Neonatal Weight Research Articles

Impact of Family Participatory Care on Neonates- A Non Randomised Interventional Study

Introduction: Family Participatory Care (FPC) is a unique concept which involves parents in caregiving to their admitted babies. It helps in defining the family's role in clinical care delivery to newborns along with doctors and nurses. The Neonatal Intensive Care Unit (NICU) is the ideal area for FPC to take place because of the unique and vulnerable nature of the mother-neonate relationship as neonates that are admitted, face immense trials from their first day of life. Aim: To know the effect of FPC on outcome of admitted neonates, analyse the impact of this model on breastfeeding rate and to compare the rate of Kangaroo Mother Care (KMC) being given to neonates at follow-up. Materials and Methods: It was a non randomised interventional study done from August 2020 to April 2021, in the NICU at Maharaja Agrasen Medical College, Agroha, Hisar, Haryana, India. Two hundred neonates, who were sequentially admitted and later discharged, were taken into account, out of which, first 100 were taken as controls and next 100 were taken in the intervention group. Routine treatment and care were given to all the admitted neonates. In addition to this, parents of the study group of newborns were given education through four audio-visual sessions, comprising hygiene measures for entry into nursery, correct method of breastfeeding, KMC and then care at home after discharge. Follow-up was done after one week of discharge and at six weeks of age. Outcome measures were breastfeeding rate and KMC rate which were compared between two groups, at discharge and at follow-up of six weeks of age. Results: The mean birth weight of neonates, mean gestational age and the socioeconomic status were comparable in both the groups. Mean duration of hospital stay was 7.13 (±4.95) days in study group and 8.06 (±5.40) days in control group (p=0.206). Mean weight at discharge and that at six weeks was comparable in both groups. However, the average weight gain per day was significantly higher (25.61 g) in the study group than the control group (18.92 g). At discharge, 92 babies in the control group and 87 in the study group were given exclusive breastfeeding or expressed breast milk with spoon feeding. At six weeks follow-up, this number was 91 in the study group and 70 in the control group (p=0.001). KMC was given to all the neonates at discharge who had birth weight less than two kg. Among them, at the time of follow-up, 33/36 in the case group and 5/37 in the control group were receiving KMC (p-value 0.001). Conclusion: FPC is feasible and effective model in terms of better neonatal outcome.

Investigating the effects of financial crisis on pregnancy

Introduction: The global economic crisis has affected many European countries and especially Greece, with main feature that in a short time period it has affected rapidly Greeks’ life and especially the field of health. As far as pregnancy is concerned the consequences have manifested with disorder of different perinatal parameters and they concerned equally both mother and fetus. The purpose of this study is the investigation of consequences of financial crisis in pregnancy, the outcome of pregnancies and childbirth, in relationship to the birth weight of neonates and prematurity. Methods: This is a retrospective study, which covered periods before, during and after the crisis (2006, 2011 and 2019) and was carried out in a public General Hospital of Thessaloniki. The data were collected from the birth registers of the delivery room and for their processing were used the x2 test, the t-test, the nonparametric Mann-Whitney U-test, the anova test and the Spearman coefficient. Results: The present study showed an increase in the rate of caesareans sections from 35% (2006) to 53.5% (2019) (p = 0.04) and statistically significant differences between native and non-native women, with foreigners showing more favorable rates of prematurity ( p = 0.03), cesarean section (p = 0.05) and lower maternity age (p = 0.00). Finally, it was found that women who gave birth prematurely (p = 0.04) or by caesarean section (p= 0.02), were older. Conclusions: Immediate need for interventions was deemed necessary in the maternal care and special mention for the mitigation of factors which are affected by the socioeconomic fluctuations (mother’s age, percentage of caesareans sections, prematurity, birth weight of neonates) and constitute insurmountable elements which required to be set in the centre of interest of the Public Health bodies.

Hemodynamically stable very low birth neonates weight gain is affected by the early initiation of full enteral feedings compared to standard feeding.

