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The Cochrane Database of Systematic... Jun 2012Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress. (Review)
Review
BACKGROUND
Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress.
OBJECTIVES
The objective of this review was to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and perinatal morbidity.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012).
SELECTION CRITERIA
Randomised trials of piracetam compared with placebo or no treatment for suspected fetal distress in labour.
DATA COLLECTION AND ANALYSIS
Both review authors assessed eligibility and trial quality.
MAIN RESULTS
One study of 96 women was included. Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03). There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score.
AUTHORS' CONCLUSIONS
There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.
Topics: Apgar Score; Cesarean Section; Delivery, Obstetric; Female; Fetal Distress; Humans; Labor, Obstetric; Neuroprotective Agents; Piracetam; Pregnancy; Randomized Controlled Trials as Topic
PubMed: 22696322
DOI: 10.1002/14651858.CD001064.pub2 -
The Journal of Invasive Cardiology Nov 2020The present study aimed to evaluate maternal and fetal outcomes in patients who underwent percutaneous balloon mitral valvuloplasty (PBMV) during antenatal care.
OBJECTIVES
The present study aimed to evaluate maternal and fetal outcomes in patients who underwent percutaneous balloon mitral valvuloplasty (PBMV) during antenatal care.
METHODS
Analysis of 117 pregnant women who underwent PBMV for rheumatic mitral stenosis. Demographic, clinical, echocardiographic, hemodynamic, and Doppler examinations were performed. The pregnant women were stratified according to New York Heart Association classification. Apgar scores were recorded at 1, 5, and 10 minutes to assess the neonatal outcomes.
RESULTS
In our study cohort, 74.36% underwent PBMV during their second trimester, at gestational age of 22.49 ± 5.82. Term birth, mode of delivery, birth weight, and Apgar score at 5 minutes were significantly associated with pregnancy and neonatal outcomes. Mitral valve area, mitral valve gradient, and pulmonary artery systolic pressure were significantly improved (P<.001) after PBMV. Pulmonary edema, medical termination of pregnancy, hypothyroidism, hepatitis B infection, pneumonia, and postprocedural delivery, as well as postprocedure severe mitral regurgitation requiring surgery in 2 patients, were the few complications observed. Mean fluoroscopy time was 4 minutes, 50 seconds, with 100% success rate. No maternal mortality was observed.
CONCLUSION
PBMV is a safe and effective intervention for mitral stenosis in pregnant women, with favorable maternal and short-term neonatal outcomes. PBMV offers excellent results in terms of symptomatic relief, hemodynamic improvement, and 100% success rate. Hence, it could be regarded as a preferred choice of intervention in managing symptomatic moderate to severe rheumatic mitral stenosis in pregnant women.
Topics: Apgar Score; Balloon Valvuloplasty; Echocardiography; Female; Humans; Infant, Newborn; Mitral Valve; Mitral Valve Stenosis; Pregnancy; Prenatal Care
PubMed: 33130593
DOI: No ID Found -
Scientific Reports Jun 2021This study examined the contribution of the Apgar score at 1 and 5 min after birth to later cognitive functioning in 168 individuals with Down syndrome who were between...
This study examined the contribution of the Apgar score at 1 and 5 min after birth to later cognitive functioning in 168 individuals with Down syndrome who were between 6 and 25 years of age at time of cognitive testing. Our results showed that a lower Apgar score at 1 min was related to a worse performance in later cognitive measures of receptive vocabulary, verbal comprehension and production, visual memory and working memory. Results also showed that a lower Apgar score at 5 min was only related to worse later outcomes of verbal comprehension and production and auditory working memory. Our findings suggest a need for future studies investigating how specific perinatal events reflected in the Apgar score are linked to later cognitive functioning in individuals with Down syndrome.
Topics: Adolescent; Adult; Apgar Score; Child; Cognition; Comprehension; Down Syndrome; Female; Humans; Infant, Newborn; Male; Memory; Neuropsychological Tests; Vocabulary; Young Adult
PubMed: 34135349
DOI: 10.1038/s41598-021-90651-3 -
Acta Obstetricia Et Gynecologica... Sep 2020The associations of epidural analgesia and low Apgar score found in the Swedish Registry might be a result of confounding by indication. The objective of this study was...
