American journal of perinatology最新文献

{"title":"Prospective Cohort Study Investigating Polyunsaturated Fatty Acids and Chronic Lung Disease in Preterm Infants.","authors":"Teryn Igawa, Tessa Gillespie, Esther S Kim, Lauren J Lee, Tristan Grogan, Alison Chu, Kara Calkins","doi":"10.1055/a-2496-2310","DOIUrl":"https://doi.org/10.1055/a-2496-2310","url":null,"abstract":"<p><strong>Objective: </strong>Chronic lung disease (CLD) is a complication of prematurity. Studies examining the effects of long-chain polyunsaturated fatty acids (LC-PUFAs) on CLD are conflicting. This study investigated LC-PUFAs in the red blood cell membrane (RBCM) in preterm infants.</p><p><strong>Study design: </strong>This prospective observational study included infants with gestational age <32 weeks or birth weight <2 kg and at least one LC-PUFA measurement in the first month of life. Subjects without CLD (CON group) were compared to those with CLD (CLD group) and then by CLD severity.</p><p><strong>Results: </strong>Seventy infants were included (CON n=29; CLD n=41). Twenty six infants had Grade 1 CLD; 12 had Grade 2 CLD; 3 had Grade 3 CLD. When the CLD group was compared to the CON group, the overall mean (95% confidence interval) RBCM% for linoleic acid (LA) was similar (CLD vs. CON 12.5% [11.7% - 13.4%] vs. 11.2% [10.2 - 12.3%] p=0.06) but the overall mean arachidonic acid (ARA) was lower (17.6% [17.1% - 18.0%] vs. 18.6% [18.1% - 19.2%], p<0.01). During weeks 1-4, LA% was similar, while ARA% was lower in weeks 2 and 3 (18.8% ± 2.2% vs. 20.0% ± 1.5%, p=0.05, 16.8% ± 2.0% vs. 18.3% ± 1.6%, p=0.01). A similar trend was noted when groups were compared by CLD severity. The CLD group had a higher overall mean ∝-linolenic acid (ALA) compared to the CON group (0.4% [0.3% - 0.4%] vs. 0.2% [0.2 % - 0.3%], p<0.01) but no difference in docosahexaenoic acid (DHA) (3.8% [3.4% - 4.1%] vs. 3.8% [3.4% - 4.3%], p=0.80). During weeks 1-4, ALA% was higher during week 1 only (0.4% ± 0.3% vs. 0.2% ± 0.1%, p<0.01), and DHA% was similar for weeks 1-4. Results were similar when groups were compared by CLD severity.</p><p><strong>Conclusions: </strong>In this study, low ARA status was associated with CLD.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Maternal Body Mass Index on N-Terminal Pro B-Type Natriuretic Peptide Levels in the Third Trimester.","authors":"Upma Saxena, Priyanka Yadav, Abhishek Lachyan, Anita Rani","doi":"10.1055/a-2463-4410","DOIUrl":"https://doi.org/10.1055/a-2463-4410","url":null,"abstract":"<p><strong>Objective: </strong> Maternal body mass index (BMI) and cardiac biomarkers, such as N-terminal pro-B-type natriuretic peptide (NT-proBNP), have been subjects of interest in obstetric research due to their potential implications for maternal and fetal health. Previous studies have explored the relationship between maternal BMI and various pregnancy outcomes, but the impact on NT-proBNP levels remains unclear. This study aims to investigate whether maternal BMI influences NT-proBNP levels in the third trimester of pregnancy, which could provide insights into maternal cardiovascular health during late gestation.</p><p><strong>Study design: </strong> A total of 234 singleton pregnant women in their third trimester (28-40 weeks) were recruited from Antenatal Care Clinic. Exclusion criteria included preexisting cardiac or renal conditions, hypertension, diabetes mellitus, and other specific medical conditions. Participants were categorized into BMI groups (< 23, 23-24.9, 25-29.9, and ≥30 kg/m²), and their NT-proBNP levels were measured using quantitative enzyme-linked immunosorbent assay kits. Statistical analyses including Spearman correlation, chi-squared test, Kruskal-Wallis test, and regression analysis were performed to assess the association between maternal BMI and NT-proBNP levels.</p><p><strong>Results: </strong> The study population exhibited a range of BMI and NT-proBNP levels within normal ranges. No significant correlation was found between maternal age, parity, and NT-proBNP levels. Similarly, no significant association was observed between maternal BMI and NT-proBNP levels across different BMI categories. Trend analyses showed no consistent relationship between BMI and NT-proBNP levels. Multivariate and univariate regression analyses confirmed the lack of significant association between maternal BMI and NT-proBNP levels.