Premature babies need to develop similarly to fetuses of the same gestational age. The majority of premature neonates experience a growth-restricted status while in the patent ductus arteriosus (PDA). Extrauterine growth failure is a significant barrier for infants with very low birth weight (VLBW). The study was conducted for six months at the Neonatology Unit, Department of Pediatrics, Coimbatore Medical College Hospital, Coimbatore, Tamil Nadu, India. Neonates with VLBW who met the inclusion criteria were assigned randomly to one of two feeding strategies, that is, full enteral feeding or partial feeding, based on the randomization sequence discovered by opening the sealed cover. The duration of stay, weight variation, neonatal variables, feeding intolerance, necrotizing enterocolitis (NEC), septicemia, apnea, newborn hyperbilirubinemia, PDA, hypoglycemia, intracranial bleeding, and mortality of neonatal recruits were all carefully evaluated. Two thousand two hundred eighty-four neonates were hospitalized throughout the six-month trial period, and 408 had low birth weight. Three hundred forty-two babies were eliminated from the study due to hemodynamic instability, persistent respiratory distress, infections, metabolic issues, and congenital abnormalities. Sixty-six babies met the study's inclusion criteria, and thus participated in the study. Sixty-six newborns weighed between 1.251 and 1.500 kg. Randomly assigning intervention and control groups. Thirty-three newborns were assigned to group A (intervention) and another 33 to group B (control). The study concluded that enteral feeding was effective, inexpensive, secure, and feasible. Early full enteral feeding reduced septicemia and infant hyperbilirubinemia. Thus, we must start enteral feeding as soon as possible to avoid inadequate nutrition in neonates with VLBW during a crucial growth period.

The Relationship Between the Weight of the Placenta and Birth Weight of the Neonate

INTRODUCTION Weight of placenta has long been associated with fetal growth and perinatal well-being. Low placental weight (standardized for sex and gestational age) is more common among stillbirths whereas high placental weight is associated with neonatal death, serious neonatal morbidity, low 5-min Apgar score, and respiratory morbidity. Low placental weight is believed to reflect an inadequate placental surface area for nutrient and gas exchange, leading to fetal compromise. However, it has also been proposed that the increased risk associated with high placental weight is the result of villous oedema, which may compress blood vessels and reduce transfer of gas and nutrients to the fetus. MATERIAL AND METHODS A descriptive cross-sectional study of the total, 798 subjects met the inclusive criteria. After consent, age, sex, prepregnancy weight, weight of mother at the time of delivery, neonatal weight and trimmed placental weight were recorded. RESULTS The mean birth weight was 2818±447.19 gm while the placental weight was 489.29±59 gm with mean placental-fetal weight ratio of 17.63. The mean birthweight of male was 2823.97±451.12 gm whereas female was 2811.69±442.93 gm. Similarly, mean placental weight of male was 490.37±57.7 gm and female was 487.98±60.58 gm. As gestational age increases placental and birth weight also increases whereas placental-birth weight ratio decreases. CONCLUSION There is a positive relation between placental weight and weight of the neonate at the time of birth. However, the ratio of the placental and neonatal birth weights at term decreases with advancing gestational age. Thus, prolongation of pregnancy at term may adversely affect the fetus.

PLACENTAL CHARACTERISTICS AND NEONATAL OUTCOME OF SINGLETON DELIVERIES IN A ZONAL HOSPITAL, JANAKPUR

Background: There are number of maternal and neonatal factors that determine placental characteristics which in turn determine intrauterine life of the fetus. There are limited studies regarding the topic in Nepalese context. Therefore this study aimed to assess the placental characteristics and neonatal outcome of singleton deliveries in a Zonal hospital. Methods: Cross-sectional study was carried out among 300 women with single term delivery using convenience sampling. A structured interview schedule, placental examination perfoma and APGAR score were used to collect data. Data were entered in SPSS version 20 for Windows and analyzed using descriptive and inferential statistics. Results: Findings revealed that almost all placentas were red in color (93.3%), round in shape (99.3%), centrally located umbilical cord (96.0%) and normally inserted placental membrane. Mean placental weight and umbilical length was 492.17 (±99.160) gm and 52.89 (±11.151) cm respectively. Almost all neonates had normal birth weight i.e. 2500 gm., mean weight 2936.13 gm. (± 368.33). Seventeen percent of neonate had mild to severe asphyxia in one minute. Significant association was found between placental weight and maternal factors such as educational status (p= 0.008), annual household income (p= 0.013) and parity (p= 0.001). Significant relationship was found between weight of placenta and weight of neonate (rs = 0.335, p = <0.05) as well as weight of neonate and APGAR score (rs =0.145, p = <0.05) Conclusions: Few deliveries have marginal cord insertion and circumvallate placenta. Some neonates have asphyxia and admitted to intensive care unit. Hence regular placental examinations provide valuable information immediate care to mother and neonates.

