Age Babies Research Articles

Supine Sleep-Promoting Baby Mattress: SIDS Prevention and Athlete Injury Relief

Sudden Infant Death Syndrome (SIDS) is a leading cause of death in infants aged one to 12 months, primarily occurring during sleep. Consequently, there is considerable interest among researchers and healthcare professionals regarding the sleeping environment and potential risk factors. One identified risk factor is infants sleeping prone (on their stomach), making supine (on the back) sleeping the recommended position. Associate Research Fellow Shing-Jye Chen from the Department of Sports Science Research at the Taiwan Institute of Sports Science (TISS) is developing a hammock-like air-based baby mattress covered with breathable mesh. This mattress is designed to promote supine sleeping and prevent babies from rolling onto their stomachs during sleep. It features air tubing within tensioned mesh fabric that automatically adjusts to suspend and support the baby’s weight. This design increases the contact surface area between the baby and the mattress, reduces contact pressure, and provides evenly distributed support as the baby grows. Chen takes an interdisciplinary approach, collaborating with experts in baby breathing, sleeping patterns, and biomechanics to develop solutions aimed at reducing the risk of SIDS based on scientific evidence, safety, and effectiveness. In a pilot study, Chen collected data on the mattress’s performance using weights to simulate babies of different ages. His team will explore the relationship between weight and the measured pressure values at different internal air pressures within the inflatable tubing design. The potential application of this product design may extend to injured athletes, particularly in areas where injuries contact the mattress surface, thereby reducing stress.

Health-related quality of life and utility of maternity health states amongst post-partum Australians.

This study aimed to measure patient-reported health-related quality of life amongst post-partum women in Queensland, Australia. Patient-reported health-related quality of life data was prospectively collected from 134 post-partum women using the EQ-5D-5L at weekly intervals during the first six weeks following birth. Data across the five health domains of the EQ-5D-5L was converted to a single health utility value to represent overall health status. Linear mixed modelling and regression analysis were used to examine changes in utility over the first six weeks post-birth and determine associations between utility and clinical and demographic characteristics of post-partum women. Gestation at birth and weeks post-partum were significantly associated with utility values when considered in a multivariate linear mixed model. Mean utility values increased by 0.01 for every week increase in gestation at birth, and utility values were 0.70 at one week post-partum and increased to 0.85 at six weeks post-partum, with the largest increase occurring between one- and two-weeks post-birth. When controlling for variables that were found to predict utility values across the first six weeks post-partum, no single state of health predicted utility values at one-week post-partum. Maternity services can use our data and methods to establish norms for their own service, and researchers and maternity services can partner to conduct cost-effectiveness analysis using our more relevant utility values than what is currently available. Time since birth and gestational age of the woman's baby should be considered when selecting post-partum health state utility values for maternity services cost-effectiveness analyses.

Perceived Infant Discomfort Linked to Lower Maternal Oral Health Quality of Life: Results from a Cross-Sectional Study

Aim: We aimed to explore whether there is an association between maternal perceived infant discomfort due to suggestive gastrointestinal alterations and oral-health-related quality of life (OHRQoL) through a survey. Materials and Methods: The present study included two main phases involving Portuguese-speaking parents with full-term infants aged 2–12 weeks old who were not previously hospitalized in a neonatal nursery. First, the original French Infant Colic Questionnaire (ColiQ) was translated, cross-culturally adapted and validated to Portuguese (ColiQ-PT). Then, a survey was distributed, and included sociodemographics, the ColiQ-PT, an oral health value scale, OHRQoL, self-perceived periodontal status, and smoking and oral health habits. Data were analyzed through inferential, correlation and multivariate logistic models in this cross-sectional study. Results: The ColiQ-PT revealed reliability and validity. From a total of 421 responses, higher infant discomfort was correlated with less maternal professional dental care prioritization (ρ = −0.096, p < 0.05). Self-perceived periodontitis correlated with all items of OHRQoL (p < 0.001), all seven OHIP-14 domains, and with the physical (p < 0.001), psychological (p = 0.006), and social (p = 0.011) super-domains. While the infant-related score was associated with baby age (p = 0.023) and physical pain (p = 0.040) related to OHRQoL, the parent score was associated with education (p = 0.005), unemployment (p = 0.035), and physical pain (p = 0.017). The total ColiQ-PT score was significantly associated with more deteriorated social disability related to maternal OHRQoL (ρ = −0.130, p < 0.05). Conclusions: Perceived infant discomfort seems to be linked to maternal deteriorated OHRQoL. This finding highlights the importance of prioritizing oral health in postpartum care. Further research is needed to explore the mechanisms underlying this association and to develop targeted interventions.

