Post-term Gestational Age Research Articles

The Effectiveness of Birthing Ball Gymnastics on Primigravida Maternity Gestational Age

One of the riskiest pregnancy conditions is post-term pregnancy, which is defined as a gestational age greater than the estimated day of delivery (HPL). This is because difficulties may arise for both the mother and the fetus, particularly when birthing is imminent. Birthing ball gymnastics is one complementary therapy that can help labor commence at full gestational age (term). The aim of the research was to evaluate the impact of birthing ball gymnastics on the gestational age of moms who were primigravidae. The study's quasi-experimental design, which included a treatment group and a control group, was randomized post-test only. The Midwife Independent Practice Place (TPMB) Sidoarjo served as the research site for five months, starting in February 2023 and ending in June 2023. Purposive sampling procedures were used in the study to collect samples from participants who satisfied the inclusion criteria. This resulted in the collection of 30 samples, 15 of which were treatment groups and 15 of which were control groups. Birthing ball exercises and birthing ball gymnastics are provided twice a week for 20 minutes to the treatment group starting at 32 weeks gestation. The control group, on the other hand, had no birthing ball gymnastics instruction and was assessed right away. Utilizing the chi square statistical test to analyze the data, the study's results (p value (0.000) < 0.05) indicated that birthing ball gymnastics was effective in reducing primigravida maternity mothers' gestational age at the Midwife Independent Practice Place (TPMB) in Sidoarjo. In order to prevent the delivery process with post-term gestational age, it is envisaged that the installation of birthing ball gymnastics can be carried out in healthcare facilities such as hospitals, clinics, or Midwife Independent Practice Places (TPMD) for primigravida pregnant women.

Associated factors with adolescent pregnancy in Brazil, 2008-2017

Adolescent pregnancy represents an important public health concern, and may interfere with maternal and child health. This study aims to compare maternal variables and perinatal outcomes of adolescent mothers to young adult mothers, who had live births for Brazil, from 2008 to 2017. It is a cross-sectional study of time series, with data collected from the Live Birth Information System (SINASC). The study covered a total of 5,500,134 live births of adolescent mothers (10 to 19 years old) and 7,674,077 live births of young adult mothers (20 to 24 years old). Data analysis occurred by Pearson Chi-squared test and odds ratio coefficient and respective confidence intervals. The level of significance was set at 5%. Mothers with up to seven years of schooling and without a partner were more likely to be adolescents when compared to young adults. Attending six or fewer prenatal consultations, preterm and postterm gestational age, natural childbirth, low birth weight, Apgar in the first and fifth minutes less than or equal to seven and the presence of congenital anomalies were also more likely to occur in a teenage pregnancy. Public policies must be strengthened with a view to the reproductive care of adolescents.

Prenatal and postnatal correlates of moderate-to-vigorous physical activity in midlife: evidence from the 1970 British Cohort Study

BackgroundIt is hypothesised that lifelong physical activity behaviours are established in early life, however there is minimal, and contradictory, evidence examining prenatal and postnatal factors in relation to adulthood physical...

Pregnant womeńs views on the timing of prophylactic antibiotics during caesarean delivery: A qualitative semi-structured interview study

ObjectiveTo gain insight into pregnant women’s preferences if given a choice between getting antibiotic prophylaxis before or after cord clamping during caesarean delivery. Study designA qualitative semi-structured interview-study. The interviews were conducted at a Danish Hospital, with about 4000 deliveries a year. Fourteen individual semi-structured interviews were conducted with pregnant women, either considering or having a planned caesarean section, or scheduled for induction due to post-term gestational age. A systematic text condensation approach was used to analyze the transcribed interviews. ResultsTen of the fourteen women favored antibiotic administration after cord clamping. Despite any adverse effects to the infant’s microbiota and increased risk of long-term health outcomes were only hypothetical and the risk reduction in postpartum infections being well documented, they did not want to expose their offspring to antibiotics. Those who preferred antibiotic prophylaxis before cord clamping were concerned, if they would be able to care for the infant in case of a maternal infection. Three of the women preferring antibiotics after cord clamping said they would potentially change preference, if the maternal risk was higher. Most women preferred to be informed of the use of prophylactic antibiotic and that the timing has consequences for trans-placental exposure to the infant. ConclusionsWith most of the interviewed women preferring antibiotic administration after cord clamping, we suggest patients should be involved in the decision regarding timing of prophylactic antibiotics before caesarean section.