</p><p><strong>Conclusion: </strong> Contrary to expectations, this study found no significant effect of maternal BMI on NT-proBNP levels in the third trimester of pregnancy. These findings suggest that factors other than maternal BMI may predominantly influence NT-proBNP levels during late gestation. Further research is warranted to elucidate the complex interactions between maternal physiology, BMI, and cardiovascular biomarkers during pregnancy.</p><p><strong>Key points: </strong>· This study aimed to examine the influence of maternal BMI on NT-proBNP.. · No significant correlation between maternal BMI and NT-proBNP levels was found.. · Other factors likely influence NT-proBNP levels, warranting further research..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omega-3 Levels in Prenatal Supplements.","authors":"Mary J Scourboutakos, Elenee H Harper, Michael T Kopec, Lauren Rose, Milena Forte","doi":"10.1055/a-2465-5163","DOIUrl":"https://doi.org/10.1055/a-2465-5163","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to systematically document the reported omega-3 levels in commercially available prenatal supplements in the United States and Canada, and compare these levels to recommended intakes in pregnancy.</p><p><strong>Study design: </strong> Commercial prenatal supplements were identified using the Dietary Supplement Label Database (<i>n</i> = 50) and the Licensed Natural Health Products Database (<i>n</i> = 18). Mean omega-3 levels and the proportion of products meeting recommendations for pregnant women were tabulated.</p><p><strong>Results: </strong> Average omega-3 levels were 368 ± 33 mg in the United States and 404 ± 72 mg in Canada. Seventy percent of products in the United States and 61% in Canada contained the amount of omega-3 levels recommended for pregnant women with sufficient intakes. Sixteen percent of products in the United States and 28% in Canada contained the dose recommended for pregnant women with insufficient intakes.</p><p><strong>Conclusion: </strong> These results illustrate that commercial prenatal supplements contain a wide variety of omega-3 fatty acid levels that may or may not be consistent with recommended intake levels.</p><p><strong>Key points: </strong>· most pregnant women consume inadequate amounts of omega-3 fatty acids.. · omega-3 fatty acids can help prevent preterm birth.. · new guidelines recommend increased intakes of omega-3 fatty acids during pregnancy.. · prenatal supplements contain a wide variety of omega-3 fatty acid levels.. · omega-3 levels in prenatal supplements may or may not be consistent with recommended intake levels..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Slow and Rapid Weight Gain before 36 Weeks of Corrected Age and 6-Year-Developmental Quotient in Infants Born at <26 Weeks of Gestation.","authors":"Masashi Hotta, Katsuya Hirata, Shinya Hirano, Kazuko Wada","doi":"10.1055/a-2462-5220","DOIUrl":"https://doi.org/10.1055/a-2462-5220","url":null,"abstract":"<p><strong>Objective: </strong> The postnatal growth of preterm infants is influenced by various factors; however, the association between growth and long-term outcomes in extremely preterm infants remains unclear. Therefore, we aimed to determine the association between 6-year development and body weight (BW) at 36 weeks of corrected age (CA) in extremely preterm infants.</p><p><strong>Study design: </strong> We conducted a retrospective observational study including extremely preterm infants born at < 26 weeks of gestation. We defined the key standard deviation score (SDS) using BW at birth and evaluated the association between BW-related values at 36 weeks of CA and the 6-year developmental quotient (DQ).</p><p><strong>Results: </strong> This study included 90 infants. The absolute difference between changes in the BW SDS from birth and the median changes in DQ ≥ 85 infants was significantly greater in infants with a DQ < 85 than ≥85 (median [interquartile range]: 0.80 [0.29, 1.31] vs. 0.34 [0.13, 0.55]; <i>p</i> = 0.001). After adjustment by the logistic regression analysis for DQ < 85, the absolute difference was statistically significant (odds ratio: 4.99, 95% confidence interval: 1.71-14.5). The correlation coefficient between the absolute difference and DQ was -0.35 (<i>p</i> < 0.001). There were no significant associations between a DQ < 85 and SDS or changes in SDS from birth.