THE RELATIONSHIP OF MOTHER'S EDUCATION, JOB, AGE AND EDUCATION TO BABY MASSAGE

Baby massage is a relaxation technique performed on babies and toddlers that has many benefits. Infant massage is great to help increase the baby's immune system, help relaxation, make it easier to sleep and help control fussiness and breathing. This study was conducted with the aim of knowing the relationship between mother's education, occupation, age and knowledge of infant massage. This study used quantitative research methods with a cross sectional research design. The study population consisted of 85 mothers and babies aged 1-12 months. The sampling method used the overall sampling method. The variables studied were presented in the form of frequency distribution tables, and tested using variance analysis and multiplication using a questionnaire tool. This research was conducted by TPMB Ririn Sevda Korini, SKM, S.Keb Tanjung Agung in July 2023. Data analysis was performed using Chi-square, univariate and bivariate statistical tests. Based on the results of univariate analysis, 40 (47.1%) respondents were well informed, out of 85 respondents who practiced baby massage, 56 (65%) respondents were well informed, 50 (58.8%) respondents were working, 48 (56.5%) respondents were old, and 40 (47%) respondents were highly educated. The results of bivariate analysis showed that there was a relationship between cognition and infant massage (p-value 0.023), between maternal employment and infant massage (p-value 0.033), age of mother and child massaged (p-value 0.02)3, value (p 0.041). There is a relationship between mother's education and infant massage (p-value 0.007).

Prioritisation of early pregnancy risk factors for stillbirth: An international multistakeholder modified e-Delphi consensus study

ObjectiveTo identify and prioritise early pregnancy risk factors for stillbirth to inform prognostic factor and model research. Study designWe used a modified e-Delphi method and consultation meeting to achieve consensus. Risk factors for early, late and stillbirth at any gestation identified from an umbrella review of risk factors for stillbirth were entered into a two-stage online Delphi survey with an international group of stakeholders made up of healthcare professionals and researchers.The RAND/ University of California at Los Angeles appropriateness method was used to evaluate consensus. Responders voted on a scale of 1–9 for each risk factor in terms of importance for early, late, and stillbirth at any gestation. Consensus for inclusion was reached if the median score was in the top tertile and at least two thirds of panellists had scored the risk factor within the top tertile. ResultsTwenty-six risk factors were identified from an umbrella review and presented to stakeholders in round 1 of our e-Delphi survey. Round 1 was completed by 68 stakeholders, 79% (54/68) of whom went on to complete the second round. Seventeen risk factors were discussed at the consensus meeting. From the twenty-six risk factors identified, fifteen of these were prioritised for stillbirth at any gestation, eleven for early stillbirth, and sixteen for late stillbirth, across three domains of maternal characteristics, ultrasound markers and biochemical markers. The prioritised maternal characteristics common to early, late, and stillbirth at any gestation were: maternal age, smoking, drug misuse, history of heritable thrombophilia, hypertension, renal disease, diabetes, previous stillbirth and multiple pregnancy. Maternal BMI, access to healthcare, and socioeconomic status were prioritised for late stillbirth and stillbirth at any gestation. Previous pre-eclampsia and previous small for gestational age baby were prioritised for late stillbirth. Of the ultrasound markers, uterine artery Doppler pulsatility index and congenital fetal anomaly were prioritised for all. One biochemical marker, placental growth factor, was prioritised for stillbirth at any gestation. ConclusionsOur prioritised risk factors for stillbirth can inform formal factor-outcome evaluation of early pregnancy risk factors to influence public health strategies on prevention of such risk factors to prevent stillbirth.

