Maternal health, neonatology and perinatology最新文献

{"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}

{"title":"Surgical site infection and its association with rupture of membrane following cesarean section in Africa: a systematic review and meta-analysis of published studies.","authors":"Alemayehu Gonie Mekonnen,&nbsp;Yohannes Moges Mittiku","doi":"10.1186/s40748-020-00122-2","DOIUrl":"https://doi.org/10.1186/s40748-020-00122-2","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical site infection occurs within 30 days after a surgical procedure and involves the skin, subcutaneous tissue, and soft tissue. Surgical site infection following cesarean section is a common postoperative complication and is associated with maternal morbidity and mortality in resource-limited settings. Even though the proportion of surgical site infection and some risk factors were reported by kinds of literature, varying results were stated across studies. There is also limited knowledge on the association between postpartum surgical site infection and the rupture of membrane. Hence, this systematic review and meta-analysis was designed to estimate the pooled proportion of surgical site infection and its association with rupture of membrane following cesarean section in Africa.</p><p><strong>Methods: </strong>Studies published from January 01, 2000 to January 30, 2020 were searched from MEDLINE via PubMed, Scopus, Medscape, Web-science and CINAHL databases to search relevant published articles. We also performed a manual search of reference lists of key articles to retrieve additional relevant articles. Initially, 559 records were identified and 15 studies included in the analysis. The statistical analysis was performed using STATA 11. Heterogeneity between-study was explored by forest plot and inconsistency index (I²). The publication bias was checked by a funnel plot and Egger's test. Pooled estimates of proportion and odds ratio were calculated by a random-effects model with a 95% confidence interval (CI).</p><p><strong>Results: </strong>The overall pooled proportion of surgical site infection following cesarean section was 10.21% (I² = 86.8, p < 0.000; 95% CI = 8.36, 12.06). The odds of developing surgical site infection among women who had the rupture of membrane before delivery were nearly 6 times higher than those who had not a rupture of the membrane (AOR = 5.65, 95% CI: 3.95-8.07).</p><p><strong>Conclusions: </strong>The proportion of surgical site infections following the cesarean section is relatively high. Women who had rupture of the membrane before delivery were more likely to develop surgical site infections following the cesarean section. Due attention should be given to the provision of prophylactic antibiotics that can reduce surgical site infection after cesarean delivery.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2021-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-020-00122-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38773587","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":"Perinatal mortality and its determinants in Sub Saharan African countries: systematic review and meta-analysis.","authors":"Dawit Tiruneh,&nbsp;Nega Assefa,&nbsp;Bezatu Mengiste","doi":"10.1186/s40748-020-00120-4","DOIUrl":"https://doi.org/10.1186/s40748-020-00120-4","url":null,"abstract":"<p><strong>Background: </strong>Despite decreasing overall perinatal and maternal mortality in high-income countries, perinatal and maternal health inequalities are persisting in Sub Saharan African countries. Therefore, this study aimed to determine the effects size of rates and determinants for perinatal mortality in Sub-Saharan countries.</p><p><strong>Method: </strong>The sources for electronic datasets were PubMed, Medline, EMBASE, SCOPUS, Google, Google Scholar, and WHO data Library. Observational studies published in the English language from January 01, 2000, to May 30, 2019 were included. STROBE and JBI tools were used to include relevant articles for this review. We used a Comberehensive Meta-Analysis version 2 software for this analysis. The I² and Q- statistic values were used to detect the level of heterogeneity. The Kendall's without continuity correction, Begg and Mazumdar rank correlation and Egger's linear regression tests were used to detect the existence of significant publication bias (P <  0.10). The effects size were expressed in the form of point estimate and odds ratio with 95% CI (P <  0.05) in the random effect analysis using the trim and fill method.</p><p><strong>Result: </strong>Twenty-one articles were included in this review. However, only fourteen studies reported the perinatal mortality rate. Among 14 studies, the observed and adjusted PMR was found to be 58.35 and 42.95 respectively. The odds of perinatal mortality among mothers who had no ANC visits was 2.04 (CI: 1.67, 2.49, P <  0.0001) as compared to those who had at least one ANC visit. The odds of perinatal mortality among preterm babies was 4.42 (CI: 2.83, 6.88, P <  0.0001). In most cases, heterogeneity was not evident when subgroup analyses were assessed by region, study design, and setting. Only perinatal mortality (P <  0.0001), antenatal care (P <  0.046) and preterm births (P <  0.034) showed a relationship between the standardized effect sizes and standard errors of these effects.