1
|
Jamaluddine Z, Sharara E, Helou V, El Rashidi N, Safadi G, El-Helou N, Ghattas H, Sato M, Blencowe H, Campbell OMR. Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review. Arch Dis Child 2023; 108:956-969. [PMID: 37339859 DOI: 10.1136/archdischild-2022-324884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 05/04/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Size at birth, an indicator of intrauterine growth, has been studied extensively in relation to subsequent health, growth and developmental outcomes. Our umbrella review synthesises evidence from systematic reviews and meta-analyses on the effects of size at birth on subsequent health, growth and development in children and adolescents up to age 18, and identifies gaps. METHODS We searched five databases from inception to mid-July 2021 to identify eligible systematic reviews and meta-analyses. For each meta-analysis, we extracted data on the exposures and outcomes measured and the strength of the association. FINDINGS We screened 16 641 articles and identified 302 systematic reviews. The literature operationalised size at birth (birth weight and/or gestation) in 12 ways. There were 1041 meta-analyses of associations between size at birth and 67 outcomes. Thirteen outcomes had no meta-analysis.Small size at birth was examined for 50 outcomes and was associated with over half of these (32 of 50); continuous/post-term/large size at birth was examined for 35 outcomes and was consistently associated with 11 of the 35 outcomes. Seventy-three meta-analyses (in 11 reviews) compared risks by size for gestational age (GA), stratified by preterm and term. Prematurity mechanisms were the key aetiologies linked to mortality and cognitive development, while intrauterine growth restriction (IUGR), manifesting as small for GA, was primarily linked to underweight and stunting. INTERPRETATION Future reviews should use methodologically sound comparators to further understand aetiological mechanisms linking IUGR and prematurity to subsequent outcomes. Future research should focus on understudied exposures (large size at birth and size at birth stratified by gestation), gaps in outcomes (specifically those without reviews or meta-analysis and stratified by age group of children) and neglected populations. PROSPERO REGISTRATION NUMBER CRD42021268843.
Collapse
Affiliation(s)
- Zeina Jamaluddine
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Eman Sharara
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Vanessa Helou
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nadine El Rashidi
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Gloria Safadi
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nehmat El-Helou
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Hala Ghattas
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Miho Sato
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Hannah Blencowe
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Oona M R Campbell
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
2
|
Tsuge M, Uda K, Eitoku T, Matsumoto N, Yorifuji T, Tsukahara H. Roles of Oxidative Injury and Nitric Oxide System Derangements in Kawasaki Disease Pathogenesis: A Systematic Review. Int J Mol Sci 2023; 24:15450. [PMID: 37895129 PMCID: PMC10607378 DOI: 10.3390/ijms242015450] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Kawasaki disease (KD) is an acute febrile vasculitis that occurs mostly in children younger than five years. KD involves multiple intricately connected inflammatory reactions activated by a cytokine cascade. Despite therapeutic advances, coronary artery damage may develop in some patients, who will be at risk of clinical cardiovascular events and even sudden death. The etiology of KD remains unclear; however, it may involve both genetic and environmental factors leading to aberrant inflammatory responses. Given the young age of onset, prenatal or perinatal exposure may be etiologically relevant. Multisystem inflammatory syndrome in children, a post-infectious hyper-inflammatory disorder associated with severe acute respiratory syndrome coronavirus 2, has features that overlap with those of KD. Available evidence indicates that vascular endothelial dysfunction is a critical step in the sequence of events leading to the development of cardiovascular lesions in KD. Oxidative stress and the dysregulation of the nitric oxide (NO) system contribute to the pathogenesis of inflammatory responses related to this disease. This review provides current evidence and concepts highlighting the adverse effects of oxidative injury and NO system derangements on the initiation and progression of KD and potential therapeutic strategies for cardiovascular pathologies in affected children.
Collapse
Affiliation(s)
- Mitsuru Tsuge
- Department of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan; (K.U.); (H.T.)
| | - Kazuhiro Uda
- Department of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan; (K.U.); (H.T.)
| | - Takahiro Eitoku
- Department of Pediatrics, Kawasaki Medical School, Kurashiki 701-0192, Japan;
| | - Naomi Matsumoto
- Department of Epidemiology, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan; (N.M.); (T.Y.)
| | - Takashi Yorifuji
- Department of Epidemiology, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan; (N.M.); (T.Y.)
| | - Hirokazu Tsukahara
- Department of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan; (K.U.); (H.T.)
| |
Collapse
|
3
|
Mielewczyk FJ, Boyle EM. Uncharted territory: a narrative review of parental involvement in decision-making about late preterm and early term delivery. BMC Pregnancy Childbirth 2023; 23:526. [PMID: 37464284 DOI: 10.1186/s12884-023-05845-6] [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: 01/18/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023] Open
Abstract
Almost 30% of live births in England and Wales occur late preterm or early term (LPET) and are associated with increased risks of adverse health outcomes throughout the lifespan. However, very little is known about the decision-making processes concerning planned LPET births or the involvement of parents in these. This aim of this paper is to review the evidence on parental involvement in obstetric decision-making in general, to consider what can be extrapolated to decisions about LPET delivery, and to suggest directions for further research.A comprehensive, narrative review of relevant literature was conducted using Medline, MIDIRS, PsycInfo and CINAHL databases. Appropriate search terms were combined with Boolean operators to ensure the following broad areas were included: obstetric decision-making, parental involvement, late preterm and early term birth, and mode of delivery.This review suggests that parents' preferences with respect to their inclusion in decision-making vary. Most mothers prefer sharing decision-making with their clinicians and up to half are dissatisfied with the extent of their involvement. Clinicians' opinions on the limits of parental involvement, especially where the safety of mother or baby is potentially compromised, are highly influential in the obstetric decision-making process. Other important factors include contextual factors (such as the nature of the issue under discussion and the presence or absence of relevant medical indications for a requested intervention), demographic and other individual characteristics (such as ethnicity and parity), the quality of communication; and the information provided to parents.This review highlights the overarching need to explore how decisions about potential LPET delivery may be reached in order to maximise the satisfaction of mothers and fathers with their involvement in the decision-making process whilst simultaneously enabling clinicians both to minimise the number of LPET births and to optimise the wellbeing of women and babies.