INTRODUCTION
The associations of epidural analgesia and low Apgar score found in the Swedish Registry might be a result of confounding by indication. The objective of this study was to assess the possible effect of intrapartum epidural analgesia on low Apgar score and neonatal intensive care unit (NICU) admission in term born singletons with propensity score matching.
MATERIAL AND METHODS
This was a propensity score matched study (n = 257 872) conducted in a national cohort of 715 449 term live born singletons without congenital anomalies in the Netherlands. Mothers with prelabor cesarean section were excluded. Main outcome measures were 5-minute Apgar score <7, 5-minute Apgar score <4 and admission to a NICU for at least 24 hours. First, an analysis of the underlying risk factors for low Apgar score <7 was performed. Multivariable analyses were applied to assess the effect of the main risk factor, intrapartum epidural analgesia, on low Apgar score to adjust the results for confounding factors. Second, a propensity score matched analysis on the main risk factors for epidural analgesia was applied. By propensity score matching the (confounding) characteristics of the women who received epidural analgesia with the characteristics of the control women without epidural analgesia, the effect of possible confounding by indication is minimized.
RESULTS
Intrapartum epidural analgesia was performed in 128 936 women (18%). Apgar score <7 was present in 1.0%, Apgar score <4 in .2% and NICU admission in .4% of the deliveries. The strongest risk factor for Apgar score <7 was epidural analgesia (adjusted odds ratio [aOR] 1.9, 95% confidence interval [CI] 1.8-2.0). The propensity score matched adjusted analysis of women with epidural analgesia showed significant adverse neonatal outcomes: aOR 1.8 (95% CI 1.7-1.9) for AS <7, aOR 1.6 (95% CI 1.4-1.9) for AS <4 and aOR 1.7 (95% CI 1.6-1.9) for NICU admission. The results of epidural analgesia on AS <7 were also significantly increased for spontaneous start of labor (aOR 2.0, 95% CI 1.8-2.1) and for spontaneous delivery.
CONCLUSIONS
Intrapartum epidural analgesia at term is strongly associated with low Apgar score and more NICU admissions, especially in spontaneous deliveries. This association needs further research and awareness.
Topics: Adult; Analgesia, Epidural; Apgar Score; Female; Humans; Infant, Newborn; Labor, Obstetric; Male; Maternal Age; Netherlands; Pregnancy; Propensity Score; Term Birth; Young Adult
PubMed: 32142154
DOI: 10.1111/aogs.13837 -
Journal of Mother and Child Jan 2021The purpose of the study was to identify the features of both the labor and the assisting physicians when evaluating the newborn according to the Apgar score and how... (Observational Study)
Observational Study
OBJECTIVE
The purpose of the study was to identify the features of both the labor and the assisting physicians when evaluating the newborn according to the Apgar score and how these correlate with the biochemical markers of fetal well-being in order to make the Apgar score more objective.
MATERIAL AND METHODS
A prospective observational clinical study conducted in a 3 reference level center between 1 April 2014 and 31 March 2015. The study enrolled 17 neonatologists and 1527 term newborns.
RESULTS
The Apgar score is highest after natural vaginal delivery, lower after instrumental labor (p <0.001). The pH of the umbilical cord blood and lactate concentration correlate better with a high score than with a lowered one. The young age of a physician does not reduce Apgar score reliability. There were no differences in Apgar assessment according to physicians' training and the time of labor. There were no correlations between abnormalities in postnatal central nervous system ultrasound and the Apgar score.
CONCLUSION
Biochemical tests of umbilical cord blood significantly increase the Apgar score reliability.
Topics: Apgar Score; Female; Fetal Blood; Humans; Infant, Newborn; Labor, Obstetric; Pregnancy; Prospective Studies; Reproducibility of Results
PubMed: 34981909
DOI: 10.34763/devperiodmed.20182203.238246 -
Interactive Cardiovascular and Thoracic... Jul 2022The surgical Apgar score (SAS) is a simple score that predicts postoperative complications based on 3 intraoperative valuables. The present study evaluated the...
OBJECTIVES
The surgical Apgar score (SAS) is a simple score that predicts postoperative complications based on 3 intraoperative valuables. The present study evaluated the association between the SAS and postoperative outcomes in non-small-cell lung cancer patients who underwent surgery.
