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Liveborn Infants (liveborn + infant)
Selected AbstractsPreterm delivery but not intrauterine growth retardation is associated with young maternal age among primiparae in rural NepalMATERNAL & CHILD NUTRITION, Issue 3 2007Christine P. Stewart Abstract Pregnancy during adolescence is associated with adverse birth outcomes, including preterm delivery and low birthweight. The nutrient availability to the fetus may be limited if the mother is still growing. This research aims to study the effects of pregnancy during adolescence in a nutritionally poor environment in rural Nepal. This study utilized data from a randomized controlled trial of micronutrient supplementation during pregnancy in south-eastern Nepal. Women of parity 0 or 1 and of age , 25 years who gave birth to a singleton liveborn infant who was measured within 72 h of delivery were included (n = 1393). There was no difference in the risk of low birthweight (OR = 0.96; 95% CI = 0.90,1.02) or small for gestational age (OR = 1.01; 95% CI = 0.94,1.08) per year of increasing maternal age among primiparae. Young maternal age did not affect the anthropometry or gestational age of the offspring of parity 1 women. Each year of increasing maternal age among primiparae was associated with increases in birth length (0.07 cm; 95% CI = ,0.01 to 0.16), head (0.05 cm; 95% CI = 0.01,0.09) and chest circumference (0.07 cm; 95% CI = 0.01,0.12), but not weight (9.0 g; 95% CI = ,2.1 to 21.8) of their offspring. Young maternal age was associated with an increased risk of preterm delivery among primiparae (OR = 2.07; 95% CI = 1.26,3.38) that occurred at an age cut-off of ,18 years relative to those 19,25 years. Thus, we conclude that young maternal age (,18 years) increased the risk of preterm delivery, but not intrauterine growth retardation, for the first but not second liveborn infant. [source] Risk factors for and timing of death of extremely preterm infantsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Dawn E. ELDER This study examined risk factors for timing and cause of death for extremely preterm infants , 23 weeks and < 28 weeks. There were 479 liveborn infants and 98 deaths reviewed over a ten-year period. Thirty-two deaths (33%) occurred on the first day of life and 72 (75%) in the first month of life. Lower gestation and intrauterine growth restriction were significant risk factors for death. Most deaths occurred in the first month of life and at the lowest gestation in the first week. [source] Birth at hospitals with co-located paediatric units for infants with correctable birth defectsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2008Charles S. ALGERT Objectives: To determine the percentage of liveborn infants with selected antenatally identifiable and correctable birth defects who were delivered at hospitals with co-located paediatric surgical units (co-located hospitals). Additionally, to determine the survival rates for these infants. Patients and methods: Data were from linked New South Wales hospital discharge records from 2001 to 2004. Livebirths with one of the selected defects were included if they underwent an appropriate surgical repair, or died during the first year of life. Infants with multiple lethal birth defects were excluded. Deliveries at co-located hospitals were identified, but no data on antenatal diagnosis were available. Results: The study identified 287 eligible livebirths with the selected defects. The highest rates of delivery at co-located hospitals were for gastroschisis (88%), exomphalos (71%), spina bifida (63%) and diaphragmatic hernia (61%), and the lowest for transposition of the great arteries (43%) and oesophageal atresia (40%). Mothers resident outside of metropolitan areas, where the co-located hospitals are located, had a similar rate of delivery at co-located hospitals as metropolitan women. For the non-metropolitan mothers of infants with a birth defect, this represented a 30-fold increase over the baseline delivery rate of 1.8%. Post-surgery survival rates were 87% or higher. Overall survival rates were , 86% except for infants with a diaphragmatic hernia. Conclusions: Delivery rates at co-located hospitals were high for mothers of infants with these correctable birth defects. Regionalised health care appears to work well for these pregnancies, as women living outside metropolitan areas had a similar rate of delivery at co-located hospitals to that of urban women. [source] Escherichia coli: a growing problem in early onset neonatal sepsisAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2004Bronwyn JONES Abstract Aims: To review the demographic characteristics, antecedents and outcome for early neonatal Escherichia coli sepsis. Secondary aims were to identify antenatal antibiotic use and to review the antimicrobial susceptibility. Methods: A retrospective chart review was performed for all infants with a positive culture for E. coli from either blood or CSF samples obtained between January 1998 and October 2002. Results: Nineteen liveborn infants with early onset sepsis and one stillborn baby with a positive maternal blood culture for E. coli were identified. Pregnancy complications included multiple pregnancy in five (25%), preterm rupture of membranes 10 (50%) and maternal urinary tract infection in five (25%). Eighteen of the cases were born preterm and two at term. The mortality was 8/20 (40%), and for nine cases with developmental outcome data available, 67% were within normal limits and 33% were abnormal. Of the 20 E. coli isolates 11 (55%) were resistant to amoxycillin and 1 (5%) was resistant to gentamicin. Conclusions: Infants with early onset E. coli sepsis had a poor outcome with high mortality and a third of the survivors manifesting neurodevelopmental impairment. Although amoxycillin resistance is common, there is a low prevalence of gentamicin resistance in local isolates. [source] Declining Trends in Cesarean Deliveries, Ohio 1989,1996: An Analysis by IndicationsBIRTH, Issue 1 2000Siran M. Koroukian PhD Background:Similar to trends observed nationwide, the rates of cesarean deliveries declined in Ohio during the late 1980s and the early 1990s. This study examined the trends in cesarean deliveries in Ohio from 1989 through 1996, in the presence or absence of indications, and in relation to the use of obstetric procedures. Methods:Birth certificate data for all singleton, liveborn infants in Ohio (n =1,204,859) were used to analyze temporal trends in cesarean sections. Results:The rates of primary and repeat cesarean