A Study to Determine the Perinatal Outcome in Isolated Oligohydramnios at Term Pregnancy

Objective: A Study to Determine the Perinatal Outcome in Isolated Oligohydramnios at Term Pregnancy Study Design: A cross-sectional study Place and Duration: Department of Gynecology and Obstetrics, Hayatabad Medical Complex from October 2022 to March 2023 Methodology: Our sample size was 250 which were divided into 1:1 including 125 cases with isolated oligohydramnios and 125 control cases. Patients with chronic medical disorders and having fetal anomalies or IUGR were excluded. The mode of delivery was noted. Neonatal outcomes in the form of Apgar score, baby weight and need for NICU were noted. Results: The cases with isolated oligohydramnios were associated with an increased incidence of CTG changes, meconium-stained amniotic fluid and the cesarean section as compared to women with normal amount of amniotic fluid. There was no difference between the cases and controls as regards duration of labor, need for oxytocin augmentation, need for neonatal resuscitation, APGAR score at 5 minutes, NICU admission birth weight of neonates or incidence of LSCS for fetal distress. A significant association (OR=1.85, P<0.001) was found between caesarean section in mothers with oligohydramnios compared to controls. Conclusion: Our study found increase cesarean section rate due to CTG changes and meconium stained liquor in isolated oligohydramnios. However neonatal outcome in the form of birth weight, Apgar score and NICU admission was same for both cases and control. Keywords: Oligohydramnios, Perinatal, Term Pregnancy

Comparison of Breastfeeding Success by Mode of Delivery.

This article identifies how mode of delivery and the presence of labor affect the initiation and effectiveness of breastfeeding. This is a retrospective cohort study of breastfeeding success after vaginal delivery, cesarean section after labor, and scheduled cesarean section in term, singleton deliveries in nulliparous patients at a large academic institution from 2017 to 2018. Exclusion criteria included major postpartum complications requiring admission to the surgical intensive care unit or neonatal intensive care unit, general anesthesia, and major fetal anomalies. Breastfeeding success in the immediate postpartum period, defined as the first 2 to 3 days postpartum prior to hospital discharge, was measured by the presence of breastfeeding, the need for formula supplementation, the average number of breastfeeding sessions per day, the average amount of time spent at each breastfeeding session, the average number of newborn stools and wet diapers produced daily, and the neonatal percentage in weight loss over the first 2 to 3 days of life. Multivariable linear and logistic regression were used to assess the association between mode of delivery and markers of breastfeeding success after adjusting for potential confounders. A Tukey's post hoc analysis with pairwise comparisons was performed to assess differences in breastfeeding outcomes between vaginal delivery, scheduled cesarean section, and cesarean section after labor. A total of 2,966 women met inclusion criteria during the study period, 1,936 (65.3%) of whom underwent spontaneous vaginal delivery, 415 (14.0%) of whom delivered by scheduled cesarean section, and 615 (20.7%) of whom underwent cesarean section after labor. There were significant differences in maternal age, obesity, race/ethnicity, insurance status, gestational age at delivery, birth weight, and 1-minute Apgar's score less than 7 between vaginal delivery, scheduled cesarean section, and cesarean section after labor. There were also significant differences between indication for oxytocin, type of anesthesia, and postpartum hemorrhage between the three groups. After controlling for these factors, women who underwent vaginal delivery were more likely to have infants with decreased need for formula supplementation (adjusted odds ratio [aOR] = 1.71, 95% confidence interval [CI]: 1.52-1.93) and were less likely to switch from breast to formula feeding (aOR = 1.71, 95% CI: 1.04-1.31) in comparison to women who delivered via cesarean section in labor or scheduled cesarean section. The infants of these women also had an increased number of breastfeeding sessions on average (β = 0.06, p = 0.002), required fewer number of daily formula feedings (β = 0.14, p < 0.001), and experienced a smaller percentage in neonatal weight loss over the first 2 to 3 days of life (β = 0.18, p < 0.001) compared to those born after cesarean section and cesarean section after labor. These women comparatively required less time at each breastfeeding session (β = 0.06, p = 0.005), and produced fewer wet diapers and stools on average (β = 0.12, p < 0.001 and β = 0.12, p < 0.001, respectively). On post hoc analysis with pairwise comparisons, and on separate sensitivity analysis of only women who underwent cesarean delivery, there was no difference in breastfeeding outcome measures between scheduled cesarean section and cesarean section in labor. Women who deliver by cesarean section, despite the presence or absence of labor, are less likely to maintain exclusive breastfeeding postpartum and are more likely to require formula supplementation. These women may need more support with breastfeeding after surgery in order to experience similar benefits for neonatal growth and weight gain. · Women who deliver by cesarean section are less likely to maintain exclusive breastfeeding.. · Women who deliver by cesarean section are more likely to require formula supplementation.. · Women may need more support with breastfeeding after cesarean delivery..