Factors associated with intrapartum ZigZag pattern of fetal heart rate: A retrospective one-year cohort study of 5150 singleton childbirths

ObjectivesRecent studies suggest that intrapartum ZigZag pattern of fetal heart rate (FHR) is significantly associated with cord blood acidaemia and neonatal complications. For the clinical significance of this pattern, it is mandatory that ZigZag episodes in cardiotocographic (CTG) recording are correctly identified. The aim of the present study was to examine maternal, fetal and delivery-related factors that could explain the occurrence of ZigZag pattern of FHR during the last 2 h of labour in a large obstetric cohort. Study designCTG recordings from 5150 singleton childbirths at ≥33 weeks of gestation during one year were evaluated retrospectively and blinded to pregnancy and neonatal outcomes in a university hospital in Helsinki, Finland. All women in the cohort were in the active phase of labour with regular uterine contractions. ZigZag FHR pattern was defined as FHR baseline amplitude changes of >25 bpm with a duration of 2–30 min. The following maternal, fetal and labour/delivery-related variables were determined: maternal age, obesity (prepregnancy BMI ≥ 30.0 kg/m2), parity, preeclampsia, maternal fever ≥38.0 °C, smoking, gestational age at delivery, fetal sex, birth weight z-score, mode of delivery, and type of onset of labour. ResultsZigZag pattern occurred in 582/5150 (11.3 %) cases, and only in childbirths after 37 weeks of gestation. Fetal male gender (OR 3.29; 95 % CI 2.70–4.02), nulliparous pregnancy (OR 2.60; 95 % CI 2.15–3.15) and post-term gestational age (≥42 weeks) (OR 1.92; 95 % CI 1.47–2.48) were independently associated with the occurrence of ZigZag pattern. Among the three significant risk factors, clustering of two or three factors was associated with an increase of the ZigZag pattern occurrence risk to 5.0–16.4-fold (95 % CI 3.16–31.60). ConclusionsZigZag pattern occurred in term pregnancies after 37 weeks of gestation only. Fetal male gender, nulliparity and post-term pregnancy are significantly associated with ZigZag FHR pattern during the last two hours of labour. Identification of maternal, fetal and delivery-related variables are imperative in order to interpret correctly the findings of CTG and to prevent adverse neonatal outcome.

The risk of atopic dermatitis in post-term gestational age at Sanglah Hospital Denpasar: A preliminary study

Backgrounds: Several studies reported that Atopic Dermatitis (AD) increases with gestational age. Prolong dominancy of Th2 activity during gestation might contribute to the risk of atopic disease in infancy or beyond the period. This study aimed to evaluate the risk AD in post-term gestational age.Methods: A prospective observational study was conducted among 73 living births at Sanglah Hospital Denpasar from December 2015 to January 2016 period. Infants were classified into 2 such as exposed (post-term) and non exposed (term and preterm) group. Parents-follow up by phone was carried out in 1 until 2 months interval. The study was finished once AD diagnosed, subject died or lost to follow up. Statistical analysis was carried out using SPSS ver. 20 software whereas P-value > 0.05 was considered significant.Results: About 20 (233%) infants were preterm, 36 (49.3%) a term, and 17 (23,3%) post-term. The median value of follow up duration was 28 (14-35) days. Based on AD, there were total 24 cases which divided into 15(62.5%), 8(33.3%) and 1(4.17%) cases of AD in post-term, aterm, and preterm respectively. The incidence rate of AD in post-term was 88.2% while in non-post-term the incidence rate was 16.1%. The relative risk (RR) of AD in post-term was 5.47 (95% CI 2.94-10.23; P = 0.001)Conclusion: Post-term is 5.47 times more likely to develop AD compared with aterm and preterm infant. In addition, the incidence rate of AD in post-term infant was 88.2% at Sanglah Hospital Denpasar

