatal outcomes between Asians and Caucasians: a population-based retrospective cohort study in Ontario

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03467-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Na Zeng ◽

Erica Erwin ◽

Wendy Wen ◽

Daniel J. Corsi ◽

Shi Wu Wen ◽

...

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Preterm Birth ◽

Cesarean Section ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Perinatal Outcomes ◽

Population Based ◽

Adverse Perinatal Outcomes

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.

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Protein demand in the premature neonate and in the small for gestational age full-term neonate

Early Human Development ◽

10.1016/s0378-3782(98)00061-9 ◽

1998 ◽

Vol 53 ◽

pp. S15-S21

Author(s):

Rafael Robles ◽

Narcisa Palomino

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Premature Neonate ◽

Full Term ◽

Term Neonate

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