</p><p><strong>Conclusion: </strong> For infants born at <26 weeks of gestation, slow and rapid weight gain were associated with a low 6-year DQ when using values representing individual body sizes at birth. Individual backgrounds should be considered to avoid both slow and rapid weight gain for the growth management of these infants for at least up to 36 weeks of CA. Further research is needed to determine which body size has a positive impact on the long-term outcomes of infants.</p><p><strong>Key points: </strong>· The median change in BW SDS was a key factor for DQ.. · Slow/rapid weight gain were related to a low 6-year DQ.. · Individual backgrounds may be important in neonatal intensive care unit care..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exhaled Breath Volatile Organic Compounds in Pregnancy: A Pilot Study.","authors":"Mohsen A A Farghaly, Somaya Abuelazm, Ruth M Farrell, Marwa M Elgendy, David Grove, Jalal M Abu-Shaweesh, Raed A Dweik, Hany Aly","doi":"10.1055/a-2463-5352","DOIUrl":"10.1055/a-2463-5352","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to assess the volatile organic compounds (VOC)s in breath samples collected noninvasively from pregnant women during pregnancy and postpartum and compare it with nonpregnant controls.</p><p><strong>Study design: </strong> This pilot study included 50 subjects: 10 pregnant patients in their first trimester, 10 in second trimester, 10 in third trimester, 10 in the first postpartum week, and 10 nonpregnant subjects as a control. We collected exhaled breath from subjects who reported to be healthy and free of any respiratory symptoms. Clinical and demographic data were collected. The samples were analyzed for VOCs using a selected-ion flow-tube mass spectrometer.</p><p><strong>Results: </strong> The VOCs monitored were 22 compounds selected for their common presence in exhaled breath. During pregnancy and postpartum period, there were differences in five compounds mainly: 2-propanol, acrylonitrile, 1-nonene, 2-nonene, and hydrogen sulfide. Significant differences in VOCs were identified during each trimester compared with controls.</p><p><strong>Conclusion: </strong> VOCs could be measured safely and noninvasively in pregnant women. VOCs differed significantly among nonpregnant, pregnant women, and postpartum period. The utilization of this novel assay to identify fetal conditions or identifying women at risk of premature delivery, which should be further investigated in future studies.</p><p><strong>Key points: </strong>· This study demonstrated that VOCs could be measured noninvasively in exhaled breath of pregnant women.. · VOCs differed significantly among women who were nonpregnant, pregnant, and in postpartum period.. · These findings might serve as a base to look for potential markers for maternal or fetal conditions..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Stakeholder Priorities for the Optimization of Care of the Preterm Infant in a Safety-Net NICU.","authors":"Elizabeth Sewell, Miguel Locsin, George Bugg, Kimarie Bugg, Kate McGinnis, Mary Jackson, Nathalie Maitre, Sierra Peagler, Dana Robinson, Andrea Serano, Jessica Roberts","doi":"10.1055/a-2463-4327","DOIUrl":"https://doi.org/10.1055/a-2463-4327","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to engage clinical and community stakeholders to create a prioritization matrix of interventions to reduce neonatal brain injury and improve neurodevelopmental outcomes.</p><p><strong>Study design: </strong> We collaborated with our community partner to establish a Lived Experience Advisory Group (LEAG). Faculty performed a literature review to identify neonatal neuroprotective interventions; additional priorities from the LEAG were also included. Project leaders scored and presented intervention bundles for impact. Stakeholder priorities for value/feasibility were obtained via questionnaire. Mean values were incorporated into a prioritization matrix.