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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 -
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 -
CoDAS 2021To characterize the use of phonological productive processes in a group of full-term children and small for gestational age and compare it with children appropriate for... (Observational Study)
Observational Study
PURPOSE
To characterize the use of phonological productive processes in a group of full-term children and small for gestational age and compare it with children appropriate for gestational age.
METHODS
Observational, analytical, case-control and non-paired study, nested in a cohort with the outcome of phonological disorder. We assessed 36 children according to the predetermined sample calculation, 24 (66.7%) without phonological disorders and 12 (33.3%) with phonological disorders. Of these, 24 (66.7%) children were classified as small for gestational age (SGA) and 12 (33%) as appropriate for gestational age (AGA). Phonological aspects of oral language were assessed by the ABFW children's language test (2004). The results were subjected to descriptive analysis and, in order to assess the existence of an association among categorical variables, we used Fisher's exact test for association.
RESULTS
The SGA group revealed a significantly higher number of phonological processes that change the syllable structure when compared to the AGA group. We noted that the phonological processes present and unexpected for age in the SGA population were: fricative plosivation, liquid simplification, palatal posteriorization and frontalization, plosive and fricative deafening, in addition to simplifying the consonant cluster and simplifying the final consonant, which were the most frequent in both groups.
CONCLUSION
Although no association was found between phonological disorders and SGA children, we have noted a greater use of productive phonological processes in this group.
Topics: Case-Control Studies; Child; Gestational Age; Humans; Infant, Newborn; Infant, Small for Gestational Age; Language Tests; Linguistics
PubMed: 34932658
DOI: 10.1590/2317-1782/20212020340 -
Respirology (Carlton, Vic.) Feb 2023
Topics: Infant, Newborn; Female; Humans; Adult; Gestational Age; Lung; Respiratory Function Tests; Infant, Newborn, Diseases; Fetal Growth Retardation
PubMed: 36411250
DOI: 10.1111/resp.14414 -
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 -
Roczniki Panstwowego Zakladu Higieny 2022Human breast milk due to its unique composition and the ability to adapt to the needs of the infant, is referred to as the "gold standard". Exclusive breastfeeding is... (Review)
Review
Human breast milk due to its unique composition and the ability to adapt to the needs of the infant, is referred to as the "gold standard". Exclusive breastfeeding is recommended for the first 6 months of a inflant's life. The composition of breast milk and its metabolites is not constant and varies depending on the influence of various factors. Its analysis allows for rational management of infant nutrition. Intermediate and final metabolites of human milk are formed as a result of various metabolic processes in the mammary gland, and their role and the influence of various factors on them are not fully determined in the context of the proper development of infants. Metabolomic studies can be used to identify intermediate and terminal metabolites in breast milk. The aim of the study was to review the current literature on the variability of human milk metabolome depending on factors such as gestational age, lactation stage and mother's diet. A review of current research shows that the composition of human milk metabolome varies depending on various factors. Better understanding of metabolome of breast milk could be crucial in the future programming of metabolic processes in infants, which is crucial in preventing many diseases and maintaining health.
Topics: Breast Feeding; Diet; Female; Gestational Age; Humans; Infant; Lactation; Metabolome; Milk, Human
PubMed: 35748503
DOI: 10.32394/rpzh.2022.0214 -
Revista Paulista de Pediatria : Orgao... 2022To perform a systematic review in order to verify the association between full-term birth of small for gestational age (SGA) children and the outcomes in the development...
OBJECTIVE
To perform a systematic review in order to verify the association between full-term birth of small for gestational age (SGA) children and the outcomes in the development of oral language.Data source:Articles from MEDLINE/PubMed, Web of Science, Embase, Lilacs, SciELO and Cochrane Library databases were identified, selected and critically evaluated by two independent reviewers and a judge, blindly, without language restriction and publication period. The PRISMA tool was used, and original studies with a theme involving children born full-term and SGA were included, outcome related to aspects of oral language development, as well as the use of tests, scales and/or specific questionnaires for the investigation, whose methodology was described in full, with children as the target population.Data synthesis:The researchers included nine articles based on the eligibility criteria. Studies have shown that being born SGA can interfere in aspects related to language and reported greater chances of under performance in SGA children when compared to children with appropriate size for gestational age. It was observed that the different studies did not have a uniform design, and the objectives were quite diverse. Furthermore, few of them had as focus issues related to the assessment of language, as well as the variability of instruments used to investigate this domain.
CONCLUSIONS
The effects of low weight for gestation age in full-term infants continue beyond the neonatal period and may impact on children's performance, mainly with regard to oral language development.
Topics: Child; Female; Fetal Growth Retardation; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Small for Gestational Age; Parturition; Pregnancy
PubMed: 35584418
DOI: 10.1590/1984-0462/2022/40/2021049IN