-
PloS One 2018Predicting preterm birth is uncertain, and numerous scientists are searching for non-invasive methods to improve its predictability. Current researches are based on the...
Predicting preterm birth is uncertain, and numerous scientists are searching for non-invasive methods to improve its predictability. Current researches are based on the analysis of ElectroHysteroGram (EHG) records, which contain information about the electrophysiological properties of the uterine muscle and uterine contractions. Since pregnancy is a long process, we decided to also characterize, for the first time, non-contraction intervals (dummy intervals) of the uterine records, i.e., EHG signals accompanied by a simultaneously recorded external tocogram measuring mechanical uterine activity (TOCO signal). For this purpose, we developed a new set of uterine records, TPEHGT DS, containing preterm and term uterine records of pregnant women, and uterine records of non-pregnant women. We quantitatively characterized contraction intervals (contractions) and dummy intervals of the uterine records of the TPEHGT DS in terms of the normalized power spectra of the EHG and TOCO signals, and developed a new method for predicting preterm birth. The results on the characterization revealed that the peak amplitudes of the normalized power spectra of the EHG and TOCO signals of the contraction and dummy intervals in the frequency band 1.0-2.2 Hz, describing the electrical and mechanical activity of the uterus due to the maternal heart (maternal heart rate), are high only during term pregnancies, when the delivery is still far away; and they are low when the delivery is close. However, these peak amplitudes are also low during preterm pregnancies, when the delivery is still supposed to be far away (thus suggesting the danger of preterm birth); and they are also low or barely present for non-pregnant women. We propose the values of the peak amplitudes of the normalized power spectra due to the influence of the maternal heart, in an electro-mechanical sense, in the frequency band 1.0-2.2 Hz as a new biophysical marker for the preliminary, or early, assessment of the danger of preterm birth. The classification of preterm and term, contraction and dummy intervals of the TPEHGT DS, for the task of the automatic prediction of preterm birth, using sample entropy, the median frequency of the power spectra, and the peak amplitude of the normalized power spectra, revealed that the dummy intervals provide quite comparable and slightly higher classification performances than these features obtained from the contraction intervals. This result suggests a novel and simple clinical technique, not necessarily to seek contraction intervals but using the dummy intervals, for the early assessment of the danger of preterm birth. Using the publicly available TPEHG DB database to predict preterm birth in terms of classifying between preterm and term EHG records, the proposed method outperformed all currently existing methods. The achieved classification accuracy was 100% for early records, recorded around the 23rd week of pregnancy; and 96.33%, the area under the curve of 99.44%, for all records of the database. Since the proposed method is capable of using the dummy intervals with high classification accuracy, it is also suitable for clinical use very early during pregnancy, around the 23rd week of pregnancy, when contractions may or may not be present.
Topics: Databases, Factual; Electromyography; Electrophysiological Phenomena; Female; Humans; Infant, Newborn; Models, Theoretical; Pregnancy; Premature Birth; Term Birth; Uterine Contraction; Uterus
PubMed: 30153264
DOI: 10.1371/journal.pone.0202125 -
CoDAS 2019To describe and compare the anthropometric measurements and the orofacial proportions of healthy term newborns (NB) according to sex, from a public maternity hospital in...
PURPOSE
To describe and compare the anthropometric measurements and the orofacial proportions of healthy term newborns (NB) according to sex, from a public maternity hospital in the state of Sergipe, northeastern Brazil.
METHODS
Descriptive and analytical randomized study was carried out. The participants included were 46 randomly selected healthy and full-term RNs of both sexes. A digital caliper was used to measure measurements (in millimeters) with the NB supine and occluded lips. Twice different, previously trained researchers measured each NB. Data were described using simple and percentage frequencies. The mean differences were assessed using the Mann-Whitney test, with a significance of 5%. Associations evaluated by the Fisher Exact test, and Cohen D size effects were calculated.
RESULTS
Differences were found between the groups for the anthropometric measurements: midface third height (glabella-subnasal or sn-g) and bottom (subnasal-gnathion or sn-gn); and filter heights (upper-lip subnasal or sn-ls), the upper lips (subnasal-estomus or sn-sto), and lower (stomatal-gnathion or sto-gn), which was always greater in males. The orofacial proportions studied did not show differences between sexes.
CONCLUSION
The study showed the presence of sexual dimorphism for the measures of the face at birth in the population born in Aracaju, Sergipe.
Topics: Anthropometry; Brazil; Cephalometry; Face; Female; Gestational Age; Humans; Infant, Newborn; Lip; Male; Random Allocation; Reference Values; Sex Characteristics; Term Birth
PubMed: 31644710
DOI: 10.1590/2317-1782/20192018261 -
JAMA Network Open May 2023Appreciation for the effects of neighborhood conditions and community factors on perinatal health is increasing. However, community-level indices specific to maternal...
