Neonatal Outcomes Research Articles

Should fathers witness childbirth? A survey of attitudes of expectant mothers attending a tertiary hospital in Kano, northern Nigeria

Background Increased paternal involvement during childbirth can enhance maternal and neonatal outcomes. However, in resource-constrained settings, cultural and health system factors often hinder the involvement of fathers in the birthing process. This study aimed to identify the factors influencing antenatal clients’ attitudes toward their partner’s presence during childbirth in northern Nigeria. Methods We administered a pre-tested, culturally adapted questionnaire to antenatal clients at a tertiary health facility (n=351). Attitudinal scores were measured on a Likert scale, and logistic regression was used to compute adjusted odds ratios (aORs) for predictors. Results Only 15.4% of respondents agreed or strongly agreed with the presence of their male partner during childbirth. Women opposed or strongly opposed the suggestion that their partner’s presence provided emotional support (35.9% and 59.8%, respectively), reduced labor pain perception (45.1% and 33.1%, respectively), strengthened the couple’s relationship (40.2% and 52.7%, respectively), or enhanced father-child bonding (32.3% and 46.6%, respectively). More than half of the respondents (57.0%) strongly disagreed that their partner’s presence enhanced paternal responsibility. Rather, the presence of the partner was considered unhelpful (49.3%), culturally unacceptable (37.9%), and against religious rulings (51.6%). Younger maternal age (<30 years, aOR=7.6, 95% CI=2.12-14.40) and higher parity (≥5 children, aOR=2.08, 95% CI=1.21-8.38) were associated with a more positive attitude towards the presence of the father during labor. Conclusions Most women did not favor having their partners present during childbirth. Policymakers and healthcare providers should integrate cultural sensitivity considerations into guidelines and initiatives that promote male involvement in childbirth in similar settings.

Effect of the WHEY protein on pregnancyneonatal outcomes and prophylactic effect on fetal growth restriction cases: A randomized clinical trial

Background: WHEY protein is a high-quality protein source that is easily absorbed and utilized by the body. It has a beneficial effect on pregnancy and neonatal outcomes. Aim: To evaluate the impact of WHEY protein on pregnancy-neonatal outcomes and its prophylactic effect on Fetal growth restriction (FGR) cases. Patients and methods: This study was a prospective randomized, controlled clinical trial conducted on 300 pregnant females from attendees of obstetrics and gynecology clinics of Al Azhar University Hospitals. They were randomly divided into two groups: Case group: The intervention group (150 cases) received a daily WHEY protein supplement containing 25 grams of protein, and the Control Group: 150 cases received a placebo supplement. Results: There was no statistically significant difference between the studied groups regarding demographic criteria (P>0.01), and the prevalence of FGR was (20% vs 18.75) in the studied groups. According to fetal biometry at birth, there was no statistically significant difference regarding sonographic parameters between the appropriate gestational age (AGA) in the studied groups (P>0.01). There was no statistically significant difference between the two groups regarding complete blood parameters, platelets, or PTT (P>0.01). There was a highly statistically significant difference regarding PT between the studied groups (P<0.001). There was no statistically significant difference between the two groups regarding liver and kidney function tests (P>0.01). There was a highly statistically significant difference regarding total proteins and serum calcium between the studied groups (P<0.001). Conclusion: WHEY protein supplementation did not affect fetal growth, but it improved some maternal parameters, such as total protein and PT.

Emergency cerclage: Neonatal outcomes and evaluation of prognostic scores − A decade of experience at a tertiary center