</p><p><strong>Results: </strong> Themes from discussions with LEAG members included the role of the neonatal intensive care unit (NICU) parent, the experience of trauma, shared decision-making, communication and trust with the health care team, and bias in medical care. Five interventions were placed in the highest priority quadrant of the prioritization matrix: thermoregulation, maternal antepartum steroids, delayed cord clamping, optimized oxygen delivery, and optimized glucose regulation.</p><p><strong>Conclusion: </strong> It is feasible to incorporate community and parent values into clinically oriented neuroprotective intervention bundles for preterm infants. This clinical-community collaboration is vital to ensure that our project objectives meet the needs and priorities of the population it is intended to serve.</p><p><strong>Key points: </strong>· Including input from parent advisory groups supports interventions that meet the needs of families.. · Collaboration between clinical and community stakeholders can improve neuroprotective and neurodevelopmental strategies.. · Incorporation of clinical interventions into a prioritization matrix improves resource utilization.. · Five perinatal interventions were ranked highly for impact and feasibility in the prioritization matrix..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retroverted Uterus in the First Trimester and Associated Pregnancy Outcomes.","authors":"Emily R Schneider, Agata Kantorowska, Joanna M Clough, Erin L Miller, Emmanuella Kobara, Jasmine Brite, Meredith L Akerman, Wendy L Kinzler, Anju Suhag, Martin R Chavez, Patricia Rekawek","doi":"10.1055/a-2466-1155","DOIUrl":"https://doi.org/10.1055/a-2466-1155","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to investigate if retroverted (RV) uterus noted on nuchal translucency (NT) ultrasound is associated with second-trimester pregnancy loss and other adverse pregnancy outcomes.</p><p><strong>Study design: </strong> This was a retrospective cohort study of patients with RV uterus documented on NT ultrasound at a single academic medical center from October 2019 to March 2023. Subjects were identified using a query for \"retroverted\" uterine position within an obstetric ultrasound imaging program. For each RV case, two anteverted (AV) subjects were selected for comparison. Patients with multiple gestation, Mullerian anomalies, or fetal aneuploidy were excluded. Maternal demographics, obstetric, and neonatal outcomes were obtained by chart review. Fisher's exact test and Mann-Whitney test were used for categorical and continuous variables, respectively, with <i>p</i>-value <0.05 denoting significance. Multivariable logistic regression was used to adjust for possible confounding variables.</p><p><strong>Results: </strong> Analysis included 249 patients-83 RV and 166 AV. RV patients were more likely to identify as Caucasian (71.1 vs. 49.4%, <i>p</i> = 0.001), have private insurance (80.7 vs. 59.4%, <i>p</i> = 0.001), lower body mass index (25.4 ± 5.1 vs 29.1 ± 7.2, <i>p</i> < 0.001), and conceive by in vitro fertilization (IVF, 11 vs. 3%, <i>p</i> = 0.018). Most RV subjects (98%) had a resolution of retroversion by the second trimester. There was no difference in second-trimester pregnancy loss (0 vs. 1.2%, <i>p</i> = 0.55). After adjusting for race and IVF, RV subjects were four times more likely to have first-trimester vaginal bleeding (16.9 vs. 4.2%, odds ratio = 4.1, <i>p</i> = 0.0056). No other differences in adverse outcomes were observed.</p><p><strong>Conclusion: </strong> Persistent RV uterus in the first trimester is associated with increased risk of first-trimester vaginal bleeding. However, rates of pregnancy loss were similar between groups, providing valuable information for patient counseling. Significantly more RV subjects conceived by IVF, highlighting the need for further study in this population.</p><p><strong>Key points: </strong>· Pregnancy outcomes of patients with retroverted uterus have not been widely studied.. · Significantly more patients with a retroverted uterus conceived by in vitro fertilization.. · Patients with retroverted uterus were four times more likely to have first-trimester bleeding.. · Despite increased rates of vaginal bleeding, there was no increased rate of pregnancy loss..