IMPORTANCE
Appreciation for the effects of neighborhood conditions and community factors on perinatal health is increasing. However, community-level indices specific to maternal health and associations with preterm birth (PTB) have not been assessed.
OBJECTIVE
To examine the association of the Maternal Vulnerability Index (MVI), a novel county-level index designed to quantify maternal vulnerability to adverse health outcomes, with PTB.
DESIGN, SETTING, AND PARTICIPANTS
This retrospective cohort study used US Vital Statistics data from January 1 to December 31, 2018. Participants included 3 659 099 singleton births at 22 plus 0/7 to 44 plus 6/7 weeks of gestation born in the US. Analyses were conducted from December 1, 2021, through March 31, 2023.
EXPOSURE
The MVI, a composite measure of 43 area-level indicators, categorized into 6 themes reflecting physical, social, and health care landscapes. Overall MVI and theme were stratified by quintile (very low to very high) by maternal county of residence.
MAIN OUTCOMES AND MEASURES
The primary outcome was PTB (gestational age <37 weeks). Secondary outcomes were PTB categories: extreme (gestational age ≤28 weeks), very (gestational age 29-31 weeks), moderate (gestational age 32-33 weeks), and late (gestational age 34-36 weeks). Multivariable logistic regression quantified associations of MVI, overall and by theme, with PTB, overall and by PTB category.
RESULTS
Among 3 659 099 births, 298 847 (8.2%) were preterm (male, 51.1%; female, 48.9%). Maternal race and ethnicity included 0.8% American Indian or Alaska Native, 6.8% Asian or Pacific Islander, 23.6% Hispanic, 14.5% non-Hispanic Black, 52.1% non-Hispanic White, and 2.2% with more than 1 race. Compared with full-term births, MVI was higher for PTBs across all themes. Very high MVI was associated with increased PTB in unadjusted (odds ratio [OR], 1.50 [95% CI, 1.45-1.56]) and adjusted (OR, 1.07 [95% CI, 1.01-1.13]) analyses. In adjusted analyses of PTB categories, MVI had the largest association with extreme PTB (adjusted OR, 1.18 [95% CI, 1.07-1.29]). Higher MVI in the themes of physical health, mental health and substance abuse, and general health care remained associated with PTB overall in adjusted models. While the physical health and socioeconomic determinant themes were associated with extreme PTB, physical health, mental health and substance abuse, and general health care themes were associated with late PTB.
CONCLUSIONS AND RELEVANCE
The findings of this cohort study suggest that MVI was associated with PTB even after adjustment for individual-level confounders. The MVI is a useful measure for county-level PTB risk that may have policy implications for counties working to lower preterm rates and improve perinatal outcomes.
Topics: Pregnancy; Female; Infant, Newborn; Male; Humans; Infant; Premature Birth; Cohort Studies; Retrospective Studies; Term Birth; Substance-Related Disorders
PubMed: 37227724
DOI: 10.1001/jamanetworkopen.2023.15306 -
European Journal of Medical Research Sep 2023This study aimed to conduct a meta-analysis to determine whether post-term birth has an increased risk of ASD. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This study aimed to conduct a meta-analysis to determine whether post-term birth has an increased risk of ASD.
MATERIALS AND METHODS
To retrieve eligible studies regarding the effect of post-term and ASD in children, major databases including PubMed, Scopus, and Web of Science were searched. A random effect model was used for meta-analysis. For assessing the quality of included studies, the GRADE checklist was used.
RESULTS
In total, 18 records were included with 1,412,667 sample populations from 12 countries. The pooled estimates of RR and OR showed a significant association between post-term birth and ASD among children, respectively (RR = 1.34, 95% CI 1.10 to 1.58) and (OR = 1.47, 95% CI 1.03 to 1.91). There was no heterogeneity among the studies that reported the risk of ASD among children based on RR (I = 6.6%, P = 0.301). There was high heterogeneity in the studies reported risk of ASD based on OR (I = 94.1%, P = 0.000).
CONCLUSION
Post-term births still occur relatively frequently (up to 5-10%) even in developed countries. Our results showed that post-term birth is an increased risk of ASD, although high heterogeneity was found among the studies reported based on adjusted and crude forms, however, after subgroup analysis by gender, this heterogeneity disappeared among males.
Topics: Child; Male; Humans; Autism Spectrum Disorder; Term Birth
PubMed: 37660041
DOI: 10.1186/s40001-023-01304-2 -
Annals of Medicine Dec 2023Since SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was first identified as the cause of Coronavirus disease 19 (COVID-19) it has caused over 649,147,421... (Review)
Review
SARS CoV-2 infection as a risk factor of preeclampsia and pre-term birth. An interplay between viral infection, pregnancy-specific immune shift and endothelial dysfunction may lead to negative pregnancy outcomes.
