The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians最新文献

{"title":"Socioeconomic impacts on the intergenerational associations of preterm birth.","authors":"Dong Liu,&nbsp;Ge Lin,&nbsp;Ming Qu,&nbsp;James M Alexander","doi":"10.1080/14767058.2021.1946503","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946503","url":null,"abstract":"<p><strong>Background: </strong>The impact of socioeconomic status on intergenerational associations of preterm birth (PTB) is poorly understood.</p><p><strong>Objective: </strong>To estimate the socioeconomic status of intergenerational impact of PTB transmission.</p><p><strong>Study design: </strong>This retrospective cohort study included all eligible singleton female infants born in Nebraska from 1995 to 2005 (<i>n</i> = 6631) and followed up from 2009 to 2019. Mothers' first singleton infants born 2009-2019 were linked to the mothers and included in the description and generalized estimating equations.</p><p><strong>Results: </strong>Mothers born PTB were 37% more likely to have a PTB infant after controlling for maternal and grandmother's prenatal care adequacy, maternal residential poverty, pre-pregnancy diabetes, hypertension, C-section, and infants' gender. In poor neighborhoods, the adjusted preterm odds ratio of former born preterm mothers (compared with mother not born PTB) was 1.56 (95% confidence interval (CI): 1.02, 2.38). Moreover, moving from a poor neighborhood to a relatively well-off neighborhood was a protective factor for PTB with an adjusted odds ratio of 0.47 (95% CI: 0.23, 0.95).</p><p><strong>Conclusions: </strong>Mothers born preterm were at increased risk of having PTB infants, especially in poor areas. Maternal upward social mobility was a protective factor for PTB recurrence.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7173-7178"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1946503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39158225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between congenital uterine anomalies and perinatal outcomes - does type of defect matters?","authors":"Amir Naeh,&nbsp;Emiliya Sigal,&nbsp;Sivan Barda,&nbsp;Mordechai Hallak,&nbsp;Rinat Gabbay-Benziv","doi":"10.1080/14767058.2021.1949446","DOIUrl":"https://doi.org/10.1080/14767058.2021.1949446","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between congenital uterine anomalies (CUA) and adverse perinatal outcomes stratified by type of anomaly.</p><p><strong>Methods: </strong>A retrospective cohort study of all women delivered in one university-affiliated medical center between 2010 and 2017 with CUA. Multiple pregnancies and pregnancies complicated by fetal anomalies were excluded. Maternal and short-term neonatal outcomes were evaluated and compared between women with unification defects (unicornuate, bicornuate, or uterus didelphys), and canalization defects represented by septate uterus. Univariate analysis was utilized followed by multivariate analysis to adjust for confounders. <i>p</i> < .05 was considered significant.</p><p><strong>Results: </strong>Among 167 pregnancies with CUA, 92 (55.1%) had bicornuate uterus, 32 (19.1%) septate uterus, 26 (15.6%) didelphys uterus, and 17 (10.1%) unicornuate uterus. Maternal demographics and obstetric characteristics were similar between women with unification and canalization defects. The entire cohort had high rates of preterm delivery (PTD), malpresentation, and cesarean delivery (CD) (25.7%, 42.5%, and 63.5%, respectively). In comparison to unification defects, pregnancies in women with canalization defects (septate uterus), had increased risk for PTD <32 weeks (12.5% <i>vs.</i> 2.9%, <i>p = .</i>02), and placental abruption (12.5% <i>vs.</i> 3%, <i>p</i> = .02), however, a lower overall rate of CD (46.9% <i>vs.</i> 67.4%, <i>p</i> = .03). Following adjustment to confounders (age, BMI, nulliparity, chronic hypertension, and smoking) none of the results remained statistically significant. There were no differences in neonatal outcomes between the groups.</p><p><strong>Conclusions: </strong>Overall, women with CUA have a high prevalence of adverse pregnancy outcomes. However, outcome does not differ by type of anomaly.