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Kashani-Ligumsky L, Neiger R, Segal E, Cohen R, Lopian M. Is Parity a Risk Factor for Late Preterm Birth? Results from a Large Cohort Study. J Clin Med 2024; 13:429. [PMID: 38256563 PMCID: PMC10816547 DOI: 10.3390/jcm13020429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Most preterm births occur in the late preterm period. While prematurity-related adverse outcomes are significantly diminished when birth occurs during this period, these infants are still at increased risk of complications. Parity affects the incidence of obstetric complications. The purpose of this study was to determine whether parity impacts the risk of spontaneous late preterm birth (SLPTB) and associated complications. A retrospective observational cohort study was conducted. Patients were divided into three study groups according to parity. The primary outcome was the rate of SLPTB in each group. Secondary outcomes were unplanned cesarean delivery (UCD), prolonged third stage of labor respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), intraventricular hemorrhage (IVH), neonatal hypoglycemia, duration of NICU admission, neonatal death, and composite adverse neonatal outcome (CANO). Primiparas were more likely to have SLPTB, UCD, and CANO compared to multiparas (2.6% vs. 1.9% OR 1.5 [1.3-1.7] p < 0.01) (4.1% vs. 1.3% OR 2.7 [1.2, 5.9] p < 0.01) (8.5% vs. 4.2 OR 2.1 [1.3-3.5] p = 0.002) and grandmultiparas (2.6% vs. 1.7% OR 1.4 [1.2-1.5] p < 0.001) 8.5% vs. 4.4% OR 2.0 [1.1, 3.8], p = 0.01) but no difference in UCD compared to grandmultiparas (4.1% vs. 3.3% OR 1.2 [0.6-2.7] p = 0.28). Primiparas are at increased risk of SLPTB and UCD, and this is accompanied by an increased risk of adverse neonatal outcomes.
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Affiliation(s)
- Lior Kashani-Ligumsky
- Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak 51544, Israel; (L.K.-L.); (R.C.)
- Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Ran Neiger
- Department of Obstetrics and Gynecology, University of South Carolina, Columbia, SC 29208, USA;
| | - Ella Segal
- Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Ronnie Cohen
- Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak 51544, Israel; (L.K.-L.); (R.C.)
- Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Miriam Lopian
- Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak 51544, Israel; (L.K.-L.); (R.C.)
- Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Yoshida-Montezuma Y, Kirkwood D, Sivapathasundaram B, Keown-Stoneman CDG, de Souza RJ, To T, Borkhoff CM, Birken CS, Maguire JL, Brown HK, Anderson LN. Late preterm birth and growth trajectories during childhood: a linked retrospective cohort study. BMC Pediatr 2023; 23:450. [PMID: 37684561 PMCID: PMC10485950 DOI: 10.1186/s12887-023-04257-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Evidence suggests that accelerated postnatal growth in children is detrimental for adult cardiovascular health. It is unclear whether children born late preterm (34-36 weeks) compared to full term (≥ 39 weeks), have different growth trajectories. Our objective was to evaluate the association between gestational age groups and growth trajectories of children born between 2006-2014 and followed to 2021 in Ontario, Canada. METHODS We conducted a retrospective cohort study of children from singleton births in TARGet Kids! primary care network with repeated measures of weight and height/length from birth to 14 years, who were linked to health administrative databases. Piecewise linear mixed models were used to model weight (kg/month) and height (cm/month) trajectories with knots at 3, 12, and 84 months. Analyses were conducted based on chronological age. RESULTS There were 4423 children included with a mean of 11 weight and height measures per child. The mean age at the last visit was 5.9 years (Standard Deviation: 3.1). Generally, the more preterm, the lower the mean value of weight and height until early adolescence. Differences in mean weight and height for very/moderate preterm and late preterm compared to full term were evident until 12 months of age. Weight trajectories were similar between children born late preterm and full term with small differences from 84-168 months (mean difference (MD) -0.04 kg/month, 95% CI -0.06, -0.03). Children born late preterm had faster height gain from 0-3 months (MD 0.70 cm/month, 95% CI 0.42, 0.97) and 3-12 months (MD 0.17 cm/month, 95% CI 0.11, 0.22). CONCLUSIONS Compared to full term, children born late preterm had lower average weight and height from birth to 14 years, had a slightly slower rate of weight gain after 84 months and a faster rate of height gain from 0-12 months. Follow-up is needed to determine if growth differences are associated with long-term disease risk.