Collapse
Affiliation(s)
- Frances J Mielewczyk
- Leicester City Football Club (LCFC) Research Programme, Department of Population Health Sciences, College of Life Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK.
| | - Elaine M Boyle
- Department of Population Health Sciences, College of Life Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK
| |
Collapse
|
4
|
Ashorn P, Ashorn U, Muthiani Y, Aboubaker S, Askari S, Bahl R, Black RE, Dalmiya N, Duggan CP, Hofmeyr GJ, Kennedy SH, Klein N, Lawn JE, Shiffman J, Simon J, Temmerman M. Small vulnerable newborns-big potential for impact. Lancet 2023; 401:1692-1706. [PMID: 37167991 DOI: 10.1016/s0140-6736(23)00354-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/27/2023] [Accepted: 02/14/2023] [Indexed: 05/13/2023]
Abstract
Despite major achievements in child survival, the burden of neonatal mortality has remained high and even increased in some countries since 1990. Currently, most neonatal deaths are attributable to being born preterm, small for gestational age (SGA), or with low birthweight (LBW). Besides neonatal mortality, these conditions are associated with stillbirth and multiple morbidities, with short-term and long-term adverse consequences for the newborn, their families, and society, resulting in a major loss of human capital. Prevention of preterm birth, SGA, and LBW is thus critical for global child health and broader societal development. Progress has, however, been slow, largely because of the global community's failure to agree on the definition and magnitude of newborn vulnerability and best ways to address it, to frame the problem attractively, and to build a broad coalition of actors and a suitable governance structure to implement a change. We propose a new definition and a conceptual framework, bringing preterm birth, SGA, and LBW together under a broader umbrella term of the small vulnerable newborn (SVN). Adoption of the framework and the unified definition can facilitate improved problem definition and improved programming for SVN prevention. Interventions aiming at SVN prevention would result in a healthier start for live-born infants, while also reducing the number of stillbirths, improving maternal health, and contributing to a positive economic and social development in the society.
Collapse
Affiliation(s)
- Per Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
| | - Ulla Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Yvonne Muthiani
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | | | - Rajiv Bahl
- Indian Council for Medical Research, New Delhi, India
| | - Robert E Black
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Nita Dalmiya
- United Nations Children's Fund, New York, NY, USA
| | - Christopher P Duggan
- Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - G Justus Hofmeyr
- Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana; Effective Care Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Obstetrics and Gynaecology, Walter Sisulu University, East London, South Africa
| | - Stephen H Kennedy
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Nigel Klein
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Jeremy Shiffman
- Paul H Nitze School of Advanced International Studies, Johns Hopkins University, Baltimore, MD, USA
| | | | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| |
Collapse
|
5
|
Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1255] [Impact Index Per Article: 1255.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
6
|
Alenius S, Kajantie E, Sund R, Nurhonen M, Haaramo P, Näsänen-Gilmore P, Lemola S, Räikkönen K, Schnitzlein DD, Wolke D, Gissler M, Hovi P. School grades and educational attainments of adolescents and young adults born preterm. Sci Rep 2023; 13:231. [PMID: 36604570 PMCID: PMC9816170 DOI: 10.1038/s41598-022-27295-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/29/2022] [Indexed: 01/07/2023] Open
Abstract
Attendance in special education (SE) is more common among individuals born preterm than among those born at term. Less is known about school grades of those born preterm in mainstream education (ME), and how these grades predict later educational attainment. This population-based register-linkage study assessed (1) attendance in SE, and then focused on those in ME by assessing (2) school grades at 16 year, (3) completed educational level at 25 year, and (4) school grades as predictors for completed education by gestational age (GA) with full-term birth (39-41 completed weeks) as reference. The sample comprised 223,744 individuals (10,521 preterm, 4.7%) born in Finland (1/1987-9/1990). Of the sample, 4.9% attended SE. Those born preterm had up to 5.5-fold rates for SE. In ME, those born extremely preterm (EPT) had marginally lower mathematics grades compared with full-term counterparts, whilst those born late preterm or early term had slightly higher grades. Those born EPT or very preterm had lower physical education grades in ME. However, the minor differences in school grades according to GA appear not to translate into educational differences in young adulthood. The associations between school grades at 16 year and completed education at 25 year did not vary by GA.
Collapse
Affiliation(s)
- Suvi Alenius
- Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271, Helsinki, Finland. .,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Eero Kajantie
- Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Faculty of Medicine, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Reijo Sund
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Nurhonen
- Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271, Helsinki, Finland
| | - Peija Haaramo
- Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271, Helsinki, Finland
| | - Pieta Näsänen-Gilmore
- Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271, Helsinki, Finland.,Tampere Center for Child, Adolescent, and Maternal Health Research: Global Health Group, Faculty of Medicine, and Health Technology, Tampere University, Tampere, Finland
| | - Sakari Lemola
- Department of Psychology, Bielefeld University, Bielefeld, Germany.,Department of Psychology, University of Warwick, Coventry, UK
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Daniel D Schnitzlein
- Institute of Labour Economics, Leibniz University, Hannover, Germany.,Institute of Labor Economics (IZA), Bonn, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
| | - Mika Gissler
- Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271, Helsinki, Finland.,Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden & Karolinska Institute, Department of Molecular Medicine and Surgery, Stockholm, Sweden
| | - Petteri Hovi
- Finnish Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
7
|
Prematurity-associated wheeze: current knowledge and opportunities for further investigation. Pediatr Res 2022:10.1038/s41390-022-02404-1. [PMID: 36463364 PMCID: PMC10238677 DOI: 10.1038/s41390-022-02404-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 12/04/2022]
Abstract
Prematurity-associated wheeze is a common complication of preterm birth, with significant impact on the health and healthcare utilization of former preterm infants. This wheezing phenotype remains poorly understood and difficult to predict. This review will discuss the current state of the literature on prematurity-associated wheeze. We will discuss etiology and pathophysiology, and offer two conceptual models for the pathogenesis of this complex condition. This review will also identify current methods of ascertainment, and discuss the strengths and limitations of each. We will explore research-backed approaches to prevention and management, and finally suggest both pre-clinical and clinical avenues for investigation. An in-depth understanding of prematurity-associated wheeze will aid clinicians in its diagnosis and management, and inspire scientists to pursue much-needed further study into causes and prevention of this common and impactful condition. IMPACT: There is no recent, concise review on the current state of research on prematurity-associated wheeze, which is a rapidly evolving area of study. This article highlights causal models of wheeze, methods of ascertainment, management strategies for the clinician, and opportunities for further research for the physician scientist.
Collapse
|
8
|
Preterm birth and Kawasaki disease: a nationwide Japanese population-based study. Pediatr Res 2022; 92:557-562. [PMID: 34625654 DOI: 10.1038/s41390-021-01780-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Previous studies showed that preterm birth increased the risk for hospital admissions in infancy and childhood due to some acute diseases. However, the risk of preterm children developing Kawasaki disease remains unknown. In the present study, we investigate whether preterm birth increased the morbidity of Kawasaki disease. METHODS We included 36,885 (34,880 term and 2005 preterm) children born in 2010 in Japan. We examined the association between preterm birth and hospitalization due to Kawasaki disease using a large nationwide survey in Japan. RESULTS In log-linear regression models that were adjusted for children's characteristics (sex, singleton birth, and parity), parental characteristics (maternal age, maternal smoking, paternal smoking, maternal education, and paternal income), and residential area, preterm infants were more likely to be hospitalized due to Kawasaki disease (adjusted risk ratio: 1·55, 95% confidence interval: 1.01-2.39). We then examined whether breastfeeding status modified the potential adverse effects of preterm birth on health outcome. Preterm infants with partial breastfeeding or formula feeding had a significantly higher risk of hospitalization due to Kawasaki disease compared with term infants with exclusive breastfeeding. CONCLUSIONS Preterm infants were at a high risk for Kawasaki disease, and exclusive breastfeeding might prevent this disease among preterm infants. IMPACT Previous studies showed that preterm birth increased the risk for hospital admissions in infancy and childhood due to some acute diseases, however, the risk of preterm children developing Kawasaki disease remains unknown. This Japanese large population-based study showed that preterm infants were at a high risk for Kawasaki disease for the first time. Furthermore, this study suggested that exclusively breastfeeding might prevent Kawasaki disease among preterm infants.