Study of Correlation of Apgar Score and Thompson Score with Hepatic Function in Perinatal Asphyxia Affected Neonates—A Prospective Observational Study

Background: Perinatal asphyxia is one of the leading causes of neonatal morbidity and mortality in the country. It leads to multi-organ failure with brain involvement as the major organ of concern (hypoxic-ischemic encephalopathy). Hepatic dysfunction is also a feature of perinatal asphyxia. Objectives: To detect hepatic dysfunction in birth asphyxia. To correlate the liver damage with increasing severity of birth asphyxia and hypoxic-ischemic encephalopathy through Apgar score and Thompson score. Methods: In this prospective observational study, after ethical clearance and informed consent from the parents, babies of gestational age >35 weeks weighing >1.8 kg, Apgar score <7 at 1 minute received in the newborn unit of a tertiary care hospital in West Bengal, India were enrolled. Thompson’s score was assessed every day. The liver function test of these patients was assessed on days 1, 3, 10, and 15. Ultrasonography of the whole abdomen was performed on days 1 and 14 of life to rule out other probable causes of hepatic injury. Results: A total of 308 neonates were studied, of which Apgar score at 1 minute indicates that 99 (32.14%) of the newborns had severe birth asphyxia and the rest had moderate birth asphyxia. All the liver enzymes except total protein and albumin showed a significant rise on days 1 and 3 with increasing severity of asphyxia. This correlation was seen with Apgar score at 1 minute on day 1 with TSB (r = -0.256, P < .001), AST (r = -0.209, P < .01), ALT (r = -0.178, P < .002), ALP (r = -0.174, P < .002). As per Thompson score, total serum bilirubin, aspartate aminotransferase and alkaline phosphatase showed maximum correlation on days 1 (r = 0.253, P < .001, r = 0.187, P < .001 and r = 0.268, P < .001, respectively) and on day 3 (r = 0.159, P < .005, r = 0.231, P < .001, and r = 0.190, P < .002, respectively). Conclusion: Thompson score and Apgar score can be correlated to perinatal asphyxia-related hepatic injury.

Utilizing Continuous Glucose Monitoring for Early Detection of Gestational Diabetes Mellitus and Pregnancy Outcomes in an Asian Population.

We explored the potential value of continuous glucose monitoring (CGM) in early pregnancy in predicting gestational diabetes mellitus (GDM) and pregnancy outcomes. The study recruited 103 multiethnic Asian pregnant women with overweight or obesity from a hospital-based, prospective cohort. All of them had worn blinded CGM devices in early pregnancy and underwent the universal GDM screening at 24-28 gestation weeks. Models were selected based on early pregnancy risk factors and CGM-derived parameters to compare their respective predictive values for GDM and pregnancy outcomes. Eighteen GDM cases were ascertained. CGM-derived novel parameters demonstrated greater performance (e.g., area under the curve: 0.953 vs. 0.722) for predicting incident GDM compared with the model using traditional risks. Such novel CGM-derived parameters significantly differentiated primary cesarean and large-for-gestational age babies. Our data suggest CGM's potential clinical utility in the first trimester for predicting GDM and adverse pregnancy outcomes, particularly in individuals with overweight or obesity.