Hubungan Usia Kehamilan Dengan Komplikasi Pada Bayi Baru Lahir Di Rs Aura Syifa Kabupaten Kediri Tahun 2017

The age of mother pregnancy is a time limit of mothers pregnant, which is calculated from the first day of the last menstrual period. Normal gestational age is 40 weeks or 280 days as is the custom of 9 months 10 days as in postterm pregnancy. Postterm pregnancy is a pregnancy lasting > 42 weeks. Postterm gestational age tends to have a greater risk of giving birth to infants with complications such as asphyxia, macrosomia and perinatal mortality. This may be because placental function achieves peak at 38 weeks' gestation and then decreases after 42 weeks of gestation. As a result of aging placenta, the supply of food and oxygen to the fetus decreases and the uteroplacental circulation is only about 50%. The purpose of this study was to determine the relationship between gestational age with complications in newborns. The research design use analytic survey with cross sectional approach, population is taken as many as 210 respondents with sampling technique that is using purposive sampling then the big sample taken using finite formula and found the sample of 137 respondents who meet inclusion criteria. The instrument used is the medical record of patients in January - Juni 2016, measuring instrument used is documentation sheet, then data analysis in this study using crosstab conclusion from result no relation between gestational age with complication in newborn. Keywords: Pregnancy Age, Postterm Pregnancy, Asphyxia, Macrosomia, Perinatal Death.

Gestational age at birth and academic performance: population-based cohort study.

Numerous studies suggest pre-term birth is associated with cognitive deficit. However, less is known about cognitive outcomes following post-term birth, or the influence of weight variations within term or post-term populations. We examined associations between gestational age (GA) and school performance, by weight-for-GA, focusing on extremely pre- and post-term births. Record linkage study of Swedish children born 1973-94 ( n = 2 008 102) with a nested sibling comparison ( n = 439 629). We used restricted cubic regression splines to examine associations between GA and the grade achieved on leaving secondary education, comparing siblings to allow stronger causal inference with regard to associations between GA and school performance. Grade averages of both pre- and post-term children were below those of full-term counterparts and lower for those born small-for-GA. The adjusted grades of extremely pre-term children (at 24 completed weeks), while improving in later study periods, were lower by 0.43 standard deviations (95% confidence interval 0.38-0.49), corresponding with a 21-point reduction (19 to 24) on a 240-point scale. Reductions for extremely post-term children (at 45 completed weeks) were lesser [-0.15 standard deviation (-0.17 to -0.13) or -8 points (-9 to -7)]. Among matched siblings, we observed weaker residual effects of pre-term and post-term GA on school performance. There may be independent effects of fetal maturation and fetal growth on school performance. Associations among matched siblings, although attenuated, remained consistent with causal effects of pre- and post-term birth on school performance.

A whole-of-population study of term and post-term gestational age at birth and children's development.

To examine the risk of poor child development according to week of gestation at birth, among children born ≥ 37 weeks' gestation. Population-based study using linked data (n = 12,601). South Australia. All births ≥ 37 weeks' gestation. Relative risks of developmental vulnerability for each week of gestation were calculated with adjustment for confounders and addressing missing information. Child development was documented by teachers during a national census of children attending their first year of school in 2009, using the Australian Early Development Index (AEDI). Children scoring in the lowest 10% of the AEDI were categorised as developmentally vulnerable. The percentage of children vulnerable on one or more AEDI domains for the following gestational ages 37, 38, 39, 40, 41, 42-45 weeks was 24.8, 22.3, 20.6, 20.0, 20.4 and 24.2, respectively. Compared with children born at 40 weeks, the adjusted relative risks [(95% confidence interval (CI)] for vulnerability on ≥ 1 AEDI domain were; 37 weeks 1.13 (0.99-1.28), 38 weeks 1.05 (0.96-1.15), 39 weeks 1.02 (0.94-1.12), 41 weeks 1.00 (0.90-1.11) and 42-45 weeks 1.20 (0.84-1.72). Children born at 40-41 weeks' gestation may have the lowest risk of developmental vulnerability at school entry, reinforcing the importance of term birth in perinatal care. Early term or post-term gestational age at birth can help clinicians, teachers and parents recognise children with potential developmental vulnerabilities at school entry.