Collapse
|
9
|
Motivating Behavior Change in Parents for Suicide Prevention in the Midwest, USA. J Community Health 2022; 47:495-503. [PMID: 35211847 DOI: 10.1007/s10900-022-01077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 10/19/2022]
Abstract
Safe storage of lethal means is an evidence-based approach to suicide prevention that is underutilized. This naturalistic study investigated whether a presentation on parenting teenagers that includes education about safe storage of firearms and medications, paired with tools to enact change, can impact storage practices. Ten community presentations for parents were given between November 2018 and September 2019 in the Midwest region of the United States. Multiple topics pertinent to parenting adolescents were included with an emphasis on safe storage of firearms and medications to reduce suicide risk. Toolkits including medication storage boxes and cable gun locks were offered to help parents enact recommended changes. Surveys were completed prior to the presentation (T1), immediately following the presentation (T2), and 2 weeks after the presentation (T3). Five-hundred eighty-one parents comprised the initial study sample, of whom 410 (70.6%) completed the primary study endpoint. Generalized linear mixed models with and without worst-case imputation were used to evaluate changes in safe storage practices. Results suggested the odds of storing firearms in the safest manner possible increased 5.9 times (95% CI 2.6-13.5, p < 0.001) without imputation and increased 2.0 times (95% CI 1.1-3.4, p = 0.02) with the worst-case imputation. Among participants with unlocked medications at baseline, 56.5% reported they had disposed of old medications and 53.0% reported locking up bottles of medication by the primary study endpoint. This study provides preliminary evidence that safe storage education paired with tools for behavior change motivates parents to enact safe storage measures.
Collapse
|
10
|
Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2468] [Impact Index Per Article: 1234.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
11
|
Alexander T, Meyer M, Harding JE, Alsweiler JM, Jiang Y, Wall C, Muelbert M, Bloomfield FH. Nutritional Management of Moderate- and Late-Preterm Infants Commenced on Intravenous Fluids Pending Mother's Own Milk: Cohort Analysis From the DIAMOND Trial. Front Pediatr 2022; 10:817331. [PMID: 35433556 PMCID: PMC9008239 DOI: 10.3389/fped.2022.817331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Exclusive breastmilk is the desired enteral nutrition for babies born moderate- and late-preterm between 32+0 and 36+6 weeks' gestation; however, this goal is often difficult to achieve. METHODS A prospective cohort of babies 32+0 -35+6 weeks' gestation enrolled in the DIAMOND trial were randomized to a condition specifying that babies should receive mother's own milk (MOM) as the only enteral feed. Factors associated with the successful transition to MOM, defined as MOM being the sole enteral feeding at the time of the first cessation of intravenous (IV) fluids, were investigated by logistic regression. Time to commencement of a milk other than MOM was analyzed by Kaplan-Meier survival curves. RESULTS A total of 151 eligible babies (60% boys) were included, 93 (63%) of whom successfully transitioned from IV fluids onto MOM only. Alternative sources of milk, mostly formula, were used to transition from IV fluids onto enteral feeds more often in multiples and Māori, and was commenced earlier in Māori than other ethnicities (p = 0.007) and in late-preterm compared with moderate-preterm babies (p=0.01). Receiving exclusively breastmilk at discharge was more likely for babies who successfully transitioned from IV fluids onto MOM only [OR (95% confidence intervals) 4.9 (2.3-10.6)] and who received only MOM in the first week after birth [4.8 (2.2-10.4)], both p < 0.0001. Receiving breastmilk exclusively at discharge was less likely for Māori than Caucasian babies [0.2 (0.1-0.6), p < 0.0006]. There was no difference in the use of alternative sources of milk in babies who received parenteral nutrition or dextrose or between small-for-gestational-age and appropriate-for-gestational-age babies. CONCLUSIONS Despite an intention to provide only MOM, significant numbers of moderate- and late-preterm babies received formula to transition from IV fluids, and this differed by ethnicity. The drivers underlying these decisions require further investigation. These data highlight an urgent need for quality initiatives to support and encourage mothers of moderate- and late-preterm babies in their lactation.
Collapse
Affiliation(s)
- Tanith Alexander
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Neonatal Unit, Kidz First, Middlemore Hospital, Counties Mankau Health, Auckland, New Zealand
| | - Michael Meyer
- Neonatal Unit, Kidz First, Middlemore Hospital, Counties Mankau Health, Auckland, New Zealand
| | - Jane E Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Jane M Alsweiler
- Newborn Services, Auckland City Hospital, Auckland, New Zealand.,The Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Clare Wall
- Department of Nutrition, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Mariana Muelbert
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | | |
Collapse
|
12
|
Bachmann CS, Risnes K, Bjørngaard JH, Schei J, Pape K. Association of Preterm Birth With Prescription of Psychotropic Drugs in Adolescence and Young Adulthood. JAMA Netw Open 2021; 4:e211420. [PMID: 33710290 PMCID: PMC7955275 DOI: 10.1001/jamanetworkopen.2021.1420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Individuals born preterm have increased risk of mental health impairment compared with individuals born at term. The associations between preterm birth and attention-deficit/hyperactivity disorder and autism are well established; for depression, anxiety, psychotic and bipolar disorder, studies show divergent results. OBJECTIVE To compare the prescription of psychotropic drugs in adolescence and young adulthood between those born preterm and those born at term. DESIGN, SETTING, AND PARTICIPANTS This cohort study used registry data to identify all Norwegians born after 23 weeks of completed gestation between 1989 and 1998. Included individuals were those without registered birth defects, alive at age 10 years, and with available maternal data. Individuals were followed up from 2004 to 2016. Psychotropic drug prescriptions received from age 10 to 23 years were compared between preterm groups and peers born at term. Individuals were compared with their siblings to control for shared family confounding. Data analyses were performed from August 2018 through February 2020. EXPOSURES Gestational age at birth (GA) was categorized in 4 groups: extremely preterm (GA, 23 weeks and 0 days to 27 weeks and 6 days), very preterm (GA, 28 weeks and 0 days to 31 weeks and 6 days), moderately or late preterm (GA, 32 weeks and 0 days to 36 weeks and 6 days), and full term (GA, 37 weeks and 0 days to 44 weeks and 6 days). MAIN OUTCOMES AND MEASURES Prescriptions of psychotropic drugs (ie, prescriptions specifically of psychostimulants, antidepressants, anxiolytics, hypnotics or sedatives, or antipsychotics or prescriptions of any of these 5 drugs) among preterm groups were compared with prescriptions among peers born at term and among siblings. RESULTS Among 505 030 individuals (259 545 [51.4%] males; mean [SD] birth weight, 3533 [580] g), 762 individuals (0.2%) were extremely preterm, 2907 individuals (0.6%) were very preterm, 25 988 individuals (5.1%) were moderately or late preterm, and 475 373 individuals (94.1%) were full term. Individuals born preterm had increased risk of psychotropic drug prescription, with a dose-response association between GA and prescription. The extremely preterm group had higher rates of prescription for all drug types compared with peers born at term, with odds ratios from 1.7 (95% CI, 1.4-2.1) for antidepressants to 2.7 (95% CI, 2.1-3.4) for psychostimulants. The elevated odds of prescription of all types were less pronounced in the moderately to late preterm group, including odds ratios of 1.1 (95% CI, 1.0-1.1) for antidepressants and 1.2 (95% CI, 1.1-1.2) for psychostimulants. The increases in odds were smaller in the sibling comparison, and increases were not significant for several groups. For example, the OR for any prescription in the sibling analysis was 1.8 (95% CI, 1.2-2.8) in the very preterm group and 1.0 (95% CI, 0.9-1.1) in the moderately or late preterm group. CONCLUSIONS AND RELEVANCE This cohort study found higher rates of prescription of psychotropic drugs throughout adolescence and young adulthood among individuals with all degrees of preterm birth compared with those born at term. These results provide further evidence for an increased risk of mental health impairment among individuals born preterm and suggest that this is not restricted to the most preterm groups.
