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Milićević M, Potić S. Assessing the Risk of Cerebral Palsy in Children Born after Assisted Conception – The Role of Multiple Pregnancy and Preterm Delivery / Procena rizika od cerebralne paralize kod dece začete vantelesnim oplođenjem – uloga višestruke trudnoće i prevremenog rođenja. ACTA FACULTATIS MEDICAE NAISSENSIS 2015. [DOI: 10.1515/afmnai-2015-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
SUMMARY
For more than three decades, assisted reproductive techniques (ART) have been used as effective treatments to overcome infertility. Since then, numerous studies have been focused on different aspects of long-term health and development of children born after assisted conception. The aim of this paper is to summarize new data on multiple pregnancy and preterm delivery as one of the risk factors which might increase the risk of developing cerebral palsy (CP) in children born after assisted conception.
A comprehensive search of eight databases retrieved 108 papers, 10 of which met inclusion criteria and were relevant for this review.
Despite the dissimilarities in methodological and analytic approaches in the selected studies, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are generally considered safe, still there is an ongoing discussion whether multiple pregnancy and preterm delivery increase or do not increase the risk of CP in children born after assisted conception.
All information about possible adverse maternal and/or infant outcomes should be made available to the couples seeking ART treatment
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Abstract
Intracranial hemorrhage remains an important factor of premature newborns?
morbidity. Its incidence is significantly influenced by adequate perinatal
care and safe neonatal transport. Risk factors for the development of
intracranial hemorrhage in premature newborns after neonatal transport were
analyzed in the retrospective transversal clinical study. Out of 150 study
subjects, 60% (n=90/150) had intracranial hemorrhage with a statistically
significant difference in relation to Apgar score, gestational age, birth
weight, age at the moment of transport and the prophylactic use of
surfactant. In this group, grades I/II intracranial hemorrhage were detected
in 77% (n=69/90), while grades III/IV intracranial hemorrhage were diagnosed
in 23% (n=21/90). A statistically significant difference was observed in
relation to gestational age, birth weight, antenatal use of tocolytics and
steroids, delivery mode and age in the time of transport between these
groups. All patients were transferred to Intensive Care Unit, the duration
of transport was less than 5 minutes in 71% 9n=107/150), whereas longer
transport was recorded in 29% (n=43/150). In the group of longer transport,
prophylactic surfactant was less frequently used with a higher incidence of
grades III/IV intracranial hemorrhage. In order to prevent the development
of intracranial hemorrhage in premature newborns, the most important
measures are the antenatal use of steroids and postnatal prophylactic use of
surfactant.
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