BACKGROUND
Since SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was first identified as the cause of Coronavirus disease 19 (COVID-19) it has caused over 649,147,421 infections and over 6,730,382 deaths worldwide. SARS-CoV-2 presents higher infectivity than other coronaviridae (MERS-CoV and SARS-CoV). Pregnant patients, according to previous studies are at high risk of severe COVID-19 course and negative pregnancy outcomes (pre-term birth, low birth weight, preeclampsia, operative delivery and ICU admission with need for mechanical ventilation).
METHODS
In this review we focus on the pathophysiology of subcellular changes in COVID-19 and try bring to light the aspects that occur in physiological pregnancy that may cause higher risk of SARS-CoV-2 infection and severe COVID-19 course.
RESULTS
Knowledge of potential interplay between viral infection and physiological changes in pregnancy may point us in the direction of future prophylaxis and treatment in this special population.Key MessagesSARS-CoV-2 having affinity to ACE-2 and causing it's downregulation receptor may cause endothelial injury leading to compliment activation and formation of NETs, together with RAS dysregulation this may cause preeclampsia to develop in pregnant patients.PTB may occur in patients as an effect of SARS-CoV-2 infection in first or second trimester as an effect of TLR4 pathway dysregulation with lower levels of IFNβ.
Topics: Pregnancy; Female; Humans; COVID-19; Pregnancy Outcome; SARS-CoV-2; Pre-Eclampsia; Term Birth; Pregnancy Complications, Infectious; Premature Birth; Risk Factors
PubMed: 37074264
DOI: 10.1080/07853890.2023.2197289 -
Journal of the American Heart... Feb 2020Background Preterm delivery and low birth weight are prospectively associated with low cardiorespiratory fitness (CRF). However, whether birth weight, within the at-term...
Background Preterm delivery and low birth weight are prospectively associated with low cardiorespiratory fitness (CRF). However, whether birth weight, within the at-term range, is associated with later CRF is largely unknown. Thus, the aim of the current study was to examine this issue and whether such association, if any, is explained by shared and/or nonshared familial factors. Methods and Results We conducted a prospective cohort study, including 286 761 young male adults and a subset of 52 544 siblings born at-term. Objectively measured data were retrieved from total population registers. CRF was tested at conscription and defined as the maximal load obtained on a cycle ergometer. We used linear and nonlinear and fixed-effects regression analyses to explore associations between birth weight and CRF. Higher birth weight, within the at-term range, was strongly associated with increasing CRF in a linear fashion. Each SD increase in birth weight was associated with an increase of 7.9 (95% CI, 7.8-8.1) and 6.6 (95% CI; 5.9-7.3) Wmax in the total and sibling cohorts, respectively. The association did not vary with young adulthood body mass index. Conclusions Birth weight is strongly associated with increasing CRF in young adulthood among men born at-term, across all categories of body mass index. This association appears to be mainly driven by factors that are not shared between siblings. Hence, CRF may to some extent be determined already in utero. Prevention of low birth weight, also within the at-term-range, can be a feasible mean of increasing adult CRF and health.
Topics: Adolescent; Adult; Age Factors; Birth Weight; Body Mass Index; Cardiorespiratory Fitness; Gene-Environment Interaction; Gestational Age; Humans; Infant, Newborn; Male; Prospective Studies; Registries; Siblings; Term Birth; Young Adult
PubMed: 32000561
DOI: 10.1161/JAHA.119.014290 -
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 -
International Journal of Epidemiology Apr 2023It has been suggested that maternal type 1 diabetes (T1D) increases the risk of autism spectrum disorder (ASD) in the offspring. However, it is unclear whether this risk...
BACKGROUND
It has been suggested that maternal type 1 diabetes (T1D) increases the risk of autism spectrum disorder (ASD) in the offspring. However, it is unclear whether this risk is mediated by pre-term birth, affecting around one-third of pregnancies with T1D, and whether maternal levels of glycated haemoglobin (HbA1c) impact the risk.
METHODS
A cohort of 1.4 million Swedish children born between 1998 and 2015, and their parents. Maternal T1D and HbA1c before or in early pregnancy, gestational and ASD diagnoses were obtained from Swedish national registers. Relative risk (RR) and 95% CIs of ASD were estimated by hazard ratios (HRs) from Cox regression or RR from log-binomial regression.
