Groups In Terms Research Articles

Effect of delivery mode on admission to neonatal intensive care unit in healthy singleton pregnancies.

The aim of this study was to evaluate the short-term results of perinatal health in vaginal and cesarean deliveries and the indications for admission to the neonatal intensive care unit (NICU) in terms of healthy singleton pregnancies. In this study, 300 pregnant women who gave birth in our tertiary hospital was included. The records of newborns admitted to the NICU of these pregnant women were reviewed between January 1, 2019 and January 1, 2021. Durations of newborn hospitalizations and problems encountered during admission were recorded. The results were statistically evaluated. There was no significant difference between vaginal delivery and cesarean section groups in terms of the indications for admission to the NICU of term low-risk pregnant women (p=0.91, p=0.17). A higher admission in the NICU was found in the early term group. The early term group required more respiratory support compared to the full term group (p=0.02). When the groups were compared in terms of IV fluid treatment support, hypoglycemia or feeding difficulty, and jaundice requiring phototherapy, no significant difference was found. Withlimited data available for admission indications to the NICU of newborns born from term pregnancies, we found that the mode of delivery affects hospitalization indications of newborns, need for support, and Apgar scores. Early term delivery is associated with higher rates of neonatal morbidity and admission to the NICU. Better maternal care and prevention of factors that may lead to preterm birth will provide the prevention and management of these problems.

Measuring Carotid Intima-Media Thickness in Young Adults Born Preterm: Comparison of Manual Versus Semi-automated B-Mode Ultrasound

Introduction: Young adults born very preterm have increased cardiovascular risks. While intima-media thickness of the common carotid artery is an early marker of atherosclerosis in adults, the most reliable method of its measurement is not established in this population. The purpose of this study is to compare manual and semi-automated B-mode ultrasound intima-media thickness measurement techniques in adults born very preterm and full-term. Methods: Intima-media thickness was measured in adults 18 to 29 years born very preterm (<30 weeks’ gestation) or full-term (≥37 weeks’ gestation) using B-mode ultrasound. Analyses included intraclass correlation coefficient (ICC) and relationships with prematurity status, age, body mass index, and metabolic and respiratory comorbidities. Results: There were 86 preterm-born participants (58% women) and 85 full-term (56% women), mean age 23 ± 2 years. Intra-observer agreement was better using semi-automated (ICC = 0.89; 95% confidence interval (CI) = [0.86-0.91]) than manual measurement (ICC = 0.73; 95% CI = [0.65-0.79]). Measures obtained using both techniques did not detect any differences according to prematurity status, did not correlate with age, and moderately correlated with body mass index. The semi-automated technique showed higher intima-media thickness values in men vs women and overall gave higher values. Results obtained through both techniques moderately correlated with each other when looking at subgroups: preterm group ICC of 0.53, full-term group ICC of 0.62. Conclusion: Manual and semi-automated intima-media thickness measurements moderately correlate in young adults. The semi-automated technique is more reproducible. Both techniques are useful in discriminating intima-media thickness according to weight. This study identifies variance of results according to different techniques of measurements. Adherence to a single technique is recommended in young adults born prematurely. Clinical implication includes adherence to the same technique for risk stratification and for follow-up of these patients.

Nomogram for predicting the risk of preterm birth in women undergoing in vitro fertilization cycles

