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Anselem O, Goffinet F, Jarreau PH, Zeitlin J, Monier I. Perinatal survival among very preterm singletons born after detection of early-onset fetal growth restriction with or without maternal hypertensive disorders: A population-based study in France. Eur J Obstet Gynecol Reprod Biol 2023; 282:43-49. [PMID: 36634405 DOI: 10.1016/j.ejogrb.2023.01.004] [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: 07/11/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To investigate the management and survival of very preterm singletons born because of fetal growth restriction (FGR) with or without maternal hypertensive disorders in France. STUDY DESIGN From a population-based cohort of very preterm births between 22 and 31 weeks in France in 2011, the study population included all non-anomalous singleton pregnancies delivered because of detected FGR with or without maternal hypertensive disorders. Antenatal detection of FGR was defined as an estimated fetal weight <10th percentile with or without fetal Doppler abnormalities or growth arrest. All fetuses were alive at the time of detection of FGR. Indicators of active perinatal management (antenatal steroids, pre-labor cesarean and birth in level 3 maternity unit) and fetal/neonatal outcomes (terminations of pregnancy (TOP), stillbirths, neonatal deaths and survival to discharge) were compared by gestational age between FGR associated with maternal hypertensive disorders and isolated FGR. RESULTS Overall, 398 pregnancies delivered before 32 weeks for FGR associated with hypertensive disorders and 234 for isolated FGR. Active perinatal care was rare before 26 weeks in both groups and about one in five cases associated with maternal hypertensive disorders received steroids and was born by prelabor cesarean compared to none for isolated FGR. Before 25 weeks of gestation age, more pregnancies resulted in TOP when FGR was associated with hypertensive disorders compared to isolated FGR (respectively, 76.2 % vs 28.0 % at 22-23 weeks, P = 0.002 and 57.9 % vs 21.1 % at 24 weeks, P = 0.028) whereas stillbirths were more common among isolated FGR (respectively, 23.8 % vs 72.0 % at 22-23 weeks, P = 0.002 and 36.8 % vs 73.7 % at 24 weeks, P = 0.030). Survival to discharge was higher at any gestational age when the cause of birth was FGR associated with hypertensive disorders compared to isolated FGR. CONCLUSION The management and pregnancy outcomes differed when FGR was associated with maternal hypertensive disorders or isolated. The proportion of TOP was higher when FGR was associated with hypertensive disorders and the proportion of stillbirths was higher in isolated FGR.
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Affiliation(s)
- Olivia Anselem
- Port-Royal Maternity Unit, Groupe Hospitalier Cochin Broca Hôtel-Dieu, AP-HP, Université Paris, FHU Prema, Paris, France
| | - François Goffinet
- Port-Royal Maternity Unit, Groupe Hospitalier Cochin Broca Hôtel-Dieu, AP-HP, Université Paris, FHU Prema, Paris, France; Université Paris Cité, Centre of Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
| | - Pierre-Henri Jarreau
- Université Paris Cité, Centre of Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France; Department of Neonatal Medicine, Cochin-Port Royal Hospital, FHU PREMA, AP-HP Centre, Paris, France
| | - Jennifer Zeitlin
- Université Paris Cité, Centre of Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
| | - Isabelle Monier
- Université Paris Cité, Centre of Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France.
