Maternal health, neonatology and perinatology最新文献

{"title":"The risk of diabetes after giving birth to a macrosomic infant: data from the NHANES cohort.","authors":"Corrie Miller,&nbsp;Eunjung Lim","doi":"10.1186/s40748-021-00132-8","DOIUrl":"https://doi.org/10.1186/s40748-021-00132-8","url":null,"abstract":"<p><strong>Aims: </strong>Gestational diabetes (GDM) increases the risk of developing type 2 diabetes and thus warrants earlier and more frequent screening. Women who give birth to a macrosomic infant, as defined as a birthweight greater than 9 lbs. (or approximately 4000 g), are encouraged to also get early type 2 diabetes screening, as macrosomia may be a surrogate marker for GDM. This study investigates whether a macrosomic infant, as defined as 9lbs, apart from GDM, increases the risk for diabetes later in life.</p><p><strong>Methods: </strong>Data on parous women from the National Health and Nutrition Examination Survey (NHANES) 2007-2016 were utilized. Rates of diabetes were compared in those with and without macrosomic infants in Rao-Scott's chi-square test. Multiple logistic regression was used to test the independent effect of macrosomia on type 2 diabetes controlling for the confounding covariates and adjusting for the complex sampling design. To investigate how onset time affects diabetes, we implemented Cox proportional hazard regressions on time to have diabetes.</p><p><strong>Results: </strong>Among 10,089 parous women, macrosomia significantly increased the risk of maternal diabetes later in life in the chi-square test and logistic regression. Independent of GDM, women who deliver a macrosomic infant have a 20% higher chance of developing diabetes compared to women who did not. The expected hazards of having type 2 diabetes is 1.66 times higher in a woman with macrosomic infant compared to counterparts.</p><p><strong>Conclusions: </strong>Women who gave birth to a macrosomic infant in the absence of GDM should be offered earlier and more frequent screening for type 2 diabetes.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"7 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-021-00132-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9193448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods for exploring the faecal microbiome of premature infants: a review.","authors":"Jacob A F Westaway,&nbsp;Roger Huerlimann,&nbsp;Catherine M Miller,&nbsp;Yoga Kandasamy,&nbsp;Robert Norton,&nbsp;Donna Rudd","doi":"10.1186/s40748-021-00131-9","DOIUrl":"https://doi.org/10.1186/s40748-021-00131-9","url":null,"abstract":"<p><p>The premature infant gut microbiome plays an important part in infant health and development, and recognition of the implications of microbial dysbiosis in premature infants has prompted significant research into these issues. The approaches to designing investigations into microbial populations are many and varied, each with its own benefits and limitations. The technique used can influence results, contributing to heterogeneity across studies. This review aimed to describe the most common techniques used in researching the preterm infant microbiome, detailing their various limitations. The objective was to provide those entering the field with a broad understanding of available methodologies, so that the likely effects of their use can be factored into literature interpretation and future study design. We found that although many techniques are used for characterising the premature infant microbiome, 16S rRNA short amplicon sequencing is the most common. 16S rRNA short amplicon sequencing has several benefits, including high accuracy, discoverability and high throughput capacity. However, this technique has limitations. Each stage of the protocol offers opportunities for the injection of bias. Bias can contribute to variability between studies using 16S rRNA high throughout sequencing. Thus, we recommend that the interpretation of previous results and future study design be given careful consideration.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2021-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-021-00131-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25449510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of stillbirths among women who gave birth at Hawassa university comprehensive specialized hospital, Hawassa, Sidama, Ethiopia 2019: a case-control study.","authors":"Rekiku Fikre,&nbsp;Samuel Ejeta,&nbsp;Taye Gari,&nbsp;Akalewold Alemayhu","doi":"10.1186/s40748-021-00128-4","DOIUrl":"https://doi.org/10.1186/s40748-021-00128-4","url":null,"abstract":"<p><strong>Background: </strong>Globally over 2.6 million pregnancy ends with stillbirth annually. Despite this fact, only a few sherds of evidence were available about factors associated with stillbirth in Ethiopia. Therefore, the study aimed to spot factors related to stillbirth among women who gave birth at Hawassa University Comprehensive Specialized Hospital Hawassa, Sidama Ethiopia, 2019.