626 CARDIOVASCULAR DISEASE PHENOTYPES IN PREGNANCY: GESTATION, PERIPARTUM, AND LONG-TERM OUTCOMES

Abstract Background Maternal cardiovascular physiology is affected by changes that may be impaired in women with cardiovascular disease. Management of these pregnancies is challenging, as prevalence of late childbearing and of women with congenital heart disease achieving pregnancy is increasing. Objective This single-center prospective study sought to evaluate the effects of maternal cardiovascular disease (CVD) on pregnancy outcome and, after birth, on maternal and fetal morbidity and mortality. Methods 140 patients with cardiovascular disease prior to pregnancy (congenital or acquired) or cardiovascular disease developed during pregnancy were enrolled at our tertiary referral hospital between 2011 and 2021. Baseline data included cardiovascular risk factors, cardiological therapy, mWHO class in pregnancy, 12-lead EKG, and transthoracic echocardiography. Birth-related data included gestational age at delivery; neonatal weight, Apgar score at 1 and 5 minutes from birth; admission to neonatal ICU. A medium-to-long term follow-up of these patients was carried out by telemedicine. The primary endpoint was pregnancy outcome in terms of live births, week of delivery and fetal growth. Secondary endpoints included neonatal complications, maternal adverse cardiovascular events (death from cardiovascular causes, sustained arrhythmia, acute heart failure, postpartum cardiac surgery) and adverse obstetric events (spontaneous abortion, fetal loss, intrauterine death, neonatal death, SGA, prematurity, frequency of caesarean sections). Results Six cohorts were identified: adult congenital heart disease (ACHD); arrhythmias; valvular heart disease (VHD); ischemic CVD; cardiomyopathies and myopericarditis (CM/MYO); aortic disease. Heart disease prior to pregnancy was the most common setting (88%), mainly including ACHD (54%), followed by VHD (15%) and arrhythmias (11%). The pregnancy-onset cardiovascular diseases (12%) were predominantly CM/MYO (53%), mainly peripartum dilated cardiomyopathy, followed by arrhythmias (35%). Intermediate and high-risk classes (mWHO II-III, III and IV) were observed in 94 patients (67%). There were no maternal deaths; acute heart failure occurred in 6% of patients with no significant difference between groups. Sustained arrhythmias were found in 7% of the total cases, with a significantly higher prevalence in the cohort with preexisting arrhythmia (p &amp;lt;0.05). Cardiac surgery was performed in 4% of the patients, all in the ACHD cohort. Live births were 135 (94%); fetal deaths were 5 (one spontaneous abortion, 3 fetal losses and one neonatal death). Caesarean section was performed in 74% of patients. The mean gestational age at birth was low in all groups (36.6 ± 4.6 weeks), as well as the neonatal weight in grams (2676.9 ± 698.3) and the percentile of neonatal weight (37.8 ± 25.2). Reduced LVEF was significantly associated with low neonatal weight in the mWHO risk class IV patients (p = 0.04). At a mean follow-up of 26 months, cardiac surgery was significantly higher in the group of aortic disease (50% in diseases of the aorta, 8% in the ACHD group, 7% in the CM/MYO group, no events in other groups; p = 0.007), despite the small sample under investigation. Conclusions We provide insights of how, by strict and timely follow-up and a multidisciplinary approach implemented before pregnancy and throughout gestation, good outcomes can be achieved in pregnancies with congenital or acquired cardiovascular disease, despite the high prevalence of intermediate and high-risk patients.

Near Infrared Light Source Versus Naked Eye Visualization for Establishing Intravenous Access in Neonates: A Randomized Control Trial

Objective: To compare efficacy of near infrared light (NIR) versus naked eye (NE) visualization for intravenous access in the neonates. Methods: This was a randomized controlled trial carried out in a tertiary care center in New Delhi, India from 2015 to 2017. A total of 480 admitted neonates, who required placement of intravenous catheter were randomized to receive intravenous access attempt with NE group or using NIR source group. Primary outcome was first attempt success rate of establishing intravenous access. Secondary outcomes were to compare the time to establish intravenous access, number of pricks taken, and cost of consumables used.Results: Of 240 neonates in each group the mean birth weight of neonates in NE group and NIR group being 1665 ± 820 grams and 1600 ± 778 grams, respectively (p-value = 0.363). Mean gestational age of neonates were 31.78 ± 3.9 weeks in NE group and 31.79 ± 3.9 weeks in NIR group (p-value= 0.972). First-attempt success rate in NE group and NIR group was 122 (50.8%) and 124 (51.7%) respectively. The median(IQR) of time taken to establish intravenous access was 37.5 (13- 134.7) sec and 43 (17-221.2) sec in the NE group and NIR group, respectively (p-value = 0.307). There was no significant difference between the groups for secondary outcomes. Conclusion: Use of NIR source as compared to NE visualization, for establishment of intravenous access in neonates, does not improve first attempt success rate. Keywords: Near Infrared Light, Neonate, Vein Viewer. Clinical Trial Registry #: CTRI/2017/01/007693

Maternal and neonatal safety of COVID-19 vaccination during the peri-pregnancy period: A prospective study.