ObjectivesEmergency cervical cerclage is a high-risk surgical procedure associated with maternal and fetal risks, including preterm birth. Authors have developed scores to try to predict the probability of success following emergency cerclage, but these tools have yet to be externally validated.Our main objective was to assess the preterm birth rate before 32 weeks following emergency cerclage. Secondary objectives included assessing perinatal outcomes and the predictive validity of two published scores in our setting. We hypothesized that predictive scores, such as Fuchs and Kokia scores, may not perform optimally in our population due to variability in clinical and biological characteristics that influence eligibility for cerclage across different settings. Study designWe conducted a retrospective, monocentric study in a tertiary maternity hospital. All patients who underwent emergency cerclage between January 1st, 2010, and December 31st, 2021, were included. The main outcome was preterm birth rate before 32 weeks. Secondary outcomes were need for maternal hospitalization after initial hospitalization for cerclage, preterm premature rupture of membrane, and perinatal death. The rate of preterm birth before 32 weeks and adverse perinatal outcomes were estimated. To assess the predictive validity of Fuchs’ score in our population, we performed a multivariable logistic regression model including the score’s variables and constructed receiver operating characteristic (ROC) curve. To assess the validity of Kokia’s score in our population, we studied the correlation between the initial score and gestational age at delivery using Pearson’s correlation coefficient. ResultsOur population was composed of 64 women who underwent an emergency cerclage. The median gestational age at delivery was 30.6 weeks (IQR (24.2; 37.6)). The preterm birth rate before 32 weeks was 54.7 %. The rate of perinatal death was 30.7 %. There were no statistical differences between the patients delivered before and after 32 weeks. The multivariable logistic regression model showed that none of the variables of Fuchs’s score were significantly associated with preterm birth risk in our population. The AUC of the ROC curve using Fuchs’ score was 0.63. There was a minor yet significant correlation between Kokia’s score and gestational age at delivery (r = 0.26 – p = 0.04). ConclusionsOur study underscores the persistent risks associated with cervical insufficiency, including very preterm birth. It highlights the variability in performance of predictive scores across different populations, underscoring the need for external validation in diverse clinical settings.

Cohen vs Pfannenstiel cesarean skin incision for body mass index ≥35 kg/m2: a randomized controlled trial

Background: Maternal obesity is recognized as a significant risk factor for adverse pregnancy outcomes, including increased cesarean delivery rates and heightened surgical complications. It is unclear if the Cohen or Pfannenstiel skin incisions at cesarean delivery are associated with different outcomes. Objective: To evaluate the impact of either Cohen or Pfannenstiel cesarean skin incision type on maternal morbidity. Study Design: Pregnant individuals with a BMI of ≥35 kg/m2, carrying either singleton or multiple gestations, were consented prenatally and in labor. Eligible participants who underwent a cesarean delivery between 24 and 41 weeks of gestation were randomized to either Pfannenstiel or Cohen skin incisions at Thomas Jefferson University Hospital from October 2016 to March 2020. The study aimed to recruit 284 participants based on a sample size calculation assuming a 50% reduction in wound complications with Cohen versus Pfannenstiel incisions (80% power, α=0.05), but recruitment was terminated early after 72 participants were randomized. The primary outcome was a composite maternal morbidity within six weeks, which consisted of the following: wound infection, hematoma, seroma, separation of skin ≥1 cm, readmission for wound complications, endometritis, and postpartum hemorrhage. Statistical analyses included bivariate tests, t-tests, and non-parametric analyses. Results: Of 331 pregnant individuals consented prenatally and in labor, 72 eventually underwent cesarean delivery and were randomized, 34 to Cohen and 38 to Pfannenstiel skin incisions. The mean BMI was >42 kg/m2, about two thirds of the patients had a pannus, 56% were Black, 47% had diabetes, and 56% hypertensive disorders. The primary outcome of composite maternal morbidity occurred in 47.1% in the Cohen and 36.8% in the Pfannenstiel groups (RR 1.24, 95% CI 0.71-2.08), and was also similar regardless of the presence of a pannus, or by degree of obesity. Surgical site infection, hematoma, seroma, wound separation/dehiscence, endometritis, and postpartum hemorrhage were each similar between Cohen and Pfannenstiel participants. Neonatal outcomes were also similar between the Cohen and Pfannenstiel groups, except that the Cohen group was found to have statistically significant lower Apgar score at 5 minutes and higher need for respiratory support compared to the Pfannenstiel group, possibly related to the trend for a longer time from skin incision to delivery. Physicians were found to be significantly less satisfied with the Cohen compared to the Pfannenstiel incision. Conclusion: In pregnant patients with BMI of ≥35 kg/m2, obstetrical providers can chose from either a Cohen or an Pfannenstiel skin incision, as they are associated in general with similar outcomes, except for lower Apgar scores and lower physician satisfaction associated with the Cohen incision. The findings of this study are limited by its early cessation for logistical reasons, leading to an underpowered analysis. It is crucial to acknowledge that these results must be interpreted cautiously due to the reduced sample size and the circumstances surrounding the study's termination. These data can inform future trial design and implementation as well as fuel individual patient level meta-analyses on this topic.