BackgroundThe aim of this study was to develop a nomogram for predicting the risk of preterm birth in women undergoing in vitro fertilization (IVF) cycles.MethodsA retrospective study of 4266 live birth cycles collected from January 2016 to October 2021 at the Center for Reproductive Medicine, First Hospital of Jilin University was performed. The sample size was sufficient based on the minimal ten events per variable (EPV) rule. The primary outcome of this study was preterm birth. The cycles were divided into the preterm birth group (n = 827) and the full-term delivery group (n = 3439). A nomogram was established based on the multivariate logistic regression analysis results. The area under the curve (AUC) was calculated to assess the prediction accuracy of the nomogram model. The calibration curve was used to measure the calibration of the nomogram.ResultsMultivariate logistic regression analyses showed that female obesity or overweight (OR = 1.366, 95% CI: 1.111–1.679; OR = 1.537, 95% CI: 1.030–2.292), antral follicle count (AFC) of more than 24 (OR = 1.378, 95% CI: 1.035–1.836), multiple pregnancies (OR = 6.748, 95% CI: 5.559–8.190), gestational hypertension (OR = 9.662, 95% CI: 6.632–14.078) and gestational diabetes (OR = 4.650, 95% CI: 2.289–9.445) were the independent risk factors for preterm birth in IVF patients. The area under curve (AUC) under the receiver operating characteristic (ROC) curve in the prediction model was 0.781(95%CI: 0.763–0.799). The calibration curve of the nomogram showed that the prediction model had a good calibration.ConclusionsWe used five risk factors to conduct a nomogram to predict preterm birth rates for patients undergoing IVF cycles. This nomogram can provide a visual assessment of the risk of preterm birth for clinical consultation.

Distribution of uterocervical angles of pregnant women at 16+ 0 to 23+ 6 weeks gestation with low risk for preterm birth: first vietnamese cohort of women with singleton pregnancies

BackgroundCervical length (CL) measured by ultrasound in the second trimester is a predictor of spontaneous preterm birth (sPTB). The uterocervical angle (UCA) has recently been suggested as a predictor to identify women at risk of sPTB. The aim of this study was to investigate the UCAs’ distribution in singleton pregnant women at 16+ 0 − 23+ 6 weeks of gestation with low risk for sPTB.MethodsThis was a prospective cohort study of 1,051 pregnant women with singleton pregnancies at low risk for preterm delivery. Pregnant women with a viable singleton fetus at 16+ 0 − 23+ 6 weeks of gestation were enrolled in the study conducted at the Haiphong Hospital of Obstetrics and Gynecology, Vietnam, from 09/2019 to 09/2020. CL and the UCA were assessed using transvaginal ultrasonography (TVS) by a single sonographer. Subjects were followed-up until the end of pregnancy, and maternal and neonatal outcomes were recorded. The UCAs’ range and their relationship with gestational age were evaluated using regression analysis. P < 0.05 was considered statistically significant.ResultsThe normal range of the UCA (5th − 95th percentiles) was 46.47° (95% CI, 40.27°-51.81°) to 127.06° (95% CI, 123.02° − 130.71°). The UCAs in the preterm birth (< 37 weeks) and full-term groups were 117.86° ± 20.25° and 83.80° ± 24.18°, respectively (p < 0.001). Linear regression analysis showed a significant change in the UCA range from 16+ 0 to 23+ 6 weeks of gestation (2.51 degrees per week, p < 0.001). The linear function yielded the highest correlation coefficient in the variation rule of the UCA values (r = 0.22). A total of 42/63 (66.7%) patients with preterm birth < 37 weeks had a UCA above the 75th percentile. The majority of women with preterm birth had a UCA ≥ 95° compared with those with full-term delivery (88.9% vs. 31.3%, p < 0.001).ConclusionsThe results of this study present background information about the normal range of UCA values in singleton pregnant women at 16+ 0 to 23+ 6 weeks at low risk for sPTB in this Vietnamese cohort. In this study population at low risk for sPTB, pregnant women with a UCA value ≥ 95o were also considered at risk for preterm birth.

Exploring cognitive, behavioral and autistic trait network topology in very preterm and term-born children.

