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Seminars in Fetal & Neonatal Medicine Feb 2019Despite an increasing body of knowledge on the adverse clinical sequelae associated with late preterm birth and early term birth, little is known about their economic... (Review)
Review
Despite an increasing body of knowledge on the adverse clinical sequelae associated with late preterm birth and early term birth, little is known about their economic consequences or the cost-effectiveness of interventions aimed at their prevention or alleviation of their effects. This review assesses the health economic evidence surrounding late preterm and early term birth. Evidence is gathered on hospital resource use associated with late preterm and early term birth, economic costs associated with late preterm and early term birth, and economic evaluations of prevention and treatment strategies. The article highlights the limited perspective and time horizon of most studies of economic costs in this area; the limited evidence surrounding health economic aspects of early term birth; the gaps in current knowledge; and it discusses directions for future research in this area, including the need for validated tools for measuring preference-based health-related quality-of-life outcomes in infants that will aid cost-effectiveness-based decision-making.
Topics: Health Care Costs; Humans; Infant, Newborn; Infant, Premature; Premature Birth; Term Birth
PubMed: 30274904
DOI: 10.1016/j.siny.2018.09.004 -
Physical and Engineering Sciences in... Dec 2021Preterm birth anticipation is a crucial task that can reduce both the rate and the complications of preterm birth. Electrohysterogram (EHG) or uterine electromyogram...
Preterm birth anticipation is a crucial task that can reduce both the rate and the complications of preterm birth. Electrohysterogram (EHG) or uterine electromyogram (EMG) data have shown that they can provide useful information for preterm birth anticipation. Four distinct time-domain features (mean absolute value, average amplitude change, difference in absolute standard deviation value, and log detector) that are commonly applied to EMG signal processing were utilized and investigated in this study. A single channel of EHG data was decomposed into its constituent components (i.e., into intrinsic mode functions) by using empirical mode decomposition (EMD) before their time-domain features were extracted. The time-domain features of the intrinsic mode functions of the EHG data associated with preterm and term births were applied for preterm-term birth classification by using a support vector machine with a radial basis function. The preterm-term birth classifications were validated by using 10-fold cross validation. From the computational results, it was shown that excellent preterm-term birth classification can be achieved by using single-channel EHG data. The computational results further suggested that the best overall performance concerning preterm-term birth classification was obtained when thirteen (out of sixteen) EMD-based time-domain features were applied. The best accuracy, sensitivity, specificity, and [Formula: see text]-score achieved were 0.9382, 0.9130, 0.9634, and 0.9366, respectively.
Topics: Electromyography; Female; Humans; Infant, Newborn; Premature Birth; Signal Processing, Computer-Assisted; Term Birth; Uterus
PubMed: 34463948
DOI: 10.1007/s13246-021-01051-w -
Redox Biology May 2020Pre-term birth is a major health concern that occurs in approximately 10% of births worldwide. Despite high incidence rate, long-term consequences of pre-term birth...
Pre-term birth is a major health concern that occurs in approximately 10% of births worldwide. Despite high incidence rate, long-term consequences of pre-term birth remain unclear. Recent evidence suggests that elevated oxidative stress observed in pre-term born infants could persist into adulthood. Given that oxidative stress is known to play an important role in response to physical activity and hypoxia, we investigated whether oxidative stress responses to acute exercise in normoxia and hypoxia may be differently modulated in pre-term vs. full-term born adults. Twenty-two pre-term born and fifteen age-matched full-term born controls performed maximal incremental cycling tests in both normoxia (FiO2: 0.21) and normobaric hypoxia (FiO2: 0.13; simulated altitude of 3800 m) in blinded and randomized manner. Plasma levels of oxidative stress (advanced oxidation protein products [AOPP] and malondialdehyde), antioxidant (ferric reducing antioxidant power, glutathione peroxidase, catalase [CAT] and superoxide dismutase [SOD]) and nitrosative stress markers (nitrotyrosine, nitrite and total nitrite and nitrate [NOx]) were measured before and immediately after each test. AOPP (+24%, P<0.001), CAT (+38%, P<0.001) and SOD (+12%, P=0.018) and NOx (+17%, P=0.024) significantly increased in response to exercise independently of condition and birth status. No difference in response to acute exercise in normoxia was noted between pre-term and full-term born adults in any of measured markers. Hypoxic exposure during exercise resulted in significant increase in AOPP (+45%, P=0.008), CAT (+55%, P=0.019) and a trend for an increase in nitrite/nitrate content (+35%, P=0.107) only in full-term and not pre-term born individuals. These results suggest that prematurely born adult individuals exhibit higher resistance to oxidative stress response to exercise in hypoxia.