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Affiliation(s)
- Yulika Yoshida-Montezuma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, ON, L8S 4L8, Canada
| | | | | | - Charles D G Keown-Stoneman
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, ON, L8S 4L8, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Population Health Research Institute, Hamilton Health Sciences Corporation, Hamilton, ON, Canada
| | - Teresa To
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- ICES, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Cornelia M Borkhoff
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Women's College Research Institute, Toronto, ON, Canada
- Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Catherine S Birken
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Jonathon L Maguire
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
- Population Health Research Institute, Hamilton Health Sciences Corporation, Hamilton, ON, Canada
- Department of Pediatrics, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- ICES, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Women's College Research Institute, Toronto, ON, Canada
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street W, Hamilton, ON, L8S 4L8, Canada.
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
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Yoshida-Montezuma Y, Sivapathasundaram B, Brown HK, Keown-Stoneman C, de Souza RJ, To T, Borkhoff CM, Birken CS, Maguire JL, Anderson LN. Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood. JAMA Netw Open 2022; 5:e2214379. [PMID: 35622362 PMCID: PMC9142868 DOI: 10.1001/jamanetworkopen.2022.14379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE The long-term cardiometabolic consequences of late preterm birth (34-36 weeks' gestation) are not well understood. OBJECTIVE To assess whether late preterm birth and size for gestational age are associated with cardiometabolic risk (CMR) in childhood. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study included 1742 children born in Ontario, Canada, between April 1, 2006, and September 30, 2014, and followed up until September 30, 2019. Data from children enrolled in The Applied Research Group for Kids (TARGet Kids!) primary care practice-based research network were linked to administrative health care data at ICES (formerly known as the Institute for Clinical Evaluative Sciences). Participants were excluded if they had conditions affecting growth (eg, failure to thrive or cystic fibrosis), any acute or chronic conditions (other than asthma and high-functioning autism), severe developmental delay, or families who were unable to communicate in English. EXPOSURES Late preterm birth, gestational age as a continuous measure, and size for gestational age. MAIN OUTCOMES AND MEASURES The primary outcome was composite CMR score (overall age- and sex-standardized z score of CMR components, including waist circumference, log triglyceride level, glucose level, systolic blood pressure, and high-density lipoprotein cholesterol level). Secondary outcomes were the individual CMR components. Multivariable linear regression analysis was used to separately evaluate the associations of late preterm birth, continuous gestational age, and size for gestational age with CMR at ages 3 to 12 years. RESULTS Among 2440 eligible children, 1742 (mean [SD] age, 5.6 [2.2] years; 951 boys [54.6%]) were included in the final cohort. Overall, 87 children (5.0%) were born moderately preterm (<34 weeks' gestation), 145 (8.3%) were born late preterm (34-36 weeks' gestation), 455 (26.1%) were born early term (37-38 weeks' gestation), and 1055 (60.6%) were born full term (≥39 weeks' gestation). Compared with children born full term, those born moderately preterm (adjusted β = 0.50; 95% CI, 0.24-0.75) and late preterm (adjusted β = 0.27; 95% CI, 0.06-0.47) had higher CMR scores. Each additional gestational week was associated with a 0.06 U (adjusted β; 95% CI, -0.08 to -0.03 U) decrease in CMR. CONCLUSIONS AND RELEVANCE In this study, children born late preterm and moderately preterm had higher CMR. These results suggest that screening and early-life interventions for these children may prevent cardiometabolic outcomes.