Compared to full-term (FT) born peers, children who were born very preterm (VPT; <32 weeks' gestation) are likely to display more cognitive and behavioral difficulties, including inattention, anxiety and socio-communication problems. In the published literature, such difficulties tend to be studied independently, thus failing to account for how different aspects of child development interact. The current study aimed to investigate children's cognitive and behavioral outcomes as interconnected, dynamically related facets of development that influence one another. Participants were 93 VPT and 55 FT children (median age 8.79 years). IQ was evaluated with the Wechsler Intelligence Scale for Children-4th edition (WISC-IV), autism spectrum condition (ASC) traits with the social responsiveness scale-2nd edition (SRS-2), behavioral and emotional problems with the strengths and difficulties questionnaire (SDQ), temperament with the temperament in middle childhood questionnaire (TMCQ) and executive function with the behavior rating inventory of executive functioning (BRIEF-2). Outcome measures were studied in VPT and FT children using Network Analysis, a method that graphically represents partial correlations between variables and yields information on each variable's propensity to form a bridge between other variables. VPT and FT children exhibited marked topological differences. Bridges (i.e., the variables most connected to others) in the VPT group network were: conduct problems and difficulties with organizing and ordering their environment. In the FT group network, the most important bridges were: difficulties with initiating a task or activity and prosocial behaviors, and greater emotional problems, such as lower mood. These findings highlight the importance of targeting different aspects of development to support VPT and FT children in person-based interventions.

Human Milk Microbiota Profile Affected by Prematurity in Argentinian Lactating Women.

To study (16S rRNA-sequencing) the impact of gestational and corrected ages on the microbiota profile of human milk (HM) of mothers that delivered full-term and pre-term children, HM samples were obtained and classified according to the gestational age as group T (full-term births ≥37 weeks), and group P (pre-term births <37 weeks). Group P was longitudinally followed, and the samples were collected at the full-term corrected gestational age: when the chronological age plus the gestational age were ≥37 weeks (PT group). The HM microbiota composition differed depending on the gestational age (T vs. P). Group T had lower levels of Staphylococcus and higher levels of Rothia and Streptococcus, as compared to group P. The alpha Simpson diversity value was higher in group T than in P, whereas no differences were found between groups T and PT, suggesting a microbial evolution of the composition of group P towards group T over chronological age. Full-term delivery was associated with a greater diversity of microbes in HM. The microbial composition of pre-term HM, at the corrected age, did not show significant differences, as compared to the samples obtained from the full-term group, suggesting that it would be appropriate to consider the corrected age in terms of the composition and the diversity of the milk in future studies.

Hippocampal volumes and cognitive performance in children born extremely preterm with and without low-grade intraventricular haemorrhage

Children born extremely preterm, especially those with intraventricular haemorrhage (IVH), are at increased risk of adverse cognitive outcomes during childhood. The present study aimed to explore the effects of IVH (grades I–II) on hippocampal volumes, and their correlates with cognitive performance. The sample consisted of 94 participants, including 54 children born extremely preterm (19 with IVH, grades I–II), and 40 children born at term. All participants underwent a magnetic resonance imaging study at the age of 10 (Mage = 10.20 years; SDage = 0.78), and 74 of them (45 extremely preterm and 29 full-term) carried out a cognitive assessment at 12 years old. Children born extremely preterm had lower scores in cognitive performance compared to their full-term peers. Significant positive partial correlations were observed between global bilateral hippocampus, left CA-field, and left subiculum volumes with processing speed in the full-term group, while no significant correlations were found in the extremely preterm group. Moderation analyses in the extremely preterm sample revealed that low-grade IVH moderated the relationship between right hippocampal volume and full-IQ (F(4,40) = 5.42, p = 0.001, R2 = 0.35). Having greater right hippocampal volume had a protective effect on full-IQ in those children born extremely preterm with low-grade IVH.

Vaginal flora during pregnancy and subsequent risk of preterm birth or prelabor rupture of membranes: a nested case–control study from China