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal Breast Milk Expression Survey of Individuals Whose Pregnancy Was Complicated by Diabetes: Exploring Knowledge, Perceptions, Experiences, and Milk Volume Expressed.","authors":"Sarah Mess, Anna Palatnik, Erwin Cabacungan","doi":"10.1055/s-0044-1786546","DOIUrl":"10.1055/s-0044-1786546","url":null,"abstract":"<p><strong>Objective: </strong> Antenatal breast milk expression (ABE) offers a host of benefits, including reduced formula consumption, support for breastfeeding success, and increased maternal satisfaction. Despite these advantages, experience with ABE differs significantly, often leading to anxiety over perceived inadequate milk supply and eventual breastfeeding cessation. This study comprehensively evaluates the knowledge, attitudes, and real-world experiences of individuals with gestational or pregestational diabetes concerning ABE, with a focus on total milk volume expressed prior to birth.</p><p><strong>Study design: </strong> Utilizing a convenience sampling method, we surveyed individuals with gestational or pregestational diabetes from three health care facilities who were trained in ABE. Knowledge and perceptions were gauged through presurvey statements, while postsurvey statements were employed to measure experiences, both using a 5-point Likert scale. In parallel, a retrospective study assessed both maternal and infant outcomes among the same participant pool. Statistical comparisons between individuals with and without reservations were made using the Wilcoxon signed rank sum, Mann-Whitney, chi-square, and Fisher's exact tests.</p><p><strong>Results: </strong> Of the 138 participants, 75% completed both survey segments, and 61% expressed reservations about ABE. Both groups were demographically similar and showed comparable newborn outcomes. However, individuals with reservations experienced heightened pain during ABE, reported lesser lactation support, and were less willing to repeat the process compared to those individuals without reservations. The median total ABE volume was significantly lower by 14 mL among those with reservations (7 vs. 21 mL, <i>p</i> = 0.009). Although both groups demonstrated improved attitudes toward the utility of ABE for individuals with gestational or pregestational diabetes, no significant shift occurred in the perception of ABE difficulty.</p><p><strong>Conclusion: </strong> Our results indicate that individuals with gestational or pregestational diabetes who have reservations about ABE face unique challenges and tend to express lower milk volumes. This underlines the need for specialized interventions and ongoing research to address antenatal lactation support and alleviate ABE-related concerns among individuals with gestational or pregestational diabetes.</p><p><strong>Key points: </strong>· Reservations of ABE were associated with reduced milk volumes.. · Regardless of reservations, ABE was felt to be beneficial.. · Our results underscore the need for more ABE education for those with reservations..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"2243-2251"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Neonatal Outcomes and Admission Hypothermia among Very Preterm Infants in Chinese Neonatal Intensive Care Units: A Multicenter Cohort Study.","authors":"Wenchao Hong, Yanping Zhu, Yanchen Wang, Siyuan Jiang, Yun Cao, Xinyue Gu, Shoo K Lee, Sheree Kuo, Jianhua Sun, Yuan Shi, Chongbing Yan, Mingxia Li, Xiaohui Gong","doi":"10.1055/s-0044-1786873","DOIUrl":"10.1055/s-0044-1786873","url":null,"abstract":"<p><strong>Objective: </strong> We aimed to investigate the relationship between admission hypothermia and outcomes among very preterm infants (VPIs) in neonatal intensive care units (NICUs) in China. We also investigated the frequency of hypothermia in VPIs in China and the variation in hypothermia across Chinese Neonatal Network (CHNN) sites.</p><p><strong>Study design: </strong> This retrospective cohort study enrolled infants with 24^0/7 to 31^6/7 weeks of gestation with an admission body temperature ≤37.5 °C who were admitted to CHNN-participating NICUs between January 1 and December 31, 2019.