Collapse
Affiliation(s)
- Christine Strand Bachmann
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Children's Clinic, St. Olavs Hospital, Trondheim, Norway
| | - Kari Risnes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Development, St. Olavs Hospital, Trondheim, Norway
| | - Johan Håkon Bjørngaard
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Jorun Schei
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim, Norway
| | - Kristine Pape
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
13
|
Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 3085] [Impact Index Per Article: 1028.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
14
|
Machado MCHDS, Santiloni AFP, Ferrari AP, Parada CMGDL, Carvalhaes MADBL, Tonete VLP. Health care in the first year of life of a prospective cohort of late-preterm and full-term infants, in Botucatu, state of São Paulo, Brazil, 2015-2017. ACTA ACUST UNITED AC 2021; 30:e2020619. [PMID: 34133640 DOI: 10.1590/s1679-49742021000200014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/04/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess association between late-preterm birth and use of referral health services in the first year of life. METHODS This was a prospective cohort study, with data collected from infants at 1, 3, 6, 9 and 12 months old. Maternal and birth characteristics were compared between full-term and late preterm infants. The effect of late preterm birth on the use of specialized outpatient clinic, emergency room/emergency care center, hospitalizations and intensive care unit (ICU) admissions was evaluated by calculating adjusted odds ratios. RESULTS 41 late preterm and 540 full-term infants differed as to frequency of low birth weight and in not staying in joint accommodation, both of which were higher in late-preterm infants, who were also more likely to be admitted to the neonatal ICU (OR=6.85 - 95%CI 2.56;18.34). Late preterm birth was not associated with the use of other referral health services. CONCLUSION late preterm birth was not associated with greater use of referral health services after discharge from maternity hospital.
Collapse
Affiliation(s)
| | | | - Anna Paula Ferrari
- Universidade Estadual Paulista 'Júlio de Mesquita Filho', Faculdade de Medicina de Botucatu, Botucatu, SP, Brasil
| | | | | | - Vera Lúcia Pamplona Tonete
- Universidade Estadual Paulista 'Júlio de Mesquita Filho', Faculdade de Medicina de Botucatu, Botucatu, SP, Brasil
| |
Collapse
|
15
|
Khasawneh W, Alyousef R, Akawi Z, Al-Dhoon A, Odat A. Maternal and Perinatal Determinants of Late Hospital Discharge Among Late Preterm Infants; A 5-Year Cross-Sectional Analysis. Front Pediatr 2021; 9:685016. [PMID: 34222151 PMCID: PMC8242188 DOI: 10.3389/fped.2021.685016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Although late preterm infants (LPIs) account for the majority of preterm births, they are mistakenly labelled and treated as "near term." Whether longer initial hospital stay improves their outcomes and lowers readmission is controversial. The aim of this study is to identify maternal and perinatal factors associated with longer hospital stay and to assess the rate of readmission. Methods: The medical records of LPIs delivered at an academic center in Jordan over a 5-year period were reviewed. They were divided according to their initial hospital stay into: Early discharge group (ED, ≤ 3 days) and late discharge group (LD, > 3 days). Maternal and perinatal factors associated with > 3-day hospital stay were reported. The rate of readmission was compared between both groups. Results: 2236 LPIs were included in the analysis representing 13% of total births and 81% of premature births. LD group constituted 54%. A thousand two hundred forty three (56%) required admission to NICU. Factors associated with longer hospital stay included maternal prolonged rupture of membranes (AOR 1.9, 95% C.I 1.5, 2.4, p 0.000), C-section delivery (AOR 2.4, 95% C.I 1.9, 3, p 0.001), <35-week gestation (AOR 3.8, 95% C.I 2.6, 5, p 0.000), small-for-gestational age (AOR 1.9, 95% C.I 1.1, 3.8, p 0.03), birthweight <2,500 g (AOR 1.3, 95% C.I 1.1, 1.6, p 0.02), NICU admission (AOR 6.3, 95% C.I 3.4, 11.5, p 0.000), RDS (AOR 2.3, 95% C.I 1.5, 3.6, p 0.005), surfactant therapy (AOR 5, 95% C.I 1.9, 13.5, p 0.001), use of CPAP (AOR 1.7, 95% C.I 1.2, 2.2, p 0.001), jaundice (AOR 11.2, 95% C.I 7.7, 16.2, p 0.000), and sepsis (AOR 10.3, 95% C.I 4.8, 22, p 0.000). Readmission rate was 19% among the LD group and 13% among the ED group. Conclusion: LPIs are at high risk for developing prematurity-related morbidities and the duration of their initial hospital stay can be anticipated based on certain predisposing maternal and perinatal factors. Late discharge of LPIs does not lower the rate of readmission.
Collapse
Affiliation(s)
- Wasim Khasawneh
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rahaf Alyousef
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Zuhour Akawi
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Areen Al-Dhoon
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahlam Odat
- Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
16
|
Maternal, Perinatal and Neonatal Outcomes With COVID-19: A Multicenter Study of 242 Pregnancies and Their 248 Infant Newborns During Their First Month of Life. Pediatr Infect Dis J 2020; 39:e393-e397. [PMID: 32947599 DOI: 10.1097/inf.0000000000002902] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Our aim was to describe the clinical features of mothers with coronavirus disease 2019 (COVID-19) infection during gestation or delivery, and the potential vertical transmission. We also wish to evaluate the possible horizontal transmission after hospital discharge, by means of a follow-up of all the newborns included at 1 month of age. METHODS This multicenter descriptive study involved 16 Spanish hospitals. We reviewed the medical records of 242 pregnant women diagnosed with COVID-19 from March 13 to May 31, 2020, when they were in their third trimester of pregnancy. They and their 248 newborn infants were monitored until the infant was 1 month old. RESULTS Caesarean sections (C-sections) were performed on 63 (26%) women. The initial clinical symptoms were coughing (33%) and fever (29.7%). Mothers hospitalized due to COVID-19 pathology had a higher risk of ending their pregnancy via C-section (P = 0.027). Newborns whose mothers had been admitted due to their COVID-19 infection had a higher risk of premature delivery (P = 0.006). We admitted 115 (46.3%) newborn infants to the neonatal unit, of those, 87 (75.6%) were only admitted due to organizational circumstances. No infants died and no vertical or horizontal transmission was detected. Regarding type of feeding, 41.7% of the newborns received exclusive breast-feeding at discharge and 40.4% at 1 month. CONCLUSIONS We did not detect COVID-19 transmission during delivery or throughout the first month of life in the newborns included in our study. Exclusive breast-feeding rates at discharge and at 1 month of age were lower than expected.