BackgroundThe findings of the association of vaginal flora with preterm birth (PTB) or prelabor rupture of membranes (PROM) were conflicts. Moreover, vaginal flora was different by ethnicity and the evidence from China was limited.MethodsThis study was a nested case control study, based on Yiwu birth cohort. We assessed vaginal microbiota in the second or third trimester, using 16S rDNA Amplicon Sequencing and explored the association between the diversity and composition of vaginal flora and PTB or PROM.ResultsWe finally included 144 pregnant women. In present study, the alpha diversity of TPROM (Term prelabor rupture of membranes) samples was lower than that of full term samples (Chao1 index: P < 0.05). When we further categorized PTB (Preterm birth) into SPB (PTB without PROM) and PPROM (Preterm prelabor rupture of membranes), there was no difference between SPB and full term. In addition, we found that the proportion of PCoA2 in TPROM group was different from that in full term group and preterm group. The difference between groups was significant according to anosim analysis (R = 0.059, P < 0.001). With LEfSe (Linear discriminant analysis Effect Size) analysis, we found that the abundance of Lactobacillus in the vaginal flora of pregnant women with preterm birth was the highest (P = 0.003).ConclusionIn Chinese pregnant women, the alpha diversity in TPROM group was significantly lower than that in both PTB and full term group. However, there was no difference between PTB and full term. Lactobacillus was the most abundant in preterm birth group. More studies should be conducted to confirm our findings.

Toxic effect window of ovarian development in female offspring mice induced by prenatal prednisone exposure with different doses and time

BackgroundPrednisone is one of the most used synthetic glucocorticoids during pregnancy. Epidemiological investigations suggested that prenatal prednisone therapy could affect fetal development, but systematic studies on its effects on ovarian development and the “toxic effect window” remained scarce.MethodsIn this study, by simulating clinical application characteristics, Kunming mice were given prednisone by oral gavage with different doses (0.25 or 1.0 mg/kg·d) or at different time gestational days (GD) (GD0-9, GD10-18, or GD0-18). Blood and ovaries of fetal mice were collected on GD18, and the serum estradiol level and the related function indexes of ovarian granulosa cells and oocytes were detected.ResultsCompared with the control group, prenatal prednisone exposure (PPE) induced pathological injury and enhanced cell proliferation in fetal mice ovary. Furthermore, the expression of steroid synthesis functional genes in pre-granulosa cells, the oocyte function markers, and developmentally related genes was enhanced with different doses or at different time of PPE. The Hippo signaling was activated in the fetal ovary of PPE groups. The above changes were most significant in the low or high-dose and full-term PPE groups.ConclusionPPE caused various cell developmental toxicity in the fetal ovary, especially in the low or high-dose, full-term exposure groups. The potential mechanism might be related to the activation of the Hippo signaling pathway.

Correlation of abnormal brain changes with perinatal factors in very preterm infants based on diffusion tensor imaging.

It remains unclear whether very preterm (VP) infants have the same level of brain structure and function as full-term (FT) infants. In addition, the relationship between potential differences in brain white matter microstructure and network connectivity and specific perinatal factors has not been well characterized. This study aimed to investigate the existence of potential differences in brain white matter microstructure and network connectivity between VP and FT infants at term-equivalent age (TEA) and examine the potential association of these differences with perinatal factors. A total of 83 infants were prospectively selected for this study: 43 VP infants (gestational age, or GA: 27-32 weeks) and 40 FT infants (GA: 37-44 weeks). All infants at TEA underwent both conventional magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Significant differences in white matter fractional anisotropy (FA) and mean diffusivity (MD) images between the VP and FT groups were observed using tract-based spatial statistics (TBSS). The fibers were tracked between each pair of regions in the individual space, using the automated anatomical labeling (AAL) atlas. Then, a structural brain network was constructed, where the connection between each pair of nodes was defined by the number of fibers. Network-based statistics (NBS) were used to examine differences in brain network connectivity between the VP and FT groups. Additionally, multivariate linear regression was conducted to investigate potential correlations between fiber bundle numbers and network metrics (global efficiency, local efficiency, and small-worldness) and perinatal factors. Significant differences in FA were observed between the VP and FT groups in several regions. These differences were found to be significantly associated with perinatal factors such as bronchopulmonary dysplasia (BPD), activity, pulse, grimace, appearance, respiratory (APGAR) score, gestational hypertension, and infection. Significant differences in network connectivity were observed between the VP and FT groups. Linear regression results showed significant correlations between maternal years of education, weight, the APGAR score, GA at birth, and network metrics in the VP group. The findings of this study shed light on the influence of perinatal factors on brain development in VP infants. These results may serve as a basis for clinical intervention and treatment to improve the outcome of preterm infants.