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7406-7411"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1949446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39165085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinopathy prematurity: a systematic review and meta-analysis study based on neonatal and maternal risk factors.","authors":"Tahereh Bahmani,&nbsp;Arezoo Karimi,&nbsp;Nazanin Rezaei,&nbsp;Salman Daliri","doi":"10.1080/14767058.2021.1940938","DOIUrl":"https://doi.org/10.1080/14767058.2021.1940938","url":null,"abstract":"<p><strong>Background: </strong>Retinopathy of prematurity is the abnormal development of retinal arteries in preterm neonates less than 32 weeks and weighing 1500 g, and less, which can lead to visual impairment during life and blindness. This study aims to investigate the relationship between some clinical characteristics of neonates and mothers with Retinopathy of prematurity in the world <i>via</i> a systematic review and meta-analysis.</p><p><strong>Materials and methods: </strong>The present study is a systematic review and meta-analysis on the relationship between maternal and neonatal clinical variables with Retinopathy of prematurity in the world from the beginning of 2000 to the end of 2020. Accordingly, all English articles published on the topic were searched in scientific databases of Web of Science, PubMed, Google Scholar, Science Direct, and Scopus. The articles were searched independently by two researchers. Statistical analysis of data was performed using fixed and random effects model statistical tests in the meta-analysis, Cochran, meta-regression, <i>I²</i> index, Funnel plot, and Begg's by STATA software program, version 14.</p><p><strong>Result: </strong>A total of 191 studies with a sample size of 140,921 persons were including in the meta-analysis. Accordingly, Preterm delivery ≤28 weeks (OR:6.3, 95% CI:4.9-8.1), Birth Weight ≤1000 g (OR:5.8, 95% CI:4.8-6.8), Birth Weight ≤1500 g (OR:4.8, 95% CI:3.8-6.1), PROM (OR:1.2, 95% CI:1.0-1.4), induced fertility (OR:1.9, 95% CI:1.1-3.0) and Chorioamnionitis (OR:1.5, 95% CI:1.0-2.2) There was a statistically significant association with retinopathy.</p><p><strong>Conclusion: </strong>Based on the results of the present meta-analysis, the risk of retinopathy of prematurity in neonates born at 28 weeks and less, LBW (weight 1500 g and less), neonatal hypotension, chorioamnionitis, and induced fertility increases.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8032-8050"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39179975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amniotic fluid and urine metabolomic alterations associated with pregnant women with Down syndrome fetuses.","authors":"Xiaohang Chen,&nbsp;Liang Hu,&nbsp;Jinjiang Su,&nbsp;Xiaoyi Liu,&nbsp;Xiaojin Luo,&nbsp;Yuanyuan Pei,&nbsp;Yushan Gao,&nbsp;Fengxiang Wei","doi":"10.1080/14767058.2021.1937990","DOIUrl":"https://doi.org/10.1080/14767058.2021.1937990","url":null,"abstract":"<p><strong>Background: </strong>Down syndrome (DS) is a chromosomal disorder caused by a third copy of all or part of chromosome 21. Clinical observations and preclinical studies both suggest that DS may be associated with significant metabolic and bioenergetic alterations. But the metabolic alterations in pregnant women carrying DS fetuses still remains unclear. In this study, we investigated the characteristic metabolomics and lipidomics changes during fetal development of DS.</p><p><strong>Methods: </strong>The AF and random urine specimens were selected from 20 pregnant women carrying DS fetuses and 20 pregnant women carrying healthy fetuses. The diagnosis of DS was screened according to chromosome karyotype analysis, and untargeted metabolomic and lipidomic analyses were performed.</p><p><strong>Results: </strong>Through the analyses of AF, 308 differential metabolites were selected between DS and controls. The metabolites with significant changes mainly involved lipid molecules, organic acids, nucleotides and carbon. Further analysis of lipidomics showed 64 differential metabolites, mainly involving glycerides, sphingolipids and glycerolipids. As for urine metabolomic and lipidomic analyses, there existed consistent metabolites with AF, but the number was much less.</p><p><strong>Conclusions: </strong>Compared with the controls, carbon metabolism, amino acid metabolism, glyceride metabolism, sphingolipid metabolism and glycerophospholipid metabolism were significantly changed in DS cases. In addition, characterized biomarkers in AF and urine were screened for DS diagnosis, and these metabolites were mainly involved in energy metabolism and liver dysfunction. This finding may help improve the efficiency of prenatal screening for DS.