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Affiliation(s)
- Yulika Yoshida-Montezuma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Branavan Sivapathasundaram
- ICES (formerly the Institute for Clinical Evaluative Sciences), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Hilary K. Brown
- ICES (formerly the Institute for Clinical Evaluative Sciences), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
- Women’s College Research Institute, Toronto, Ontario, Canada
| | - Charles Keown-Stoneman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Russell J. de Souza
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada
| | - Teresa To
- ICES (formerly the Institute for Clinical Evaluative Sciences), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Cornelia M. Borkhoff
- Women’s College Research Institute, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S. Birken
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L. Maguire
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, St Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Laura N. Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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Yoshida‐Montezuma Y, Stone E, Iftikhar S, De Rubeis V, Andreacchi AT, Keown‐Stoneman C, Mbuagbaw L, Brown HK, de Souza RJ, Anderson LN. The association between late preterm birth and cardiometabolic conditions across the life course: A systematic review and meta-analysis. Paediatr Perinat Epidemiol 2022; 36:264-275. [PMID: 34806197 PMCID: PMC9299497 DOI: 10.1111/ppe.12831] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The effect of being born late preterm (34-36 weeks gestation) on cardiometabolic outcomes across the life course is unclear. OBJECTIVES To systematically review the association between being born late preterm (spontaneous or indicated), compared to the term and cardiometabolic outcomes in children and adults. DATA SOURCES EMBASE(Ovid), MEDLINE(Ovid), CINAHL. STUDY SELECTION AND DATA EXTRACTION Observational studies up to July 2021 were included. Study characteristics, gestational age, cardiometabolic outcomes, risk ratios (RRs), odds ratios (ORs), hazard ratios (HRs), mean differences and 95% confidence intervals (CIs) were extracted. SYNTHESIS We pooled converted RRs using random-effects meta-analyses for diabetes, hypertension, ischemic heart disease (IHD) and body mass index (BMI) with subgroups for children and adults. The risk of bias was assessed using the Newcastle-Ottawa scale and certainty of the evidence was assessed using the grading of recommendations, assessment, development and evaluation (GRADE) approach. RESULTS Forty-one studies were included (41,203,468 total participants; median: 5.0% late preterm). Late preterm birth was associated with increased diabetes (RR 1.24, 95% CI 1.17, 1.32; nine studies; n = 6,056,511; incidence 0.9%; I2 51%; low certainty) and hypertension (RR 1.21, 95% CI 1.13, 1.30; 11 studies; n = 3,983,141; incidence 3.4%; I2 64%; low certainty) in children and adults combined. Late preterm birth was associated with decreased BMI z-scores in children (standard mean difference -0.38; 95% CI -0.67, -0.09; five studies; n = 32,602; proportion late preterm 8.3%; I2 96%; very low certainty). There was insufficient evidence that late preterm birth was associated with increased IHD risk in adults (HR 1.20, 95% CI 0.89, 1.62; four studies; n = 2,706,806; incidence 0.3%; I2 87%; very low certainty). CONCLUSIONS Late preterm birth was associated with an increased risk of diabetes and hypertension. The certainty of the evidence was low or very low. Inconsistencies in late preterm and term definitions, confounding variables and outcome age limited the comparability of studies.
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Affiliation(s)
- Yulika Yoshida‐Montezuma
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada
| | - Erica Stone
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada
| | - Saman Iftikhar
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada
| | - Vanessa De Rubeis
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada
| | - Alessandra T. Andreacchi
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada
| | - Charles Keown‐Stoneman
- Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoOntarioCanada,Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada,Biostatistics UnitFather Sean O’Sullivan Research CentreSt Joseph’s Healthcare HamiltonHamiltonOntarioCanada,Centre for the Development of Best Practices in HealthYaoundéCameroon,Department of Global HealthStellenbosch UniversityStellenboschSouth Africa
| | - Hilary K. Brown
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada,Department of Health & SocietyUniversity of Toronto ScarboroughTorontoOntarioCanada,Women’s College Research InstituteTorontoOntarioCanada
| | - Russell J. de Souza
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada,Population Health Research InstituteHamilton Health Sciences CorporationHamiltonOntarioCanada
| | - Laura N. Anderson
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonOntarioCanada,Child Health Evaluative SciencesThe Hospital for Sick ChildrenTorontoOntarioCanada
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5