Iranian midwives’ experiences of using the World Health Organization’s Safe Childbirth Checklist: A qualitative research

BACKGROUND: The goal of natural childbirth care is to have a healthy mother and baby with minimal interventions that are contrary to health. Worldwide, there is concern that non-evidence-based interventions and care in labor and childbirth will remain standard practice. Therefore, access to care related to pregnancy and childbirth is considered a priority. To address safety concerns during organized births, the Safe Childbirth Checklist (SCC) was created by the World Health Organization (WHO). This checklist is a tool that combines evidence-based practices that should be provided before, during, and after childbirth. As midwives have a vital role in using this up-to-date evidence, this study was conducted to explore Iranian midwives’ perception of using SCC. MATERIALS AND METHOD: This qualitative study was conducted from January 2022 to April 2023 in two public (teaching and nonteaching) hospitals in Ahvaz, Iran. Seventeen semi-structured interviews were conducted with midwives who had more than one year of work experience in maternity wards. Participants were selected purposefully. A content analysis approach was used to analyze the data and extract themes. RESULTS: All midwives had a positive attitude toward using SCC. The midwives’ reasons for being in favor of using the checklist during the clinical procedures of childbirth are summarized in four main themes, namely “standardized maternity care practices,” “SCC as a guide for performing essential childbirth practices,” “self-efficacy of midwifery care,” and “improved maternal and neonatal outcomes.” CONCLUSION: Midwives have endorsed this checklist as a guide to standard childbirth management. It seems that the use of this checklist will help to improve the health outcomes of mothers and babies by strengthening the self-efficacy of midwives.

Systematic review of ultrasound-guided central venous catheter placement-related complications in neonates and infants aged

Although ultrasound can be considered an assistant method, successful placement of a central venous catheter (CVC) in infants is still challenging. The incidence of CVC placement-related complications is still high. Therefore, this systematic review aimed to synthesize evidence to assess the effects of ultrasound-guided CVC placement on adverse outcomes in infants and neonates aged <12 months. PubMed, Ovid, EMBASE, and the Cochrane Library were searched to identify potentially relevant studies. The main outcome was the incidence of adverse events, which included inadvertent arterial puncture, hematoma, pneumothorax and hemothorax, catheter kinking, threading, and malpositioning problems, venous thrombosis, catheter-related infection, phlebitis, and cardiac tamponade. Eleven studies involving 2097 patients were included in the final analysis. The odds of inadvertent arterial puncture, and catheter kinking, threading, and malpositioning problems were lower in the ultrasound group than in the control group. No significant difference was detected in the incidence of hematoma or venous thrombosis between the control and ultrasound groups. Other complications, such as pneumothorax, hemothorax, phlebitis, and cardiac tamponade, rarely occurred. Ultrasound-guided CVC placement can improve the safety of punctures in neonates and infants. CVC punctures should be guided in real-time by ultrasound.

Exploring the Fundamentals of Bilirubinometry: Methods of Assessment, Timely Monitoring, and Intervention in Neonatal Jaundice with Integrated Phototherapy Solutions—A Review

A frequent ailment in infants, neonatal jaundice is characterized by high bilirubin levels and yellowing of the skin and eyes. It needs to be carefully managed to avoid serious consequences like kernicterus. The principles of bilirubinometry are examined in this review paper, with particular attention paid to different evaluation techniques, the value of prompt monitoring, and modern intervention approaches. Newborns may find it uncomfortable to undergo intrusive blood drawing as part of traditional bilirubin measurement methods. Transcutaneous bilirubinometry (TcB), on the other hand, provides a non-invasive substitute that improves monitoring effectiveness and lessens patient pain. The mainstay of care for newborn jaundice is still phototherapy, which uses light to change bilirubin into a form that is easier to excrete. The efficacy and safety of phototherapy have been enhanced by recent developments, especially about LED-based technology. The evaluation also looks at integrated phototherapy options that optimize therapeutic results and improve neonatal safety by combining automated treatment modifications with real-time bilirubin monitoring. To improve neonatal health outcomes and lessen difficulties related to hyperbilirubinemia, this review emphasizes the significance of timely and effective care of neonatal jaundice by synthesizing existing achievements and highlighting the incorporation of technology innovations

Male and female human papilloma virus infection and assisted reproductive technology outcomes: A comprehensive assessment from prevalence in semen to obstetric outcomes.

