The impact of Covid 19 on perinatal care

Changes in perinatal care occurring during the coronavirus disease 2019 (COVID-19) pandemic may negatively affect mothers’ mental health and breastfeeding. This study, performed between April and May 2020, aimed to investigate the effect of restricted partners’ visiting policies on non-infected mother’s anxiety symptoms, the perceived postpartum support, and the breastfeeding outcomes at discharge. A cross-sectional study was conducted in a neonatal tertiary referral center in northern Italy during Italy’s lockdown. We enrolled mothers with a negative nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), adequate oral and written comprehension of the Italian language, and absence of underlying maternal or neonatal clinical conditions. Maternal anxiety levels were assessed through the State-Trait Anxiety Inventory-Form Y (STAI-Y). Maternal perception of staff’s support was evaluated by the Nurse Parent Support Tool (NPST). A STATE-A (concurrent emotional state after a specific situation) score ≥ 40 was considered indicative of clinically significant symptoms of anxiety. A total of 109 mothers completed the study. Mean STATE-A score was ≥40 in 42% of mothers, and median NPST score was 4.23. Mothers separated from their partner had a mean STATE-A score ≥ 40 in a higher percentage of cases than those who were not (51% vs. 30%, p = 0.03) and a lower perception of caregiver support. A NPST score ≤4.23, partner ‘s absence during the hospital stay and primiparity were independently associated with a STATE-A score ≥ 40. Breastfeeding rates at discharge were not influenced by maternal anxiety levels and partner’s restricted policies. Instead, they were influenced by mode of delivery, a well-known risk factor, and pre-pandemic intention to breastfeed. Our study demonstrates the positive impact of a partner’s presence on maternal mental health and perception of caregiver support.

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Perinatal Care at the Threshold of Viability

PEDIATRICS ◽

10.1542/peds.96.5.974 ◽

1995 ◽

Vol 96 (5) ◽

pp. 974-976

Author(s):

◽

Keyword(s):

Perinatal Care ◽

Survival Rates ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

Term Outcome ◽

Long Term Outcome ◽

Obstetric Management ◽

The Cost ◽

The Impact

The survival rate for infants at the threshold of viability has been improving. However, there are insufficient data regarding the cost(s) of initial and ongoing care of these infants and the long-term outcome of survivors. Furthermore, there has been little study of the impact of obstetric management on the survival rates of extremely low birth weight infants and on long-term morbidities. Continued research on these issues is imperative, and physicians need to remain informed of changing statistics.

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Perinatal Profile of Twin Pregnancies: A Retrospective Review of 11 Years (1969–1979) at Hôpital Notre-Dame, Montréal, Canada

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000008242 ◽

1982 ◽

Vol 31 (3-4) ◽

pp. 157-163 ◽

Cited By ~ 6

Author(s):

Marie-Françoise Desgranges ◽

Xavier De Muylder ◽

Jean-Marie Moutquin ◽

Francisco Lazaro-Lopez ◽

Bernard Leduc

Keyword(s):

Perinatal Mortality ◽

Perinatal Care ◽

Fetal Mortality ◽

Ultrasound Technique ◽

Intrauterine Growth ◽

Before And After ◽

The Impact ◽

Second Period ◽

Twin Pregnancies ◽

Main Factor

Four hundred and thirty four twins occurring in 220 women were studied during a period of 11 years (1969–1979) at Notre-Dame Hospital.Perinatal mortality (< 28 days) was compared before and after 1974, and the impact of ultrasound technique upon perinatal outcome was assessed during the second period (1974–1979). The main factor associated with perinatal mortality was low birth weight caused by either prematurity or intrauterine growth retardation.While fetal mortality remained unchanged within the two study periods, neonatal mortality decreased from 68.2/1,000 to 28.9/1,000 mainly due to increased survival rate of twins below 1,500 g at birth.With identical perinatal care during the same period, perinatal mortality and incidence of intrauterine growth-retarded twins remained unchanged despite early diagnosis by ultrasound.