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Murphy MSQ, Fell DB, Sprague AE, Corsi DJ, Dougan S, Dunn SI, Holmberg V, Huang T, Johnson M, Kotuba M. Data Resource Profile: Better Outcomes Registry & Network (BORN) Ontario. Int J Epidemiol 2021; 50:1416-1417h. [PMID: 34097034 PMCID: PMC8580270 DOI: 10.1093/ije/dyab033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Malia S Q Murphy
- OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Deshayne B Fell
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Canada
| | - Ann E Sprague
- BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Daniel J Corsi
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Canada
| | - Shelley Dougan
- BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Sandra I Dunn
- BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Vivian Holmberg
- BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Tianhua Huang
- BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Moya Johnson
- BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Michael Kotuba
- BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, Canada
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6
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Yasseen III AS, Bassil K, Sprague A, Urquia M, Maguire JL. Late preterm birth and previous cesarean section: a population-based cohort study. J Matern Fetal Neonatal Med 2018; 32:2400-2407. [DOI: 10.1080/14767058.2018.1438397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Abdool S. Yasseen III
- Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kate Bassil
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Toronto Public Health, Toronto, Canada
| | - Ann Sprague
- Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Marcelo Urquia
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
| | - Jonathon L. Maguire
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- Department of Pediatrics, St. Michael’s Hospital, Toronto, Canada
- Department of Pediatrics, University of Toronto, Toronto, Canada
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Bouchet N, Gayet-Ageron A, Lumbreras Areta M, Pfister RE, Martinez de Tejada B. Avoiding late preterm deliveries to reduce neonatal complications: an 11-year cohort study. BMC Pregnancy Childbirth 2018; 18:17. [PMID: 29310615 PMCID: PMC5759878 DOI: 10.1186/s12884-017-1650-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 12/28/2017] [Indexed: 02/02/2023] Open
Abstract
Background Late preterm (LPT) newborns, defined as those born between 34 0/7 and 36 6/7 gestational weeks, have higher short- and long-term morbidity and mortality than term infants (≥37 weeks). A categorization to justify a non-spontaneous LPT delivery has been proposed to distinguish evidence-based from non-evidence-based criteria. This study aims to describe rates and temporal trends of non-spontaneous LPT neonates delivered according to evidence-based or non-evidence-based criteria and to evaluate the number of avoidable LPT deliveries, including severe neonatal morbidity rates and associated risk factors. Methods Retrospective cohort study including all LPT neonates born at a Swiss university maternity unit between January 1, 2002 and December 31, 2012. Trends of LPT neonates and neonatal complications were assessed across time using Poisson regression and risk factors for neonatal complications by logistic regression. Results Among 40,609 singleton live births, 4223 (10.5%) were preterm and 2017 (4.9%) LPT. In the latter group, 26.2% were non-spontaneous (evidence-based: 12.0%; non-evidence-based: 14.2%). The most frequent indications for evidence-based non-spontaneous LPT delivery were severe preeclampsia (51.8%) and abnormal fetal tracing (24.7%). Indications for non-evidence-based non-spontaneous LPT deliveries were hemorrhage (36.2%) and mild preeclampsia (15.7%). LPT birth rates remained stable over time. The rate of neonatal complications after non-evidence-based LPT birth remained high over time (43.8% vs. 43.5% in 2002 and 2012, respectively; P = 0.645), whereas the annual proportion of neonatal complications overall showed a decreasing trend (from 38.0% in 2002 to 33.5% in 2012; P = 0.051). Conclusions LPT birth rates were stable over time, but neonatal complications remained high, particularly after non-evidence-indicated LPT birth. A total of 287 LPT births could have been potentially avoided if an evidence-based protocol for delivery indications had been used. Efforts should be made to avoid non-spontaneous LPT births in order to reduce neonatal complications.
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Affiliation(s)
- Noémie Bouchet
- Obstetrics Unit, Department of Obstetrics and Gynecology, Geneva University Hospitals and Faculty of Medicine, 30 Boulevard de la Cluse, 1205, Geneva, Switzerland
| | - Angèle Gayet-Ageron
- Clinical Research Centre and Division of Clinical Epidemiology, Department of Community Health and Medicine, Geneva University Hospitals and Faculty of Medicine, 6 rue Gabrielle-Perret-Gentil, 1205, Geneva, Switzerland
| | - Marina Lumbreras Areta
- Obstetrics Unit, Department of Obstetrics and Gynecology, Geneva University Hospitals and Faculty of Medicine, 30 Boulevard de la Cluse, 1205, Geneva, Switzerland
| | - Riccardo Erennio Pfister
- Neonatology Unit, Department of Pediatrics, Geneva University Hospitals and Faculty of Medicine, 30 Boulevard de la Cluse, 1205, Geneva, Switzerland
| | - Begoña Martinez de Tejada
- Obstetrics Unit, Department of Obstetrics and Gynecology, Geneva University Hospitals and Faculty of Medicine, 30 Boulevard de la Cluse, 1205, Geneva, Switzerland.