Infertility, affecting approximately 16% of the global population, has led to increased reliance on reproductive medicine. The impact of human papillomavirus (HPV) infection in one or both partners on outcomes of Assisted Reproduction Technologies (ART) remains unclear. This prospective cohort study aimed to evaluate prevalence and effects of HPV infection in subjects and couples candidates to ART. A total of n = 510 men and n = 246 women were included and n = 145 couples (n = 290 individuals) had both partners enrolled in the study. The HPV semen infection rate was 17% (95% CI: 14-20) with HPV-42, HPV-16, HPV-53 and HPV-51 as the most frequently detected genotypes. In women, 26% (95% CI: 21-32) tested HPV-positive in cervical swabs. In 6% (95% CI: 3-11) of the couples, both partners were positive but only three couples shared the same genotypes (HPV-16; HPV-39, HPV-51, and HPV-42; HPV-31). Follicular fluids were positive in 20% (95% CI: 11-33) of samples, showing genotype discrepancies with cervical tests. Semen treatment could not completely eliminate the virus in positive samples but reduced the positivity to one-third. No significant differences in semen and embryological variables, clinical pregnancy and live birth rates, neonatal and obstetrics outcomes were observed in subjects with positivity in semen or cervix compared to respective negative groups. Cumulative live birth rates per oocyte retrieval in couples where both partners were negative or both were positive did not differ, being 37% (95% CI: 28%-47%) and 44% (95% CI: 19-73), respectively. In conclusion, HPV testing should not be considered a prerequisite for accessing ART treatments. Robust inferences for natural fertility cannot be made using our findings, as the ART setting does not fully reflect natural conditions.

Can maternal inflammatory and nutritional status, evaluated by the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the prognostic nutritional index (PNI) in the first trimester, predict late-onset fetal growth restriction?

ObjectiveThe aim of this study was to evaluate the potential of immunonutritional markers, specifically the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the prognostic nutritional index (PNI), in predicting late-onset fetal growth restriction (LO-FGR) during the first trimester.Materials and methodsThis retrospective study was conducted at a tertiary care center between October 2022 and August 2023. The study included a total of 213 singleton pregnancies, with 99 women in the LO-FGR group and 114 in the healthy control group, matched by maternal age and gestational age at delivery. All blood samples were collected between 11 and 14 weeks of gestation (during the first-trimester screening test). We analyzed first-trimester laboratory parameters, specifically focusing on hemoglobin levels, white blood cells (WBCs), lymphocytes, platelets, and albumin levels. Afterwards, we calculated the HALP score and PNI, and then compared the values of both groups.ResultsBoth HALP score (3.58 ± 1.31 vs. 4.19 ± 1.8, p = 0.012) and PNI (36.75 ± 2.9 vs. 39.37 ± 3.96, p < 0.001) were significantly lower in the FGR group than in the control group. The HALP score cut-off value of < 3.43 in predicting FGR had a sensitivity of 62.3% and specificity of 54.5% (AUC = 0.600, 95% CI: 0.528–0.672, p = 0.012). The PNI cut-off value of < 37.9 in predicting FGR had a sensitivity of 65.8% and specificity of 62.9% (AUC = 0.707, 95% CI: 0.632–0.778, p < 0.001). While the HALP score was not a significant predictor of composite adverse neonatal outcomes in the FGR group, PNI showed a cut-off value of < 37.7 with a sensitivity of 60.9% and specificity of 59.7% (AUC = 0.657, 95% CI: 0.581–0.733, p < 0.001).ConclusionThe HALP score and PNI are valuable prognostic tools for predicting the risk of FGR in the first trimester. Low PNI values are also associated with composite adverse neonatal outcomes in pregnancies complicated by FGR.