RESULTS
Of 1 406 650 children, 8003 (0.6%) were born to mothers with T1D, 24 941 (1.8%) were diagnosed with ASD and 81 915 (5.8%) were born pre-term. The risk of ASD was increased in offspring of mothers with T1D was HR = 1.40 (1.21-1.61). The RR for each +5-mmol/mol excess HbA1c was estimated at HR = 1.03 (0.97-1.10). The T1D effect on ASD mediated through pre-term birth was estimated at RR = 1.06 (1.05 to 1.08), corresponding to 22% (16% to 41%) of the total effect. T1D in pregnancy was associated with increased ASD risk in the offspring. Twenty percent of the total effect was accounted for by pre-term birth. HbA1c was not associated with ASD risk, beyond the risk associated by the T1D diagnosis itself.
CONCLUSION
Awareness of ASD in the offspring of mothers with T1D may be warranted, especially considering the additional effect of pre-term birth.
Topics: Pregnancy; Child; Female; Humans; Diabetes Mellitus, Type 1; Autism Spectrum Disorder; Prospective Studies; Term Birth; Mothers
PubMed: 35657363
DOI: 10.1093/ije/dyac116 -
Frontiers in Endocrinology 2022Despite vast research, premature birth's electrophysiological mechanisms are not fully understood. Prediction of preterm birth contributes to child survival by providing...
INTRODUCTION
Despite vast research, premature birth's electrophysiological mechanisms are not fully understood. Prediction of preterm birth contributes to child survival by providing timely and skilled care to both mother and child. Electrohysterography is an affordable, noninvasive technique that has been highly sensitive in diagnosing preterm labor. This study aimed to choose the more appropriate combination of characteristics, such as electrode channel and bandwidth, as well as those linear, time-frequency, and nonlinear features of the electrohysterogram (EHG) for predicting preterm birth using classifiers.
METHODS
We analyzed two open-access datasets of 30 minutes of EHG obtained in regular checkups of women around 31 weeks of pregnancy who experienced premature labor (P) and term labor (T). The current approach filtered the raw EHGs in three relevant frequency subbands (0.3-1 Hz, 1-2 Hz, and 2-3Hz). The EHG time series were then segmented to create 120-second windows, from which individual characteristics were calculated. The linear, time-frequency, and nonlinear indices of EHG of each combination (channel-filter) were fed to different classifiers using feature selection techniques.
RESULTS
The best performance, i.e., 88.52% accuracy, 83.83% sensitivity, and 93.22% specificity, was obtained in the 2-3 Hz bands using Medium Frequency, Continuous Wavelet Transform (CWT), and entropy-based indices. Interestingly, CWT features were significantly different in all filter-channel combinations. The proposed study uses small samples of EHG signals to diagnose preterm birth accurately, showing their potential application in the clinical environment.
DISCUSSION
Our results suggest that CWT and novel entropy-based features of EHG could be suitable descriptors for analyzing and understanding the complex nature of preterm labor mechanisms.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Electromyography; Entropy; Obstetric Labor, Premature; Premature Birth; Term Birth; Uterus; Wavelet Analysis
PubMed: 36704040
DOI: 10.3389/fendo.2022.1035615 -
Medicinski Glasnik : Official... Aug 2020Aim To compare maternal, foetal and neonatal characteristics, and perinatal outcome of preterm and term deliveries in twins pregnancies in order to improve perinatal...
Aim To compare maternal, foetal and neonatal characteristics, and perinatal outcome of preterm and term deliveries in twins pregnancies in order to improve perinatal care in Bosnia and Herzegovina. Methods This retrospective cohort study included pregnant women with twin pregnancy who delivered during the period between 1 January 2012 and 31 December 2018 at the Clinic for Gynaecology and Obstetrics, University Clinical Centre Tuzla. Results During the seven-year period 26 734 deliveries were recorded, out of which 362 (1.35 %) were twin pregnancies, 226 (62.4%) preterm and 136 (37.5%) term ones. In the preterm group 38 (16.8%) pregnancies were assisted medical reproduction, and 16 (11.7%) of those were in the term group. The average birth weight was significantly higher for the first twin in both groups (p<0.00001). Incipient intrauterine foetal asphyxia was more frequent in the preterm group (p<0.05). The most common indication for Caesarean section was abnormalities of foetal presentation and lie, 176 (68.2%) for the overall sample. Conclusion Cornerstone of twin pregnancy antenatal care is to get correct data about amnionicity and chorionicity. Since majority of prenatal data did not have this information we call all obstetricians to declare about amnionicity and chorionicity in twin pregnancies during the first trimester ultrasound examination.
Topics: Bosnia and Herzegovina; Cesarean Section; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Pregnancy, Twin; Retrospective Studies; Term Birth
PubMed: 32483959
DOI: 10.17392/1148-20