Impact of a ROP mentoring program in rural regions of Colombia

PurposeTo assess the impact of a retinopathy of prematurity (ROP) mentoring program in four rural regions with 31 neonatal units in Colombia between 2011 and 2019. MethodsIndicators recommended by the national program were used for assessment: screening coverage of eligible preterm newborns, proportion screened with any stage of ROP, and proportion of screened infants treated. Data were also collected on the number of units with ROP services and birth weight (BW) and gestational age (GA) of babies treated. Data on the number of preterm births, BWs of infants screened, and their ROP status (any/none) were extracted from the national health information system. Ophthalmologists in each region provided data on the number screened and treated. A linear-by-linear statistic was used to assess trends in the indicators before and during mentoring. ResultsOf the 31 neonatal units, the number providing ROP services increased from 7 (23%) to 26 (84%). The number of eligible infants born in the four regions (total 33,521) was stable over the study period, the proportion screened increased from 14% to 41%, the proportion of those screened who were found to have any ROP tended to decrease overtime, and the proportion of those screened who were treated declined from 9% to 3%, with some regional variation. By year 3 no infant with a BW ≥2000 g or GA of >36 weeks was treated. ConclusionsIn our study, mentoring rural providers proved a valuable strategy for inducing new screening programs, increasing coverage, and improving local capacities in neonatal care and ROP services.

Clinicoepidemiological Profile of Retinopathy of Prematurity.

Purpose In previously performed studies, retinopathy of prematurity (ROP) has been shown to occur postpartum. As a result, mechanical ventilation and oxygen dependence were eventually connected to the development of ROP in these preterm children, and ROP prevalence is on the rise globally. Despite various improvements in childcare, ROP still tends to arise due to various risk factors associated with the disease. So, clinically the research was performed to determine the clinical and epidemiological profile of ROP. Materials and methods A total of 268 participants were to be enrolled in the study. It was an observational, cross-sectional study carried out at Department of Ophthalmology and Neonatal Intensive Care Unit in Veer Surendra Sai Institute of Medical Sciences and Research Centre, Burla, Sambalpur, Odisha, India. Ethical approval was provided on 30 November 2019. Results Overall 123 (46%) infants out of 268 infants developed retinopathy of prematurity. Majorly, the infants had stage 1 and stage 2 ROP. Most of the infants were male. Birth weight in ROP patients was 1000 g or less in 54% of infants, 1000-1500 g in 46% of infants and >1500 g in 33% of infants. Gestational age was found to be a predictor of retinopathy of prematurity. The adverse events that were found to be associated with retinopathy of prematurity were sepsis (53%), respiratory distress syndrome (RDS) (54.6%), intraventricular haemorrhage (IVH) (60%), anaemia (61.5%). Conclusion It has been observed that babies with higher birth weights and older gestations are also susceptible to developing ROP. Therefore, the greater birth weight newborns up to 1750 g and older gestational age babies >34 weeks should also be included in the screening criteria, especially if they have risk factors such as oxygen supplementation, sepsis, RDS, and anaemia.

Relationship Between Early Complex Food Practice with Nutritional Status Among Children Age 7 to 23 Months

Aims:: Knowing the factors associated with the practice of early complementary feeding with the nutritional status of infants aged 7 to 23 months in Sipayung Village, Cipanas District, Lebak Regency. Method: A cross-sectional design was used for quantitative and analytical study. A purposive sampling method was used to choose 51 mothers with babies between the ages of 7 and 23 months as the study sample. A questionnaire was used as the study tool. The square test was used to look at the primary data. Result: The single-variable study showed that 82.4% of infants had good nutrition and 72.5% of those who were given MP ASI did so correctly. The bivariate analysis showed that there was a link between the number of times MP-ASI was given, the age at which it was first given, how often it was given, how consistently it was given, and the infant's nutritional status (p value = 0.000). Conclusion: The practice of giving MP-ASI has to do with how well babies ages 7 to 23 months are eating. Mothers of babies should always pay attention to how, how often, and how much they feed their babies as they get older. This includes the form, frequency, and amount of food. The mother of the baby can also regularly weigh her child at the posyandu

Metformin and small for gestational age babies: findings of a randomised placebo-controlled clinical trial of metformin in gestational diabetes (EMERGE).

Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes because of suboptimal glucose management and glucose control and excessive weight gain. Metformin can offset these factors but is associated with small for gestational age (SGA) infants. We sought to identify risk factors for SGA infants, including the effect of metformin exposure on SGA status. In this prespecified secondary analysis of the EMERGE trial, which evaluated the effectiveness of metformin vs placebo in treating GDM and found reduced gestational weight gain and longer time to insulin initiation with metformin use, we included women with a live-born infant and known infant birthweight and gestational age at delivery. We compared the numbers of SGA infants in both groups and explored baseline predictive factors to help identify those at highest risk of delivering an SGA infant. Baseline maternal characteristics were similar between SGA and non-SGA pregnancies. On multivariable-adjusted regression, no baseline maternal variables were associated with SGA status. Mothers of SGA infants were more likely to develop pre-eclampsia or gestational hypertension (18.2% vs 2.0%, p=0.001; 22.7% vs 5.4%, p=0.005, respectively); after multivariable adjustment, pre-eclampsia was positively associated with SGA status). Among SGA pregnancies, important perinatal outcomes including preterm birth, Caesarean delivery and neonatal care unit admission did not differ between the metformin and placebo groups (20.0% vs 14.3%, p=1.00; 50.0% vs 28.6%, p=0.25; 13.3% vs 42.9%, p=0.27, respectively). Pre-eclampsia was strongly associated with SGA infants. Metformin-exposed SGA infants did not display a more severe SGA phenotype than infants treated with placebo. Clinical Trials.gov NCT02980276; EudraCT number: 2016-001644-19.

A customised fetal growth and birthweight standard for Qatar: a population-based cohort study.

Customized birthweight centiles have improved the detection of small for gestational age (SGA) and large for gestational age (LGA) babies compared to existing population standards. This study used perinatal registry data to derive coefficients for developing customized growth charts for Qatar. The PEARL registry data on women delivering inQatar (2017-2018) was used to develop a multivariable linear regression model predicting optimal birthweight. Physiological variables included gestational age, maternal height, weight, ethnicity, parity, and sex of the baby. Pathological variables such as hypertension, preexisting and gestational diabetes and smoking were calculated and excluded to derive the optimal weight at term. The regression model found a term optimal birthweight of 3,235 g for a Qatari nationality mother with median height (159 cm), booking weight (72 kg), parity (1) and gestation at birth (276days) at the end of an uncomplicated pregnancy. Constitutional coefficients significantly affecting birthweight were gestational age, height, weight, and parity. The main pathological factors were preexisting diabetes (increase by +175.7 g) and smoking (decrease by-190.9 g). The SGA and LGA rates in the entire cohort after applying the population-specific customized centiles were 11.1 and 12.2 %, respectively (contrasting with the Hadlock standard: SGA-26.3 % and LGA-1.8 %, and Fenton standard: SGA-12.9 % and LGA-4.0 %). Constitutional and pathological variations infetal growth and birthweight apply in the maternity population in Qatar and have been quantified to allow the generation of customised charts for better identification ofpregnancies with abnormal growth. Currently in-use population standards may misdiagnose many SGA and LGAbabies.

Prevention of diaper rash in newborns and children under 1 year old: results of a clinical study