Maternal Prenatal Cannabis Use and Child Autism Spectrum Disorder

Despite an increase in maternal prenatal cannabis use and associations with adverse neonatal outcomes, research on child neurodevelopmental outcomes is limited. To evaluate the association between maternal cannabis use in early pregnancy and child autism spectrum disorder (ASD). This population-based retrospective birth cohort study included children born between 2011 and 2019 to pregnant Kaiser Permanente Northern California members screened for prenatal cannabis use during pregnancy. Statistical analysis was conducted February 2023 to March 2024. Maternal prenatal cannabis use was assessed at entrance to prenatal care (approximately 8- to 10-weeks' gestation) via self-report and/or positive urine toxicology test. Use frequency was assessed. Child ASD was defined by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis codes ascertained from the electronic health record. Associations between maternal prenatal cannabis use and child ASD were modeled using Cox proportional hazards regression adjusted for maternal sociodemographic, other substance use and disorders, prenatal care initiation, comorbidities, and clustering among maternal siblings. The study cohort included 178 948 singleton pregnancies among 146 296 unique pregnant individuals, including 48 880 (27.3%) Asian or Pacific Islander, 42 799 (23.9%) Hispanic, 9742 (5.4%) non-Hispanic Black, and 70 733 (39.5%) non-Hispanic White pregnancies. The median (IQR) maternal age at pregnancy onset was 31 (6) years; 8486 (4.7%) screened positive for cannabis use, 7054 (3.9%) via urine toxicology testing and 3662 (2.0%) by self-report. In the total study population, the frequency of self-reported use was monthly or less for 2003 pregnancies (1.1%), weekly for 918 pregnancies (0.5%), daily for 741 pregnancies (0.4%), and unknown for 4824 pregnancies (2.7%). ASD was diagnosed in 3.6% of children. After adjustment for maternal characteristics, maternal prenatal cannabis use was not associated with child ASD (hazard ratio [HR], 1.05; 95% CI, 0.84-1.32). When self-reported frequency of use was assessed, no statistically significant associations were observed after confounder adjustment. No sex-specific associations were documented (males: HR, 1.01; 95% CI, 0.77-1.32; and females: HR, 1.19; 95% CI, 0.77-1.85). In this cohort study, maternal cannabis use assessed in early pregnancy was not associated with child ASD. Additional studies are needed to evaluate different patterns of use throughout pregnancy. Given the known adverse neonatal health effects of maternal prenatal cannabis use, clinicians should follow national guidelines and advise against use.

A Review of Third-Trimester Complications in Pregnancies Complicated by Diabetes Mellitus.

Pregnancies affected by both pregestational and gestational diabetes mellitus carry an increased risk of adverse maternal and neonatal outcomes. While the risks associated with diabetes in pregnancy have been well documented and span across all trimesters, maternal and neonatal morbidity have been associated with select third-trimester complications. Further, modifiable risk factors have been identified that can help improve pregnancy outcomes. This review aims to examine the relationship between select third-trimester complications (large for gestational age, intrauterine fetal demise, hypertensive disorders of pregnancy, preterm birth, perineal lacerations, shoulder dystocia, and cesarean delivery) and the aforementioned modifiable risk factors, specifically glycemic control, blood pressure control, and gestational weight gain. It also highlights how early optimization of these modifiable risk factors can reduce adverse maternal, fetal, and neonatal outcomes. KEY POINTS: · Diabetes mellitus in pregnancy increases the risk of third-trimester complications.. · Modifiable risk factors exist for these complications.. · Optimizing these modifiable risk factors improves maternal and neonatal outcomes..

Effect Of Cerclage Suture Type On Pregnancy And Newborn Results: Mersylene Suture Versus Prolene Suture

Purpose: The aim of this study is to compare pregnancy and neonatal outcomes according to the type of the suture material used in the transvaginal cerclage operation. Materials and Methods: Patients who underwent transvaginal cervical cerclage due to cervical insufficiency in a tertiary health center between 2020 and 2024 were evaluated retrospectively. Demographic data regarding cerclage indications (ultrasound-based, prophylactic or physical examination-based), number of weeks of gestation in cerclage, cerclage suture type (prolene, mersilen), gestational week at cerclage insertion and delivery, routes of delivery were recorded. In addition, birth weight, 1st and 5th minute APGAR scores, and neonatal intensive care unit (NICU) requirements were recorded as neonatal parameters. Patients were divided into two groups according to cerclage suture type (mersilene or prolene) and maternal, newborn and pregnancy outcomes were compared between these groups. Results: Comparison of the groups in terms of age, gravidity, parity, number of miscarriages and BMI revealed significantly higher mean gravidity in group 1 compared to group 2 (P0.05). No difference was determined with regard to gestational week at cerclage application, cervical length, cervical dilatation just before cerclage insertion, gestational age at cerclage removal and delivery and birth weight (p&gt;0.05). Groups were comparable in terms of subgroups established according to their numbr number of previous deliveries (p&gt;0.05). Groups were comparable in terms of indications for cerclage insertion (p&gt;0.05). Cesarean delivery rate was 40 % in group 1 while it was 43.6 % in groups 2, no statistical difference was determined in terms of rate of cesarean delivery (p&gt;0.05). Similar number of newborns needed NICU admission between the two groups following delivery (17.5% versus 17.9 %p&gt;0.05). Mean APGAR scores at 1st (6.8 versus 7.4) and 5 th (7.8 versus 8.3) min were comparable between the groups (p&gt;0.05) Conclusion: Although mersilen stitch is commonly preferred, data analysis revealed similar results with prolene stitch in terms of maternal and neonatal outcomes.