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7882-7889"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1937990","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39233534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A regional survey evaluating patient experience seeking trial of labor after cesarean.","authors":"Christina Davidson,&nbsp;Caroline Haley Walker,&nbsp;Haleh Sangi-Haghpeykar","doi":"10.1080/14767058.2021.1938529","DOIUrl":"https://doi.org/10.1080/14767058.2021.1938529","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate access to trial of labor after cesarean (TOLAC) in a large metropolitan city.</p><p><strong>Study design: </strong>In 2012, a public tertiary care hospital in Houston, TX promoted its TOLAC services on social media, resulting in a surge of self-referrals. In 2018, an electronic survey was distributed by email to 200 women who had previously contacted the hospital regarding TOLAC and posted on 2 local social media TOLAC sites. Women were asked to participate if they ever sought TOLAC in the Houston area. Data were analyzed for trends in patient experience seeking TOLAC and comparisons were made based on number of prior cesarean deliveries (CD) and race/ethnicity.</p><p><strong>Results: </strong>The survey was open for responses for 1 month, with 128 completed surveys by the end of the study time period. Of the respondents, most (64%) had 1 prior CD and identified as White (63%). Most (60%) of all women reported contacting ≥3 providers before finding one that offered TOLAC, with no difference reported for women with 1 vs 2 prior CD (<i>p</i> = .2). Over half (52%) reported their experience seeking TOLAC to be difficult with more difficulty noted by those with 2 vs 1 prior CD, (61.8% vs 42.7%,) but not statistically significant (<i>p</i> = .06). White women were more likely to report an easier experience seeking TOLAC compared to Black women (55.6% vs 30%, <i>p</i> = .04).Overall, 37% attempted TOLAC at the reference hospital. Black (50%) and Hispanic (68.2%) women were significantly more likely to have delivered at the reference hospital than White women (24%) (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>Our results suggest that women seeking TOLAC have difficulty finding providers who offer the service. This may be especially true for Black and Hispanic women and women with >1 prior CD. Women may utilize social media forums for resources and recommendations and such platforms may represent an underutilized opportunity to identify regional TOLAC services.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7924-7928"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1938529","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39238811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal cardiovascular function in the prediction of fetal distress in labor: a prospective cohort study.","authors":"Ilenia Mappa,&nbsp;Maria Luviso,&nbsp;Silvio Tartaglia,&nbsp;Pavjola Maqina,&nbsp;Jia Li Angela Lu,&nbsp;Alexander Makatsariya,&nbsp;Giuseppe Rizzo","doi":"10.1080/14767058.2021.1945028","DOIUrl":"https://doi.org/10.1080/14767058.2021.1945028","url":null,"abstract":"Abstract Objective To explore the strength of association and the diagnostic accuracy of maternal hemodynamic parameters detected noninvasively in predicting an adverse perinatal outcome in labor. Methods Prospective cohort study of singleton women undergoing antepartum care at 37–39 weeks of gestation. A noninvasive ultrasonic cardiac output monitor (USCOM®) was used for cardiovascular assessment. The study outcome was a composite score of adverse perinatal outcome, which included at least one of the following variables: Cesarean or instrumental delivery for abnormal fetal heart monitoring, umbilical artery pH <7.10 or admission to neonatal special care unit. Attending clinicians were blinded to maternal cardiovascular indices. Multivariate logistic regression and area under the curve (AUC) analyses were used to test the diagnostic accuracy of different maternal and ultrasound characteristics in predicting adverse perinatal outcome. Results A total of 133 women were recruited. The rate of adverse perinatal outcome was 25.6% (34/133). Women who delivered without abnormal perinatal outcome (controls) were more likely to be