</p><p><strong>Results: </strong> A total of 5,913 VPIs were included in this study, of which 4,075 (68.9%) had hypothermia (<36.5 °C) at admission. The incidence of admission hypothermia varied widely across CHNN sites (9-100%). Lower gestational age (GA), lower birth weight, antenatal steroid administration, multiple births, small for GA, Apgar scores <7 at the 5th minute, and intensive resuscitation were significantly associated with admission hypothermia. Compared with infants with normothermia (36.5-37.5 °C), the adjusted odds ratios (ORs) for composite outcome among infants with admission hypothermia <35.5 °C increased to 1.47 (95% confidence interval [CI], 1.15-1.88). The adjusted ORs for mortality among infants with admission hypothermia (36.0-36.4 and <35.5 °C) increased to 1.41 (95% CI, 1.09-1.83) and 1.93 (95% CI, 1.31-2.85), respectively. Admission hypothermia was associated with a higher likelihood of bronchopulmonary dysplasia, but was not associated with necrotizing enterocolitis ≥stage II, severe intraventricular hemorrhage, cystic periventricular leukomalacia, severe retinopathy of prematurity, or sepsis.</p><p><strong>Conclusion: </strong> Admission hypothermia remains a common problem for VPIs in a large cohort in China and is associated with adverse outcomes. Continuous quality improvement of admission hypothermia in the future may result in a substantial improvement in the outcomes of VPIs in China.</p><p><strong>Key points: </strong>· Admission hypothermia is common in VPIs.. · The incidence of admission hypothermia in VPIs remains high in China.. · Admission hypothermia is associated with adverse outcomes in VPIs..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"2298-2307"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Risk of Intrahepatic Cholestasis Increased with Supplemental Progesterone?","authors":"Matthew C H Rohn, Lindsey Vignali, Isabel Reeder, Kiana Khosravian, Scott Petersen","doi":"10.1055/s-0044-1786719","DOIUrl":"10.1055/s-0044-1786719","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to evaluate the relationship between supplemental progesterone use during pregnancy and the development of intrahepatic cholestasis of pregnancy (ICP).</p><p><strong>Study design: </strong> A retrospective, matched case-control study was conducted among a population of women who delivered at George Washington University Hospital (GW) between 2012 and 2022. Women diagnosed with ICP (cases) were identified using International Statistical Classification of Diseases (ICD) codes, and data were collected via chart abstraction. Descriptive data included patient demographics, pregnancy characteristics, and medical history. Laboratory values related to ICP were collected. Cases were matched on a 1:3 ratio by maternal age, body mass index, and gravidarum to women who delivered at GW during the same month and did not carry a diagnosis of ICP (controls). A univariate logistic regression model was created to assess the use of supplemental progesterone between groups, adjusting for the use of assisted reproductive technology in the current pregnancy, and a history of liver disease.</p><p><strong>Results: </strong> One hundred and twenty women who delivered during the study period were confirmed to have a diagnosis of ICP. Cases were matched with 360 controls and measures compared between the two groups. Cases were significantly more likely to have a history of liver disease (5.9 vs. 1.7%, <i>p</i> = 0.0021), multiple gestation (10.0 vs. 3.3%, <i>p</i> < 0.0001), a history of ICP in a previous pregnancy (10.0 vs. 0%, <i>p</i> < 0.0001), and to have delivered at an earlier gestational age (mean 37.1 vs. 38.6 weeks, <i>p</i> < 0.0001) as compared with controls. No differences were seen in the odds of supplemental progesterone use in both unadjusted and adjusted models (OR = 1.14, 95% CI: 0.30-4.34; adjusted Odds Ratio [aOR] = 0.98 [0.24-3.94]).</p><p><strong>Conclusion: </strong> Contrary to recent evidence, no association was seen with the use of supplemental progesterone. It is possible that the associated risk with supplemental progesterone is dependent on medication formulation or route of administration.</p><p><strong>Key points: </strong>· Supplemental progesterone use in pregnancy may increase the risk of developing ICP.. · Previous investigations of progesterone and ICP have demonstrated mixed results.. · The association may be dependent on the route of administration and formulation of progesterone..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"2258-2262"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}