Disease Burden and Outcome of Neonatal Admissions at the Tamale Teaching Hospital, Ghana: A Prospective Study

Objective: To determine the pattern of diseases and factors affecting the outcome of neonates admitted at the Tamale Teaching Hospital Neonatal Intensive Care Unit (TTH NICU) over three months. Methodology: A hospital-based prospective cohort design was used to collect data from participants. A sample size of 399 neonates (participants) admitted into the NICU from 1st March 2021 to 10th June 2021. Data was obtained using KoboCollect, exported into Excel for cleaning, coding and analysed using SPSS version 20. Results: This study screened a total of 450 neonates under 28 days admitted in the NICU of Tamale Teaching Hospital, Ghana, over three months. Fifty-one of them were rejected, and 399 were included in the final analysis. The mean birth weight was 2600 g (±810g), with 33.1% of the neonates having low birth weight. Three hundred and forty-one (341) (85.5%) neonates survived, while 58 (14.5%) died during hospitalisation. The pattern of diseases showed that neonatal sepsis (37.3%, n=149/399), small for gestational age or low birth weight (SGA/LBW) (33.1%, n=132/399), neonatal jaundice (28.1%, n=112/399), prematurity (23.6%, n=94/399), birth asphyxia (13.5%, n=54/399) and congenital anomalies (7.8%, n=31/399) were the most common causes of admissions. All variables which had an association with neonatal mortality (p &lt;0.05) were entered into a binomial logistic model, prematurity (AOR=6.974, 95% CI: 1.766-27.537; p=0.006) was the main predictor of mortality. Conclusion: The common causes of admission and deaths in the TTH NICU during the study were neonatal sepsis, prematurity, birth asphyxia, LBW/SGA and neonatal jaundice. This highlights the need for interventions to address these conditions as we strive to reduce institutional neonatal mortality.

Blastocysts originated from oocytes with smooth endoplasmic reticulum aggregates have a reduced euploidy rate: a retrospective cohort study.

Does the presence of smooth endoplasmic reticulum aggregates (SERa) in oocytes adversely impact the euploidy rate of subsequent blastocysts? We performed a retrospective cohort study with 671 young patients (< 38 years) undergoing their first preimplantation genetic testing for aneuploidy (PGT-A) between January 2019 and October 2022 at a reproductive medical center of university affiliated teaching hospitals in China. Cycles were categorized as either SERa(+) cycles (containing at least one SERa(+) oocyte) or SERa(-) cycles (all oocytes without SERa). In SERa(+) cycles, oocytes were further subdivided into the SERa(+) oocyte group and the sibling SERa(-) oocyte group, comprising oocytes with normal morphology. No significant differences were observed in the normal fertilization rate (72.9% vs. 75.4% vs. 72.6%, P=0.343), and cleavage rate (96.8% vs. 97.1% vs. 96.4%, P=0.839) among the SERa(-) cycle group, the SERa(-) oocyte group, and the SERa(+) oocyte group. Additionally, there were no statistically significant differences in the rates of good quality embryos (44.7% vs. 48.8% vs. 46.2%, P=0.177) or blastocyst formation (60.1% vs. 60.9% vs. 60.5%, P=0.893) among the groups. However, the euploidy rate of blastocysts derived from SERa(+) oocytes was significantly lower compared to those from SERa(-) oocytes in SERa(+) cycles and normal oocytes in SERa(-) cycles (39.3% vs. 51.2% vs. 54.5%, P=0.005). Despite this, there were no significant differences in pregnancy and neonatal outcomes after euploid embryo transfer among the three groups. Blastocysts derived from SERa(+) oocytes have a lower euploidy rate than those derived from SERa(-) oocytes. Nevertheless, comparable reproductive outcomes were achieved following euploid embryo transfer from both SERa(+) and SERa(-) oocytes.