To investigate the safety of inactivated COVID-19 vaccine in Chinese pregnant women and their fetuses when inoculated during the peri-pregnancy period. Eligible pregnant women were prospectively collected and divided into a vaccine group (n = 93) and control group (n = 160) according to whether they had been vaccinated against COVID-19 within 3 months before their last menstruation period (LMP) and after pregnancy. Demographic data of couples, complications during pregnancy and delivery of pregnant women, and data of newborns at birth were collected. Sixty-six women were vaccinated with a median time of 35.5 (range = 0-91) days before LMP, and 27 women were vaccinated with a median time of 17 (range = 1-72) days after LMP. The incidence of premature rupture of membrane (PROM) in the vaccine group was significantly higher than that in the control group (16.13% vs. 6.88%, p = 0.019). Multivariate logistic regression analysis revealed that maternal peri-pregnancy COVID-19 vaccination was not an independent risk factor for PROM (odds ratio: 2.407, 95% confidence interval: 0.932-6.216, p = 0.069). There was no difference in the incidence of other complications during pregnancy and delivery between the two groups. A total of 253 neonates were delivered, including two cases with congenital abnormalities in each group. The incidence of congenital abnormalities between the two groups was similar (2.15% vs. 1.25%, p = 0.626). There was no difference in neonatal length, weight, head circumference, and Apgar score between the two groups (p > 0.05), but the incidence of neonatal jaundice in the vaccine group was significantly higher than that in the control group (20.43% vs. 7.5%, p = 0.002). Multivariate logistic regression analysis revealed that maternal peri-pregnancy vaccination, postpartum blood loss, cesarean section, 1-min Apgar score, and paternal smoking were independent risk factors for neonatal jaundice. It is safe for pregnant women and their fetuses to be inoculated the inactivated COVID-19 vaccine during the peri-pregnancy period, but attention should be paid to neonatal jaundice.

Analysis of the Risk Factors for Massive Hemorrhage in Pernicious Placenta Previa and Evaluation of the Efficacy of Internal Iliac Artery Balloon Occlusion.

To investigate the risk factors of intraoperative massive hemorrhage in patients with pernicious placenta previa (PPP) and analyze the value of bilateral internal iliac artery balloon occlusion in Cesarean section for these patients. The clinical data of 134 patients with PPP admitted to the Second Hospital of Shanxi Medical University from January 2012 to January 2019 were analyzed. A logistic regression analysis was used to analyze the risk factors for intraoperative massive hemorrhage in PPP. The study subjects were divided into the intervention group (38 cases) and the routine group (96 cases) according to whether bilateral internal iliac artery balloon occlusion was conducted during the operation. The differences in some clinical indicators were compared between the two groups. The risk factors for intraoperative massive hemorrhage in PPP were age ≥35 years, gestational age ≥34 weeks, complete placenta previa, and the presence of placenta accreta. The differences in the operation time, postoperative transfer to the intensive care unit, postoperative length of the hospital stay, and neonatal weight and score were not statistically significant between the intervention group and the routine group (P > 0.05 for all). While the intraoperative blood loss and the transfusion volume in the intervention group were lower than in the routine group, the hospitalization cost was higher in the former than in the latter, and the differences were statistically significant (P < 0.05 for all). Moreover, there was no case of hysterectomy in the intervention group, while there were two cases of hysterectomies in the routine group. The risk factors for intraoperative massive hemorrhage in PPP were age ≥35 years, gestational age ≥34 weeks, complete placenta previa, and the presence of placenta accreta. Internal iliac artery balloon occlusion during PPP could reduce intraoperative blood loss and the hysterectomy rate.

Effect of Abdominal Massage on Feeding Intolerance and Weight of Preterm Neonates

Effect of Abdominal Massage on Feeding Intolerance and Weight of Preterm Neonates

Effects of Daily Peat Smoke Exposure on Present and Next Generations.