Clinical characteristics of meconium aspiration syndrome in neonates with different gestational ages and the risk factors for neurological injury and death: A 9-year cohort study.

The presence of meconium is associated with gestational age, and the incidence of meconium aspiration syndrome (MAS) increases with gestational age. Our study compared the differences in the clinical characteristics of patients with MAS at different gestational ages and discussed the risk factors for neurological injury and death from MAS. A total of 294 neonates diagnosed with MAS between 2013 and 2021 were included. Patients were divided into preterm, early-term, full-term, and late-term groups according to gestational age. We compared the patients' basic demographic, treatment, complications, and clinical outcomes in the different groups. We also analyzed the risk factors of neurological injury and death in patients with MAS. The mean age at admission (0.55 ± 0.9 h) was lower and the proportion of cesarean deliveries (90.00%, 27/30) was higher in the preterm group than in the other three groups. There was no statistically significant difference among the four groups regarding 1- and 5-min Apgar scores and the need for delivery room resuscitation. In terms of complications, early-term infants had the highest incidence of neurological injury (52.9%, 27/51), and late-term infants had the highest incidence of pneumothorax (37.8%, 17/45). The overall mortality rate of children with MAS was 7.80% (23/294), and the difference in mortality rates among the four groups was not significant. Low 1-min Apgar score and gestational age, metabolic acidosis, and respiratory failure were independent risk factors for neurological injury; metabolic acidosis, respiratory failure, and sepsis were independent risk factors for death in neonates with MAS. The clinical characteristics of MAS neonates of different gestational age are different mainly in complications. Early-term infants are more likely to complicate with neurological injury, and late-term infants are more likely to complicate with pneumothorax. Low 1-min Apgar score and gestational age, metabolic acidosis, and respiratory failure were established as risk factors for neurological injury; metabolic acidosis, respiratory failure, and sepsis were independent risk factors for death in neonates with MAS.

Oral characteristics and dietary habits of preterm children: A retrospective study using National Health Screening Program for Infants and Children.

The rate of preterm birth is increasing worldwide and preterm infants are susceptible to oral health problems. Hence, this study aimed to investigate the effect of premature birth on dietary and oral characteristics as well as dental treatment experiences of preterm infants using a nationwide cohort study. Data was retrospectively analyzed from National Health Screening Program for Infants and Children (NHSIC) of the National Health Insurance Service of Korea. 5% sample of children born between 2008 and 2012 who completed first or second infant health screening were included and divided into full-term and preterm-birth groups. Clinical data variables such as dietary habits, oral characteristics, and dental treatment experiences were investigated and comparatively analyzed. Preterm infants showed significantly lower rates of breastfeeding at 4-6 months (p<0.001), delayed start of weaning food at 9-12 months (p<0.001), higher rates of bottle feeding at 18-24 months (p<0.001), poor appetite at 30-36 months (p<0.001) and higher rates of improper swallowing and chewing function at 42-53 months (p = 0.023) than full-term infants. Preterm infants also had eating habits leading to poor oral conditions and higher percentage of absence of dental visit compared to full-term infants (p = 0.036). However, dental treatments including 1-visit pulpectomy (p = 0.007) and 2-visit pulpectomy (p = 0.042) significantly decreased when oral health screening was completed at least once. The NHSIC can be an effective policy for oral health management in preterm infants.