PREGNANCY OUTCOME IN PERIPARTUM CARDIOMYOPATHY

Background:Peripartum cardiomyopathy(PPCM) is characterized by the onset of heart failure due to left ventricular systolic dysfunction in late pregnancy or shortly after delivery. The incidence of PPCM varies widely globally, with reports ranging from 1 in 100-15000 pregnancies This study aims to evaluate the incidence, clinical characteristics, and outcomes of PPCM in a cohort of women at Basaweshwara General and Teaching Hospital, Kalaburgi. Methods:A retrospective observational study was conducted over one year (January 1 to December 31, 2023). Inclusion criteria were based on NHLBI standards for diagnosing PPCM, while patients with preexisting cardiac conditions, liver disorders, and malignancies were excluded. Data were collected from hospital records, focusing on demographics, clinical presentations,echocardiographic findings, complications, and outcomes. Statistical analysis was performed using SPSS version22. Results:Among 2,200 deliveries, 12 cases of PPCM were identified, yielding an incidence of 0.55%. The mean age of affected women was 26.33 years, with 66% being primigravida. A significant proportion (58.33%) presented with hypertensive disorders.Maternal outcomes included a 25% mortality rate and high rates of cesarean delivery (83.33%).Neonatal outcomes were concerning, with 58.33% of infants requiring NICU admission and 16.66% experiencing intrauterine death. Conclusion:PPCM poses substantial risks to maternal and fetal health, particularly in younger and first-time mothers. Identifying women with risk factors such as hypertensive disorders and anemia is crucial for optimizing care and improving outcomes. Enhanced monitoring and intervention strategies are necessary to address the complexities of PPCM in pregnancy.

Impact of SARS-CoV-2 infection on neonates born to mothers with positive COVID-19 tests. Retrospective cohort study

Background and objectives. COVID-19 infection in pregnant women has an important impact on perinatal and neonatal outcomes. In the small group with critically ill mothers, the complications in the neonates are influenced more by the mother’s state of health than by the disease caused by the SARS-CoV-2 infection. The authors aimed to evaluate the impact of neonatal positive results on SARS-CoV-2 testing. Materials and methods. The retrospective cohort study included all newborns with positive results on SARS-CoV-2 PRC testing admitted to IMSP Mother and Child Institute Kishinev, Republic of Moldova, between 2020 and 2021. Analyzed data were extracted from the maternal and neonatal medical charts, focusing on gestational age, gender, birthweight, Apgar score, type of delivery, respiratory support, radiography findings, and the number of days spent in the NICU. Results. In the present study, of the total number of patients (47), only 7 neonates had a positive COVID-19 test. Two premature infants with a positive test did not suffer from respiratory distress, while the other five needed nasal CPAP (one term infant and four premature infants of 32, 33, and 34 weeks gestational age). There was a high prematurity rate (89.36%) and a high C-section delivery rate (74.4%). Conclusions. In conclusion, the results of our study have shown the direct impact of maternal COVID-19 infection on neonates, irrespective of whether the SARS-CoV-2 test was positive or negative.

Clinical Profile and Outcomes of Late Preterm Neonates in Relation to Gestational Age and Maternal Psychosocial Factors in a Tertiary Care Centre

The relationship between maternal psychosocial factors and outcomes among LPN remains unexplored. Objectives: To determine the morbidity profile of LPN with respect to gestational age and study its association with maternal psychosocial, lifestyle and demographic factors. Methodology: Cross-sectional study on LPNs in a tertiary care centre over one year. Results: Total sample: 263. LPN incidence: 94/1000 live births; Maternal age 20-30 years (p=0.03), high screen time (p=0.02), Caesarean section (p=0.02), moderate Maternal Stress (MS) (p=0.014) was associated with (a/w) births at 35 0/6 to 6/7 weeks of gestation (WOG).Low Birth Weight (LBW) LPN: 66.5% incidence, highest at 35 0/6 to 6/7 WOG; a/w maternal age 20-30 (p=0.002), nulliparity (p=0.02), moderate to severe MS (p=0.012), and Pregnancy Induced Hypertension (PIH) (p=0.04).Small for Gestational Age (SGA): 35%, peaking at 35 0/6 to 6/7 WOG; a/w nulliparity and severe MS. Sepsis 12.2%, highest at 34-35 0/6 to 6/7 WOG (p=0.001); a/w lower-middle socioeconomic status (p=0.05) and multiparity (p=0.02). Respiratory Distress Syndrome (RDS) 5.3%, peaked at 34 0/6 to 6/7 WOG (p=0.044); a/w poor socioeconomic status (p= 0.00). Transient tachypnoea of Newborn (TTN) 49.4%, a/w nulliparity (p=0.02). Neonatal hyperbilirubinemia (NNH) 57.8%, peaking at 34-35 0/6 to 6/7 WOG (p=0.01); a/w nulliparity (p=0.03). Perinatal asphyxia (PA) 6.5%, highest at 35 WOG. Conclusion: NNH and TTN were common in LPN. 35 WOG related to various risk factors and morbidities. LPN born to mothers with moderate MS, PIH, nulliparity, and age 20-30 were LBW. Mother’s screen time &gt; 4 hours/day a/w LPNs born at 35 WOG.