Collapse
|
17
|
Migliorelli F, Martin C, Martínez de Tejada B. Preterm prelabor rupture of membranes management in Switzerland: a national survey. J Matern Fetal Neonatal Med 2020; 35:3743-3750. [PMID: 33108920 DOI: 10.1080/14767058.2020.1839878] [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: 10/23/2022]
Abstract
OBJECTIVE To gain an overview of the current management of patients with preterm prelabor rupture of membranes (PPROM) in Swiss maternity hospitals. STUDY DESIGN We conducted a survey among all maternity hospitals in Switzerland from January to December 2018, irrespective of their annual birth rate and level of complexity. The survey consisted of an 11-item questionnaire, which was developed to retrieve information relevant to different areas of PPROM management. RESULTS Of 64 questionnaires distributed by email, 36 (56.3%) centers responded to the survey. Up to 12 different antibiotic regimens were reported. Among these, 91.7% included a beta-lactam, with amoxicillin as the preferred agent (55.6%). Combined antibiotic schemes were used in 30.6% of hospitals. All centers considered the use of corticosteroids for fetal lung maturity if PPROM occurred before 34 weeks, although 36.1% would consider their use until 37 weeks' gestation in the presence of an increased risk of neonatal respiratory distress syndrome. Maternity hospitals who accept deliveries at any gestational age usually used magnesium sulfate as fetal neuroprotection when delivering babies <32 weeks, with the exception of two hospitals where it was either not used or only indicated if maternal preeclampsia was present. Concerning the time to delivery, 58.3% centers tended to wait until 37 weeks' gestation, while the others considered that it was not necessary to go beyond 34 weeks. CONCLUSION Our survey shows that the current management of PPROM in Switzerland appears to be mostly in line with international recommendations. However, some heterogeneity exists, thus reflecting a lack of international consensus across guidelines, together with the absence of national Swiss guidelines, and this needs to be addressed to ensure high quality care for all patients and neonates.
Collapse
Affiliation(s)
- Federico Migliorelli
- Department of Pediatrics, Gynecology, and Obstetrics, Division of Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Clara Martin
- Department of Pediatrics, Gynecology, and Obstetrics, Division of Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Begoña Martínez de Tejada
- Department of Pediatrics, Gynecology, and Obstetrics, Division of Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
18
|
Talbo MK, Besner ME, Plourde H, Claveau M, Beltempo M. Association of Caloric Intake, Protein Intake, and Enteral Feeding Initiation with Weight Gain in Infants Born 32 to 34 Weeks' Gestation. Am J Perinatol 2020; 37:1228-1233. [PMID: 31238346 DOI: 10.1055/s-0039-1692717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study aimed to determine the association of caloric intake, protein intake, and enteral feed initiation time in the first 3 days of life with weight loss percentage (%WL) at 7 days among infants born 32 to 34 weeks' gestational age (GA). STUDY DESIGN This is a retrospective cohort study of 252 infants admitted to a neonatal intensive care unit. Patient data included patient characteristics, daily weight, intake, and method of nutrition in the first 3 days. Multivariate linear regression was used to explore associations between outcome (%WL at day 7 of life) and exposures (caloric intake, protein intake, and enteral feed initiation time) and adjusted for covariates (GA, birth weight, and sex). RESULTS Median 7 days %WL was 2.3% (interquartile range: -5.2, 1.2). Average caloric intake and average protein intake in the first 3 days were 57 kcal/kg/d and 2.3 g/kg/d. In the adjusted linear regression, caloric intake and protein intake (coefficient = 0.03, 95% confidence interval [CI]: -0.06, 0.09 and coefficient = 0.11, 95% CI: -0.36, 2.30) were not associated with %WL at 7 days. Enteral feeds ≤12 hours were associated with less %WL at 7 days of life (Coef = -0.15, 95% CI: -2.67, -0.17). CONCLUSION Enteral feeds ≤12 hours after delivery is associated with lower %WL at 7 days among preterm infants 32 to 34 weeks' GA.
Collapse
Affiliation(s)
- Meryem Khadija Talbo
- School of Human Nutrition, Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Marie-Eve Besner
- Department of Clinical Nutrition, Montreal Children's Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Hugues Plourde
- School of Human Nutrition, Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Martine Claveau
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Marc Beltempo
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
19
|
Nakamura K, Matsumoto N, Nakamura M, Takeuchi A, Kageyama M, Yorifuji T. Exclusively Breastfeeding Modifies the Adverse Association of Late Preterm Birth and Gastrointestinal Infection: A Nationwide Birth Cohort Study. Breastfeed Med 2020; 15:509-515. [PMID: 32543213 DOI: 10.1089/bfm.2020.0064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introduction: Late preterm infants (LPIs) are at greater risk for short- and long-term morbidity compared with term infants. However, little is known about whether breastfeeding can reduce the adverse effect of late preterm (LP) birth on various diseases. Therefore, we examined the association of LP birth with the risk of hospitalizations from 6 to 18 months of age, then explored the possible modification of this effect by breastfeeding. Materials and Methods: Data were extracted from a nationwide population-based longitudinal survey in Japan. We restricted our analysis to term and LPIs with information on hospitalization (n = 31,578). Multivariate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated to evaluate the association between LP birth and hospitalization using term birth as the reference. We then examined whether breastfeeding status modified the potential adverse effects of LP birth on each health outcome. Results: LPIs were more likely to be hospitalized for all-cause (aOR, 1.58; 95% CI, 1.35-1.86), respiratory (aOR, 1.52; 95% CI, 1.21-1.92) and gastrointestinal infections (aOR, 1.73; 95% CI, 1.14-2.62) than term infants. While LPIs had a higher risk of hospitalization for all-cause and respiratory infection regardless of breastfeeding status, we did not observe an increased risk of hospitalization for gastrointestinal infection among the exclusively breastfed LPIs, in contrast with increased risk among the non-exclusively breastfed LPIs. Conclusions: We found that LPIs had a higher risk of all-cause and cause-specific hospitalization compared with term infants. Moreover, exclusive breastfeeding probably reduced the adverse effect of LP birth on gastrointestinal infection.