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Dap M, Allouche D, Gauchotte E, Bertholdt C, Morel O. Perinatal outcomes of severe, isolated intrauterine growth restriction before 25 weeks' gestation: A retrospective cohort study. J Gynecol Obstet Hum Reprod 2023; 52:102514. [PMID: 36436808 DOI: 10.1016/j.jogoh.2022.102514] [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: 08/24/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the perinatal outcome associated with severe and isolated intrauterine growth restriction (IUGR) diagnosed before 25 weeks and to describe factors related to fetal death. METHODS This retrospective study included singleton pregnancies with an estimated fetal weight (EFW) ≤ 3rd centile between 21 + 0 and 24 + 6 weeks' gestation referred between 2013 and 2020. All fetuses with morphological or chromosomal abnormalities were excluded. We constituted three groups based on perinatal outcomes to highlight poor prognostic factors: live birth, fetal death and termination of pregnancies (TOP). RESULTS We included 98 pregnancies with an overall survival rate of 61.2% (60/98). There were 63.2% (62/98) live births, 24.5% (24/98) TOP, and 12.2% (12/98) fetal death. Of the live births, 27.4% (17/62) of fetuses were born before 32 weeks, and two died in the neonatal period (2/62; 3.2%). The fetal death rate was higher with the presence of an EFW below the first percentile (83.3% of fetal death Vs 33.8% of live births; p = 0.002), Doppler abnormalities (83.3% of fetal death Vs 6.4% of live births; p<0.001), and oligoamnios (41.9% of fetal death Vs 11.3% of live births; p = 0.05). CONCLUSION Severe growth restriction detected before 25 weeks was associated with poor perinatal outcomes. There were more often EFW <1st percentile, abnormal Doppler and oligoamnios in cases of fetal death compared to live births.
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Affiliation(s)
- Matthieu Dap
- Obstetrics and fetal medicine Unit, CHRU of Nancy, Nancy, France; Department of fetopathology and placental pathology, CHRU of Nancy, Nancy, France; Inserm, Diagnostic and Interventional Adaptive Imaging, University of Lorraine, Nancy, France.
| | - Dan Allouche
- Obstetrics and fetal medicine Unit, CHRU of Nancy, Nancy, France
| | - Emilie Gauchotte
- Obstetrics and fetal medicine Unit, CHRU of Nancy, Nancy, France
| | - Charline Bertholdt
- Obstetrics and fetal medicine Unit, CHRU of Nancy, Nancy, France; Inserm, Diagnostic and Interventional Adaptive Imaging, University of Lorraine, Nancy, France
| | - Olivier Morel
- Obstetrics and fetal medicine Unit, CHRU of Nancy, Nancy, France; Inserm, Diagnostic and Interventional Adaptive Imaging, University of Lorraine, Nancy, France
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Hini JD, Kayem G, Quibel T, Berveiller P, De Carne Carnavale C, Delorme P. Risk of preterm delivery after medically indicated termination of pregnancy with induced vaginal delivery: a case-control study. J OBSTET GYNAECOL 2022; 42:1693-1702. [PMID: 35653800 DOI: 10.1080/01443615.2022.2071147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We investigated whether nonsurgical termination of pregnancy after 14 weeks of gestation increases the risk of preterm delivery in a subsequent pregnancy. We conducted a two-centre retrospective case-control study. Patients who underwent non-surgical termination of pregnancy after 14 weeks of gestation between 2012 and 2015 and who gave birth after 14 weeks of gestation to a live-born singleton infant were included. Control patients were those who gave birth after 37 weeks of gestation (the same month as a case patient) and had a second delivery of a singleton foetus after 14 weeks of gestation. The primary outcome was preterm delivery during the second pregnancy period. We included 151 cases and 302 controls and observed 13 (8.6%) preterm births during the second pregnancy in the case group versus 8 (2.6%) (odds ratio: 3.62; 95% confidence interval: 1.40-8.65, p < .001) in the control group. This result remained significant after multivariate analysis. Impact statementWhat is already known about this topic? Many studies have evaluated the association between first-trimester surgical or non-surgical termination of pregnancy and the risk of preterm birth in the subsequent pregnancy. However, no study has evaluated the association between second- or third-trimester non-surgical termination of pregnancy due to foetal disease and the risk of preterm birth in the subsequent pregnancy. A small number of studies have included a small proportion of patients who previously underwent non-surgical termination of pregnancy after 14 weeks of gestation and later experienced first-trimester termination during their second pregnancy. These studies focussed on the impact of the interpregnancy interval or pharmacological induction of labour on the risk of preterm delivery in the subsequent pregnancy.What did the results of this study add? This is the first study to specifically evaluate the association between second- and third-trimester non-surgical terminations of pregnancy and the risk of preterm birth in the subsequent pregnancy. When compared with term birth, nonsurgical termination of pregnancy was associated with the risk of spontaneous preterm birth and hospitalisation in the neonatal intensive care unit in the subsequent pregnancy.What are the implications of these findings for clinical practice and further research? Further studies are required to confirm our results, but information delivered to patients with a late termination of pregnancy and during their pregnancy follow-up for the subsequent pregnancy could be modified to provide this information.
