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Seminars in Fetal & Neonatal Medicine Dec 2018Necrotizing enterocolitis (NEC) is the most common serious gastrointestinal morbidity in preterm infants. A number of risk factors for NEC have been reported in the... (Review)
Review
Necrotizing enterocolitis (NEC) is the most common serious gastrointestinal morbidity in preterm infants. A number of risk factors for NEC have been reported in the literature. With the exception of decreasing gestational age, decreasing birth weight and formula feeding, there is disagreement on the importance of reported risk factors with uncertain causality. Causal risk factors may be observed at any time before the onset of NEC, including prior to an infant's birth. The purpose of this review is to examine the existing literature and summarize risk factors for NEC. This review may be helpful in understanding the epidemiology of NEC and inform the measurement and assessment of risks factors for NEC in research studies and quality improvement projects.
Topics: Enterocolitis, Necrotizing; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Risk Factors
PubMed: 30115546
DOI: 10.1016/j.siny.2018.07.005 -
The Western Journal of Emergency... Oct 2022An abortion is a procedure defined by termination of pregnancy, most commonly performed in the first or second trimester. There are several means of classification, but... (Review)
Review
An abortion is a procedure defined by termination of pregnancy, most commonly performed in the first or second trimester. There are several means of classification, but the most important includes whether the abortion was maternally "safe" (performed in a safe, clean environment with experienced providers and no legal restrictions) or "unsafe" (performed with hazardous materials and techniques, by person without the needed skills, or in an environment where minimal medical standards are not met). Complication rates depend on the procedure type, gestational age, patient comorbidities, clinician experience, and most importantly, whether the abortion is safe or unsafe. Safe abortions have significantly lower complication rates compared to unsafe abortions. Complications include bleeding, retained products of conception, retained cervical dilator, uterine perforation, amniotic fluid embolism, misoprostol toxicity, and endometritis. Mortality rates for safe abortions are less than 0.2%, compared to unsafe abortion rates that range between 4.7-13.2%. History and physical examination are integral components in recognizing complications of safe and unsafe abortions, with management dependent upon the diagnosis. This narrative review provides a focused overview of post-abortion complications for emergency clinicians.
Topics: Female; Pregnancy; Humans; Abortion, Induced; Gestational Age; Hazardous Substances; Physical Examination
PubMed: 36409940
DOI: 10.5811/westjem.2022.8.57929 -
Advances in Nutrition (Bethesda, Md.) Jan 2019This is the first systematic review to examine the global prevalence of catch-up growth (CUG) in small for gestational age (SGA) infants who were born at full term (FT)....
This is the first systematic review to examine the global prevalence of catch-up growth (CUG) in small for gestational age (SGA) infants who were born at full term (FT). Size at birth and subsequent growth is an important indicator of neonatal and adult health. Globally, 16% of infants are SGA at birth, ranging from 7% in industrialized countries to 41.5% in South Asia. SGA infants are at increased risk for negative developmental and adult health outcomes. Some achieve CUG but others do not. CUG has immediate and late health implications especially in low- and middle-income countries. This systematic review sought to determine the global prevalence of CUG among FT-SGA infants. We performed a literature search of MEDLINE, Pubmed, Embase, Web of Science, and Scopus, as well as grey literature databases, and identified 3137 studies. The final analysis included 11 studies. The median prevalence of CUG was 87.4% across all definitions of SGA and CUG. However, multiple definitions were used to classify SGA and CUG. Nine unique reference populations were used to classify SGA, and 6 to approximate CUG. Due to this heterogeneity, a meta-analysis could not be conducted. Program implementation for this vulnerable group of infants is dependent on proper classification. Given the wide range of definitions and reference standards used in the past, it is not possible to determine the global need for programs to address CUG for FT-SGA infants or to rationally plan any such programs. We highlight the need and propose standard definitions and references for SGA and CUG.