Collapse
Affiliation(s)
- Kazue Nakamura
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.,Division of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan
| | - Naomi Matsumoto
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Makoto Nakamura
- Division of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan
| | - Akihito Takeuchi
- Division of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan
| | - Misao Kageyama
- Division of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan
| | - Takashi Yorifuji
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| |
Collapse
|
20
|
Gonçalves JL, Fuertes M, Alves MJ, Antunes S, Almeida AR, Casimiro R, Santos M. Maternal pre and perinatal experiences with their full-term, preterm and very preterm newborns. BMC Pregnancy Childbirth 2020; 20:276. [PMID: 32375667 PMCID: PMC7204281 DOI: 10.1186/s12884-020-02934-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/13/2020] [Indexed: 01/07/2023] Open
Abstract
Background Mothers’ reports about pregnancy, maternity and their experiences during the perinatal period have been associated with infants’ later quality of attachment and development. Yet, there has been little research with mothers of very preterm newborns. This study aimed to explore mothers’ experiences related to pregnancy, premature birth, relationship with the newborn, and future perspectives, and to compare them in the context of distinct infants’ at-birth-risk conditions. Methods A semi-structured interview was conducted with women after birth, within the first 72 h of the newborn’s life. A total of 150 women participated and were divided in three groups: (1) 50 mothers of full-term newborns (Gestational Age (GA) ≥ 37 weeks; FT), (2) 50 mothers of preterm newborns (GA 32–36 weeks; PT) and (3) 50 mothers of very preterm newborns (GA < 32 weeks; VPT). Results Mothers of full-term infants responded more often that their children were calm and that they did not expect difficulties in taking care of and providing for the baby. Mothers of preterm newborns although having planned and accepted well the pregnancy (with no mixed or ambivalent feelings about it) and while being optimistic about their competence to take care of the baby, mentioned feeling frightened because of the unexpected occurrence of a premature birth and its associated risks. Mothers of very preterm newborns reported more negative and distressful feelings while showing more difficulties in anticipating the experience of caring for their babies. Conclusion The results indicate that Health Care Systems and Neonatal Care Policy should provide differentiated psychological support and responses to mothers, babies and families, taking into account the newborns’ GA and neonatal risk factors.
Collapse
Affiliation(s)
- Joana L Gonçalves
- Center for Psychology at University of Porto (CPUP), Rua Alfredo Allen, 4200-135, Porto, Portugal.
| | - Marina Fuertes
- Center for Psychology at University of Porto (CPUP), Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Maria João Alves
- Center for Psychology at University of Porto (CPUP), Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Sandra Antunes
- School of Health Technology, Polytechnic Institute of Lisbon, Lisbon, Portugal
| | - Ana Rita Almeida
- Lisbon School of Education/CIED, Polytechnic Institute of Lisbon, Lisbon, Portugal
| | - Rute Casimiro
- Lisbon School of Education/CIED, Polytechnic Institute of Lisbon, Lisbon, Portugal
| | - Margarida Santos
- School of Health Technology, Polytechnic Institute of Lisbon, Lisbon, Portugal.,Faculty of Psychology and Education Sciences, University of Lisbon, Lisbon, Portugal
| |
Collapse
|
21
|
Karnati S, Kollikonda S, Abu-Shaweesh J. Late preterm infants - Changing trends and continuing challenges. Int J Pediatr Adolesc Med 2020; 7:36-44. [PMID: 32373701 PMCID: PMC7193066 DOI: 10.1016/j.ijpam.2020.02.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Late preterm infants, defined as newborns born between 340/7-366/7 weeks of gestational age, constitute a unique group among all premature neonates. Often overlooked because of their size when compared to very premature infants, this population is still vulnerable because of physiological and structural immaturity. Comprising nearly 75% of babies born less than 37 weeks of gestation, late preterm infants are at increased risk for morbidities involving nearly every organ system as well as higher risk of mortality when compared to term neonates. Neurodevelopmental impairment has especially been a concern for these infants. Due to various reasons, the rate of late preterm births continue to rise worldwide. Caring for this high risk population contributes a significant financial burden to health systems. This article reviews recent trends in regarding rate of late preterm births, common morbidities and long term outcomes with special attention to neurodevelopmental outcomes.
Collapse
Affiliation(s)
- Sreenivas Karnati
- Department of Pediatrics, Cleveland Clinic Children’s, Cleveland, OH, USA
| | - Swapna Kollikonda
- Department of Obstetrics and Gynecology, Women’s Health Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jalal Abu-Shaweesh
- Department of Pediatrics, Cleveland Clinic Children’s, Cleveland, OH, USA
| |
Collapse
|
22
|
Franck LS, McLemore MR, Williams S, Millar K, Gordon AY, Williams S, Woods N, Edwards L, Pacheco T, Padilla A, Nelson F, Rand L. Research priorities of women at risk for preterm birth: findings and a call to action. BMC Pregnancy Childbirth 2020. [PMID: 31928534 DOI: 10.1186/s12884-0192664-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Traditional hierarchical approaches to research give privilege to small groups with decision-making power, without direct input from those with lived experience of illness who bear the burden of disease. A Research Justice framework values the expertise of patients and communities as well as their power in creating knowledge and in decisions about what research is conducted. Preterm birth has persisted at epidemic levels in the United States for decades and disproportionately affects women of color, especially Black women. Women of color have not been included in setting the agenda regarding preterm birth research. METHODS We used the Research Priorities of Affected Communities protocol to elicit and prioritize potential research questions and topics directly from women of color living in three communities that experience disproportionately high rates of preterm birth. Women participated in two focus group sessions, first describing their healthcare experiences and generating lists of uncertainties about their health and/or healthcare during pregnancy. Women then participated in consensus activities to achieve 'top-priority' research questions and topic lists. The priority research questions and topics produced by each group were examined within and across the three regions for similarities and differences. RESULTS Fifty-four women participated in seven groups (14 sessions) and generated 375 researchable questions, clustered within 22 topics and four overarching themes: Maternal Health and Care Before, During, and After Pregnancy; Newborn Health and Care of the Preterm Baby; Understanding Stress and Interventions to Prevent or Reduce Stress; and Interpersonal and Structural Health Inequities. The questions and topics represent a wide range of research domains, from basic science, translational, clinical, health and social care delivery to policy and economic research. There were many similarities and some unique differences in the questions, topics and priorities across the regions. CONCLUSIONS These findings can be used to design and fund research addressing unanswered questions that matter most to women at high risk for preterm birth. Investigators and funders are strongly encouraged to incorporate women at the front lines of the preterm birth epidemic in research design and funding decisions, and more broadly, to advance methods to deepen healthcare research partnerships with affected communities.
Collapse
Affiliation(s)
- Linda S Franck
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA.
