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Journal of Psychosomatic Obstetrics and... Dec 2023Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality. Maternal stress during pregnancy is an established risk factor for PTB. We aimed to review... (Meta-Analysis)
Meta-Analysis Review
Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality. Maternal stress during pregnancy is an established risk factor for PTB. We aimed to review the effects of stress-reducing interventions during pregnancy on PTB. Studies reporting on stress-reducing interventions during pregnancy and PTB rates in general low-risk obstetric populations were included. PTB rates, low birth weight (LBW) rates, mean gestational age and birth weight, maternal anxiety and stress, and adverse perinatal outcomes were investigated. Data were extracted using a standardized extraction form, pooled effect sizes were calculated with the random effects model. Ten studies with a total of 4.816 women were included. The interventions included Pilates, yoga, a multidisciplinary stress reduction program, combination therapy (combining mindfulness, yoga, music, baby bonding, and education), and hypnosis. The incidence of PTB was significantly lower in the intervention group (RR 0.50, 95% CI 0.35 - 0.71). The overall quality of the included studies was low, and the risk of bias was high. In conclusion, this study provides evidence supporting the potential efficacy of stress-reducing interventions in reducing the incidence of PTB in low-risk women. We propose a RCT of high quality to determine the effectiveness of stress-reducing interventions in reducing PTB risk.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Premature Birth; Risk Factors; Gestational Age
PubMed: 38064297
DOI: 10.1080/0167482X.2023.2281238 -
Seminars in Fetal & Neonatal Medicine Jun 2012Preterm birth affects 12.5% of all births in the USA. Infants of Black mothers are disproportionately affected, with 1.5 times the risk of preterm birth and 3.4 times... (Review)
Review
Preterm birth affects 12.5% of all births in the USA. Infants of Black mothers are disproportionately affected, with 1.5 times the risk of preterm birth and 3.4 times the risk of preterm-related mortality. The preterm birth rate has increased by 33% in the last 25 years, almost entirely due to the rise in late preterm births (34-36 weeks' gestation). Recently attention has been given to uncovering the often subtle morbidity and mortality risks associated with moderate (32-33 weeks' gestation) and late preterm delivery, including respiratory, infectious, and neurocognitive complications and infant mortality. This section summarizes the epidemiology of moderate and late preterm birth, case definitions, risk factors, recent trends, and the emerging body of knowledge of morbidity and mortality associated with moderate and late preterm birth.
Topics: Female; Gestational Age; Humans; Infant Mortality; Infant, Newborn; Pregnancy; Premature Birth; Risk Factors; United States
PubMed: 22264582
DOI: 10.1016/j.siny.2012.01.007 -
Cell Cycle (Georgetown, Tex.) 2017Senescence contributes to the local and systemic aging of tissues and has been associated with age-related diseases. Recently, roles for this process during pregnancy... (Review)
Review
Senescence contributes to the local and systemic aging of tissues and has been associated with age-related diseases. Recently, roles for this process during pregnancy have come to light, the dysregulation of which has been associated with adverse pregnancy outcomes such as preterm birth. Here, we summarize recent advances that support a role for senescence in birth timing and propose new aspects of study in this emerging field.
Topics: Aging; Animals; Apoptosis; Cellular Senescence; Female; Humans; Infant, Newborn; Male; Parturition; Pregnancy; Premature Birth; Time Factors
PubMed: 28873006
DOI: 10.1080/15384101.2017.1371888 -
Redox Biology Jul 2018Preterm birth is a global health issue that can induce lifelong medical sequela. Presently, at least one in ten newborns are born prematurely. At birth, preterm newborns... (Review)
Review
Preterm birth is a global health issue that can induce lifelong medical sequela. Presently, at least one in ten newborns are born prematurely. At birth, preterm newborns exhibit higher levels of oxidative stress (OS) due to the inability to face the oxygen rich environment in which they are born into. Moreover, their immature respiratory, digestive, immune and antioxidant defense systems, as well as the potential numerous medical interventions following a preterm birth, such as oxygen resuscitation, nutrition, phototherapy and blood transfusion further contribute to high levels of OS. Although the acute effects seem well established, little is known regarding the long-term effects of preterm birth on OS. This matter is especially important given that chronically elevated OS levels may persist into adulthood and consequently contribute to the development of numerous non-communicable diseases observed in people born preterm such as diabetes, hypertension or lung disorders. The purpose of this review is to summarize the current knowledge regarding the consequences of preterm birth on OS levels from newborn to adulthood. In addition, the effects of physical activity and hypoxia, both known to disrupt redox balance, on OS modulation in preterm individuals are also explored.