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Affiliation(s)
- Jean-Daniel Hini
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France.,Sorbonne Université, Paris, France
| | - Gilles Kayem
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France.,Sorbonne Université, Paris, France
| | - Thibaud Quibel
- Department of Obstetrics and Gynecology, Poissy-Saint Germain en Laye Hospital Center, Poissy, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy-Saint Germain en Laye Hospital Center, Poissy, France
| | | | - Pierre Delorme
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France.,Sorbonne Université, Paris, France
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4
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Gissler M, Durox M, Smith L, Blondel B, Broeders L, Hindori-Mohangoo A, Kearns K, Kolarova R, Loghi M, Rodin U, Szamotulska K, Velebil P, Weber G, Zurriaga O, Zeitlin J. Clarity and consistency in stillbirth reporting in Europe: why is it so hard to get this right? Eur J Public Health 2022; 32:200-206. [PMID: 35157046 PMCID: PMC8975542 DOI: 10.1093/eurpub/ckac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Stillbirth is a major public health problem, but measurement remains a challenge even in high-income countries. We compared routine stillbirth statistics in Europe reported by Eurostat with data from the Euro-Peristat research network. Methods We used data on stillbirths in 2015 from both sources for 31 European countries. Stillbirth rates per 1000 total births were analyzed by gestational age (GA) and birthweight groups. Information on termination of pregnancy at ≥22 weeks’ GA was analyzed separately. Results Routinely collected stillbirth rates were higher than those reported by the research network. For stillbirths with a birthweight ≥500 g, the difference between the mean rates of the countries for Eurostat and Euro-Peristat data was 22% [4.4/1000, versus 3.5/1000, mean difference 0.9 with 95% confidence interval (CI) 0.8–1.0]. When using a birthweight threshold of 1000 g, this difference was smaller, 12% (2.9/1000, versus 2.5/1000, mean difference 0.4 with 95% CI 0.3–0.5), but substantial differences remained for individual countries. In Euro-Peristat, missing data on birthweight ranged from 0% to 29% (average 5.0%) and were higher than missing data for GA (0–23%, average 1.8%). Conclusions Routine stillbirth data for European countries in international databases are not comparable and should not be used for benchmarking or surveillance without careful verification with other sources. Recommendations for improvement include using a cut-off based on GA, excluding late terminations of pregnancy and linking multiple sources to improve the quality of national databases.