Topics: Adult; Exercise; Humans; Hypoxia; Malondialdehyde; Oxidative Stress; Term Birth
PubMed: 32199333
DOI: 10.1016/j.redox.2020.101497 -
The Journal of Maternal-fetal &... Dec 2024To assess pre-term birth, low birth-weight and growth restriction according to maternal thyroid screening results and subsequent treatment.
OBJECTIVE
To assess pre-term birth, low birth-weight and growth restriction according to maternal thyroid screening results and subsequent treatment.
METHODS
This is a nonintervention nested case-control study derived from 10,052 asymptomatic women previously screened during the first trimester marker with anti-thyroid peroxidase antibodies, serum thyroid stimulating hormone, and free thyroxine. Screening results had been classified as positive with one or more markers outside the normal range and referred to an endocrinologist. Cases were 512 women with positive results and information on recommended treatment: 204 thyroxine, propylthiouracil or surgery, and 308 no treatment or only iodine. Controls were a sequential sample of 1292 women with negative results. All cases and controls had information on gestation at delivery or birth-weight. Outcome measures were pre-term birth (<37 weeks), low birth-weight (<2.5 kg) and, for singletons, small for gestational age (SGA; <10th percentile).
RESULTS
Among singleton pregnancies, there was a higher prevalence of both pre-term birth (risk ratio (RR) 1.69, 95% confidence interval (CI) 1.21-2.36, < .002) and low birth-weight (RR 1.72, 95% CI 1.13-2.62, < .02) in cases compared with controls. An increase in low birth-weight was also present in term pregnancies, but not significant (RR 1.80, 95% CI 0.78-4.14, = .16), and there was no difference in SGA prevalence (1.24, 95% CI 0.93-1.65, = .14). Among cases there was no significant difference in these rates according to treatment even after logistic regression, allowing for the individual screening marker levels and maternal weight.
CONCLUSIONS
Women with positive thyroid screening results are at increased risk of pre-term birth regardless of thyroid dysfunction or subsequent treatment. An association with low birth-weight is probably secondary to early delivery.
Topics: Pregnancy; Female; Humans; Thyroid Gland; Thyroxine; Case-Control Studies; Term Birth; Prenatal Diagnosis
PubMed: 38191240
DOI: 10.1080/14767058.2023.2300416 -
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 -
European Journal of Pediatrics Apr 2016Perfusion index is a continuous parameter provided by pulse oximetry and might be useful for evaluating hemodynamic changes at birth and identifying transitional...
UNLABELLED
Perfusion index is a continuous parameter provided by pulse oximetry and might be useful for evaluating hemodynamic changes at birth and identifying transitional problems. The objective was to describe perfusion index values in term infants immediately after birth. Perfusion index of 71 healthy term born infants were recorded during the first 10 min after birth, using a pulse oximetry sensor placed preductally. A Wilcoxon signed-rank test was used to compare between time points. No significant trend in perfusion index could be observed in term-delivered infants. There was a significant difference between 2 and 3 min (2.4 (1.6-5.0) vs. 2.3 (1.6-3.7), p = 0.05) and between 3 and 4 min after birth (2.3 (1.6-3.7) vs. 2.1 (1.4-3.2), p < 0.001). There was no significant change in median PI values in the following 8 min.
CONCLUSION
Perfusion index does not change significantly during transition at birth in healthy term infants born by normal vaginal delivery or cesarean section. Large variation in perfusion index causes monitoring this parameter to have limited value.
WHAT IS KNOWN
• Perfusion index is a non-invasive indicator for peripheral perfusion. • Perfusion index values <1.24 are seen as an accurate predictor for severity of illness for infants admitted to the neonatal intensive care unit. What is new: • Although significant physiological changes occur during birth, perfusion index remains stable. • Large variation in perfusion index causes monitoring of this value to have limited value as an additional parameter for evaluating transition at birth.
Topics: Delivery, Obstetric; Heart Rate; Hemodynamics; Humans; Infant, Newborn; Monitoring, Physiologic; Oximetry; Oxygen; Reference Values; Retrospective Studies; Term Birth; Time Factors
PubMed: 26498646
DOI: 10.1007/s00431-015-2650-1 -
Journal of Obstetric, Gynecologic, and... Nov 2019To summarize the findings of recent studies on neonatal weight changes that occur in the early weeks of life among full-term, breastfed newborns.
OBJECTIVE
To summarize the findings of recent studies on neonatal weight changes that occur in the early weeks of life among full-term, breastfed newborns.
DATA SOURCES
Using the keywords breastfeeding, newborn, infant, weight, weight loss, and growth, we searched PubMed, Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, and MEDLINE for primary studies and secondary analyses. We also reviewed the reference lists of retrieved articles.
STUDY SELECTION
Quantitative studies published in the English language from 2015 through 2019 that focused on newborn weight changes. From a total of 827 records initially screened, we included 11 studies in this analysis.