Corpus callosum structural characteristics in very preterm children and adolescents: Developmental trajectory and relationship to cognitive functioning

Previous studies suggest that structural alteration of the corpus callosum, i.e., the largest white matter commissural pathway, occurs after a preterm birth in the neonatal period and lasts across development. The present study aims to unravel corpus callosum structural characteristics across childhood and adolescence in very preterm (VPT) individuals, and their associations with general intellectual, executive and socio-emotional functioning. Neuropsychological assessments, T1-weighted and multi-shell diffusion MRI were collected in 79 VPT and 46 full term controls aged 6–14 years. Volumetric, diffusion tensor and neurite orientation dispersion and density imaging (NODDI) measures were extracted on 7 callosal portions using TractSeg. A multivariate data-driven approach (partial least squares correlation) and a cohort-based age normative modelling approach were used to explore associations between callosal characteristics and neuropsychological outcomes. The VPT and a full-term control groups showed similar trends of white-matter maturation over time, i.e., increase FA and reduced ODI, in all callosal segments, that was associated with increase in general intellectual functioning. However, using a cohort-based age-related normative modelling, findings show atypical pattern of callosal development in the VPT group, with reduced callosal maturation over time that was associated with poorer general intellectual and working memory functioning, as well as with lower gestational age.

Physical growth and neurodevelopment of preterm infants at the corrected age of 18-24 months

To investigate the levels of physical growth and neurodevelopment in preterm infants at the corrected age of 18-24 months. The physical growth data and neurodevelopment data of 484 preterm infants at corrected age of 18-24 months were prospectively collected by a post-discharge follow-up system for preterm infants. The infants were regularly followed up in Shenzhen Bao'an Maternal and Child Health Hospital Affiliated to Jinan University from April 2018 to December 2021. The neurodevelopment was evaluated by the Children Neuropsychological and Behavioral Scale-Revision 2016. A total of 219 full-term infants served as controls. The infants were divided into groups (extremely preterm, very preterm, moderate late preterm, and full-term) based on gestational age, and the groups were compared in the levels of physical growth and neurodevelopment. Except that the moderate preterm group had a higher length-for-age Z-score than the full-term group (P=0.038), there was no significant difference in physical growth indicators between the preterm groups and the full-term group (P>0.05). Each preterm group had a significantly lower total developmental quotient (DQ) than the full-term group (P<0.05). Except for the social behavior domain, the DQ of other domains in the extremely preterm and very preterm groups was significantly lower than that in the full-term group (P<0.05). The <32 weeks preterm group had a significantly higher incidence rate of global developmental delay than the full-term group (16.7% vs 6.4%, P=0.012), and the incidence rate of global developmental delay tended to increase with the reduction in gestational age (P=0.026). Preterm infants can catch up with full-term infants in terms of physical growth at the corrected age of 18-24 months, but with a lower neurodevelopmental level than full-term infants. Neurodevelopment monitoring and early intervention should be taken seriously for preterm infants with a gestational age of <32 weeks.

Corneal topography in preterm children aged 2 years to 12 years with or without retinopathy of prematurity.

To evaluate corneal topography in full-term and preterm children with or without retinopathy of prematurity (ROP). We enrolled children aged from 2 years to 12 years between January 2019 and May 2021 in the following four groups: full-term (group 1), premature without ROP (group 2), untreated premature with ROP (group 3), and laser-treated and/or intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF)-treated premature with ROP (group 4). Corneal topography was measured with the Galilei Placido-dual Scheimpflug analyzer G4 every half year, and was compared among the groups using generalized estimating equation models at approximately 7 years of age. We included 77, 178, 45, and 131 participants in groups 1, 2, 3, and 4, respectively. The mean (standard deviation) number of visits per patient was 2.9 (1.4). Compared with full-term eyes, premature eyes demonstrated steeper anterior corneal curvature (p = 0.016 and p = 0.008 for the mean and steep K, respectively), higher anterior and posterior corneal astigmatism (p = 0.036 and p = 0.016, respectively), and thinner thinnest pachymetry (p < 0.001). The laser-treated ROP eyes displayed steeper anterior corneal curvature (p = 0.040 for steep K) and higher anterior corneal astigmatism (p = 0.005) than the IVI-treated eyes. Moreover, they exhibited high cone location and magnitude index (1.96) reaching the cut-off for detecting keratoconus (1.82). The premature status led to greater corneal ectasia, and laser treatment for ROP caused further corneal steepness. Higher anterior corneal astigmatism was associated with laser treatment. The ROP pathology and IVI anti-VEGF treatment exerted a marginal effect on corneal topography.