parous, compared to those who had an adverse perinatal outcome (44.4 vs. 73.5%; p = .005). Control women had significantly lower systemic vascular resistance (SVR) (median, 1166 vs. 1352 dynes × s/cm5, p = .023) and SVR index (SVRI) (median, 2168 vs. 2627 dynes × s/cm5/m2, p = .039) compared to women who had an adverse perinatal outcome. In this latter group the prevalence of SV <50 ml was significantly higher than in the control group (38.2% (13/34) vs. 11.1%, (11/99) p = .0012). At multivariable logistic regression analysis, SVR (aOR 1.307; 95% CI 1.112–2.23), SV <50 ml (aOR 4.70; 95% CI 1.336–12.006) and parity (3.90: 95% CI 1.545–10.334) were the only variables independently associated with adverse perinatal outcome. A model considering only SVR showed an AUC of 0.631. Integration of SVR with SV <50 ml and parity significantly improves the diagnostic performance of SVR alone to predict adverse outcome (AUC 0.732; p = .016). Conclusion Pre-labor modifications of maternal cardiovascular variables are associated with adverse perinatal outcome. However, their predictive accuracy for perinatal compromise is low, and thus their use as standalone screening test for adverse perinatal outcome in singleton pregnancies at term is not supported.","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7139-7145"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39269164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes of dendritic cell and natural killer cell on the cord blood with idiopathic fetal growth restriction.","authors":"Lili Huang,&nbsp;Ping Li,&nbsp;Ting Feng,&nbsp;Fei Xiong","doi":"10.1080/14767058.2021.1951214","DOIUrl":"https://doi.org/10.1080/14767058.2021.1951214","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the characteristics of dendritic cells (DC) and natural killer cells (NK) in umbilical cord blood of pregnant patients diagnosed with idiopathic fetal growth restriction (IFGR).</p><p><strong>Methods: </strong>A prospective study cohort of IFGR patients was established who were in the third trimester (28-36 weeks), with a healthy, pregnant woman cohort selected as controls. Umbilical cord blood was collected.</p><p><strong>Results: </strong>The study included 50 pregnant women in the IFGR group and 50 pregnant women in the healthy, control group. The incidence of SGA in the IFGR group was 52.0%, and the incidence of preterm birth was 18.0%. The incidence of neonatal complications in neonates with live birth in the IFGR group was 12.0%. The birth weight, body length and placental weight of the newborns in the IFGR group were significantly lower than those in the control group (<i>p</i> < .05). Flow cytometry revealed no significant difference in the proportion or maturity of DC in umbilical cord blood between IFGR group and control group (<i>p</i> > .05). The proportion of NK cells in umbilical cord blood of IFGR group was significantly higher than that of normal control group. The proportion of CD56dimCD16+ NK cells was also significantly higher than that of the normal control group (<i>p</i> < .05), but the expression of NK cell surface killing activator receptor NKG2D and inhibitory receptor NKG2A was not statistically significant (<i>p</i> > .05).</p><p><strong>Conclusion: </strong>The number and proportion of DC cells in cord blood may not be the key factors affecting the outcomes observed during FGR pregnancies. However, we found the proportion of NK cells in cord blood to be significantly increased, as well as the ratio of CD56dimCD16 + NK to CD56highCD16-NK to be imbalanced, which may be one of the pathogenesis of the pathological pregnancy leading to IFGR.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7526-7531"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39301293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal progesterone for preterm birth prevention in women with arrested preterm labor.","authors":"Heather A Frey,&nbsp;Molly J Stout,&nbsp;Mahmoud Abdelwahab,&nbsp;Methodius G Tuuli,&nbsp;Candice Woolfolk,&nbsp;Alireza A Shamshirsaz,&nbsp;George A Macones,&nbsp;Alison G Cahill","doi":"10.1080/14767058.2021.1963705","DOIUrl":"https://doi.org/10.1080/14767058.2021.1963705","url":null,"abstract":"<p><strong>Objective: </strong>We tested the hypothesis that administration of vaginal progesterone in women with arrested preterm labor would result in lower rates of preterm birth <37 weeks compared to placebo.