United States birth weight reference corrected for implausible gestational age estimates.

To provide an updated US birth weight for gestational age reference corrected for likely errors in last menstrual period (LMP)-based gestational age dating, as well as means and SDs, to enable calculation of continuous and categorical measures of birth weight for gestational age. From the 2009-2010 US live birth files, we abstracted singleton births between 22 and 44 weeks of gestation with at least 1 nonmissing estimate of gestational age (ie, LMP or obstetric/clinical) and birth weight. Using an algorithm based on birth weight and the concordance between these gestational age estimates, implausible LMP-based gestational age estimates were either excluded or corrected by using the obstetric/clinical estimate. Gestational age- and sex-specific birth weight means, SDs, and smoothed percentiles (3rd, 5th, 10th, 90th, 95th, 97th) were calculated, and the 10th and 90th percentiles were compared with published population-based references. A total of 7 818 201 (99% of eligible) births were included. The LMP-based estimate of gestational age comprised 85% of the dataset, and the obstetric/clinical estimate comprised the remaining 15%. Cut points derived from the current reference identified ∼10% of births as ≤10th and ≥90th percentiles at all gestational weeks, whereas cut points derived from previous US-based references captured variable proportions of infants at these thresholds within the preterm and postterm gestational age ranges. This updated US-based birth weight for gestational age reference corrects for likely errors in gestational age dating and allows for the calculation of categorical and continuous measures of birth size.

Pre-emptive Penile Ring Block With Sucrose Analgesia Reduces Pain Response to Neonatal Circumcision

To compare retrospective use of oral sucrose (SUC) vs oral sucrose plus lidocaine ring block (SUC + RB) in the management of pain during neonatal circumcision. A retrospective review of medical records of newborns circumcised using the "Neonatal Infant Pain Scale" was done. With regard to pain, the SUC group had a significantly greater percentage of those with pain than the SUC + RB group at 1 minute (77.7% vs 69.4%; P = .01) and 5 minutes (65.7% vs 55.7%; P = .004). There was no significant pain difference at 30 minutes. In the multivariate logistic regression analyses, those in the SUC group had significantly greater odds for pain at 1 minute than those in the SUC + RB group (odds ratio 1.45, 95% confidence interval 1.04-2.02; P = .03). No significant difference was noted at 5 minutes. Each of the SUC and SUC + RB groups had significant decreases in pain percentages at 5 minutes and 30 minutes (P <.001). In addition, post-term gestational age had significantly greater odds for pain at 5 minutes (odds ratio 3.67, 95% confidence interval 1.51-8.93; P = .004). We found that sucrose use alone as compared with sucrose and ring block combined had greater odds for pain at 1 minute but not at 5 minutes. In addition, those with post-term gestational age had greater odds for pain at 5 minutes as compared with those with regular gestational age. We recommend for hospital-based circumcision using clamps, the use of combined sucrose and ring block for increased analgesia. In addition, for post-term neonates, we recommend greater focus on pain levels, including considering higher dosages of pain medications.