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8
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Downes KL, Grantz KL, Shenassa ED. Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review. Am J Perinatol 2017; 34:935-957. [PMID: 28329897 PMCID: PMC5683164 DOI: 10.1055/s-0037-1599149] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption. Results A total of 123 studies were included. Abruption was associated with elevated risk of cesarean delivery, postpartum hemorrhage and transfusion, preterm birth, intrauterine growth restriction or low birth weight, perinatal mortality, and cerebral palsy. Additional maternal outcomes included relaparotomy, hysterectomy, sepsis, amniotic fluid embolism, venous thromboembolism, acute kidney injury, and maternal intensive care unit admission. Additional perinatal outcomes included acidosis, encephalopathy, severe respiratory disorders, necrotizing enterocolitis, acute kidney injury, need for resuscitation, chronic lung disease, infant death, and epilepsy. Conclusion Few studies examined outcomes beyond the initial birth period, but there is evidence that both mother and child are at risk of additional adverse outcomes. There was also considerable variation in, or absence of, the reporting of abruption definitions.
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Affiliation(s)
- Katheryne L. Downes
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
- Maternal and Child Health Program, University of Maryland, College Park, Maryland
- Department of Obstetrics and Gynecology, Center for Research in Reproduction and Women’s Health, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Katherine L. Grantz
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Edmond D. Shenassa
- Maternal and Child Health Program, University of Maryland, College Park, Maryland
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland
- Department of Epidemiology and Biostatistics, University of Maryland, Baltimore, Maryland
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9
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Tabet M, Jakhar S, Williams CA, Rawat U, Hailegiorgis YD, Flick LH, Chang JJ. Racial/Ethnic Differences in Correlates of Spontaneous and Medically-Indicated Late Preterm Births among Adolescents. J Pediatr Adolesc Gynecol 2017; 30:63-70. [PMID: 27543000 DOI: 10.1016/j.jpag.2016.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 08/03/2016] [Accepted: 08/06/2016] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE To investigate the racial/ethnic differences in the correlates of spontaneous and medically-indicated late preterm birth (LPTB), defined as deliveries between 34 0/7 and 36 6/7 weeks gestation, among US adolescents. DESIGN Population-based, retrospective cohort study. SETTING Births in the United States to adolescents in 2012. PARTICIPANTS Adolescents (younger than 20 years; n = 171,573) who delivered nonanomalous singleton first births between 34 and 44 weeks of gestation. INTERVENTIONS AND MAIN OUTCOME MEASURES Bivariate and multivariable logistic regression were used to evaluate the associations between maternal risk factors and spontaneous and medically-indicated LPTB, stratified according to maternal race/ethnicity. RESULTS Risk factors for spontaneous LPTB included single marital status among Asian adolescents; no insurance coverage among whites, Asian, and Hispanic adolescents; inadequate prenatal care among all racial/ethnic groups except American Indian, and adequate plus prenatal care among all races/ethnicities; prenatal smoking among whites and black adolescents; insufficient gestational weight gain among all racial/ethnic groups except American Indian; and prepregnancy underweight among white, black, and Hispanic adolescents. Risk factors for medically-indicated LPTB included inadequate prenatal care among white, black, and Hispanic adolescents, and adequate plus prenatal care among all racial/ethnic groups except Asian; insufficient gestational weight gain among white, black, and Hispanic adolescents; and prepregnancy overweight and obesity among white, black, and Hispanic adolescents. CONCLUSION Our results show racial/ethnic differences in the correlates of spontaneous and medically-indicated LPTB among US adolescents and support the need for risk-specific interventions among different racial/ethnic groups.
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Affiliation(s)
- M Tabet
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - S Jakhar
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - C A Williams
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - U Rawat
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - Y D Hailegiorgis
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - L H Flick
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
| | - J J Chang
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri.