</p><p><strong>Methods: </strong>Facility-based unmatched case-control study was conducted at Hawassa University Comprehensive Specialized Hospital. Cases were selected using simple random sampling technique and controls were recruited to the study consecutively after every case selection with case to control ratio of 1 to 3. Data were coded and entered into Epi-data version 3.1 and exported to SPSS version 24 for analysis.</p><p><strong>Results: </strong>A total of 106 cases and 318 controls were included in the study. Number of antenatal care visit [AOR = 0.38, 95% CI (0.15, 0.95)], lack of partograph utilization [AOR = 4.1 95% CI (2.04, 10.5)], prolonged labor [AOR = 6.5, 95% CI (2.9, 14.4)], obstructed labor [AOR = 3.5, 95% CI (1.5, 9.4)], and congenital defect [AOR = 9.7, 95% CI (4.08, 23.0)] were significantly associated with stillbirth.</p><p><strong>Conclusion: </strong>Absence of partograph utilization, prolonged labor, obstructed labor, antepartum hemorrhage and congenital anomaly were found to have positive association with stillbirth.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2021-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-021-00128-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25376472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional medicine utilisation and maternal complications during antenatal care among women in Bulilima, Plumtree, Zimbabwe.","authors":"Nicholas Mudonhi,&nbsp;Wilfred Njabulo Nunu","doi":"10.1186/s40748-021-00130-w","DOIUrl":"https://doi.org/10.1186/s40748-021-00130-w","url":null,"abstract":"<p><strong>Background: </strong>As part of the expectation enshrined in the Sustainable Development Goals, countries are expected to ensure maternal health outcomes are improved. It follows that under ideal circumstances, pregnant women should deliver safely without complications, neonatal, and maternal mortality. This paper analyses the relationship between traditional medicine utilisation and maternal complications during antenatal care among women in Bulilima, Plumtree, Zimbabwe.</p><p><strong>Methods: </strong>A quantitative cross-sectional survey was conducted on 185 randomly selected women who responded to a pre-tested semi-structured questionnaire. The Fisher's Exact Test and the Test of Proportions were used to probe the relationship between traditional medicine utilisation and the prevalence of maternal complications using STATA SE Version 13.</p><p><strong>Results: </strong>Complications were reported by (51) 29% of the women who were under study. The proportion of women who developed complications was higher in those that did not use traditional medicine as compared to those that used traditional medicine (30 and 26% respectively). In a generalised assessment, women who did not use traditional medicine contributed a significantly higher proportion of complications as compared to those that utilised traditional medicine.</p><p><strong>Conclusion: </strong>This study found a significant relationship between the utilisation of traditional medicines and lesser chances of experiencing maternal complications. Significantly higher prevalence of maternal complications was observed in women who did not use traditional medicine compared to those that did. There is, therefore, a need to investigate further the constituents or active ingredients in this traditional medicine. This study provides a window of opportunity for fully recognising and integrating traditional medicine into Modern Health Systems. It can be argued that traditional medicine utilisation could be a viable alternative to modern medicine, particularly in resource-poor settings where access to modern medicine is seriously constrained.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-021-00130-w","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25349950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of rhesus D-negative blood type and the challenges of rhesus D immunoprophylaxis among obstetric population in Ethiopia: a systematic review and meta-analysis.","authors":"Asteray Assmie Ayenew","doi":"10.1186/s40748-021-00129-3","DOIUrl":"10.1186/s40748-021-00129-3","url":null,"abstract":"<p><strong>Background: </strong>Transplacental or fetomaternal hemorrhage (FMH) may occur during pregnancy or at delivery and lead to immunization to the D antigen if the mother is Rh-negative and the baby is Rh-positive. This can result in hemolytic disease of the fetus and newborn (HDFN) in subsequent D-positive pregnancies. Therefore, the aim of this systematic review and meta-analysis was to estimate distribution of ABO and Rh (D) blood groups among pregnant women in Ethiopia.