Topics: Antioxidants; Exercise; Female; Humans; Hypoxia; Infant, Newborn; Oxidative Stress; Oxygen; Pregnancy; Premature Birth
PubMed: 29775962
DOI: 10.1016/j.redox.2018.04.022 -
Infectious Diseases in Obstetrics and... 2012Preterm birth (PTB) remains a major cause of neonatal morbidity and mortality. The association between PTB and infection is clear. The purpose of this report is to... (Review)
Review
OBJECTIVE
Preterm birth (PTB) remains a major cause of neonatal morbidity and mortality. The association between PTB and infection is clear. The purpose of this report is to present a focused review of information on the use of antibiotics to prevent PTB.
METHODS
We performed a search of the PubMed database restricted to clinical trials or meta-analyses published in English from 1990 through May 2011 using keywords "antibiotics or antimicrobials" and "preterm."
RESULTS
The search yielded 67 abstracts for review. We selected 31 clinical trials (n = 26) or meta-analysis (n = 5) for further full-text review. Discussion of each eligible clinical trial, its specific inclusion criteria, antibiotic regimen used, and study results are presented. Overall, trials evaluating antibiotic treatment to prevent preterm birth have yielded mixed results regarding any benefit.
CONCLUSION
Routine antibiotic prophylaxis is not recommended for prevention of preterm birth.
Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Clinical Trials as Topic; Female; Humans; Meta-Analysis as Topic; Pregnancy; Premature Birth; Risk Factors; Vagina
PubMed: 22505797
DOI: 10.1155/2012/157159 -
Journal of the American Medical... Jan 2022The study sought to develop and apply a framework that uses a clinical phenotyping tool to assess risk for recurrent preterm birth.
OBJECTIVE
The study sought to develop and apply a framework that uses a clinical phenotyping tool to assess risk for recurrent preterm birth.
MATERIALS AND METHODS
We extended an existing clinical phenotyping tool and applied a 4-step framework for our retrospective cohort study. The study was based on data collected in the Genomic and Proteomic Network for Preterm Birth Research Longitudinal Cohort Study (GPN-PBR LS). A total of 52 sociodemographic, clinical and obstetric history-related risk factors were selected for the analysis. Spontaneous and indicated delivery subtypes were analyzed both individually and in combination. Chi-square analysis and Kaplan-Meier estimate were used for univariate analysis. A Cox proportional hazards model was used for multivariable analysis.
RESULTS
: A total of 428 women with a history of spontaneous preterm birth qualified for our analysis. The predictors of preterm delivery used in multivariable model were maternal age, maternal race, household income, marital status, previous caesarean section, number of previous deliveries, number of previous abortions, previous birth weight, cervical insufficiency, decidual hemorrhage, and placental dysfunction. The models stratified by delivery subtype performed better than the naïve model (concordance 0.76 for the spontaneous model, 0.87 for the indicated model, and 0.72 for the naïve model).
DISCUSSION
The proposed 4-step framework is effective to analyze risk factors for recurrent preterm birth in a retrospective cohort and possesses practical features for future analyses with other data sources (eg, electronic health record data).
CONCLUSIONS
We developed an analytical framework that utilizes a clinical phenotyping tool and performed a survival analysis to analyze risk for recurrent preterm birth.
Topics: Cesarean Section; Female; Humans; Infant, Newborn; Longitudinal Studies; Placenta; Pregnancy; Premature Birth; Proteomics; Retrospective Studies; Risk Assessment; Risk Factors
PubMed: 34559221
DOI: 10.1093/jamia/ocab184 -
Seminars in Fetal & Neonatal Medicine Apr 2018Despite considerable effort aimed at decreasing the incidence of spontaneous preterm birth, it remains the leading cause of perinatal morbidity and mortality. Screening... (Review)
Review
Despite considerable effort aimed at decreasing the incidence of spontaneous preterm birth, it remains the leading cause of perinatal morbidity and mortality. Screening strategies are imperfect. Approaches used to identify women considered by historical factors to be low risk for preterm delivery (generally considered to be women with singleton pregnancies without a history of a previous preterm birth) as well as those at high risk for preterm birth (those with a previous preterm birth, short cervix, or multiple gestation) continue to evolve. Herein, we review the current evidence and approaches to screening women for preterm birth, and examine future directions for clinical practice. Further research is necessary to better identify at-risk women and provide evidence-based management.