Recent Challenges in Diagnosis and Treatment of Invasive Candidiasis in Neonates.

Invasive Candida infections represent a significant cause of morbidity and mortality in the neonatal intensive care unit (NICU), particularly among preterm and low birth weight neonates. The nonspecific clinical presentation of invasive candidiasis, resembling that of bacterial sepsis with multiorgan involvement, makes the diagnosis challenging. Given the atypical clinical presentation and the potential detrimental effects of delayed treatment, empirical treatment is often initiated in cases with high clinical suspicion. This underscores the need to develop alternative laboratory methods other than cultures, which are known to have low sensitivity and a prolonged detection time, to optimize therapeutic strategies. Serum biomarkers, including mannan antigen/anti-mannan antibody and 1,3-β-D-glucan (BDG), both components of the yeast cell wall, a nano-diagnostic method utilizing T2 magnetic resonance, and Candida DNA detection by PCR-based techniques have been investigated as adjuncts to body fluid cultures and have shown promising results in improving diagnostic efficacy and shortening detection time in neonatal populations. This review aims to provide an overview of the diagnostic tools and the current management strategies for invasive candidiasis in neonates. Timely and accurate diagnosis followed by targeted antifungal treatment can significantly improve the survival and outcome of neonates affected by Candida species.

Maternal and Neonatal Consequences of Early Augmentation of Labor Among Women With Spontaneous Onset of Labor: A National Population-Based Study.

While some labor interventions are essential in preventing maternal and neonatal morbidity, there is little evidence to support systematic early augmentation of labor (EAL). Our objective was to assess the association between EAL and cesarean delivery rate, postpartum hemorrhage and adverse neonatal outcomes. Population-based study using data from the 2016 French Perinatal Survey. Women with a singleton cephalic fetus, delivering at term after a spontaneous labor were included. "EAL" was defined by artificial rupture of the membranes (AROM) and/or oxytocin within 1 h of admission and/or duration between interventions of less than 1 h. Women without EAL were women without labor augmentation or without EAL. The primary endpoint, cesarean delivery and the secondary endpoints were compared between women with and without EAL using univariate analysis. A multivariable logistic regression was adjusted on the suspected confounders and a propensity score approach was then performed. Among the 7196 women included, 1524 (21.2%) had EAL. Cesarean delivery rates were significantly higher in the EAL group compared with the no EAL group, 8.40% versus 6.15% (p < 0.01). EAL was associated with cesarean delivery in the multivariable analysis aOR 1.45 95% CI [1.15-1.82] and in the cohort matched on the propensity score, OR 1.56 [1.17-2.07]. EAL was not associated with severe postpartum hemorrhage, low 5-min Apgar score, low neonatal cord pH or transfer to NICU. EAL is frequent, involving one in five spontaneous laboring women in France. This practice is associated with an increased cesarean delivery risk.

Evaluation of Labour Care Guide: Labor progression in obese women from Basra, Iraq

The prevalence of maternal obesity has emerged as a significant global public health issue. The World Health Organization (WHO) has just introduced a revolutionary tool known as the WHO Labour Care Guide for the purpose of monitoring the well-being of mothers and infants throughout the process of labor. The study aims to evaluate the impact of obesity on the progression of labor, mode of delivery, and subsequent neonatal complications. Our research was conducted on 176 women who fulfilled the inclusion criteria at Basra Maternity and Child Hospital, the number of women with normal BMI was 100, while the class 1 obese was 76 cases. The results show the risk of emergency caesarean section is significantly increased among the class 1 obese woman, the percentages were 40.7%, and 14% respectively (p-value &lt;0.001), regarding the neonatal outcome assessed by the APGAR scoring system, there was a relatively low APGAR score among the total deliveries of class 1 obese women regardless of the mode of delivery, (p-value was significant &lt;0.001) compared with the average Body Mass Index women, the neonatal birth weight was significantly different between the two Body Mass Index groups, there is an increase in the birth weight among class 1 obese women (p-value &lt;0.001). The study concludes obesity has a substantial influence on the increased incidence of caesarean section deliveries among women classified as having obesity class I, and there is a positive correlation between body mass index and the desire for oxytocin administration among obese women.