This study aimed to follow the neurotoxic effect of peat smoke on adult outbred rats and its influence on central nervous system (CNS) parameters in first-generation offspring. Under experimental conditions, exposure to peat smoke was carried out on adult male Wistar rats for 24 h. After the end of the exposure, an open field test (OFT), electroencephalography (EEG), and histological analysis of the testes and brains of smoke-exposed males were performed, after which they were mated with intact females to obtain F1 offspring. Stillbirth, neonatal mortality, and body weight at 4, 7, 14, and 21 postnatal days, as well as behavior in the OFT and EEG parameters during puberty (3 months), were assessed. The results of the examination of F0 males showed a significant increase in motor activity and anxiety in the open field test and a violation of EEG parameters. Histopathologically, peat smoke caused a sharp increase in shadow cells (homogeneous cells with pale-stained cytoplasm, in which the cell and nuclear membranes are not visualized) and degeneratively altered neurons in the brain; we found no changes in the testicles. Peat smoke exposure during preconception did not affect neonatal mortality and weight gain in F1 offspring. Adult females born to peat-smoke-exposed males showed an increase in locomotor activity, and the behavior of adult F1 males did not differ from the control. In F1 males, a statistically significant increase in slow-wave activity indices in the delta band was observed.

Ultrasound-Indicated Cerclage in Twin Pregnancies: A Cohort Study.

To report the pregnancy and neonatal outcomes in patients with twin pregnancies who underwent ultrasound-indicated cerclage (UIC) and to compare them to patients with singleton pregnancies undergoing the same procedures. Patients who underwent UIC between January 2010 and December 2020 at Kangnam Sacred Heart Hospital were reviewed. We compared characteristics, pregnancy, and neonatal outcomes between patients with singleton and twin pregnancies. A total of 94 women (56 singleton and 38 twin pregnancies) underwent UIC were included. The mean gestational age (GA) at cerclage and preoperative cervical length (CL) were not significantly different. Twin pregnancies were more likely to deliver at earlier median gestations than singletons (singleton, 36 + 1 weeks vs twin, 32 + 6 weeks, and p = 0.004). The frequency of preterm delivery <34 weeks in twin group was higher than in singleton group (15 (26.8%) vs 20 (52.6%) and p =0.016). However, the frequency of preterm delivery <32, <28, and <24 weeks was not significantly different between two groups. Although neonatal weights in singleton pregnancies were heavier than twin pregnancies, neonatal mortality and morbidities were not significantly different between two groups. Among various factors contributing to preterm birth, preoperative CL ≤ 15 mm was independently associated with a higher risk of preterm delivery before 34 weeks. Furthermore, pregnancy and neonatal outcomes of twin pregnancies with cervical length ≤ 15 mm are comparable with those of singleton pregnancies (GA at delivery, singleton, 35 + 1 weeks vs twin, 32 + 5 weeks, and p = 0.24; neonatal mortality, singleton, 3.4% vs twin, 4.8%, and p = 0.64). The pregnancy and neonatal outcomes of UIC in twin pregnancies were comparable to those in singleton pregnancies, especially when CL is ≤15 mm. UIC might be considered a safe procedure for twin pregnancies.

Timing of Maternal Smoking Cessation and Newborn Weight, Height, and Head Circumference.

To examine the relationship between timing of smoking cessation during pregnancy and anthropometric indices of newborns. Mothers and neonates enrolled in the JECS (Japan Environment and Children's Study), a nationwide birth cohort study, were examined. Patients with full-term neonates were included in the analysis, and 73,025 mother-neonate pairs with complete data were identified. The mothers were classified into six groups according to smoking status during pregnancy (nonsmokers [Q1, n=44,198]; ex-smokers who quit before pregnancy [Q2, n=16,461]; ex-smokers who quit in the first trimester [Q3, n=8,948]; ex-smokers who quit in the second trimester [Q4, n=498]; ex-smokers who quit in the third trimester [Q5, n=651]; and smokers who smoked throughout pregnancy [Q6, n=2,269)]). Data on smoking were based on questionnaires administered in the first, second, or third trimester and 1 month after delivery. The primary outcomes were birth weight, height, and head circumference. Compared with nonsmokers (Q1), no adverse outcomes were observed for ex-smokers who quit before pregnancy (Q2). The mean adjusted weights of male and female neonates were 135 g and 125 g lower, respectively, in Q6 participants than in Q1 participants. Comparing Q1 and Q6 participants, height was 0.6 cm and 0.7 cm smaller for male and female neonates, respectively. Head circumference in neonates of Q6 participants was 0.3 cm and 0.3 cm smaller for male and female neonates, respectively, than that in Q1 participants. Across all three measures, smoking cessation in the first and second trimester reduced the differential in outcomes between nonsmokers and individuals who smoked throughout pregnancy. Smoking during pregnancy is associated with reduced newborn birth weight, height, and head circumference. Earlier smoking cessation during pregnancy reduces the adverse effects of smoking on fetal growth.

Maternal vitamin D levels correlate with fetal weight and bone metabolism during pregnancy: a materno-neonatal analysis of bone metabolism parameters.