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Affiliation(s)
- Mika Gissler
- THL Finnish Institute for Health and Welfare, Helsinki, Finland and Karolinska Institute, Stockholm, Sweden
| | - Mélanie Durox
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, F-75004, France
| | - Lucy Smith
- Department of Health Sciences, College of Life Sciences, University of Leicester, LE1 7RH, UK
| | - Béatrice Blondel
- THL Finnish Institute for Health and Welfare, Helsinki, Finland and Karolinska Institute, Stockholm, Sweden
| | - Lisa Broeders
- The Netherlands Perinatal Registry (Perined), Utrecht, The Netherlands
| | - Ashna Hindori-Mohangoo
- Foundation for Perinatal Interventions and Research in Suriname (PeriSur), Paramaribo, Suriname.,Tulane University, School of Public Health and Tropical Medicine, New Orleans, USA
| | - Karen Kearns
- National Finance Division, Healthcare Pricing Office, HSE, Dublin
| | | | - Marzia Loghi
- Directorate for Social Statistics and Welfare, Italian Statistical Institute (ISTAT), Rome, Italy
| | - Urelija Rodin
- Croatian Institute of Public Health, School of Public Health 'Andrija Štampar', School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Katarzyna Szamotulska
- Department of Epidemiology and Biostatistics, National Research Institute of Mother and Child, Warsaw, Poland
| | - Petr Velebil
- Institute for the Care of Mother and Child, Prague, Czech Republic
| | - Guy Weber
- Department of Epidemiology and Statistics, Directorate of Health, Luxembourg
| | - Oscar Zurriaga
- Public Health General Directorate, Valencia Regional Public Health Authority, Spain.,Public Health and Preventive Medicine Department, University of Valencia, Spain.,Centre for Network Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, F-75004, France
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Morgan AS, Zeitlin J, Källén K, Draper ES, Maršál K, Norman M, Serenius F, van Buuren S, Johnson S, Benhammou V, Pierrat V, Kaminski M, Foix L'Helias L, Ancel P, Marlow N. Birth outcomes between 22 and 26 weeks' gestation in national population-based cohorts from Sweden, England and France. Acta Paediatr 2022; 111:59-75. [PMID: 34469604 PMCID: PMC9291863 DOI: 10.1111/apa.16084] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/30/2021] [Accepted: 08/16/2021] [Indexed: 01/14/2023]
Abstract
AIM We investigated the timing of survival differences and effects on morbidity for foetuses alive at maternal admission to hospital delivered at 22 to 26 weeks' gestational age (GA). METHODS Data from the EXPRESS (Sweden, 2004-07), EPICure-2 (England, 2006) and EPIPAGE-2 (France, 2011) cohorts were harmonised. Survival, stratified by GA, was analysed to 112 days using Kaplan-Meier analyses and Cox regression adjusted for population and pregnancy characteristics; neonatal morbidities, survival to discharge and follow-up and outcomes at 2-3 years of age were compared. RESULTS Among 769 EXPRESS, 2310 EPICure-2 and 1359 EPIPAGE-2 foetuses, 112-day survival was, respectively, 28.2%, 10.8% and 0.5% at 22-23 weeks' GA; 68.5%, 40.0% and 23.6% at 24 weeks; 80.5%, 64.8% and 56.9% at 25 weeks; and 86.6%, 77.1% and 74.4% at 26 weeks. Deaths were most marked in EPIPAGE-2 before 1 day at 22-23 and 24 weeks GA. At 25 weeks, survival varied before 28 days; differences at 26 weeks were minimal. Cox analyses were consistent with the Kaplan-Meier analyses. Variations in morbidities were not clearly associated with survival. CONCLUSION Differences in survival and morbidity outcomes for extremely preterm births are evident despite adjustment for background characteristics. No clear relationship was identified between early mortality and later patterns of morbidity.
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Affiliation(s)
- Andrei S. Morgan
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)CRESSINSERMINRAEUniversité de ParisParisFrance
- UCL Elizabeth Garrett Anderson Institute for Women's Health LondonUniversity College LondonLondonUK
- Department of NeonatologyMaternity Port RoyalAssistance Publique‐Hôpitaux de ParisParisFrance
| | - Jennifer Zeitlin
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)CRESSINSERMINRAEUniversité de ParisParisFrance
| | - Karin Källén
- Centre of Reproductive EpidemiologyLund UniversityLundSweden
| | | | - Karel Maršál
- Department of Obstetrics and GynecologySkåne University HospitalLund UniversityLundSweden
| | - Mikael Norman
- Division of PediatricsDepartment of Clinical Science, Intervention, and TechnologyKarolinska InstitutetStockholmSweden
- Department of Neonatal MedicineKarolinksa University HospitalStockholmSweden
| | - Fredrik Serenius
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Stef van Buuren
- Netherlands Organisation for Applied Scientific Research TNOLeidenNetherlands
- Methodology & StatisticsUtrecht UniversityUtrechtNetherlands
| | | | - Valérie Benhammou
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)CRESSINSERMINRAEUniversité de ParisParisFrance
| | - Véronique Pierrat