METHODS
A total of 585 patients who underwent lung resection were enrolled in the present study. We calculated the SAS of each patient and investigated its influence on the short- and long-term outcomes.
RESULTS
Postoperative complications of any grade were detected in 164 cases (28%). The morbidity rate increased with decreasing SAS. When all the patients were divided into 2 groups (SAS <7 vs ≥7), postoperative complications were observed more frequently in the SAS <7 group than in the SAS ≥7 group (41% vs 25%, P < 0.001). In the multivariate analysis, the SAS was an independent risk factor for postoperative complications (odds ratio: 1.64 [1.03-2.61], P = 0.036). In terms of long-term outcomes, the 5-year disease-free survival (54.1% vs 73.2%, P < 0.001) and overall survival (73.8% vs 83.0%, P = 0.031) were significantly worse in the SAS <7 group than in the SAS ≥7 group. In a multivariate analysis, however, the SAS was not found to be an independent prognostic factor for either disease-free survival (hazard ratio: 1.39 [0.97-2.00], P = 0.075) or overall survival (hazard ratio: 0.90 [0.57-1.42], P = 0.642).
CONCLUSIONS
The SAS reflected preoperative and intraoperative characteristics and was able to stratify the morbidity rate, suggesting it to be a useful predictor of short-term outcomes in non-small-cell lung cancer patients who undergo surgery.
Topics: Apgar Score; Carcinoma, Non-Small-Cell Lung; Humans; Infant, Newborn; Lung Neoplasms; Postoperative Complications; Retrospective Studies; Risk Factors
PubMed: 35640534
DOI: 10.1093/icvts/ivac150 -
BMC Oral Health Jul 2016The aetiology of molar incisor hypomineralisation (MIH) is unclear. The asymmetric distribution of MIH in the dentition may indicate that an insult of short duration...
BACKGROUND
The aetiology of molar incisor hypomineralisation (MIH) is unclear. The asymmetric distribution of MIH in the dentition may indicate that an insult of short duration that affects ameloblasts at a vulnerable stage could be a causative factor. Apgar ≤ 5 at 5 min may indicate asphyxia (hypoxic-ischemic insult) during birth. It was hypnotised that low Apgar score during birth may cause MIH. The present study aimed to examine a possible association between Apgar ≤ 5 at 5 min and the occurrence of MIH.
METHOD
Two study groups were selected for examination. The cases comprised 67 children aged 8-10 years born with Apgar score equal to or below 5 after 5 min. The control group comprised 157 age-matched healthy children. First permanent molars, second primary molars and all permanent incisors were examined in all children. Clinical examination was undertaken by two calibrated examiners and intraoral close-up photographs of the teeth were later evaluated by three calibrated and blinded clinicians. Demarcated opacities, post-eruptive breakdown, atypical restorations and extractions due to MIH, according to the criteria of the European Association of Paediatric Dentistry, were assessed.
RESULTS
The prevalence of MIH did not differ between the two groups. A chi-square test failed to confirm any statistically significant relationship between 5-min Apgar scores and MIH occurrence. In addition, there was no statistically significant relationship between the number of affected first permanent molars in cases and controls.
CONCLUSION
There was no association between Apgar ≤ 5 at 5 min and the occurrence of MIH.
Topics: Apgar Score; Case-Control Studies; Child; Dental Enamel Hypoplasia; Female; Humans; Incisor; Infant, Newborn; Male; Molar; Prevalence
PubMed: 27449152
DOI: 10.1186/s12903-016-0253-5 -
Anaesthesia Nov 2014
Topics: Analgesia, Epidural; Analgesia, Obstetrical; Apgar Score; Drug Therapy, Combination; Female; Heart Rate, Fetal; Humans; Pregnancy; Umbilical Cord
PubMed: 25302972
DOI: 10.1111/anae.12874 -
Turkish Journal of Medical Sciences Dec 2017Background/aim: Juvenile obesity is associated with several metabolic abnormalities, one of them being atherogenic dyslipidemia. Suboptimal fetal growth is associated...