Comparative analysis of pulmonary function in children born preterm and full-term at 6-9 years of age.

Objective:To compare pulmonary function parameters and the prevalence of altered pulmonary function in children born preterm and full-term, using the Global Lung Initiative reference values.Methods:This is a cross-sectional study with 6–9-year-old children submitted to measurement of airway resistance (Rint) and spirometry according to the American Thoracic Society and European Respiratory Society Technical Statement. The inclusion criteria were, among the preterm group: gestational age <37 weeks and birth weight <2000g; among the full-term group: schoolchildren born full-term with birth weight >2500g, recruited at two public schools in São Paulo, Brazil, matched by sex and age with the preterm group. As exclusion criteria, congenital malformations, cognitive deficit, and respiratory problems in the past 15 days were considered.Results:A total of 112 children were included in each group. Preterm children had gestational age of 30.8±2.8 weeks and birth weight of 1349±334g. Among them, 46.6% were boys, 46.4% presented respiratory distress syndrome, 19.6% bronchopulmonary dysplasia, and 65.2% were submitted to mechanical ventilation in the neonatal unit. At study entry, both groups were similar in age and anthropometric parameters. Parameters of pulmonary function (Z scores) in preterm and full-term groups were: Rint (0.13±2.24 vs. -1.02±1.29; p<0.001); forced vital capacity (FVC) (-0.39±1.27 vs. -0.15±1.03; p=0.106), forced expiratory volume in one second (FEV1)/FVC (-0.23±1.22 vs. 0.14±1.11; p=0.003), FEV1 (-0.48±1.29 vs. -0.04±1.08; p=0.071), and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) (1.16±1.37 vs. 2.08±1.26; p=0.005), respectively. The prevalence values of altered airway resistance (16.1 vs. 1.8%; p<0.001) and spirometry (26.8 vs. 13.4%, p=0.012) were higher in preterm infants than in full-term ones.Conclusions:Preterm children had higher prevalence of altered pulmonary function, higher Z scores of airway resistance, and lower Z scores of FEV1/FVC and FEF25-75 compared with those born full-term.

Autoeficácia e desfechos da amamentação em mães de bebês prematuros e a termo: um estudo longitudinal

ABSTRACT Purpose To analyze the breastfeeding self-efficacy in mothers of premature and full-term newborns, in the period of 180 days, and to know the social and obstetric factors that influence the practice of maintaining the exclusive breastfeeding in the period of exclusive recommendation. Methods Cohort with 44 mothers admitted to a public maternity hospital between January and October 2018. The mothers were divided into two groups: Premature and Full-term Groups. The Breastfeeding Self-efficacy Scale was applied in the immediate postpartum period, in addition to a questionnaire elaborated by the authors to collect sociodemographic and obstetric variables. The follow-up was done on the 30th, 120th and 180th days of the newborn’s life, by telephone. For the statistical analysis between the groups, the Statistical Package for the Social Sciences (SPSS) was used. Results There was no difference in the self-efficacy score, nor in the obstetric and socioeconomic characteristics between the groups, except for family income (lower in the Premature Group - p = 0.031). The diet type was different on the 30th day after delivery (p = 0.023), with greater adherence to the exclusive breastfeeding in the Premature Group. No association was found between breastfeeding self-efficacy and exclusive breastfeeding practice in the 180-day period. Conclusion In this sample, the breastfeeding self-efficacy was not related to the exclusive breastfeeding practice in the period of 180 days, in both groups. The premature group showed lower family income and greater adherence to exclusive breastfeeding on the 30th day postpartum.

Self-efficacy and breastfeeding outcomes in mothers of premature and term infants: a longitudinal study.