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)CRESSINSERMINRAEUniversité de ParisParisFrance
| | - Monique Kaminski
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)CRESSINSERMINRAEUniversité de ParisParisFrance
| | - Laurence Foix L'Helias
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)CRESSINSERMINRAEUniversité de ParisParisFrance
- Sorbonne UniversityParisFrance
- Department of Neonatal Pediatrics, Trousseau HospitalAssistance Publique‐Hôpitaux de ParisParisFrance
| | - Pierre‐Yves Ancel
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)CRESSINSERMINRAEUniversité de ParisParisFrance
- Clinical Investigation Center P1419Assistance Publique‐Hôpitaux de ParisParisFrance
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health LondonUniversity College LondonLondonUK
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6
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Murano Y, Shoji H, Ikeda N, Okawa N, Hayashi K, Kantake M, Morisaki N, Shimizu T, Gilmour S. Analysis of Factors Associated With Body Mass Index at Ages 18 and 36 Months Among Infants Born Extremely Preterm. JAMA Netw Open 2021; 4:e2128555. [PMID: 34648012 PMCID: PMC8517745 DOI: 10.1001/jamanetworkopen.2021.28555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
IMPORTANCE The development of neonatology has been associated with improved survival among infants born extremely preterm, and understanding their long-term outcomes is becoming increasingly important. However, there is little information on body mass index (BMI) among these children. OBJECTIVE To determine factors associated with BMI at ages 18 months and 36 months among infants born extremely preterm. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study was conducted using data from the Neonatal Research Network Japan database for 8838 infants born at gestational ages 23 to 28 weeks with data on BMI at 18 months and 36 months. Data were analyzed from April 2018 through June 2021. EXPOSURES BMI and BMI z score at ages 18 months and 36 months were regressed with gestational age, intrauterine growth restriction (IUGR) status, and complications during pregnancy and the neonatal period separately by presence of multiple pregnancy and sex. MAIN OUTCOMES AND MEASURES BMI and BMI z score at ages 18 months and 36 months. RESULTS Among 16 791 eligible infants born extremely preterm, 8838 infants were included in the analysis. There were 7089 infants born from single pregnancies (mean [SD] gestational age, 26.0 [1.6] weeks; 3769 [53.2%] boys; mean [SD] birth weight, 847 [228] g) and 1749 infants born from multiple pregnancies (mean [SD] gestational age, 26.3 [1.5] weeks; 903 [51.6%] boys; mean [SD] birth weight, 860 [217] g). In single pregnancies, every week of increased gestational age was associated with an increase in BMI of 0.21 (95% CI, 0.17-0.25) among boys and 0.20 (95% CI, 0.15-0.25) among girls at age 18 months and 0.21 (95% CI, 0.18-0.24) among boys and 0.21 (95% CI, 0.18-0.24) among girls at age 36 months. There was an interaction association between gestational age and IUGR among boys at age 36 months, with a decrease in the change associated with gestational age of 0.12 (95% CI, 0.05-0.19). Every week of increased gestational age in single pregnancies was associated with an increase in BMI z score of 0.14 (95% CI, 0.17-0.21) among boys and 0.17 (95% CI, 0.13-0.21) among girls at age 18 months and 0.19 (95% CI, 0.16-0.22) among boys and 0.17 (95% CI, 0.15-0.20) among girls at age 36 months. Among single pregnancies, IUGR was associated with a decrease in BMI among boys (0.59 [95% CI, 0.23-0.95]) and girls (0.75 [95% CI, 0.39-1.11]) and BMI z score among boys 0.85 [95% CI, 0.25-0.95)] and girls (0.67 [95% CI, 0.36-0.97] at age 18 months and BMI among boys (0.44 [95% CI, 0.17-0.18]) and girls (0.84 [95% CI, 0.55-1.12]) and BMI z score among boys (0.46 [95% CI, 0.21-0.71]) and girls (0.77 [95% CI, 0.53-1.01]) at age 36 months. In multiple pregnancies, IUGR was associated with a decrease in BMI z score at age 36 months among boys (0.26 [95% CI, 0.42-0.89]) and girls (0.29 [95% CI, 0.22-0.79]). In single pregnancies intraventricular hemorrhage (IVH) was associated with a decrease in BMI of 0.47 (95% CI, 0.21-0.73) among boys and 0.42 (95% CI, 0.13-0.71) among girls at age 18 months and 0.53 (95% CI, 0.32-0.74) among boys and 0.31 (95% CI, 0.07-0.54) among girls at age 36 months. IVH was associated with a decrease in BMI z score in single pregnancies of 0.63 (95% CI, 0.20-0.41) among boys and 0.35 (95% CI, 0.12-0.60) among girls at age 18 months and 0.53 (95% CI, 0.34-0.71) among boys and 0.30 (95% CI, 0.11-0.50) among girls at age 36 months. Similar associations were seen in multiple pregnancies. CONCLUSIONS AND RELEVANCE This study found that gestational age, the presence of IUGR and multiple pregnancy, and IVH complications were associated with infant BMI at ages 18 months and 36 months. These findings suggest that these complicating factors should be considered when setting growth targets and nutrition strategies for infants born extremely preterm.