Background/aim: Juvenile obesity is associated with several metabolic abnormalities, one of them being atherogenic dyslipidemia. Suboptimal fetal growth is associated with obesity risk in childhood, but also with increased rate of metabolic diseases in later life. This study investigated associations of neonatal data (Apgar score, birth weight and birth length) with low-density lipoprotein and high-density lipoprotein (LDL and HDL) subclasses in a group of obese children, as well as a possible impact of breastfeeding duration on obesity-associated lipoprotein subclasses distributions.Materials and methods: We included 42 obese children, aged 14.2 ± 2.1 years. LDL and HDL subfractions were separated by gradient gel electrophoresis and biochemical parameters were assessed by routine methods.Results: Compared with obese children with Apgar ≥ 9, the group with Apgar < 9 had significantly higher percentages of small, dense LDL particles (P < 0.05), due to reduced LDL I (P < 0.01) and increased LDL III subclasses (P < 0.05). Birth weight was positively associated with the proportions of LDL I particles (P < 0.001), whereas birth height positively correlated with the amount of HDL 2b subclasses (P < 0.05). The group of never or less than 3 months breastfed children had significantly smaller LDL size (P < 0.01) and lower proportion of HDL 2a particles (P < 0.05) than their ≥3 months breastfed peers.Conclusion: The results showed significant associations of neonatal characteristics with LDL and HDL particle distributions in obese children. In addition, our results point toward positive aspects of longer breastfeeding duration on lipoprotein particle distributions in obese children.
Topics: Adolescent; Apgar Score; Birth Weight; Breast Feeding; Child; Cohort Studies; Female; Humans; Lipoproteins; Male; Pediatric Obesity
PubMed: 29306242
DOI: 10.3906/sag-1702-164 -
PLoS Medicine Jul 2022Apgar scores measure newborn health and are strongly associated with infant outcomes, but their performance has largely been determined in primarily white populations....
BACKGROUND
Apgar scores measure newborn health and are strongly associated with infant outcomes, but their performance has largely been determined in primarily white populations. Given the majority of the global population is not white, we aim to assess whether the association between low Apgar score and mortality in infants varies across racial groups.
METHODS AND FINDINGS
Population-based cohort study using 2016 to 2017 United States National Vital Statistics System data. The study included singleton infants born between 37+0 and 44+6 weeks to mothers over 15 years, without congenital abnormalities. We looked at 3 different mortality outcomes: (1) early neonatal mortality; (2) overall neonatal mortality; and (3) infant mortality. We used logistic regression to assess the association between Apgar score (categorized as low, intermediate, and normal) and each mortality outcome, and adjusted for gestational age, sex, maternal BMI, education, age, previous number of live births, and smoking status, and stratified these models by maternal race group (as self-reported on birth certificates). The cohort consisted of 6,809,653 infants (52.8% non-Hispanic white, 23.7% Hispanic, 13.8% non-Hispanic black, 6.6% non-Hispanic Asian, and 3.1% non-Hispanic other). A total of 6,728,829 (98.8%) infants had normal scores, 63,467 (0.9%) had intermediate scores, and 17,357 (0.3%) had low Apgar scores. Compared to infants with normal scores, low-scoring infants had increased odds of infant mortality. There was strong evidence that this association varied by race (p < 0.001) with adjusted odds ratios (AORs) of 54.4 (95% confidence interval [CI] 49.9 to 59.4) in non-Hispanic white, 70.02 (95% CI 60.8 to 80.7) in Hispanic, 23.3 (95% CI 20.3 to 26.8) in non-Hispanic black, 100.4 (95% CI 74.5 to 135.4) in non-Hispanic Asian, and 26.8 (95% CI 19.8 to 36.3) in non-Hispanic other infants. The main limitation was missing data for some variables, due to using routinely collected data.
CONCLUSIONS
The association between Apgar scores and mortality varies across racial groups. Low Apgar scores are associated with mortality across racial groups captured by United States (US) records, but are worse at discriminating infants at risk of mortality for black and non-Hispanic non-Asian infants than for white infants. Apgar scores are useful clinical indicators and epidemiological tools; caution is required regarding racial differences in their applicability.
Topics: Apgar Score; Cohort Studies; Female; Hispanic or Latino; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; United States
PubMed: 35819949
DOI: 10.1371/journal.pmed.1004040