</p><p><strong>Conclusion: </strong>In general, engaging in systematic review and meta-analysis would potentially improve under-represented strategies and actions by informing policy makers and program implementers for minimizing the existing socioeconomic inequalities between regions and nations.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":" ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-020-00120-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38772119","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 and associated factors of early initiation of breastfeeding among women delivered via Cesarean section in South Gondar zone hospitals Ethiopia, 2020.","authors":"Bekalu Getnet,&nbsp;Alemu Degu,&nbsp;Fantahun Yenealem","doi":"10.1186/s40748-020-00121-3","DOIUrl":"https://doi.org/10.1186/s40748-020-00121-3","url":null,"abstract":"<p><strong>Background: </strong>Early initiation of breastfeeding is putting the newborn to breast within one hour after birth. This study was aimed to assess prevalence of early initiation of breastfeeding and its associated factors among mothers who delivered by cesarean section in South Gondar Zone hospitals Northwest Ethiopia, 2020.</p><p><strong>Methods: </strong>An institutional based cross-sectional study was employed in South Gondar Zone hospitals from June 12 to July 03, 2020. A total of 356 cesarean delivered mothers were included. Data were collected using interviewer administered questionnaire and entered in to Epi Data version 4.2 and then exported to SPSS version 23.0. Logistic regression statistical analyses were used to identify factors associated with the outcome variables.</p><p><strong>Results: </strong>The prevalence of early initiation of breastfeeding among mothers who delivered by cesarean section was 51.9%. Mothers who had intended pregnancy [AOR = 2.69, 95% CI (1.34-5.38)], had professional guidance [AOR = 2.68, 95% CI (1.18-6.10)], had breastfeeding experience [AOR = 2.25, 95% CI (1.35-3.75)], and had four and above antenatal care visits [AOR = 2.20, 95% CI (1.24-3.91)] were positively associated with early initiation of breastfeeding among mothers who delivered by cesarean section.</p><p><strong>Conclusion: </strong>Type of pregnancy, professional guidance, had four or more antenatal care and breastfeeding experience were significantly associated with early initiation of breast feeding among mothers who delivered by cesarean section. Community based breastfeeding education and counseling to pregnant mothers and encouraging all mothers to follow recommended ANC visit is should be recommended.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"6 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-020-00121-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38694544","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":"Maternal and cord blood vitamin D level and the infant gut microbiota in a birth cohort study.","authors":"Zeinab Kassem, Alexandra Sitarik, Albert M Levin, Susan V Lynch, Suzanne Havstad, Kei Fujimura, Anita Kozyrskyj, Dennis R Ownby, Christine Cole Johnson, Germaine J M Yong, Ganesa Wegienka, Andrea E Cassidy-Bushrow","doi":"10.1186/s40748-020-00119-x","DOIUrl":"10.1186/s40748-020-00119-x","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence suggests both vitamin D and the early life gut microbiome influence childhood health outcomes. However, little is known about how these two important exposures are related. We aimed to examine associations between plasma 25-hydroxyvitamin D (25[OH]D) levels during pregnancy or at delivery (cord blood) and infant gut microbiota.</p><p><strong>Methods: </strong>Maternal and cord blood 25[OH]D levels were assessed in a sample of pregnant women. Compositional analyses adjusted for race were run on the gut microbiota of their offspring at 1 and 6 months of age.</p><p><strong>Results: </strong>Mean prenatal 25(OH)D level was 25.04 ± 11.62 ng/mL and mean cord blood 25(OH)D level was 10.88 ± 6.77 ng/mL. Increasing prenatal 25(OH)D level was significantly associated with decreased richness (<i>p</i> = 0.028) and diversity (<i>p</i> = 0.012) of the gut microbiota at 1 month of age. Both prenatal and cord 25(OH)D were significantly associated with 1 month microbiota composition. A total of 6 operational taxonomic units (OTUs) were significantly associated with prenatal 25(OH)D level (four positively and two negatively) while 11 OTUs were significantly associated with cord 25(OH)D (10 positively and one negatively). Of these, OTU 93 (<i>Acinetobacter</i>) and OTU 210 (<i>Corynebacterium</i>)<i>,</i> were consistently positively associated with maternal and cord 25(OH)D; OTU 64 (<i>Ruminococcus gnavus</i>) was positively associated with prenatal 25(OH)D but negatively associated with cord 25(OH)D.</p><p><strong>Conclusions: </strong>Prenatal maternal and cord blood 25(OH)D levels are associated with the early life gut microbiota. Future studies are needed to understand how vitamin D and the microbiome may interact to influence child health.