</p><p><strong>Method: </strong>We searched PubMed, Google Scholar, EMBASE, Cochrane Library, HINARI, AFRO Library Databases, and African Online Journal databases for all available studies using the following keywords: \"High rhesus (Rh(D)) negative frequency\", \"ABO blood group distribution\", \"haemolytic disease of the newborn (HDN)\", \"rh isoimmunization\", \"anti-RhD immunoglobulin\", \"D-negative pregnancies\", \"Frequency\", \"ABO and Rh blood group distribution\", \"feto-maternal hemorrhage\", \"rhesus D negative pregnant mothers\", \"kleihauer-betke test (KBT)\", \"Neonatal Hyperbilirubinemia\", \"non-sensitized RhD-negative pregnant women\", \"antenatal anti-D immunoglobulin prophylaxis\", \"Hemolytic disease of the newborn (alloimmunization), Ethiopia. The search string was developed using \"AND\" and \"OR\" Boolean operators. All published and unpublished observational studies reporting the distribution of ABO and Rh (D) blood groups among pregnant women in Ethiopia were included. The study participants were all pregnant women in Ethiopia, and the main outcome measure of this systematic review and meta-analysis was Rhesus D-negative blood type and ABO blood group distribution among pregnant women in Ethiopia. The data was extracted by the author (AAA) by using a standardized JBI data extraction format. Microsoft Excel (2016), and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) software were used for data entry and analysis, respectively. The random effect model was used for estimating the pooled effects, and the publication bias was assessed by visual inspection of the funnel plots and objectively by using the Egger's test (i.e. p < 0.05).</p><p><strong>Results: </strong>One hundred thirty-two articles were identified through electronic database searching. Of which, 34 were excluded due to duplication, 65 through review of titles and abstracts, and 22 full-text articles were excluded for not reporting the outcome variable and other reasons. Finally, 7 were included to estimate the distribution of ABO and Rh (D) blood groups among pregnant women in Ethiopia. The pooled distribution of Rh-negative blood group among pregnant women in Ethiopia was 10.8% (95%CI: 7.53-14.07, I² = 85%, p < 0.001). In the ABO system, type O was the most prevalent 39.9% (37.51-42.38), followed by A (30.59% (26.00-35.18)), B (23.04% (20.03-26.05)), and AB the least (4.82%(3.17-6.47)), in the pattern O > A > B > AB.</p><p><strong>Conclusion: </strong>The pooled distribution of Rh-negati","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2021-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7852089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25323766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic exposure and growth patterns in preterm, very low birth weight infants.","authors":"Alaina K Pyle,&nbsp;Joseph B Cantey,&nbsp;L Steven Brown,&nbsp;Roy J Heyne,&nbsp;Phillip S Wozniak,&nbsp;Elizabeth Heyne,&nbsp;Amy Holcombe,&nbsp;Elizabeth M Brammer,&nbsp;Cheryl S Lair,&nbsp;Pablo J Sánchez","doi":"10.1186/s40748-021-00126-6","DOIUrl":"https://doi.org/10.1186/s40748-021-00126-6","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic exposure in term infants has been associated with later obesity. Premature, very-low-birth-weight (birth weight ≤ 1500 g) infants in the neonatal intensive care unit frequently are exposed to antibiotics. Our hypothesis was that in preterm infants, there is a positive linear and dose-dependent relationship between antibiotic exposure and growth from birth through 12 months' corrected age.</p><p><strong>Methods: </strong>Retrospective analysis of prospectively collected data of all antibiotic use among inborn, preterm (≤32 weeks' gestation), very-low-birth-weight infants admitted to the neonatal intensive care unit at Parkland Memorial Hospital and followed in the Low Birth Weight Clinic at Children's Medical Center, Dallas, TX. Antibiotic use was quantified by days of therapy which was compared with weight and length parameters at birth, 36 weeks' postmenstrual age, and 2, 4, 6, and 12 months' corrected age. The change in weight and length z-scores from birth to all subsequent age points was calculated. Stepwise multivariate regression analysis was performed to determine predictors of weight, length, and weight-for-length delta z-scores from birth to each subsequent age point.