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Changing patterns in regionalization of perinatal care and the impact on neonatal mortality

American Journal of Obstetrics and Gynecology ◽

10.1016/s0002-9378(98)70639-8 ◽

1998 ◽

Vol 178 (1) ◽

pp. 131-135 ◽

Cited By ~ 76

Author(s):

John D. Yeast ◽

Mary Poskin ◽

Joseph W. Stockbauer ◽

Stanley Shaffer

Keyword(s):

Neonatal Mortality ◽

Perinatal Care ◽

Changing Patterns ◽

The Impact

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Study of Clinical Proﬁle of Neonatal Seizures in Level III NICU

Asian Journal of Clinical Pediatrics and Neonatology ◽

10.47009/ajcpn.2020.8.4.7 ◽

2020 ◽

Vol 8 (4) ◽

pp. 30-35

Author(s):

P. Anil Kumar ◽

V. Ramgopal Rao

Keyword(s):

Neurological Disorders ◽

Clinical Presentation ◽

Perinatal Care ◽

Birth Asphyxia ◽

Close Monitoring ◽

Neonatal Seizures ◽

Before And After ◽

Clonic Seizures ◽

The Impact ◽

Comprehensive History

Background: During the neonatal age, seizures are the most distinctive sign of neurological disease. Convulsive symptoms are the most promi- nent forms of neonatal neurological disorders. The goal of this research was to have a better view of the epidemiology, etiology, incidence, forms and mortality of neonatal seizures in our hospital. This research was undertaken to evaluate the prevalence, forms of neonatal seizures, etiology, occurrence period and correlation with etiology, and to establish the mortality correlated with neonatal seizures. For research the etiology and its etiological connection, the occurrence of neonatal seizures. Subjects and Methods: A comprehensive history was collected for the antenatal, natal, postnatal and family history. Age of initiation, form, duration and amount of seizures, consciousness before and after the seizures were taken. Comprehensive neonate examination was performed after detailed history. Relevant investigations were carried out depending upon clinical presentation. Results: In our analysis of 200 neonatal seizures, 194 had one of the four classically identified neonatal seizures. Multifocal clonic seizures were among the most common type of seizures 36% (72 cases) followed by subtle 27% (54 cases), GTS 26% (52 cases), Myoclonic 7% (15 cases), mixed type of seizures 3% (6 cases) and focal clonic seizures 1% (2 cases). Conclusion: Because neonatal seizures are most frequently due to birth asphyxia, better antenatal and perinatal care reduces birth asphyxia and if mothers are identified as high-risk. The impact of neonatal seizures is thereby minimized. Subtle seizures are the most frequent form of psychiatric seizure; thus, close monitoring of newborns at risk is important.

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Hormonal Biomarkers for Evaluating the Impact of Fetal Growth Restriction on the Development of Chronic Adult Disease

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1683904 ◽

2019 ◽

Vol 41 (04) ◽

pp. 256-263 ◽

Cited By ~ 3

Author(s):

Elizabeth Magalhães ◽

Maria Méio ◽

Maria Moreira

Keyword(s):

Fetal Growth ◽

Developmental Plasticity ◽

Perinatal Care ◽

Growth Patterns ◽

Growth Restriction ◽

Fetal Origins ◽

Environmental Signals ◽

Adult Disease ◽

Thrifty Phenotype ◽

The Impact

AbstractThe hypothesis of fetal origins to adult diseases proposes that metabolic chronic disorders, including cardiovascular diseases, diabetes, and hypertension originate in the developmental plasticity due to intrauterine insults. These processes involve an adaptative response by the fetus to changes in the environmental signals, which can promote the reset of hormones and of the metabolism to establish a “thrifty phenotype”. Metabolic alterations during intrauterine growth restriction can modify the fetal programming. The present nonsystematic review intended to summarize historical and current references that indicated that developmental origins of health and disease (DOHaD) occur as a consequence of altered maternal and fetal metabolic pathways. The purpose is to highlight the potential implications of growth factors and adipokines in “developmental programming”, which could interfere in the development by controlling fetal growth patterns. These changes affect the structure and the functional capacity of various organs, including the brain, the kidneys, and the pancreas. These investigations may improve the approach to optimizing antenatal as well as perinatal care aimed to protect newborns against long-term chronic diseases.