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10
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Suzuki K, Goto A, Fujimori K. Effect of medical institution change on gestational duration after the Great East Japan Earthquake: The Fukushima Health Management Survey. J Obstet Gynaecol Res 2016; 42:1704-1711. [PMID: 27528440 DOI: 10.1111/jog.13102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 05/04/2016] [Accepted: 06/14/2016] [Indexed: 12/13/2022]
Abstract
AIM The aim of this study was to examine the association between medical institution change for perinatal care and gestational duration after the Great East Japan Earthquake using data from the Fukushima Health Management Survey. METHODS The data of pregnant women who experienced the earthquake in Fukushima prefecture and participated in the Pregnancy and Birth Survey as part of the Fukushima Health Management Survey were analyzed. The primary and secondary outcomes of this study were gestational duration and preterm birth, respectively. The main study factor was prenatal checkup institution (only one institution, changed institution due to self-referral, changed institution due to medical indication, and went to parents' home for childbirth). Self-referral was considered as indicative of relocation after the disaster. Multiple linear and logistic regression analyses were conducted to examine the effect of earthquake on each outcome. RESULTS A total of 5593 (60.2%) participants experienced the earthquake between the 4th and 37th weeks of their gestational period. After controlling for variables, pregnant women who changed their perinatal checkup institution due to medical indication were significantly associated with shorter gestational duration (β = -10.6, P < 0.001) and preterm birth (adjusted odds ratio, 8.5; 95% confidence interval, 5.8-12.5) compared with women who visited only one institution. Self-referral, however, was not significantly associated with the outcomes. CONCLUSION According to prenatal checkup status, our results suggest that the effect on gestational duration of the Great East Japan Earthquake and the subsequent Fukushima Daiichi nuclear disaster was not significant.
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Affiliation(s)
- Kohta Suzuki
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Aya Goto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.,Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Keiya Fujimori
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.,Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
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11
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Teng SW, Lee WL, Li YT. An echo of an important but often neglected issue-late preterm births. Taiwan J Obstet Gynecol 2015; 54:213. [PMID: 25951736 DOI: 10.1016/j.tjog.2014.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2014] [Indexed: 10/23/2022] Open
Affiliation(s)
- Sen-Wen Teng
- Department of Obstetrics and Gynecology, Cardinal Tien Hospital-Hsintien, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Wen-Ling Lee
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan; Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Yiu-Tai Li
- Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan.
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12
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Wang PHP, Chen CY, Lee CN. Late preterm births: an important issue but often neglected. Taiwan J Obstet Gynecol 2015; 53:285-6. [PMID: 25286778 DOI: 10.1016/j.tjog.2014.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2014] [Indexed: 11/24/2022] Open
Affiliation(s)
- Peng-Hui Peter Wang
- Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research, China Medical University, Taichung, Taiwan.
| | - Chih-Yao Chen
- Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Nan Lee
- Department of Obstetrics and Gynecology, National Taiwan University, Hospital and National Taiwan University, Taipei, Taiwan
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13
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Byrnes J, Mahoney R, Quaintance C, Gould JB, Carmichael S, Shaw GM, Showen A, Phibbs C, Stevenson DK, Wise PH. Spatial and temporal patterns in preterm birth in the United States. Pediatr Res 2015; 77:836-44. [PMID: 25760546 DOI: 10.1038/pr.2015.55] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 11/26/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Despite years of research, the etiologies of preterm birth remain unclear. In order to help generate new research hypotheses, this study explored spatial and temporal patterns of preterm birth in a large, total-population dataset. METHODS Data on 145 million US births in 3,000 counties from the Natality Files of the National Center for Health Statistics for 1971-2011 were examined. State trends in early (<34 wk) and late (34-36 wk) preterm birth rates were compared. K-means cluster analyses were conducted to identify gestational age distribution patterns for all US counties over time. RESULTS A weak association was observed between state trends in <34 wk birth rates and the initial absolute <34 wk birth rate. Significant associations were observed between trends in <34 wk and 34-36 wk birth rates and between white and African American <34 wk births. Periodicity was observed in county-level trends in <34 wk birth rates. Cluster analyses identified periods of significant heterogeneity and homogeneity in gestational age distributional trends for US counties. CONCLUSION The observed geographic and temporal patterns suggest periodicity and complex, shared influences among preterm birth rates in the United States. These patterns could provide insight into promising hypotheses for further research.