</p><p><strong>Study design: </strong>We performed a randomized, placebo-controlled trial comparing vaginal progesterone to placebo in women with arrested preterm labor. Our trial included women with a singleton or twin gestation at 24⁰^/7-33^6/7 weeks' gestation who presented with preterm labor with cervical dilation ≥1 centimeter but remained undelivered. Participants were randomized to receive vaginal progesterone 200 mg daily or an identical placebo. The primary outcome was preterm birth <37 weeks. We performed an updated systematic review and meta-analysis of clinical trials, including our results. We searched MEDLINE, EMBASE, CINHAL, Scopus, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov using the key terms to identify relevant trials. The risk of bias was appraised using the Cochrane risk-of-bias tool. Data were synthesized using random-effects models. Heterogeneity was assessed using Higgins <i>I</i>².</p><p><strong>Results: </strong>The randomized trial was prematurely terminated due to slow recruitment. There were 18 women randomized to receive vaginal progesterone who had complete follow-up data and 18 women in the placebo group. The risk of preterm birth <37 weeks was not significantly different in the groups (RR 1.10, 95% CI 0.63-1.19). Secondary outcomes were also similar. Thirteen trials with 1658 women (835 in the vaginal progesterone and 823 in the control groups) were included in the meta-analysis. Risk of preterm birth <37 weeks was similar in women who received progesterone and those in the control group (pooled RR 1.06, 95% CI 0.83-1.35). Latency was significantly longer among women with arrested preterm labor who received vaginal progesterone (weighted mean difference: 9.2 d, 95% CI 3.2-15.1), but further analysis showed that prolonged latency was only observed in the subgroup of studies that were not placebo-controlled.</p><p><strong>Conclusions: </strong>This randomized controlled trial and meta-analysis do not support the use of vaginal progesterone for the prevention of preterm birth in women who present in preterm labor.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8160-8168"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39325327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and clinical relevance of colonization with methicillin-resistant <i>Staphylococcus aureus</i> in the obstetric population.","authors":"Emma Bauters,&nbsp;Stijn Jonckheere,&nbsp;Isabelle Dehaene,&nbsp;Patricia Vandecandelaere,&nbsp;Maria Angeles Argudín,&nbsp;Geert Page","doi":"10.1080/14767058.2021.1966411","DOIUrl":"https://doi.org/10.1080/14767058.2021.1966411","url":null,"abstract":"<p><strong>Background and aims: </strong>Routine screening for Methicillin-Resistant <i>Staphylococcus aureus</i> (MRSA) in pregnant women is common practice in many hospitals. However, little is known on its prevalence and clinical relevance in this population. In this prospective longitudinal study, we aimed to investigate the MRSA prevalence in our obstetric population, the rate of vertical transmission of MRSA and the potential clinical relevance of MRSA colonization for both mother and child. A possible correlation between GBS and MRSA colonization was also investigated.</p><p><strong>Materials and methods: </strong>MRSA screening samples were collected at 35-37 weeks of gestation (from mother), at delivery and at discharge (from mother and newborn). All samples were analyzed by conventional microbiological methods and MRSA strains were subjected to spa-typing to investigate genetic similarity. The medical records of all positive mother-child pairs were analyzed to detect the occurrence of clinical infection in the postpartum period.</p><p><strong>Results: </strong>679 mother-child pairs were included between June 2014 and July 2016. Maternal MRSA positivity rate was 1.3% at 35-37 weeks (vaginal/anorectal), 3.1% at delivery (nose/throat) and 3.6% at discharge (nose/throat). MRSA positivity in neonates was 0.3% at delivery and increased to 3% at discharge (nose/umbilicus). Almost all MRSA positive children were born to MRSA positive mothers (OR 120.40, 95% CI: 38.42-377.32). Genetic similarity of the MRSA strains found in mother and child was illustrated for all but one case. 57.7% of the cases of MRSA colonization in our cohort were associated with livestock exposure. 