- Department of Family Health Care Nursing, University of California San Francisco, San Francisco, 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA.
| | - Monica R McLemore
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Shanell Williams
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Kathryn Millar
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | | | | | - Nakia Woods
- Oakland Best Babies Zone (formerly), San Francisco, CA, USA
| | | | | | - Artie Padilla
- Fresno Every Neighborhood Partnership, Fresno, CA, USA
| | - Fanta Nelson
- Fresno County Black Infant Health, Fresno, CA, USA
| | - Larry Rand
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
23
|
Franck LS, McLemore MR, Williams S, Millar K, Gordon AY, Williams S, Woods N, Edwards L, Pacheco T, Padilla A, Nelson F, Rand L. Research priorities of women at risk for preterm birth: findings and a call to action. BMC Pregnancy Childbirth 2020; 20:10. [PMID: 31928534 PMCID: PMC6956492 DOI: 10.1186/s12884-019-2664-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 12/06/2019] [Indexed: 11/19/2022] Open
Abstract
Background Traditional hierarchical approaches to research give privilege to small groups with decision-making power, without direct input from those with lived experience of illness who bear the burden of disease. A Research Justice framework values the expertise of patients and communities as well as their power in creating knowledge and in decisions about what research is conducted. Preterm birth has persisted at epidemic levels in the United States for decades and disproportionately affects women of color, especially Black women. Women of color have not been included in setting the agenda regarding preterm birth research. Methods We used the Research Priorities of Affected Communities protocol to elicit and prioritize potential research questions and topics directly from women of color living in three communities that experience disproportionately high rates of preterm birth. Women participated in two focus group sessions, first describing their healthcare experiences and generating lists of uncertainties about their health and/or healthcare during pregnancy. Women then participated in consensus activities to achieve ‘top-priority’ research questions and topic lists. The priority research questions and topics produced by each group were examined within and across the three regions for similarities and differences. Results Fifty-four women participated in seven groups (14 sessions) and generated 375 researchable questions, clustered within 22 topics and four overarching themes: Maternal Health and Care Before, During, and After Pregnancy; Newborn Health and Care of the Preterm Baby; Understanding Stress and Interventions to Prevent or Reduce Stress; and Interpersonal and Structural Health Inequities. The questions and topics represent a wide range of research domains, from basic science, translational, clinical, health and social care delivery to policy and economic research. There were many similarities and some unique differences in the questions, topics and priorities across the regions. Conclusions These findings can be used to design and fund research addressing unanswered questions that matter most to women at high risk for preterm birth. Investigators and funders are strongly encouraged to incorporate women at the front lines of the preterm birth epidemic in research design and funding decisions, and more broadly, to advance methods to deepen healthcare research partnerships with affected communities.
Collapse
Affiliation(s)
- Linda S Franck
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA. .,Department of Family Health Care Nursing, University of California San Francisco, San Francisco, 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA.
| | - Monica R McLemore
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Shanell Williams
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Kathryn Millar
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | | | | | - Nakia Woods
- Oakland Best Babies Zone (formerly), San Francisco, CA, USA
| | | | | | - Artie Padilla
- Fresno Every Neighborhood Partnership, Fresno, CA, USA
| | - Fanta Nelson
- Fresno County Black Infant Health, Fresno, CA, USA
| | - Larry Rand
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
24
|
Sharma D, Padmavathi IV, Tabatabaii SA, Farahbakhsh N. Late preterm: a new high risk group in neonatology. J Matern Fetal Neonatal Med 2019; 34:2717-2730. [PMID: 31575303 DOI: 10.1080/14767058.2019.1670796] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Late preterm infants are those infants born between 34 0/7 weeks through 36 6/7 week of gestation. These are physiologically less mature and have limited compensatory responses to the extrauterine environment compared with term infants. Despite their increased risk for morbidity and mortality, late preterm newborns are often cared in the well-baby nurseries of hospital after birth and are discharged from the hospital by 2-3 days of postnatal age. They are usually treated like developmentally mature term infants because many of them are of same birth weight and same size as term infants. There is a steady increase in the late preterm birth rate in last decade because of either maternal, fetal, or placental/uterine causes. There has been shift in the distribution of births from term and post-term toward earlier gestations. Although late preterm infants are the largest subgroup of preterm infants, there has been little research on this group until recently. This is mainly because of labeling them as "near-term". Such infants were being looked upon as "almost mature", and were thought as neonate requiring either no or minimal concern. In the obstetric and pediatric practice, late preterm infants are often considered functionally and developmentally mature and often managed by protocols developed for full-term infants. Thus, limited efforts are taken to prolong pregnancy in cases of preterm labor beyond 34 weeks, moreover after 34 weeks most centers do not administer antenatal prophylactic steroids. These practices are based on previous studies reporting neonatal mortality and morbidity in the late preterm period to be only slightly higher in comparison with term infants and whereas in the current scenario the difference is significant. Late preterm infants have 2-3-fold increased risk of morbidities such as hypothermia, hypoglycemia, delayed lung fluid clearance, respiratory distress, poor feeding, jaundice, sepsis, and readmission rates after initial hospital discharge. This leads to huge impact on the overall health care resources. In this review, we cover various aspects of these late preterm infants like etiology, immediate and long-term outcome.
Collapse
Affiliation(s)
- Deepak Sharma
- Department of Neonatology, National Institute of Medical Sciences, Jaipur, India
| | | | | | - Nazanin Farahbakhsh
- Department of Pulmonology, Pediatric Department, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
25
|
Yaacoby-Bianu K, Plonsky MT, Gur M, Bar-Yoseph R, Kugelman A, Bentur L. Effect of late preterm birth on lung clearance index and respiratory physiology in school-age children. Pediatr Pulmonol 2019; 54:1250-1256. [PMID: 31091024 DOI: 10.1002/ppul.24357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 04/06/2019] [Accepted: 04/26/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND We hypothesized that former late preterm (LP) children have abnormal pulmonary physiology parameters, including uneven ventilation distribution, due to premature disruption of normal lung development. METHODS A cross-sectional study evaluating former LP children at the age of 6 to 12 years as compared to term controls. Demographics and child's and family history of asthma/atopy/smoking were recorded. The outcome parameters were spirometry, multiple breath washout (MBW) measurement by lung clearance index (LCI), 6-minute walk test (6MWT), symptoms related to asthma and allergy, and Godin Leisure-Time Exercise Questionnaire. RESULTS Twenty-nine former LP were compared to 30 term-control children (mean age, 8.2 ± 1.7 and 8.8 ± 1.8 years, respectively). LP had reduced forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) compared to term controls (FEV1 1.59 ± 0.48 vs 1.80 ± 0.39 L, P = 0.005 and FVC 1.73 ± 0.45 vs 1.99 ± 0.49 L, P = 0.009). There were no differences between the two groups regarding FEV1/FVC, forced expiratory flow between 25 and 75 (FEF25-75), LCI (7.10 ± 0.79 vs 6.96 ± 0.75, P = 0.50), 6MW distance, and weekly leisure-activity score. Former LP children had more episodes of wheezing and greater use of asthma medication. CONCLUSIONS This pilot study suggests that LP have lower pulmonary function tests (PFTs) but not ventilation inhomogeneity measured by LCI or functional disturbance. It is unclear if the differences in PFTs are due to late prematurity by itself or are the consequence of maternal and neonatal factors associated with LP. Further larger studies are required to assess the long-term respiratory consequences of LP birth.