Topics: Child Development; Female; Gestational Age; Humans; Infant, Newborn; Infant, Small for Gestational Age; Male; Term Birth
PubMed: 30649167
DOI: 10.1093/advances/nmy091 -
Ugeskrift For Laeger Oct 2022Congenital hydrops fetalis describes an abnormal accumulation of fluid in two or more compartments in a fetus. The disease is categorized based on the aetiology: immune-... (Review)
Review
Congenital hydrops fetalis describes an abnormal accumulation of fluid in two or more compartments in a fetus. The disease is categorized based on the aetiology: immune- and non-immune hydrops fetalis. Today, the non-immune form is the most common. Once born, the child is initially handled symptomatically and will often need intensive care and treatment. Even though approximately one in five cases is still idiopathic, genetic diagnostic tools have become increasingly important in the diagnostic process. The prognosis depends on the aetiology and the gestational age when diagnosed and at birth, as argued in this review.
Topics: Infant, Newborn; Female; Child; Humans; Hydrops Fetalis; Gestational Age; Prognosis
PubMed: 36331166
DOI: No ID Found -
Acta Obstetricia Et Gynecologica... Aug 2019
Topics: Adult; Cesarean Section; Female; Gestational Age; Humans; Labor, Induced; Labor, Obstetric; Pregnancy; Pregnancy Outcome; Unnecessary Procedures
PubMed: 31328261
DOI: 10.1111/aogs.13683 -
Pediatrics Aug 2021To estimate associations between gestational age (GA) and teacher-reported academic outcomes at age 9 years among children born at term (37-41 weeks).
OBJECTIVES
To estimate associations between gestational age (GA) and teacher-reported academic outcomes at age 9 years among children born at term (37-41 weeks).
METHODS
A secondary data analysis of 1405 children participating in a national US birth cohort study was conducted. At age 9 years, students were evaluated by their teachers in the areas of mathematics, science and social studies, and language and literacy. Unadjusted and adjusted logistic regression models of associations between GA and teacher-reported academic outcomes were estimated and neonatal morbidities were explored as potential pathways.
RESULTS
A continuous measure of GA in weeks was significantly associated with above-average rankings in all areas. The associations were similar across outcomes (eg, mathematics [odds ratio (OR): 1.13; confidence interval (CI): 1.02-1.25], science and social studies [OR: 1.13; CI: 1.01-1.26], and language and literacy [OR: 1.16; CI: 1.05-1.28]) in a model that adjusted for child sex, maternal characteristics, and obstetric risk factors and delivery complications. Other specifications indicate a positive association between late term (41 weeks) and mathematics and a negative association between early term (37-38 weeks) and language and literacy, compared with term (39-40). The associations did not appear to operate through neonatal morbidity.
CONCLUSIONS
The findings highlight the importance of GA, even at term. Whereas current guidelines suggest waiting until at least 39 weeks to deliver when possible, our findings add to a small group of studies suggesting that GA through 41 weeks is associated with improvements in some educational outcomes.
Topics: Child; Cohort Studies; Educational Status; Female; Gestational Age; Humans; Male; Term Birth
PubMed: 34244451
DOI: 10.1542/peds.2020-021287 -
Obstetrics and Gynecology Sep 2023The distinction between “pregnancy viability” and “fetal viability” indicates the need for care and clarity when using the term “viability” in clinical...
The distinction between “pregnancy viability” and “fetal viability” indicates the need for care and clarity when using the term “viability” in clinical practice and guidance.
Topics: Humans; Gestational Age; Fetal Viability
PubMed: 37535950
DOI: 10.1097/AOG.0000000000005280 -
ISUOG Practice Guidelines (updated): performance of the routine mid-trimester fetal ultrasound scan.Ultrasound in Obstetrics & Gynecology :... Jun 2022
Topics: Female; Gestational Age; Humans; Pregnancy; Pregnancy Trimester, Second; Ultrasonography, Prenatal
PubMed: 35592929
DOI: 10.1002/uog.24888 -
International Journal of Environmental... Jan 2022Gestational age is associated with greater school achievement and variation in newborn metabolic markers. Whether metabolic markers are related to gestational age...