31% of the MRSA positive mothers developed an infectious complication in the postpartum period. No neonatal infectious complications were observed. GBS positivity was not a predictive factor for MRSA colonization in our cohort.</p><p><strong>Conclusion: </strong>The rate of MRSA colonization (overall 4.3%) in our obstetric population is similar to that described in the literature and that of the general population admitted to our hospital in the same period. Maternal MRSA colonization appeared to be an important risk factor for neonatal colonization. Whereas mothers were at higher risk of developing infectious morbidity in the postpartum period, no neonatal infectious complications were observed. We observed no correlation between GBS and MRSA colonization.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8186-8191"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39327172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal growth restriction: underdiagnosed condition with non-optimal screening.","authors":"Anthony Atallah,&nbsp;Marine Butin,&nbsp;Stéphanie Moret,&nbsp;Olivier Claris,&nbsp;Pascal Gaucherand,&nbsp;Muriel Doret-Dion","doi":"10.1080/14767058.2021.1967924","DOIUrl":"https://doi.org/10.1080/14767058.2021.1967924","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Fetal Growth restriction (FGR) is the pathological failure of a fetus to reach its biologically determined growth potential. Detection of FGR fetuses is a universally agreed key objective of antenatal care. Antenatal detection of FGR has undeniable benefits, juggling between intensive fetal surveillance and optimized timing of delivery; it reduces adverse perinatal outcomes by up to four-fold. However, FGR is still widely underdiagnosed. We aimed to identify the prevalence of FGR diagnosis in our wards and study the impact of the 2013 published French guidelines on the detection rate of FGR. The secondary objective aimed to highlight the factors of suboptimal screening in the population of non-diagnosed FGR fetuses and emphasize the screening method that led to antenatal diagnosis of FGR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We conducted a retrospective study at a single tertiary maternity center in Lyon-France, the Femme Mère Enfant Hospital, including the exhaustive population of FGR born after 24 + 0 weeks of gestation from 1 January 2011 to 31 December 2017. FGR was defined combining the neonatal and antenatal consensus-based definitions for early and late FGR in absence of congenital anomalies, excluding small for gestational age fetuses. For all FGR fetuses, we compared the antenatal detection rate of FGR during 2011-2013 to 2015-2017, since the French guidelines were published in December 2013. When FGR fetuses underwent an antenatal diagnosis of FGR, we retrospectively collected the characteristics that led to the diagnosis. When fetuses were not diagnosed as FGR, we retrospectively reviewed the implementation of the recommended screening method, enabling to evaluate whether screening was optimal or not. Statistical analysis was performed in July 2018, and statistical significance was regarded as a &lt;i&gt;p&lt;/i&gt;-value &lt;.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over the seven-year period, and among 31,052 newborns, 1020 (3.3%) infants were identified as FGR and met the inclusion criteria. The detection rate of FGR was similar before and after publication of the French Guidelines related to FGR in 2013. Indeed, 50.8% (201/395) FGR were diagnosed between 2011 and 2013 versus 52.6% (245/465) between 2015 and 2017 (&lt;i&gt;p&lt;/i&gt; = .59). In the population of non-diagnosed FGR infants, screening was suboptimal in 80%. Symphysis-fundal height (SFH) was not measured in 10.7%, with no difference before and after 2014 (7.3 versus 11.8% &lt;i&gt;p&lt;/i&gt; = .11). Ultrasound examination for fetal biometry had not been prescribed in spite of abnormal SFH in 47.7% of undiagnosed FGR infants. Diagnosis has been missed in 11.5% of infants because of misinterpretation of the estimated fetal weight's centile.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;FGR is widely underdiagnosed. However, the limited performances can partially be explained by the regular misuse of screening method in clinical practice. Despite the systematic third trimester ultraso","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8237-8244"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39346486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}