Collapse
Affiliation(s)
- Karin Yaacoby-Bianu
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Moran T Plonsky
- Department of Pediatrics B, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Michal Gur
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ronen Bar-Yoseph
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Amir Kugelman
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Neonatal Intensive Care, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Lea Bentur
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
26
|
Huff K, Rose RS, Engle WA. Late Preterm Infants: Morbidities, Mortality, and Management Recommendations. Pediatr Clin North Am 2019; 66:387-402. [PMID: 30819344 DOI: 10.1016/j.pcl.2018.12.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Infants born between 34 weeks 0 days and 36 weeks 6 days of gestation are termed late preterm. This group accounts for the majority of premature births in the United States, with rates increasing in each of the last 3 years. This increase is significant given their large number: nearly 280,000 in 2016 alone. Late preterm infants place a significant burden on the health care and education systems because of their increased risk of morbidities and mortality compared with more mature infants. This increased risk persists past the newborn period, leading to the need for continued health monitoring throughout life.
Collapse
Affiliation(s)
- Katie Huff
- Department of Neonatology, Indiana University School of Medicine, 699 Riley Hospital Drive, RR 208, Indianapolis, IN 46202, USA
| | - Rebecca S Rose
- Department of Neonatology, Indiana University School of Medicine, 699 Riley Hospital Drive, RR 208, Indianapolis, IN 46202, USA
| | - William A Engle
- Department of Neonatology, Indiana University School of Medicine, 699 Riley Hospital Drive, RR 208, Indianapolis, IN 46202, USA.
| |
Collapse
|
27
|
Nishizaki N, Obinata K, Kantake M, Yoshida N, Ohtomo Y, Niijima S, Yanagisawa N, Nishizaki Y, Shoji H, Shimizu T. Association between the frequency of bedwetting and late preterm birth in children aged ≥5 years. Acta Paediatr 2019; 108:282-287. [PMID: 29953662 DOI: 10.1111/apa.14481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/23/2018] [Accepted: 06/26/2018] [Indexed: 11/28/2022]
Abstract
AIM We examined the associations between late preterm (LPT) birth children aged ≥5 years and the frequency of bedwetting. Moreover, those who were born full-term/low birthweight (BW), LPT/low BW, LPT/normal BW and LPT/low BW were compared. METHODS In total, we evaluated 614 patients who underwent assessments for frequent bedwetting at the three hospitals from January 2014 to December 2016. Data at the initial visit were collected from the electronic medical records. We assessed the patients' bladder diaries and questionnaires containing detailed information on demographics and frequency of bedwetting per month. Neonatal data were collected from the Maternal and Child Health Handbook. RESULTS Frequency of bedwetting in the LPT/low BW group was higher than in the term/low BW group (28 vs. 22.5, p < 0.05). However, the frequency between the LPT/normal BW group and the LPT/low BW group was not significantly different (28 vs. 28, p = 1.00). Multiple regression analyses were conducted to eliminate potential confounding factors, attention-deficit/hyperactivity disorder and intellectual disability, but results were not changed. CONCLUSION This study revealed that LPT/low BW was associated with increased frequency of bedwetting in children. The results suggest that gestational age should be considered when examining patients with severe bedwetting.
Collapse
Affiliation(s)
- Naoto Nishizaki
- Department of Pediatrics; Juntendo University Urayasu Hospital; Chiba Japan
| | - Kaoru Obinata
- Department of Pediatrics; Juntendo University Urayasu Hospital; Chiba Japan
| | - Masato Kantake
- Department of Pediatrics; Juntendo University Shizuoka Hospital; Shizuoka Japan
| | - Noboru Yoshida
- Department of Pediatrics; Juntendo University Nerima Hospital; Tokyo Japan
| | - Yoshiyuki Ohtomo
- Department of Pediatrics; Juntendo University Nerima Hospital; Tokyo Japan
| | - Shinichi Niijima
- Department of Pediatrics; Juntendo University Nerima Hospital; Tokyo Japan
| | - Naotake Yanagisawa
- Clinical Research and Trial Center; Juntendo University Hospital; Tokyo Japan
| | - Yuji Nishizaki
- Clinical Research and Trial Center; Juntendo University Hospital; Tokyo Japan
- Medical Technology Innovation Center; Juntendo University; Tokyo Japan
| | - Hiromichi Shoji
- Department of Pediatrics and Adolescent Medicine; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Toshiaki Shimizu
- Department of Pediatrics and Adolescent Medicine; Juntendo University Graduate School of Medicine; Tokyo Japan
| |
Collapse
|
28
|
Muganthan T, Boyle EM. Early childhood health and morbidity, including respiratory function in late preterm and early term births. Semin Fetal Neonatal Med 2019; 24:48-53. [PMID: 30348617 DOI: 10.1016/j.siny.2018.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Late preterm (LP) and early term (ET) infants have generally been considered in the same way as their healthy full term (FT) counterparts. It is only in the last decade that an increased risk of later poor health in children born LP has been recognised; evidence for health outcomes following ET birth is still emerging. However, reports are largely consistent in highlighting an increased risk, which lessens approaching FT but is measurable and persists into adolescence and beyond. The most thoroughly explored area to date is respiratory morbidity. This article reviews the body of available evidence for effects of LP birth on pulmonary function and ongoing morbidity, and other areas where an increased risk of health problems has been identified in this population. Implications for delivery of health care are considered and areas for further research are highlighted.
Collapse
Affiliation(s)
- Trishula Muganthan
- Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Elaine M Boyle
- Department of Health Sciences, University of Leicester, Leicester, UK.
| |
Collapse
|
29
|
Sanghera RS, Boyle EM. Outcomes of infants born near term: not quite ready for the "big wide world"? Minerva Pediatr 2018; 71:47-58. [PMID: 30299031 DOI: 10.23736/s0026-4946.18.05406-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Until recently, there has been a strongly held belief on the part of neonatal and pediatric clinicians that outcomes for infants born close to term are not different from those of babies born at full term. In the last decade, however, this assumption has been challenged by reports suggesting that this is not correct, and highlighting differences in morbidity and mortality both in the short and long term. This has led to development of new terminology to more accurately reflect the impact of immaturity associated with birth at 32-33 weeks (moderately preterm) and 34-36 weeks (late preterm) of gestation. These babies account for around 5-7% of all births and more than 75% of the preterm births in developed countries, so this new recognition of the associated increase in adverse outcomes may have a substantial impact on health care services. This review article will discuss the changing perceptions and concepts of gestational age in the preterm population, and explore the recent and emerging evidence around neonatal, early childhood, school-age, adolescent and adult outcomes for babies who are born moderately preterm and late preterm. It highlights important neonatal and childhood morbidities and will summarize associated health care, developmental and educational problems of affected children. The implications for the provision of ongoing primary and secondary health care, educational and social support to this large and heterogeneous group of individuals will be discussed.
Collapse
Affiliation(s)
- Ranveer S Sanghera
- Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Elaine M Boyle
- Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK - .,Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| |
Collapse
|