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Affiliation(s)
- Yayoi Murano
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
- Graduate School of Public Health, St. Luke’s International University, Akashi-cho, Chuo-ku, Tokyo, Japan
| | - Hiromichi Shoji
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Naho Ikeda
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Natsuki Okawa
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Kuniyoshi Hayashi
- Graduate School of Public Health, St. Luke’s International University, Akashi-cho, Chuo-ku, Tokyo, Japan
| | - Masato Kantake
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke’s International University, Akashi-cho, Chuo-ku, Tokyo, Japan
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7
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Bruckner TA, Gailey S, Das A, Gemmill A, Casey JA, Catalano R, Shaw GM, Zeitlin J. Stillbirth as left truncation for early neonatal death in California, 1989-2015: a time-series study. BMC Pregnancy Childbirth 2021; 21:478. [PMID: 34215208 PMCID: PMC8252318 DOI: 10.1186/s12884-021-03852-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some scholars posit that attempts to avert stillbirth among extremely preterm gestations may result in a live birth but an early neonatal death. The literature, however, reports no empirical test of this potential form of left truncation. We examine whether annual cohorts delivered at extremely preterm gestational ages show an inverse correlation between their incidence of stillbirth and early neonatal death. METHODS We retrieved live birth and infant death information from the California Linked Birth and Infant Death Cohort Files for years 1989 to 2015. We defined the extremely preterm period as delivery from 22 to < 28 weeks of gestation and early neonatal death as infant death at less than 7 days of life. We calculated proportions of stillbirth and early neonatal death separately by cohort year, race/ethnicity, and sex. Our correlational analysis controlled for well-documented declines in neonatal mortality over time. RESULTS California reported 89,276 extremely preterm deliveries (live births and stillbirths) to Hispanic, non-Hispanic (NH) Black, and NH white mothers from 1989 to 2015. Findings indicate an inverse correlation between stillbirth and early neonatal death in the same cohort year (coefficient: -0.27, 95% CI of - 0.11; - 0.42). Results remain robust to alternative specifications and falsification tests. CONCLUSIONS Findings support the notion that cohorts with an elevated risk of stillbirth also show a reduced risk of early neonatal death among extremely preterm deliveries. Results add to the evidence base that selection in utero may influence the survival characteristics of live-born cohorts.