Vitamin D plays an essential role in neonatal skeletal development and maternal weight gain during pregnancy. We aim to study the association between vitamin D status, maternal weight, and materno-neonatal bone metabolism parameters. From January to June 2017, we conducted this cross-sectional study among 103 pregnant women (21-42 years old) and their singletons. The levels of serum 25-(OH)D, PTH, P1NP, OC, and CTX were measured for mothers andneonates (cord blood). Serum vitamin D and OC weremeasured using chemiluminescence and two-site immunoradiometric assay, respectively. Meanwhile, P1NP, CTX, and PTH were measured by ELISA. The average serum vitamin D levels from mothers were 15.1ng/mL during pregnancy and 16.2ng/mL in the umbilical cord. At baseline, vitamin D deficient mothers were more likely to have higher PTH (36.4 vs. 18pg/mL; p=0.029) and lower P1NP levels (90 vs. 92.5ng/mL; p=0.026). Also, vitamin D deficient status was associated with lower fetal weight (3,293 vs. 3,358 g; p=0.019). Maternal weight was significantly correlated with P1NP (65.86 vs. 109.35; p=0.001) and OC (14.52 vs. 18.24; p=0.038), as well as cord vitamin D level (13.31 vs. 18.46; p=0.039) among normal vs. overweight women. No significant differences were found for the correlation between maternal weight and fetal parameters except for fetal weight which significantly increased with the increase in maternal weight (overweight vs. obese women=3,280 vs. 3,560; p=0.06). Maternal vitamin D status is associated with maternal and neonatal bone metabolism parameters as well as maternal and neonatal weight.

Maternal and infant outcomes in women with and without gestational diabetes mellitus in the COVID-19 era in China: Lessons learned.

The global COVID-19 pandemic has required a drastic transformation of prenatal care services. Whether the reformulation of the antenatal care systems affects maternal and infant outcomes remains unknown. Particularly, women with gestational diabetes mellitus (GDM) are among those who bear the greatest brunt. Thus, this study aimed to evaluate the impact of COVID-19 lockdown during late pregnancy on maternal and infant outcomes in women stratified by the GDM status in China. The participants were women who experienced the COVID-19 lockdown during late pregnancy (3185 in the 2020 cohort) or not (2540 in the 2019 cohort) that were derived from the Beijing Birth Cohort Study. Maternal metabolic indicators, neonatal outcomes, and infant anthropometrics at 12 months of age were compared between the two cohorts, stratified by the GDM status. Participants who experienced COVID-19 lockdown in late pregnancy showed lower gestational weight gain than those in the control cohort. Nevertheless, they displayed a worse metabolic profile. COVID-19 lockdown during pregnancy was associated with higher glycosylated hemoglobin (HbA1c) (β= 0.11, 95% CI = 0.05-0.16, q-value = 0.002) and lower high density lipoprotein cholesterol level (HDL-C) level (β=-0.09, 95% CI = -0.14 to -0.04, q-value = 0.004) in women with GDM, adjusted for potential confounders. In normoglycemic women, COVID-19 lockdown in late pregnancy was associated with higher fasting glucose level (β= 0.10, 95% CI = 0.08-0.12, q-value <0.0001), lower HDL-C level (β=-0.07, 95% CI = -0.08 to -0.04, q-value <0.0001), and increased risk of pregnancy-induced hypertension (adjusted OR=1.80, 95%CI=1.30-2.50, q-value=0.001). The fasting glucose level decreased less from early to late pregnancy in women who experienced COVID-19 lockdown than in the controls, regardless of the GDM status. The HDL-C has risen less with COVID-19 lockdown in the normoglycemic subgroup. In contrast, no significant differences regarding neonatal outcomes or infant weight were found between the two cohorts. Experiencing the COVID-19 lockdown in pregnancy was associated with worse maternal metabolic status but similar neonatal outcomes and infant weight.

Using ear molding to correct auricular helix adhesion deformity.

This study examined the effectiveness of Byrd's EarWell system for the treatment of auricular helix adhesion. The newborns with helix adhesion were treated with ear molding. The photos of pinna were taken before, during, and after the treatment. The immediate and long-term outcomes, as well as the complications, were assessed by two independent plastic surgeons. A retrospective study. Data on family history, neonatal weight, gestational age, delivery method, laterality, gender, age of initiating treatment, medical comorbidities, duration of treatment, and follow-up time were collected. From 2019 to 2021, infants treated with the EarWell System in the Eye and ENT Hospital of Fudan University were enrolled in this study. A total of 46 newborns (66 ears) with helix adhesion were included. The average onset time of treatment was 4.57 ± 3.63 weeks. The average duration of treatment was 7.40 ± 2.05 weeks. 97.0% ears' (64/66) immediate results were excellent or good. During long-term follow-up, 95.5% ears achieved excellent or good outcomes. Age of initiation treatment significantly affected immediate (p = 0.001) and long-term (p = 0.004) outcomes. EarWell System was an effective method to correct auricular helix adhesion. Using this approach, patients with helix adhesion could avoid surgeries. Age of initiation treatment was the predictor of successful correction.