Topics: Biomarkers; Biomedical Research; Cervical Length Measurement; Combined Modality Therapy; Early Diagnosis; Evidence-Based Medicine; Female; Humans; Infant; Infant Mortality; Infant, Newborn; Male; Obstetric Labor, Premature; Practice Guidelines as Topic; Pregnancy; Premature Birth; Prenatal Diagnosis; Risk Factors
PubMed: 29229486
DOI: 10.1016/j.siny.2017.11.007 -
Respiratory Research Feb 2021Delivery of medications to preterm neonates receiving non-invasive ventilation (NIV) represents one of the most challenging scenarios for aerosol medicine. This... (Review)
Review
Delivery of medications to preterm neonates receiving non-invasive ventilation (NIV) represents one of the most challenging scenarios for aerosol medicine. This challenge is highlighted by the undersized anatomy and the complex (patho)physiological characteristics of the lungs in such infants. Key physiological restraints include low lung volumes, low compliance, and irregular respiratory rates, which significantly reduce lung deposition. Such factors are inherent to premature birth and thus can be regarded to as the intrinsic factors that affect lung deposition. However, there are a number of extrinsic factors that also impact lung deposition: such factors include the choice of aerosol generator and its configuration within the ventilation circuit, the drug formulation, the aerosol particle size distribution, the choice of NIV type, and the patient interface between the delivery system and the patient. Together, these extrinsic factors provide an opportunity to optimize the lung deposition of therapeutic aerosols and, ultimately, the efficacy of the therapy.In this review, we first provide a comprehensive characterization of both the intrinsic and extrinsic factors affecting lung deposition in premature infants, followed by a revision of the clinical attempts to deliver therapeutic aerosols to premature neonates during NIV, which are almost exclusively related to the non-invasive delivery of surfactant aerosols. In this review, we provide clues to the interpretation of existing experimental and clinical data on neonatal aerosol delivery and we also describe a frame of measurable variables and available tools, including in vitro and in vivo models, that should be considered when developing a drug for inhalation in this important but under-served patient population.
Topics: Administration, Inhalation; Aerosols; Bronchodilator Agents; Drug Delivery Systems; Humans; Infant, Newborn; Nebulizers and Vaporizers; Noninvasive Ventilation; Premature Birth; Respiratory Mechanics
PubMed: 33637075
DOI: 10.1186/s12931-020-01585-9 -
The Keio Journal of Medicine Mar 2008Premature birth rate and low birth weight rate are increasing in industrialized countries including USA and Japan. The Infant mortality rate (IMR) is three times and... (Review)
Review
Premature birth rate and low birth weight rate are increasing in industrialized countries including USA and Japan. The Infant mortality rate (IMR) is three times and 50-75 times greater for infants born at 32-36 weeks and <32 weeks respectively than term-born counterparts. In the U.S., the IMR is greater than in Japan particularly among black infants and simply the "lower socioeconomic class" is not the answer. Premature birth is heterogeneous in origin and idiopathic in 70% of the cases. Increased utilization of assisted reproductive technology only accounts for a part of the recent trend. Evidence suggests environmental factors play a significant role, and genetic-environmental interaction is plausible. A chronic psychosocial stress of pregnant women has been postulated to be modifying the endocrine milieu thereby influencing pregnancy outcomes. In a preliminary observation in St. Louis, homeless pregnant women with high behavioral and social risks, when accommodated in a shelter home designed for these women, produced significantly less numbers of premature and low birth weight infants as compared with the general population. Furthermore, in a randomized controlled study in Washington DC, psychobehavioral intervention specifically targeting smoking (primary and secondary), intimate partner violence (IPV), and depression among black pregnant women significantly decreased the rate of miscarriage and low birth weight. These reports may have significant implication to the Japanese situation. Increasing number of Japanese women at reproductive age are exposed to smoking, may have underling psychosocial stress and may suffer from subclinical depression and/or from IPV. Detailed epidemiological studies of women before and during the reproductive age with regard to risk factors can lead to an effective intervention strategy against premature birth in Japan.
Topics: Cross-Cultural Comparison; Humans; Infant, Newborn; Japan; Premature Birth; Risk Factors; United States
PubMed: 18382124
DOI: 10.2302/kjm.57.45 -
Cadernos de Saude Publica Oct 2012The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care... (Meta-Analysis)
Meta-Analysis Review
The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care during pregnancy on preventing preterm birth and low birth weight. The meta-analysis included randomized trials with pregnant women with a diagnosis of periodontal disease before 20 weeks of gestation. Relative risk (RR) with 95% confidence intervals (95%CI) was calculated. We evaluated the reduction in preterm and low birth weight. Thirteen trials were included, comparing 3,576 women in intervention groups with 3,412 women receiving usual care. The meta-analysis of the effects of periodontal disease treatment during pregnancy indicated a non-significant reduction in preterm births (RR = 0.90; 95%CI: 0.68-1.19) and low birth weights (RR = 0.92; 95%CI: 0.71-1.20). The creation and examination of a funnel plot revealed clear evidence of publication bias. In summary, primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.
Topics: Adult; Female; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Periodontal Diseases; Pregnancy; Pregnancy Complications; Premature Birth; Randomized Controlled Trials as Topic
PubMed: 23090163
DOI: 10.1590/s0102-311x2012001000002