</p><p><strong>Results: </strong>During the 18-month study, 161 infants received a median of 11 (IQR, 5.5-19.5) antibiotic days of therapy which was not associated with weight or length delta z-scores from birth through 12 months' corrected age.</p><p><strong>Conclusion: </strong>Association of prolonged antibiotic use and neonatal morbidities and mortality may override the potential association with increased weight gain in the NICU and beyond.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2021-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25310989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case study of the first pregnant woman with COVID-19 in Bukavu, eastern Democratic Republic of the Congo.","authors":"Etienne Kajibwami Birindwa, Guy Mulinganya Mulumeoderhwa, Olivier Nyakio, Guy-Quesney Mateso Mbale, Serge Zigabe Mushamuka, Jeanne Maningo Materanya, Pierrot Mulumeoderhwa Kahasha, Yvette Kujirakwinja Bisimwa, Freddy Mirindi Kampara, Jules Mongane Irenge, Isaac Barhishindi Kibalama, Pierre Kabuya Luzadi, Espoir Bwenge Malembaka, Daniel Garhalangwa-Na-Muntu Mayeri, Marius Baguma, Ghislain Bisimwa Balaluka","doi":"10.1186/s40748-021-00127-5","DOIUrl":"10.1186/s40748-021-00127-5","url":null,"abstract":"<p><strong>Introduction: </strong>Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus.</p><p><strong>Case presentation: </strong>We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-CoV-2 during the last term of her pregnancy. She gave birth by caesarean at 34 weeks of gestation to a newborn baby also infected with SARS-CoV-2. The peri-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels.</p><p><strong>Conclusion: </strong>This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38761489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of timing of umbilical cord clamping on preventing early infancy anemia in low-risk Japanese term infants with planned breastfeeding: a randomized controlled trial.","authors":"Eriko Shinohara,&nbsp;Yaeko Kataoka,&nbsp;Yukari Yaju","doi":"10.1186/s40748-021-00125-7","DOIUrl":"https://doi.org/10.1186/s40748-021-00125-7","url":null,"abstract":"<p><strong>Background: </strong>Japanese infants have relatively higher risk of anemia and neonatal jaundice. This study aimed to assess the effects of delayed cord clamping (DCC) on the incidence of anemia during early infancy in low-risk Japanese term infants with planned exclusive breastfeeding for 4 months. This study also aimed to explore the effects of DCC on neonatal jaundice.</p><p><strong>Methods: </strong>We conducted an open-label, parallel-arm, multicenter randomized controlled trial of DCC (clamping the cord after more than a minute or pulsation stops) vs. early cord clamping (ECC; clamping the cord within 15 s) at one birth center and two clinics in Japan. Low-risk pregnant women planning to have a vaginal birth and to exclusively breastfeed and term singleton infants delivered in cephalic presentation were included in this study. The primary outcome was spectrophotometric estimation of hemoglobin at 4 months. Secondary outcomes were anemia incidence at 4 months, four outcomes related to neonatal jaundice, hematocrit levels, and related outcomes.</p><p><strong>Results: </strong>Overall, 150 pregnant women were recruited. Participants (N = 138) were randomly allocated to two groups (DCC n = 68, ECC n = 70). There were no significant differences between the two groups in spectrophotometric estimation of hemoglobin at 4 months: mean difference = 0.1 g/dL, 95% confidence interval - 0.14, 0.35, DCC 12.4 g/dL, ECC 12.3 g/dL. Only the hematocrit levels on days 3 to 5 were significantly higher in the DCC group than in the ECC group: DCC 57.0%, ECC 52.6%, mean difference = 4.4, 95% confidence interval 2.61, 6.20. There were no significant differences in other secondary outcomes, including outcomes related to neonatal jaundice.</p><p><strong>Conclusion: </strong>Among low-risk Japanese term infants with planned exclusive breastfeeding, DCC showed no significant effects on spectrophotometric hemoglobin levels at 4 months compared with ECC. We observed significantly higher hematocrit levels on days 3 to 5 in infants who underwent DCC, while these levels were within the normal range. Jaundice outcomes remained similar to those of infants who underwent ECC. Although a larger sample size is required to assess the effects of cord clamping on neonatal jaundice, DCC may prevent anemia in newborn infants.</p><p><strong>Trial registration: </strong>UMIN-CTR; UMIN000022573, 06/01/2016 - retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000023056.