Introduction. Modern preventive measures of skin diseases aim to maintain the protective skin barrier. The area that comes in direct contact with the diaper becomes excessively wet, the corneous layer is damaged, which results in a weakened barrier function of the epidermis and the occurrence of an inflammatory process, diaper dermatitis.Aim. To study the clinical efficacy and safety of the use of disposable diapers and pull up pants in full-term and premature infants from birth to 1 year of age to prevent diaper dermatitis.Materials and methods. A total of 45 full-term and premature children under 1 year old with various diseases, including skin eruptions in the area covered by the diaper were included in the study. The proposed care products were used for 14 days on the strict condition that they would be reapplied after defecation and during hygiene procedures in a timely manner. The skin status was assessed visually by a paediatrician from Day 1 to 14 of the study using the M. Odio skin assessment scale.Results. The M. Odio scale evaluation of the skin around waist, buttocks, genitals, anal region, and inguinal folds in all children on Days 1, 7 and 14 showed 0 scores. No adverse events were reported during assessment of the skin status over 14 days of the use of care products.Discussion. The observations were consistent with the previously published data demonstrating that maintenance of the functional characteristics of the skin in the area covered by the diaper and exposed to faecal and urinary enzymes, elevated temperature and humidity prevented the development of diaper dermatitis and skin diseases.Conclusion. No signs of diaper dermatitis were detected in all 45 full-term and premature children under 1 year old, including children with various diseases, during 2 weeks of application of disposable Tanoshi Premium diapers and pull up pants in clinical practice. This fact proves the safety and good tolerance of disposable diapers by children under 1 year old provided that the skin care requirements were met. Tanoshi Premium diapers and pull up pants can be recommended for babies of different ages and body weights, including those with diaper dermatitis.

The association between maternal fruit consumption before and during pregnancy and fetal growth: The Lanzhou birth cohort study

BackgroundThe association between maternal fruit consumption and fetal growth remains inconsistent. The current study aimed to determine whether maternal fruit consumption was associated with low birth weight (LBW) or small for gestational age (SGA) babies. MethodsA large birth cohort study was conducted in Lanzhou, China, from 2010 to 2012 and included 10,076 pregnant women at the 1st, 2nd, and 3rd trimester of pregnancy for analysis. Fruit consumption in the 1st, 2nd, and 3rd trimester of pregnancy was measured by a self-designed food frequency questionnaire (FFQ) and divided into three groups: 1) inadequate fruit consumption: <200 g/d for the1st, 2nd, and 3rd trimester; 2) adequate fruit consumption: 200–350 g/d for the 1st trimester or 200–400 g/d for the 2nd and 3rd trimester; 3) excessive fruit consumption: >350 g/d for the 1st trimester or > 400 g/d for the 2nd and 3rd trimester. A case-control study was used to analyze the association between fruit intake during pregnancy and low birth weight infants. ResultsCompared to adequate fruit consumption, excessive fruit consumption throughout each trimester of pregnancy was associated with a lower risk of LBW, with an odds ratio (OR) ranging from 0.70 to 0.79 (95 % confidence interval, CI: 0.57–0.98); while inadequate fruit consumption was associated with a higher risk of infant LBW, with an OR ranging from 1.26 to 1.36 (95%CI: 1.04–1.66). After stratifying by mother's pre-pregnancy body mass index (BMI), the results were similar among women with underweight BMI. No significance was found between fruit consumption and SGA in the general population. Still, stratified analyses showed that inadequate fruit consumption was associated with an increased risk of SGA in underweight mothers, with an OR ranging from 1.66 to 1.79 (95%CI: 1.13–2.64). ConclusionsFruit consumption during pregnancy reduces the risk of LBW in Chinese women, especially in women with low pre-pregnancy BMI.

Maternal anaemia and polycythaemia during pregnancy and risk of inappropriate birth weight for gestational age babies: a retrospective cohort study in the northern belt of Ghana

BackgroundSmall for gestational age (SGA) and large for gestational age (LGA) births are topical issues due to their devastating effects on the life course and are also accountable for neonatal...

Development and validation of prediction models for fetal growth restriction and birthweight: an individual participant data meta-analysis.