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Controlled Evaluation of Rural Regional Perinatal Care: Developmental and Neurologic Outcomes at 1 Year

PEDIATRICS ◽

10.1542/peds.77.2.187 ◽

1986 ◽

Vol 77 (2) ◽

pp. 187-195 ◽

Cited By ~ 2

Author(s):

Earl Siegel ◽

Dennis Gillings ◽

Suzann Campbell ◽

Priscilla Guild

Keyword(s):

High Risk ◽

Physical Health ◽

Control Region ◽

Professional Education ◽

Perinatal Care ◽

Newborn Infants ◽

Receptive Language ◽

Policy Implications ◽

Study Region ◽

The Impact

The effectiveness of a rural regionalized perinatal care (RPC) program was evaluated by a controlled, population-based design. The RPC program, begun in a carefully selected study region in July 1975, evolved into a system of care which included the following major components: identification of high-risk pregnancies and high-risk newborn infants; obstetric and newborn consultation and referral services between Level I, II, and III centers; professional education for physicians, nurses, and other health professionals; and nutrition and social work consultation. Substantial resources were made available from 1975 to 1980 to implement this "total package" of RPC. A matched, control region was identified which, except for the RPC program, was as comparable as possible to the study region. It was hypothesized that the RPC intervention would have the following effects when the study region was compared with the control region: reduction in fetal and neonatal mortality, no increase in postneonatal mortality, and reduction in obstetric and newborn morbidity. These findings were reported previously. This paper presents results of hypothesized reductions in adverse developmental, neurologic, maternal-infant attachment, and selected physical health outcomes. A sample of 447 infants was assessed by an extensive battery of instruments at 1 year, adjusted for gestational age. The most notable findings were mothers' reports of receptive language development and observations of maternal attachment behaviors that significantly favored the study region. No significant differences between study and control regions were observed for Bayley Mental and Motor Scores, abnormal neurologic signs, and the physical health measures. The impact of rural RPC in North Carolina on the 1-year outcomes is discussed and policy implications are presented.

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Impact of physiotherapy on neuromotor development of premature newborns

Fisioterapia em Movimento ◽

10.1590/0103-5150.027.003.ao12 ◽

2014 ◽

Vol 27 (3) ◽

pp. 413-420 ◽

Cited By ~ 2

Author(s):

Giselle Athayde Xavier Coutinho ◽

Daniela de Mattos Lemos ◽

Antônio Prates Caldeira

Keyword(s):

Preterm Infants ◽

Motor Development ◽

Perinatal Care ◽

Monitoring Program ◽

Full Term ◽

Control Group ◽

Term Infants ◽

Significance Level ◽

The Impact ◽

Neuromotor Development

Introduction The population of children born prematurely has increased in line with improving the quality of perinatal care. It is essential to ensure to these children a healthy development. Objective We evaluate the neuromotor development of a group of preterm infants regularly assisted by a physiotherapy service in comparison to full-term newborns, checking, so the impact of the service. Materials and methods We randomly assigned preterm and full-term infants that formed two distinct groups. The group of preterm infants was inserted into a monitoring program of physiotherapy while the other infants were taken as a control group not receiving any assistance in physiotherapy. The groups were compared using the Alberta Infant Motor Scale (AIMS) at forty-week, four and six months of corrected gestational age and the scores were compared using Student's t-test, assuming a significance level of 5% (p < 0.05). Results The preterm group had significantly lower scores at 40th week compared to the control group, but subsequent scores showed no significant differences between the two groups. Conclusion The timely and adequate stimulation was efficient to promote the motor development of premature infants included in a follow up clinic.