To analyze the breastfeeding self-efficacy in mothers of premature and full-term newborns, in the period of 180 days, and to know the social and obstetric factors that influence the practice of maintaining the exclusive breastfeeding in the period of exclusive recommendation. Cohort with 44 mothers admitted to a public maternity hospital between January and October 2018. The mothers were divided into two groups: Premature and Full-term Groups. The Breastfeeding Self-efficacy Scale was applied in the immediate postpartum period, in addition to a questionnaire elaborated by the authors to collect sociodemographic and obstetric variables. The follow-up was done on the 30th, 120th and 180th days of the newborn's life, by telephone. For the statistical analysis between the groups, the Statistical Package for the Social Sciences (SPSS) was used. There was no difference in the self-efficacy score, nor in the obstetric and socioeconomic characteristics between the groups, except for family income (lower in the Premature Group - p = 0.031). The diet type was different on the 30th day after delivery (p = 0.023), with greater adherence to the exclusive breastfeeding in the Premature Group. No association was found between breastfeeding self-efficacy and exclusive breastfeeding practice in the 180-day period. In this sample, the breastfeeding self-efficacy was not related to the exclusive breastfeeding practice in the period of 180 days, in both groups. The premature group showed lower family income and greater adherence to exclusive breastfeeding on the 30th day postpartum.

Gestational Exposure to Plastic Additives and Associations with Placental Function-Related Genes

Despite an increasing number of environmental reports on plastic additives, gestational exposure to these chemicals has been poorly characterized. The present work aimed to characterize gestational exposure to a total of 50 broadly used plasticizers and antioxidants in women with full-term (n = 155) and preterm deliveries (n = 75) and to explore the associations of prenatal exposure with the expressions of placental function-related genes. A few of them exhibited significantly different concentrations between the preterm and full-term deliveries group, including 2,6-di-tert-butyl-4-(dimethylamino-methyl)phenol (AO4703), dibutyl fumarate (DBF), tributyl citrate (TBC), triethyl citrate (TEC) 2,4-di-tert-butyl-phenol (2,4-DtBP), 2,4-(1,1,3,3-tetra-methylbutyl)phenol (4-tOP), 2,6-di-tert-butyl-4-hydroxytoluene (BHT), and their transformation products. Significant associations were determined between the concentrations of selected chemicals among the 14 substances with detection frequency greater than 60% and the mRNA expression levels of selected genes related to placental functions. The associations also exhibited chemical-specific patterns and significantly differed between preterm and full-term deliveries. Our work represents the first population-based study to assess potential links between gestational exposure to selected plasticizers and antioxidants and placental functions, calling for further efforts to elucidate the potential mechanisms and subsequent impacts on adverse pregnancy outcomes.

Microbiota of preterm infant develops over time along with the first teeth eruption.

The temporal growth of the infant microbiome in the early years of life influences short- and long-term infant health. The aim of this longitudinal study was to investigate bacterial dynamics in the microbiome of preterm infants during tooth eruption. Saliva samples from normally delivered (n = 24) and preterm infants (n = 31) were collected 30 days after birth and after the eruption of two primary mandibular incisors. Based on Illumina MiSeq Sequencing of the 16S rRNA gene, the dynamic microbial changes of newborns at two-time points were investigated. Meanwhile, the Human Oral Microbiome Database was adopted for assigning taxonomy. Using alpha and beta diversity analyses, different shift patterns of microbiome structures in preterm and healthy participants and bacterial diversity over time were observed. The relative abundance and shifts trend, along with the two lower primary central incisors eruption, of core oral flora varies in full-term and preterm groups, including Gemella spp., Rothia mucilaginosa, Veillonella atypica, etc. Several microorganisms colonize later in the oral microbiome development of premature babies, such as Gemella spp. In addition to teeth eruption, the growth of the saliva microbiome in preterm infants could be influenced by breastfeeding durations and birth weight. This study provided insights into how the oral microbiota changes during tooth eruption in preterm infants and how the colonization of the oral cavity with bacteria in preterm infants differs significantly from that in full-term infants.