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Affiliation(s)
- Tim A Bruckner
- Program in Public Health & Center for Population, Inequality, and Policy, University of California Irvine, 653 E. Peltason Dr., Irvine, CA, 92697, USA
| | - Samantha Gailey
- School of Social Ecology, University of California Irvine, 209 Social Ecology I, Irvine, CA, 92697, USA.
| | - Abhery Das
- Program in Public Health, University of California Irvine, 653 E. Peltason Dr., Irvine, CA, 92697, USA
| | - Alison Gemmill
- Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
| | - Joan A Casey
- Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY, 10032, USA
| | - Ralph Catalano
- School of Public Health, University of California Berkeley, Berkeley, CA, 94720, USA
| | - Gary M Shaw
- School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, F-75004, Paris, France
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8
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Maurice P, Letourneau A, Benachi A, Jouannic JM. Feticide in second- and third-trimester termination of pregnancy for fetal anomalies: Results of a national survey. Prenat Diagn 2019; 39:1269-1272. [PMID: 31671210 DOI: 10.1002/pd.5594] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/16/2019] [Accepted: 10/20/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To conduct an audit of the practice of feticide in second- and third-trimester termination of pregnancy for fetal anomalies (TOPFA) in prenatal diagnosis (PD) centers in France. RESULTS A questionnaire was sent out to the 49 French PD centers and completed by 39/49 centers; 5350 TOPFAs were performed. The gestational age after which feticide was performed was 20 weeks in two centers (5%), 22 weeks in 28 centers (72%), 23 weeks in four centers (10%), and 24 weeks in five centers (13%). Fifteen of 39 centers reported that feticide was not performed in all cases, because of a fetal abnormality associated with a high probability of rapid neonatal death (13 centers), pregnant woman's refusal (11 centers), and technical impossibility of performing feticide (one center). Feticide was done using xylocaine in 38 of the 39 centers and using KCl in the remaining center. All but one of the centers before feticide used fetal anesthesia. Feticide was done on the day of induction of labor in 35/39 centers (90%), after maternal epidural analgesia in 33 centers, or after maternal subcutaneous local anesthesia in two centers. Feticide was done the day before induction of labor in two centers. CONCLUSION In France, most TOPFAs performed in second and third trimesters are associated with feticide, which is most often done after fetal anesthesia.
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Affiliation(s)
- Paul Maurice
- Fetal Medicine Department, Trousseau Hospital, APHP Sorbonne, Sorbonne Université, Paris, France
| | - Alexandra Letourneau
- Obstetrics and Gynaecology Department, Antoine Béclère Hospital, APHP, Clamart, France
| | - Alexandra Benachi
- Obstetrics and Gynaecology Department, Antoine Béclère Hospital, APHP, Clamart, France.,Fédération Française des Centres Pluridisciplinaires de Diagnostic Prénatal, Paris, France
| | - Jean-Marie Jouannic
- Fetal Medicine Department, Trousseau Hospital, APHP Sorbonne, Sorbonne Université, Paris, France.,Fédération Française des Centres Pluridisciplinaires de Diagnostic Prénatal, Paris, France
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Shelmerdine SC, Sebire NJ, Arthurs OJ. Perinatal post-mortem ultrasound (PMUS): radiological-pathological correlation. Insights Imaging 2019; 10:81. [PMID: 31432284 PMCID: PMC6702254 DOI: 10.1186/s13244-019-0762-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/18/2019] [Indexed: 12/16/2022] Open
Abstract
There has been an increasing demand and interest in post-mortem imaging techniques, either as an adjunct or replacement for the conventional invasive autopsy. Post-mortem ultrasound (PMUS) is easily accessible and more affordable than other cross-sectional imaging modalities and allows visualisation of normal anatomical structures of the brain, thorax and abdomen in perinatal cases. The lack of aeration of post-mortem foetal lungs provides a good sonographic window for assessment of the heart and normal pulmonary lobulation, in contrast to live neonates.In a previous article within this journal, we published a practical approach to conducting a comprehensive PMUS examination. This covered the basic principles behind why post-mortem imaging is performed, helpful techniques for obtaining optimal PMUS images, and the expected normal post-mortem changes seen in perinatal deaths. In this article, we build upon this by focusing on commonly encountered pathologies on PMUS and compare these to autopsy and other post-mortem imaging modalities.
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Affiliation(s)
- Susan C Shelmerdine
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK.
- UCL Great Ormond Street Institute of Child Health, London, UK.
| | - Neil J Sebire
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Owen J Arthurs
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
- UCL Great Ormond Street Institute of Child Health, London, UK
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