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Affiliation(s)
- John Byrnes
- Artificial Intelligence Center, SRI International, San Diego, California
| | | | - Cele Quaintance
- 1] Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California [2] March of Dimes Center for Prematurity Research at Stanford, Stanford University School of Medicine, Stanford, California
| | - Jeffrey B Gould
- 1] Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California [2] March of Dimes Center for Prematurity Research at Stanford, Stanford University School of Medicine, Stanford, California
| | - Suzan Carmichael
- 1] Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California [2] March of Dimes Center for Prematurity Research at Stanford, Stanford University School of Medicine, Stanford, California
| | - Gary M Shaw
- 1] Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California [2] March of Dimes Center for Prematurity Research at Stanford, Stanford University School of Medicine, Stanford, California
| | - Amy Showen
- David Geffen School of Medicine, University of California, Los Angeles, California
| | - Ciaran Phibbs
- 1] Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California [2] March of Dimes Center for Prematurity Research at Stanford, Stanford University School of Medicine, Stanford, California
| | - David K Stevenson
- 1] Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California [2] March of Dimes Center for Prematurity Research at Stanford, Stanford University School of Medicine, Stanford, California
| | - Paul H Wise
- 1] Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California [2] March of Dimes Center for Prematurity Research at Stanford, Stanford University School of Medicine, Stanford, California [3] Center for Policy, Outcomes and Prevention, Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, Stanford, California
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14
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Pike KC, Lucas JSA. Respiratory consequences of late preterm birth. Paediatr Respir Rev 2015; 16:182-8. [PMID: 25554628 DOI: 10.1016/j.prrv.2014.12.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/03/2014] [Accepted: 12/03/2014] [Indexed: 11/30/2022]
Abstract
In developed countries most preterm births occur between 34 and 37 weeks' gestation. Deliveries during this 'late preterm' period are increasing and, since even mild prematurity is now recognised to be associated with adverse health outcomes, this presents healthcare challenges. Respiratory problems associated with late preterm birth include neonatal respiratory distress, severe RSV infection and childhood wheezing. Late preterm birth prematurely interrupts in utero lung development and is associated with maternal and early life factors which adversely affect the developing respiratory system. This review considers 1) mechanisms underlying the association between late preterm birth and impaired respiratory development, 2) respiratory morbidity associated with late preterm birth, particularly long-term outcomes, and 3) interventions which might protect respiratory development by addressing risk factors affecting the late preterm population, including maternal smoking, early life growth restriction and vulnerability to viral infection.
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Affiliation(s)
- Katharine C Pike
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Tremona Road, Southampton SO16 6YD, UK; NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK; University College London, Institute of Child Health, 30 Guilford Street London WC1N 1EH, UK.
| | - Jane S A Lucas
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Tremona Road, Southampton SO16 6YD, UK; NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK.
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15
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Weaver EH, Gibbons L, Belizán JM, Althabe F. The increasing trend in preterm birth in public hospitals in northern Argentina. Int J Gynaecol Obstet 2015; 130:137-41. [PMID: 25916964 DOI: 10.1016/j.ijgo.2015.02.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 02/02/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To identify factors associated with the increasing incidence of preterm birth in northern Argentina. METHODS In an observational study, data were reviewed from a prospective, population-based registry of pregnancy outcomes in six cities in 2009-2012. The primary outcome was preterm birth (at 20-37 weeks). Bivariate tests and generalized estimating equations were used within a conceptual hierarchical framework to estimate the cluster-corrected annual trend in odds of preterm birth. RESULTS The study reviewed data from 11 433 live births. There were 484 (4.2%) preterm births. The incidence of preterm births increased by 38% between 2009 and 2012, from 37.5 to 51.7 per 1000 live births. Unadjusted risk factors for preterm birth included young or advanced maternal age, normal body mass index, nulliparity, no prenatal care, no vitamins or supplements during pregnancy, multiple gestation, and maternal hypertension or prepartum hemorrhage. The prevalence of many risk factors increased over the study period, but variations in these factors explained less than 1% of the increasing trend in preterm birth. CONCLUSION The incidence of preterm births in six small cities in northern Argentina increased greatly between 2009 and 2012. This trend was unexplained by the risk factors measured. Other factors should be assessed in future studies.
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Affiliation(s)
- Emily H Weaver
- Carolina Population Center, University of North Carolina School at Chapel Hill, Chapel Hill, NC, USA.
| | - Luz Gibbons
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - José M Belizán
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Fernando Althabe
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
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