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"6 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38526727","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":"Retraction Note: Application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries: a systematic review and meta-analysis.","authors":"Aklilu Abrham Roba,&nbsp;Maleda Tefera,&nbsp;Teshager Worku,&nbsp;Tamirat Tesfaye Dasa,&nbsp;Abiy Seifu Estifanos,&nbsp;Nega Assefa","doi":"10.1186/s40748-020-00118-y","DOIUrl":"https://doi.org/10.1186/s40748-020-00118-y","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1186/s40748-019-0111-y.].</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"6 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-020-00118-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054054","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":"Helping Babies Breathe (2nd edition) implementation on a shoestring budget in Zanzibar, Tanzania.","authors":"Gina M Wilson,&nbsp;Ame M Ame,&nbsp;Maimuna Mohamed Khatib,&nbsp;Bimkubwa Suleiman Khalfan,&nbsp;Julie Thompson,&nbsp;Jane Blood-Siegfried","doi":"10.1186/s40748-020-00117-z","DOIUrl":"https://doi.org/10.1186/s40748-020-00117-z","url":null,"abstract":"<p><strong>Background: </strong>To assess the efficacy and viability of implementing Helping Babies Breathe, a neonatal resuscitation program for resource-limited environments on a small budget in two of the largest delivery centers in Zanzibar, Tanzania. The quality improvement initiative concentrated on training midwives, who directly care for neonates at birth on Helping Babies Breathe to address high rates of neonatal mortality secondary to birth asphyxia.</p><p><strong>Methods: </strong>The convenience sample was 59 midwives working in the two delivery centers of interest in Zanzibar, Tanzania. The train-the-trainer implementation strategy with repeated measures design was used to assess knowledge and skills at three time points. Observations were completed through supportive supervision of deliveries in both facilities. A budget was kept throughout the implementation.</p><p><strong>Results: </strong>Knowledge scores and resuscitation skills significantly improved and were sustained over a 6-month period of time, <i>Ps</i> < .001. 130 supportive supervision observations were completed. Eighteen times (14%) a baby did not cry at birth and needed intervention. All were appropriately intervened for and survived the Golden Minute. The budget for this implementation was 9015.50 USD. Considering in-kind donations and financial support by the Zanzibar Ministry of Health the bottom line cost was much lower.</p><p><strong>Conclusion: </strong>Results indicate that participants retained knowledge and skills over time and were able to translate these skills into clinical practice. This initiative provides an alternative approach to implementing Helping Babies Breathe, relying on a small budget, local leadership and government support.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"6 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-020-00117-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38029546","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":"Negativity about the outcomes of extreme prematurity a persistent problem - a survey of health care professionals across the North Queensland region.","authors":"Susan Ireland,&nbsp;Sarah Larkins,&nbsp;Robin Ray,&nbsp;Lynn Woodward","doi":"10.1186/s40748-020-00116-0","DOIUrl":"https://doi.org/10.1186/s40748-020-00116-0","url":null,"abstract":"<p><strong>Background: </strong>Extremely preterm babies are at risk of significant mortality and morbidity due to their physiological immaturity. At periviable gestations decisions may be made to either provide resuscitation and intensive care or palliation based on assessment of the outlook for the baby and the parental preferences. Health care professionals (HCP) who counsel parents will influence decision making depending on their individual perceptions of the outcome for the baby. This paper aims to explore the knowledge and attitudes towards extremely preterm babies of HCP who care for women in pregnancy in a tertiary, regional and remote setting in North Queensland.</p><p><strong>Methods: </strong>A cross sectional electronic survey of HCP was performed. Perceptions of survival, severe disability and intact survival data were collected for each gestational age from 22 to 27 completed weeks gestation. Free text comment enabled qualitative content analysis.</p><p><strong>Results: </strong>Almost all 113 HCP participants were more pessimistic than the actual outcome data suggests. HCP caring for women antenatally were the most pessimistic for survival (<i>p</i> = 0.03 at 23 weeks, <i>p</i> = 0.02 at 25,26 and 27 weeks), severe disability (<i>p</i> = 0.01 at 24 weeks) and healthy outcomes (p = 0.01 at 24 weeks), whilst those working in regional and remote centres were more negative than those in tertiary unit for survival (<i>p</i> = 0.03 at 23,24,25 weeks). Perception became less negative as gestational age increased.</p><p><strong>Conclusion: </strong>Pessimism of HCP may be negatively influencing decision making and will negatively affect the way in which parents perceive the chances of a healthy outcome for their offspring.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"6 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2020-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40748-020-00116-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37901726","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}