deliveries declined, respectively, from 15.7 to 12.4 percent and from 83 to 63.3 percent during the 8-year study period. Significant declines in repeat cesarean deliveries were observed both in the presence and absence of documented medical conditions that could present a potential indication for the procedure. The rates of repeat cesareans remained comparable among women with and without documented indications for cesarean section (64% and 61%, respectively). In addition, 45 and 30 percent of repeat cesareans in 1989 and 1996, respectively, were performed in the absence of any documented indications, or on an elective basis. The declines in cesarean delivery rates during the 8-year study period occurred simultaneously with an increase in the use of electronic fetal monitoring, induction, and stimulation of labor. Conclusions:The findings suggest that a sizable proportion of repeat cesarean deliveries in 1996 may be unnecessary, even though a marked decline in the procedure has occurred between 1989 and 1996. [source] Periconceptional nutrient intakes and risks of conotruncal heart defects,BIRTH DEFECTS RESEARCH, Issue 3 2010Gary M. Shaw Abstract BACKGROUND Few inquiries into periconceptional nutrition, other than folate, and risk of heart defects exist. We investigated the observed association between conotruncal heart defects and periconceptional vitamin use, as well as potential associations with other dietary nutrients. METHODS Data derived from a population-based, case-control study of fetuses and liveborn infants among California births between July 1999 and June 2004; 76% of eligible case mothers and 77% of eligible control mothers were interviewed. Cases included 140 with d-transposition of great arteries (dTGA), and 163 with tetralogy of Fallot (TOF). Total number of controls was 698. Use of vitamins was elicited by questionnaire for the periconceptional period. Dietary nutrient intake was elicited by a well-known food frequency questionnaire. RESULTS The odds ratio for dTGA associated with supplemental vitamin use was 1.0 (95% confidence interval [CI], 0.7,1.5) and for TOF was 0.9 (95% CI, 0.6,1.3). We observed increased risks associated with lower dietary intakes of linoleic acid, total carbohydrate, and fructose for dTGA, whereas decreased risks were observed for lower intakes of total protein and methionine for TOF. Lower dietary intake of several micronutrients,namely folate, niacin, riboflavin, and vitamins B12, A, and E, even after simultaneous adjustment for other studied nutrients,was associated with increased risk of dTGA but not TOF. These associations were observed among women who did not use vitamin supplements periconceptionally. Analytic consideration of several potential confounders did not reveal alternative interpretations of the results. CONCLUSION Evidence continues to accumulate to show that nutrients, particularly folate, influence risks of structural birth defects. Our results extend observations that other nutrients may also be important in heart development. Birth Defects Research (Part A), 2010. © 2010 Wiley-Liss, Inc. [source] Postmarketing surveillance for human teratogenicity: A model approach,BIRTH DEFECTS RESEARCH, Issue 5 2001Christina D. Chambers Background Most congenital defects associated with prenatal exposures are notable for a pattern of major and minor malformations, rather than for a single major malformation. Thus, traditional epidemiological methods are not universally effective in identifying new teratogens. The purpose of this report is to outline a complementary approach that can be used in addition to other more established methods to provide the most comprehensive evaluation of prenatal exposures with respect to teratogenicity. Methods We describe a multicenter prospective cohort study design involving dysmorphological assessment of liveborn infants. This design uses the Organization of Teratology Information Services, a North American network of information providers who also collaborate for research purposes. Procedures for subject selection, methods for data collection, standard criteria for outcome classification, and the approach to analysis are detailed. Results The focused cohort study design allows for evaluation of a spectrum of adverse pregnancy outcomes ranging from spontaneous abortion to functional deficit. While sample sizes are typically inadequate to identify increased risks for single major malformations, the use of dysmorphological examinations to classify structural anomalies provides the unique advantage of screening for a pattern of malformation among exposed infants. Conclusions As the known human teratogens are generally associated with patterns of structural defects, it is only when studies of this type are used in combination with more traditional methods that we can achieve an acceptable level of confidence regarding the risk or safety of specific exposures during pregnancy. Teratology 64:252,261, 2001. © 2001 Wiley-Liss, Inc. [source] Trends in outcomes for very preterm infants in the southern region of Sweden over a 10-year periodACTA PAEDIATRICA, Issue 4 2009Pia Lundqvist Abstract Aim: To investigate trends in mortality and morbidity in very preterm infants. Methods: Population-based perinatal register; liveborn infants 22 + 0 to 31 + 6 gestational weeks were investigated (time period 1995,2004). Time trends for mortality and common morbidities were explored using logistic regression analyses. Results: Data from 1614 liveborn infants were included. There was an increase in live born infants below 25 gestational weeks, annual odds ratio (OR) 1.15 (95% CI: 1.08,1.23) and a decrease in mortality annual OR 0.82 (95% CI: 0.69,0.98). The rates of bronchopulmonary dysplasia (BPD) and sepsis increased during the study period, annual ORs of 1.10 (95% CI: 1.04,1.17) and 1.09 (95% CI: 1.03,1.16). The duration of mechanical ventilation increased for surviving infants <25 gestational weeks (p = 0.003), while the duration of continuous positive airway pressure (CPAP) increased for infants <28 gestational weeks (p = <0.001). There were no changes in the rates of intraventricular haemorrhages (IVH, 3,4), retinopathy of prematurity (ROP, 3,5), seizures or necrotizing enterocolitis (NEC). Conclusion: During the 10-year period changes in mortality and morbidity were most pronounced for infants with GA <28 gestational weeks. The increasing rate of sepsis was present in infants <28 gestational weeks, whereas the increase in BPD was demonstrated in the whole study population <32 gestational weeks. [source] | ||||||||||