Fetal growth restriction is associated with perinatal morbidity and mortality. Early identification of women having at-risk fetuses can reduce perinatal adverse outcomes. To assess the predictive performance of existing models predicting fetal growth restriction and birthweight, and if needed, to develop and validate new multivariable models using individual participant data. Individual participant data meta-analyses of cohorts in International Prediction of Pregnancy Complications network, decision curve analysis and health economics analysis. Pregnant women at booking. External validation of existing models (9 cohorts, 441,415 pregnancies); International Prediction of Pregnancy Complications model development and validation (4 cohorts, 237,228 pregnancies). Maternal clinical characteristics, biochemical and ultrasound markers. fetal growth restriction defined as birthweight <10th centile adjusted for gestational age and with stillbirth, neonatal death or delivery before 32 weeks' gestation birthweight. First, we externally validated existing models using individual participant data meta-analysis. If needed, we developed and validated new International Prediction of Pregnancy Complications models using random-intercept regression models with backward elimination for variable selection and undertook internal-external cross-validation. We estimated the study-specific performance (c-statistic, calibration slope, calibration-in-the-large) for each model and pooled using random-effects meta-analysis. Heterogeneity was quantified using τ2 and 95% prediction intervals. We assessed the clinical utility of the fetal growth restriction model using decision curve analysis, and health economics analysis based on National Institute for Health and Care Excellence 2008 model. Of the 119 published models, one birthweight model (Poon) could be validated. None reported fetal growth restriction using our definition. Across all cohorts, the Poon model had good summary calibration slope of 0.93 (95% confidence interval 0.90 to 0.96) with slight overfitting, and underpredicted birthweight by 90.4 g on average (95% confidence interval 37.9 g to 142.9 g). The newly developed International Prediction of Pregnancy Complications-fetal growth restriction model included maternal age, height, parity, smoking status, ethnicity, and any history of hypertension, pre-eclampsia, previous stillbirth or small for gestational age baby and gestational age at delivery. This allowed predictions conditional on a range of assumed gestational ages at delivery. The pooled apparent c-statistic and calibration were 0.96 (95% confidence interval 0.51 to 1.0), and 0.95 (95% confidence interval 0.67 to 1.23), respectively. The model showed positive net benefit for predicted probability thresholds between 1% and 90%. In addition to the predictors in the International Prediction of Pregnancy Complications-fetal growth restriction model, the International Prediction of Pregnancy Complications-birthweight model included maternal weight, history of diabetes and mode of conception. Average calibration slope across cohorts in the internal-external cross-validation was 1.00 (95% confidence interval 0.78 to 1.23) with no evidence of overfitting. Birthweight was underestimated by 9.7 g on average (95% confidence interval -154.3 g to 173.8 g). We could not externally validate most of the published models due to variations in the definitions of outcomes. Internal-external cross-validation of our International Prediction of Pregnancy Complications-fetal growth restriction model was limited by the paucity of events in the included cohorts. The economic evaluation using the published National Institute for Health and Care Excellence 2008 model may not reflect current practice, and full economic evaluation was not possible due to paucity of data. International Prediction of Pregnancy Complications models' performance needs to be assessed in routine practice, and their impact on decision-making and clinical outcomes needs evaluation. The International Prediction of Pregnancy Complications-fetal growth restriction and International Prediction of Pregnancy Complications-birthweight models accurately predict fetal growth restriction and birthweight for various assumed gestational ages at delivery. These can be used to stratify the risk status at booking, plan monitoring and management. This study is registered as PROSPERO CRD42019135045. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 17/148/07) and is published in full in Health Technology Assessment; Vol. 28, No. 14. See the NIHR Funding and Awards website for further award information.

Risk factors for neurological disorders at an early age in premature babies with different gestational ages

Risk factors for neurological disorders at an early age in premature babies with different gestational ages

The impact of hyperandrogenemia on pregnancy complications and outcomes in patients with PCOS: a systematic review and meta-analysis