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Street drug use during pregnancy: potential programming effects on preschool wheeze

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174412000670 ◽

2012 ◽

Vol 4 (2) ◽

pp. 191-199 ◽

Cited By ~ 3

Author(s):

M. E. Alton ◽

S. C. Tough ◽

P. J. Mandhane ◽

A. L. Kozyrskyj

Keyword(s):

Alcohol Use ◽

Drug Use ◽

Perinatal Care ◽

Maternal Distress ◽

Substance Abusing ◽

Prenatal Programming ◽

Questionnaire Data ◽

Independent Association ◽

The Impact

Street drug use during pregnancy is detrimental to fetal development. Although the prevalence of wheeze is high in offspring of substance-abusing mothers, nothing is known about the role of street drug use during pregnancy in its development. We investigated the impact of maternal street drug use and distress during pregnancy on the development of wheeze and allergy in preschool children. Questionnaire data were accessed from the Community Perinatal Care trial of 791 mother–child pairs in Calgary, Alberta. Using logistic regression, the association between maternal substance use and distress during pregnancy, and wheeze and allergy at age 3 years was determined in boys and girls. After adjusting for alcohol use during pregnancy, pre- and postnatal tobacco use, preterm birth, duration of exclusive breastfeeding, daycare attendance and maternal socioeconomic status, maternal street drug use during pregnancy [odds ratio (OR): 5.02, 95% confidence interval (CI): 1.30–19.4] and severe maternal distress during pregnancy (OR: 5.79, 95% CI: 1.25–26.8) were associated with wheeze in girls. In boys, an independent association was found between severe distress during pregnancy (OR: 3.85, 95% CI: 1.11–13.3) and allergies, but there was no association with maternal street drug use. In conclusion, we found an association between maternal street drug use and wheeze in preschool girls that could not be accounted for by maternal distress, smoking or alcohol use during pregnancy. Prenatal programming effects of street drugs may explain this association.

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Identifying ‘at risk’ women and the impact of maternal obesity on National Health Service maternity services

Proceedings of The Nutrition Society ◽

10.1017/s0029665111001625 ◽

2011 ◽

Vol 70 (4) ◽

pp. 439-449 ◽

Cited By ~ 19

Author(s):

Nicola Heslehurst

Keyword(s):

Maternal Obesity ◽

Perinatal Care ◽

Epidemiological Data ◽

Health Concern ◽

Individual Choice ◽

National Guidelines ◽

Maternity Services ◽

Published Evidence ◽

Increased Risk ◽

The Impact

Obesity is a public health concern worldwide, arising from multifaceted and complex causes that relate to individual choice and lifestyle, and the influences of wider society. In addition to a long-standing focus on both childhood and adult obesity, there has been more recent concern relating to maternal obesity. This review explores the published evidence relating to maternal obesity incidence and associated inequalities, the impact of obesity on maternity services, and associated guidelines. Epidemiological data comprising three national maternal obesity datasets within the UK have identified a significant increase in maternal obesity in recent years, and reflect broad socio-demographic inequalities particularly deprivation, ethnicity and unemployment. Obese pregnancies present increased risk of complications that require more resource intensive antenatal and perinatal care, such as caesarean deliveries, gestational diabetes, haemorrhage, infections and congenital anomalies. Healthcare professionals also face difficulties when managing the care of women in pregnancy as obesity is an emotive and stigmatising topic. There is a lack of good-quality evidence for effective interventions to tackle maternal obesity. Recently published national guidelines for the clinical management and weight management of maternal obesity offer advice for professionals, but acknowledge the limitations of the evidence base. The consequence of these difficulties is an absence of support services available for women. Further evaluative research is thus required to assess the effectiveness of interventions with women before, during and after pregnancy. Qualitative work with women will also be needed to help inform the development of more sensitive risk communication and women-centred services.

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