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-021-00125-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38838548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: necrotizing enterocolitis with a transverse colonic perforation in a 2-day old term neonate and literature review.","authors":"Jo-Anna Hudson, Simon Byrns, Elizabeth Nizalik, Emanuela Ferretti","doi":"10.1186/s40748-020-00124-0","DOIUrl":"10.1186/s40748-020-00124-0","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing enterocolitis (NEC), while classically discussed in preterm and low birth weight neonates, also occurs in the term infant and accounts for 10% of all NEC cases. Despite there being fewer reported cases of NEC in term infants, these presentations demonstrate differences in the onset, severity and risk factors from the classic presentation observed in premature infants. We present a novel case of term NEC that contravenes the reported literature making departures from clinical presentation, risk factors and location of perforation in an otherwise healthy term two-day old infant born after an uncomplicated pregnancy who presented with hematochezia.</p><p><strong>Case presentation: </strong>A healthy term baby born after an uneventful pregnancy presented with bloody stool at 2 days of life who was otherwise well. Investigations revealed pneumoperitoneum from a large proximal transverse colonic perforation secondary to NEC. No typical risk factors for NEC were found.</p><p><strong>Conclusion: </strong>Given the life-threatening potential of an unrecognized perforation we recommend the inclusion of NEC on the differential for neonatal hematochezia.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2021-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38793557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of severe maternal morbidity: describing risk factors and methodological approaches to inform population-based surveillance.","authors":"Lisa M Korst, Kimberly D Gregory, Lisa A Nicholas, Samia Saeb, David J Reynen, Jennifer L Troyan, Naomi Greene, Moshe Fridman","doi":"10.1186/s40748-020-00123-1","DOIUrl":"10.1186/s40748-020-00123-1","url":null,"abstract":"<p><strong>Background: </strong>Current interest in using severe maternal morbidity (SMM) as a quality indicator for maternal healthcare will require the development of a standardized method for estimating hospital or regional SMM rates that includes adjustment and/or stratification for risk factors.</p><p><strong>Objective: </strong>To perform a scoping review to identify methodological considerations and potential covariates for risk adjustment for delivery-associated SMM.</p><p><strong>Search methods: </strong>Following the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews, systematic searches were conducted with the entire PubMed and EMBASE electronic databases to identify publications using the key term \"severe maternal morbidity.\"</p><p><strong>Selection criteria: </strong>Included studies required population-based cohort data and testing or adjustment of risk factors for SMM occurring during the delivery admission. Descriptive studies and those using surveillance-based data collection methods were excluded.</p><p><strong>Data collection and analysis: </strong>Information was extracted into a pre-defined database. Study design and eligibility, overall quality and results, SMM definitions, and patient-, hospital-, and community-level risk factors and their definitions were assessed.</p><p><strong>Main results: </strong>Eligibility criteria were met by 81 studies. Methodological approaches were heterogeneous and study results could not be combined quantitatively because of wide variability in data sources, study designs, eligibility criteria, definitions of SMM, and risk-factor selection and definitions. Of the 180 potential risk factors identified, 41 were categorized as pre-existing conditions (e.g., chronic hypertension), 22 as obstetrical conditions (e.g., multiple gestation), 22 as intrapartum conditions (e.g., delivery route), 15 as non-clinical variables (e.g., insurance type), 58 as hospital-level variables (e.g., delivery volume), and 22 as community-level variables (e.g., neighborhood poverty).</p><p><strong>Conclusions: </strong>The development of a risk adjustment strategy that will allow for SMM comparisons across hospitals or regions will require harmonization regarding: a) the standardization of the SMM definition; b) the data sources and population used; and c) the selection and definition of risk factors of interest.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2021-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38790838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}