ABSTRACT Background Polycystic ovary syndrome (PCOS) is a metabolic and reproductive disorder. Current research findings present conflicting views on the effects of different PCOS phenotypes on outcomes in pregnancy and for newborns. Methods This research study followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). A thorough search of literature was carried out using the Cochrane Menstrual Disorders and Subfertility Group trials register, Web of Science, and EMBASE databases from their start to December 2023. The search focused on studies examining the links between hyperandrogenic and non-hyperandrogenic PCOS phenotypes and risks in pregnancy and neonatology. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using either a fixed-effects or random-effects model. Results Our analysis incorporated 10 research studies. Expectant mothers with a hyperandrogenic PCOS subtype had increased ORs for gestational diabetes mellitus (GDM) and preeclampsia (PE) compared to those with a non-hyperandrogenic PCOS subtype, with respective values of 2.14 (95% CI, 1.18–3.88, I2 = 0%) and 2.04 (95% CI, 1.02–4.08, I2 = 53%). Nevertheless, no notable differences were detected in ORs for outcomes like preterm birth, live birth, miscarriage, cesarean delivery, pregnancy-induced hypertension, small for gestational age babies, large for gestational age newborns, and neonatal intensive care unit admissions between pregnant women with hyperandrogenic PCOS phenotype and those without. Conclusions This meta-analysis highlights that the presence of hyperandrogenism heightens the risks of GDM and PE within the PCOS population. Healthcare providers ought to be aware of this connection for improved patient management.

"It Shook My Whole Parenting Plan": Parents' Experiences of Being at Home with Their Newborn Baby During the COVID-19 Pandemic.

A cross-sectional online survey was undertaken (July-August 2020) to ascertain parents' experiences during the COVID-19 pandemic of being at home with their newborn baby in the first 6 weeks. Participants (n = 371) were mostly biological mothers (n = 369, 99.4%), white British (n = 351, 94,5%), first baby (n = 186, 50%). A statistically significant positive correlation was found between maternal confidence and number of children (rho (369) = 0.295, p < .001) and baby's age at time of participation (rho (369) = 0.139, p = .009). Participants without higher educational qualifications (median = 62, SIQR = 3.5) had statistically significant higher confidence (U = 11831.500, p < .001) than participants with higher educational qualifications (median = 58, SIQR = 2). Parents of babies without health issues at birth (median, 61, SIQR = 3.5) had statistically significant higher confidence (U = 13213.500, p < .001) than parents of babies with health issues at birth (median = 58, SIQR = 5). Three qualitative themes have emerged: the impact of "no partner" restrictions; mixed emotions and lack of information and support. In conclusion, parenting during a pandemic created anxiety and fear, affected by "no partner" restrictions, not being allowed to appointments, scans, and during labor. Some parents were more confident and indicated benefits including heightening bonding with baby and partner during social distancing.

High-Density Lipoproteins-Cholesterol (HDL-C) in Women With Gestational Diabetes (GDM): A Predictor for Large Gestational Age (LGA) Babies.

Introduction The present study aimed to evaluate the associations between the clinical and biochemical characteristics of women with gestational diabetes (GDM) and the incidence of large for gestational age (LGA) babies. Methods This cohort study included data collected during prenatal follow-up of GDM women from January 2008 to August 2022. Clinical and biochemical variables were compared among small (SGA), adequate (AGA), or large for gestational age (LGA) babies. Associations of the main variables with the incidence of LGA were determined by multiple regression analysis. Results Out of 659 women, 56 had LGA, 547 had AGA, and 56 had SGA babies. We observed differences in the means of age, pregestational body mass index (BMI), high-density lipoproteins-cholesterol (HDL-C)levels, gestational weight gain (GWG), and gestational age at birth according to LGA, AGA, and SGA (p < 0.05). All other variables were not different between the groups. The frequencies (%) and relative risk (RR) of LGA babies were evaluated according to HDL-C in the first tertile and/or obesity, with 12.2% and risk ratio (RR)=2.77 (95% confidence interval (CI) 1.35-5.69, p=0.005) if the women had obesity and HDL in the first tertile, 11.3% and RR=2.27 (95% CI1.03-5.03, p=0.042) if only HDL in the first tertile was present, 10.9% and RR=2.68 (95% CI 1.31-5.48, p=0.007) if the women had only obesity, using as a reference group those women without obesity or HDL-C in the first tertile (4.6% and RR=1) adjusted for age, age at birth and GWG. Conclusion In women with GDM, lower levels of HDL-cholesterol during pregnancy, as well as pregestational obesity, seem to be good predictors of the occurrence of LGA babies.