BACKGROUND
Gestational age is associated with greater school achievement and variation in newborn metabolic markers. Whether metabolic markers are related to gestational age differences in achievement is unknown. This study examines whether newborn metabolic markers are associated with gestational age differences in performance on standardized school tests.
METHODS
This retrospective cohort study linked birth certificates of children born in Iowa between 2002 and 2010 to newborn screening records and school tests between 2009 and 2018. The analytical sample includes up to 229,679 children and 973,247 child-grade observations. Regression models estimate the associations between gestational age and 37 newborn metabolic markers with national percentile ranking (NPR) scores on math, reading comprehension, and science tests.
RESULTS
An additional gestational week is associated with 0.6 (95% CI: 0.6, 0.7), 0.5 (95% CI: 0.4, 0.5), and 0.4 (95% CI: 0.4, 0.5) higher NPRs on math, reading, and science, respectively. Compared to full term children (37-44 weeks), preterm children (32-36 weeks) have 2.2 (95% CI: -2.6, -1.8), 1.5 (95% CI: -1.9, -1.1), and 1.0 (95% CI: -1.4, -0.7) lower NPRs on math, reading comprehension, and science. Very preterm children (20-31 weeks) have 8.3 (95% CI: -9.4, -7.2), 5.2 (95% CI: -6.2, -4.0), and 4.7 (95% CI: -5.6, -3.8) lower NPRs than full term children on math, reading, and science. Metabolic markers are associated with 27%, 36%, and 45% of gestational age differences in math, reading, and science scores, respectively, and over half of the difference in test scores between preterm or very preterm and full term children.
CONCLUSIONS
Newborn metabolic markers are strongly related to gestational age differences in school test scores, suggesting that early metabolic differences are important markers of long-term child development.
Topics: Academic Success; Adult; Educational Status; Gestational Age; Humans; Infant, Newborn; Mathematics; Retrospective Studies
PubMed: 35162571
DOI: 10.3390/ijerph19031549 -
Pediatric Research Dec 2022Foetal growth restriction (FGR) and being born small for gestational age (SGA) are associated with neurodevelopmental delay. Early diagnosis of neurological damage is... (Review)
Review
Foetal growth restriction (FGR) and being born small for gestational age (SGA) are associated with neurodevelopmental delay. Early diagnosis of neurological damage is difficult in FGR and SGA neonates. Electroencephalography (EEG) has the potential as a tool for the assessment of brain development in FGR/SGA neonates. In this review, we analyse the evidence base on the use of EEG for the assessment of neonates with FGR or SGA. We found consistent findings that FGR/SGA is associated with measurable changes in the EEG that present immediately after birth and persist into childhood. Early manifestations of FGR/SGA in the EEG include changes in spectral power, symmetry/synchrony, sleep-wake cycling, and the continuity of EEG amplitude. Later manifestations of FGR/SGA into infancy and early childhood include changes in spectral power, sleep architecture, and EEG amplitude. FGR/SGA infants had poorer neurodevelopmental outcomes than appropriate for gestational age controls. The EEG has the potential to identify FGR/SGA infants and assess the functional correlates of neurological damage. IMPACT: FGR/SGA neonates have significantly different EEG activity compared to AGA neonates. EEG differences persist into childhood and are associated with adverse neurodevelopmental outcomes. EEG has the potential for early identification of brain impairment in FGR/SGA neonates.
Topics: Child, Preschool; Infant, Newborn; Pregnancy; Infant; Female; Humans; Fetal Growth Retardation; Infant, Small for Gestational Age; Birth Weight; Parturition; Gestational Age
PubMed: 35197567
DOI: 10.1038/s41390-022-01992-2