Birth weights of singleton neonates of 14 Chinese ethnic groups in 11 cities of China

To develop the birth weight curves of the Chinese Han (26-41 weeks of gestation) and Zhuang (28-41 weeks of gestation) singleton neonates in 11 cities of China, as well as the birth weight means of full-term neonates of 14 Chinese ethnic groups. The live singleton neonates who were born in 11 maternal and child health care hospitals from 11 cities of China between January 2017 and December 2020 were classified according to the mother's ethnic group. Birth weight means were calculated for the full-term neonates of each ethnic group. For the Han and Zhuang singleton neonates with a large sample size, the Lambda-Mu-Sigma (LMS) method was used to establish the birth weight percentile curves of the Han and Zhuang singleton neonates with different gestational ages. A total of 105 365 live singleton neonates were included, among whom the Han neonates had the highest number of 84 851 (26-41 weeks of gestation), followed by the Zhuang neonates (12 803 neonates with a gestational age of 28-41 weeks). The neonates of the other Chinese ethnic groups enrolled were live full-term singleton neonates, with a sample size of more than 100 neonates for each ethnic group. The 3rd-97th percentile curves of birth weight were established for the Han singleton neonates with a gestational age of 26-41 weeks and the Zhuang singleton neonates with a gestational age of 28-41 weeks. The birth weight curves of the Han singleton neonates at each gestational age were higher than those of the Zhuang singleton neonates. Birth weight means (3 199-3 499 g) and standard deviations were determined for 14 Chinese ethnic groups, i.e., Li, Mulao, Zhuang, Yao, Dong, Miao, Han, Buyi, Mongolian, Tujia, Yi, Hui, Man, and Korean ethnic groups. The Li ethnic group had the lowest birth weight, followed by the Mulao, Zhuang, Yao, Dong, Miao, Han, Buyi, Mongolian, Tujia, Yi, Hui, Man, and Korean ethnic groups. The 3rd-97th percentile curves of birth weight are developed for the Han (26-41 weeks of gestation) and Zhuang (28-41 weeks of gestation) singleton neonates in 11 cities of China, and birth weight means are determined for the full-term neonates of 14 Chinese ethnic groups in 11 cities of China, which provides a reference for evaluating the intrauterine growth of neonates in these ethnic groups.

The relationship between pelvic floor functions and vaginal microbiota in 6-8 weeks postpartum women.

The impairment of pelvic floor muscle functions and Lactobacillus-deficient vaginal microbiota is common in postpartum women. However, few studies have explored the correlation between pelvic floor muscle functions and vaginal microbiota. Given this research gap, our study aims to investigate any potential association between these two conditions of postpartum women (6-8 weeks after childbirth). A total of 230 women who required postpartum pelvic floor function examination at Peking University International Hospital from December 2021 to April 2022 were enrolled in this study. The collected questionnaire information included progestational weight, body mass index (BMI), weight gain during pregnancy, neonatal weight, delivery type, multiparity, postpartum time, and urinary incontinence (UI). A total of 187 samples of vaginal secretions were collected, and the vaginal microbiota was detected by 16S rRNA sequence analysis. Finally, 183 samples were analyzed in the trial. All individuals were divided into two groups according to the results of pelvic floor muscle assessment to explore the difference between the incidence of postpartum urinary incontinence and vaginal microbiota. We found that the prevalence of UI was higher in the group with weakened pelvic floor muscles. Vaginal delivery, overweight, age, neonatal weight, and weight gain during pregnancy were all risk factors for postpartum urinary incontinence. The vaginal microbiome was no longer Lactobacillus dominant of most postpartum women (91.8%), while the diversity of microbiota increased. The Lactobacillus-deficient community, commonly labeled as community state type (CST) IV, was sub-divided into four communities. The abundance of vaginal Lactobacillus decreased in the group with compromised pelvic muscle functions, while the species richness and diversity increased significantly. In conclusion, the decreased pelvic floor muscle functions of postpartum women 6-8 weeks after delivery may disrupt the balance of vaginal microbiota, and the restoration of pelvic floor functions may contribute to a healthy and balanced vaginal microbiota.