DATA EXTRACTION
Two authors independently reviewed the selected articles with the use of the Johns Hopkins Nursing Evidence-Based Practice Synthesis and Recommendations Tool. To determine evidence levels and quality ratings, we evaluated the consistency and generalizability of study results, sample sizes, study designs, adequacy of controls, and definitive nature of the conclusions.
DATA SYNTHESIS
By 2 days after birth, mean weight loss among neonates was 6% to 7% of birth weight, and by Day 3, mean weight loss was usually 7% to 8%. The nadir of lost birth weight occurred on Days 2, 3, or 4 after birth. At times, breastfed newborns lost 10% or more of their birth weight. By 10 to 14 days, most newborns regained their birth weight. Rates of exclusive breastfeeding decreased when newborns lost greater amounts of weight. Compared with past studies, more sample groups in this review included exclusively breastfed newborns and weight assessments beyond birth hospitalization.
CONCLUSION
Weight loss is commonly 7% to 8% of birth weight or greater by the third day after birth among healthy, full-term, breastfed newborns.
Topics: Birth Weight; Breast Feeding; Female; Humans; Infant, Newborn; Postpartum Period; Term Birth; Weight Loss
PubMed: 31610141
DOI: 10.1016/j.jogn.2019.09.004 -
The Journal of Pediatrics Apr 2015To measure exhaled carbon dioxide (ECO2) in term infants immediately after birth. (Comparative Study)
Comparative Study
OBJECTIVE
To measure exhaled carbon dioxide (ECO2) in term infants immediately after birth.
STUDY DESIGN
Infants >37 weeks gestation born at The Royal Women's Hospital, Melbourne, Australia were eligible. A combined flow sensor and mainstream carbon dioxide (CO2) analyzer was placed in series proximal to a facemask to measure ECO2 and tidal volumes in the first 120 seconds after birth.
RESULTS
Term infants (n = 20) with a mean (SD) birth weight of 2976 (697) g and gestational age of 38 (2) weeks were included. Infants took a median (range) 3 (1-8) breaths before ECO2 was detected. The median (range) of maximum ECO2 was 51 (40-73) mm Hg at 70 (21-106) seconds after birth. Within the first 10 breaths, CO2 increased from 0-27 (22-34) mm Hg. The median (IQR) tidal volume during the breaths without CO2 was 1.2 (0.8-3.1) mL/kg compared with 7.3 (3.2-10.9) mL/kg during the first 10 breaths where CO2 was exhaled.
CONCLUSIONS
The first breaths for an infant after birth did not contain ECO2. With aeration of the distal gas exchange regions, tidal volume and ECO2 significantly increased. ECO2 can be used to monitor lung aeration immediately after birth.
Topics: Birth Weight; Carbon Dioxide; Exhalation; Female; Gestational Age; Humans; Infant, Newborn; Lung; Male; Pulmonary Gas Exchange; Reference Values; Respiratory Function Tests; Term Birth
PubMed: 25596099
DOI: 10.1016/j.jpeds.2014.12.007 -
Pediatric Critical Care Medicine : a... Sep 2017
Topics: Cardiac Surgical Procedures; Extracorporeal Membrane Oxygenation; Heart Defects, Congenital; Humans; Infant, Newborn; Pregnancy; Term Birth
PubMed: 28863093
DOI: 10.1097/PCC.0000000000001262 -
Pediatric Obesity Mar 2019Infants born very preterm experience poor postnatal growth relative to intrauterine growth, but at term equivalent age, they have increased percentage body fat compared...
BACKGROUND
Infants born very preterm experience poor postnatal growth relative to intrauterine growth, but at term equivalent age, they have increased percentage body fat compared with infants born at term.
OBJECTIVES
The aim of this study was to assess body composition in very preterm infants born before 32 weeks postmenstrual age and to compare this with infants born at 32-36 weeks of gestation.
METHODS
Percentage fat, fat mass and fat-free mass were measured in 87 very preterm infants born <32 weeks of gestation and studied at 32-36 weeks and in 88 control infants born at 32-36 weeks of gestation and measured on days 2-5 postnatally.
RESULTS
At 32-36 weeks, very preterm infants were lighter and shorter, had significantly greater percentage fat and absolute fat mass and had a significantly lower absolute fat-free mass than the control group. The trajectory in percentage fat over increasing postnatal age in very preterm infants was closely aligned to that in term infants.
CONCLUSIONS
Infants born very preterm accumulate fat rapidly after birth and have a deficit in fat-free mass. Fat accumulation may be triggered by birth or associated events. If this rapid fat accretion is not taken into account, assessment of growth based on weight alone will underestimate the deficit in fat-free mass.
Topics: Adipose Tissue; Australia; Body Composition; Body Weight; Cross-Sectional Studies; Female; Humans; Infant, Extremely Premature; Infant, Newborn; Male; Term Birth
PubMed: 30257276
DOI: 10.1111/ijpo.12472