Recurrence of Prolonged and Postterm Gestational Age Across Generations

A postterm pregnancy is defined as a pregnancy lasting for >294 days (42 or more completed weeks). Infants born postterm have increased perinatal morbidity and mortality. The etiology of prolonged pregnancy is poorly understood. A number of studies have found that several birth outcomes, including b

Recurrence of prolonged and post-term gestational age across generations: maternal and paternal contribution

To estimate intergenerational recurrence risk of prolonged and post-term gestational age. Population-based cohort study. Norway, 1967-2006. Intergenerational data from the Medical Birth Registry of Norway of singleton mothers and fathers giving birth to singleton children: 478 627 mother-child units and 353 164 father-child units. A combined mother-father-child file including 295 455 trios was also used. Relative risks were obtained from contingency tables and relative risk modelling. Gestational age ≥41 weeks (≥287 days), ≥42 weeks (≥294 days) and ≥43 weeks (≥301 days) of gestation in the second generation. A post-term mother (≥42 weeks) had a 49% increased risk of giving birth to a child at ≥42 weeks (relative risk [RR] 1.49, 95% CI 1.47-1.51) and a post-term father had a 23% increased risk of fathering a child at ≥42 weeks (RR 1.23, 95%CI 1.20-1.25). The RRs for delivery at ≥41 weeks were 1.29 (1.28-1.30) and 1.14 (1.13-1.16) for mother and father, respectively, and for ≥43 weeks 1.55 (1.50-1.59) and 1.22 (1.17-1.27). The RR of a pregnancy at ≥42 weeks in the second generation was 1.76 (1.68-1.84) if both mother and father were born post-term. Adjustment for maternal age in both generations, fetal sex in the second generation, parity, and maternal and paternal birthweight did not influence the risk estimates. There is a familial factor related to recurrence of prolonged pregnancy across generations and both mother and father seem to contribute.

Fetal constraint as a potential risk factor for craniosynostosis

Non-syndromic craniosynostosis is multifactorial, and fetal head constraint has been hypothesized as one factor thought to play a role. Data from the National Birth Defects Prevention Study (NBDPS), a large multi-site case-control study of birth defects, were used to evaluate associations between four selected factors related to fetal constraint and craniosynostosis: plurality (twins or higher), macrosomia (birth weight >4,000 g), post-term gestational age (> or =42 weeks), and nulliparity (no previous live births). Case infants (n = 675) had craniosynostosis documented either by radiographic evidence or by surgical intervention. Infants with a recognized or strongly suspected single-gene conditions or chromosomal abnormalities were excluded. Control infants (n = 5,958) had no major birth defects and were randomly selected from the same population as case infants. Logistic regression was used to estimate odds ratios for the association between these four factors and craniosynostosis, while adjusting for several covariates. We found that plurality and nulliparity were associated with a twofold increased risk for metopic craniosynostosis, and macrosomia had almost twice the risk of developing coronal craniosynostosis. Contrary to our hypothesis, prematurity and low birth weight were also associated with craniosynostosis. In conclusion, these four constraint-related factors were not found to be associated with craniosynostosis when all suture types were combined, though some types of craniosynostosis were associated with individual constraint-related factors.

Increased neonatal mortality among normal-weight births beyond 41 weeks of gestation in California

The purpose of this study was to examine whether postterm gestational age increases the risk of neonatal mortality. We retrieved data from 1,815,811 liveborn infants in California from 1999 to 2003. We excluded multiple births and congenital anomalies, as well as infants with a gestational age of less than 38 w0d, or greater than 42 w6d, weeks. We used multivariable logistic regression models to adjust for demographic variables thought to confound the association. Compared to infants born at 38, 39, or 40 weeks, those born at 41 w0d to 42 w6d have a greater odds of neonatal mortality (aOR: 1.34, 95% CI, 1.08-1.65). Subdividing by gestational week, infants delivered at 41 w0d to 41 w6d showed elevated mortality relative to earlier term births (aOR: 1.37, 95% CI, 1.08-1.73). Additional analyses support this increased neonatal mortality across all normal birthweight categories. Infants born beyond 41 w0d of gestation experience greater neonatal mortality relative to term infants born between 38 w0d and 40 w6d.