Incidence Of Preterm Birth Research Articles

Probiotics in the Prophylaxis of Premature Rupture of Membranes and Cervical Incompetence

Premature rupture of membranes (PROM) and cervical incompetence (CI) are major contributors to preterm birth, a leading cause of neonatal morbidity and mortality. Background/Objectives: Disorders of the vaginal microbiota, such as bacterial vaginosis, have been associated with an increased risk of PROM, CI, and subsequent preterm birth. Probiotics, particularly Lactobacillus strains, have been proposed as a preventive strategy to restore and maintain a healthy vaginal microbiome. This review aims to summarize the latest evidence on the role of probiotics in the prevention of PROM and CI. Methods: A comprehensive review was conducted to evaluate the effectiveness of probiotic interventions in the prevention of PROM and CI, yielding 1809 records from 2005 to 2024. Seven relevant studies were selected by searching medical databases and focusing on studies that investigated the restoration of healthy vaginal flora, the reduction of pathogenic bacteria colonization, and the modulation of immune responses by probiotics. Results: The studies analyzed suggest that probiotics may help restore healthy vaginal flora, reduce pathogenic bacterial colonization, and modulate immune responses, thereby reducing the risk of membrane rupture and cervical insufficiency. Evidence from randomized controlled trials and observational studies shows that the use of probiotics is associated with a lower incidence of PROM and preterm birth, especially in high-risk groups. Conclusions: Probiotics emerge as a potential non-invasive and cost-effective strategy to improve pregnancy outcomes in women at risk of preterm birth due to PROM. According to our research, probiotic prophylaxis of cervical insufficiency has not yet been sufficiently investigated. Despite the promising findings, further research is needed to determine standardized probiotic formulations, optimal timing, and routes of administration. Personalized probiotic therapies may represent the future of preterm birth prevention as they offer targeted interventions based on individual microbiome composition.

Cesarean Section and Its Impact on Uterine Artery Resistance and the Risk of Pre-eclampsia in Subsequent Pregnancies

Background: The purpose of the current study was to compare the color Doppler findings of uterine arteries and perinatal outcomes in pregnant women with and without previous cesarean section (C/S). Methods: This cohort study enrolled 308 pregnant women aged 20-35 without underlying diseases, with at least one previous pregnancy and childbirth. The participants were divided into two groups: 154 women without C/S and 154 women with C/S. Baseline data were collected, followed by uterine artery Doppler scans. Then, the perinatal outcomes, including pre-eclampsia, intrauterine growth restriction (IUGR), premature delivery, and birth weight were evaluated. Results: The average age of patients in the C/S group was 30.46±3.81, which was significantly higher than the non-C/S group (28.86±4.64). It was found that uterine artery resistance was higher in women with C/S history (1.11±0.44, p<0.001) compared to those without (1.00±0.37, p<0.001). Pre-eclampsia incidence was also higher in C/S group (16.1%, p=0.042) compared to non-C/S group (9.1%, p=0.042). The incidence of preterm birth in the C/S group (p=0.209), the incidence of IUGR (p= 0.791), and the average birth weight (p=0.291) in the two groups did not differ significantly. The average gestational age in the C/S group was 37.54±1.4, and in the non-C/S group was 38.01±1.99 weeks. The results were not affected by potential confounders such as age, the time interval between pregnancies, and also body mass index. Conclusion: Previous cesarean section can significantly increase the uterine artery resistance in subsequent pregnancy.

Analysis of the relationship between the quality of antenatal care examinations and the incidence of preterm birth and low birth weight

BackgroundAntenatal care (ANC) plays a crucial role in ensuring maternal and child safety and reducing adverse delivery outcomes. This study aimed to analyze the association between the quality of ANC and the occurrence of preterm birth and low birth weight in a sample of the population from 16 regions in 8 provinces in China.MethodsData from all closed cases of pregnant women and newborns reported in the Maternal and Child Health Monitoring System from January 1, 2018, to December 31, 2018, in 16 monitoring regions across 8 provinces in China were collected and included in the analysis, resulting in a total of 49,084 pregnant women and 49,026 newborns.ResultsThe mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% of the women received ANC examinations at least five times. The percentage of normative ANC examinations and the percentage of qualified ANC examinations was 30.98% and 8.0% respectively. The gestational age(χ2 = 229.305, p<0.001), birth weight (χ2 = 171.990, p<0.001) and the occurrence of neonatal complications (χ2 = 53.112, p<0.001) were all significantly related to the number of ANC visits to mothers. There was a correlation between gestational age (χ2 = 1021.362, p<0.001;χ2 = 194.931, p<0.001) and birth weight (χ2 = 259.009, p<0.001; χ2 = 70.042, p<0.001) with normative ANC and qualified ANC examinations. As the number of ANC examinations increased, the rates of preterm birth and low birth weight decreased. Pregnant women who did not receive normative ANC examinations had a higher risk of preterm birth and neonatal low birth weight compared to those who did; Adjusted Odds Ratio (95%CI) was 23.33(16.97~32.07)and 1.61(1.37~1.90) respectively. Pregnant women who did not receive qualified ANC examinations had a higher risk of preterm birth and neonatal low birth weight compared to those who did; Adjusted Odds Ratio (95%CI) was 15.05(8.45~26.79)and 1.36 (1.02~1.82) respectively.ConclusionThe percentage of women who received normative ANC examination and qualified ANC examination is still low in China, and the quality of antenatal care significantly affects the occurrence of preterm birth and low birth weight in newborns.

The Role of Uterocervical Angle on Preterm Birth Incidence

Background: Preterm birth (PB) is associated with significant morbidities in surviving infants. Accurate prediction of PB is essential for effective prevention and management. Continuous monitoring of cervical parameters has shown utility in several studies. Objectives: This study aimed to investigate the role of the anterior uterocervical angle (UCA) in predicting the incidence of PB. Methods: A prospective, descriptive-analytic study was conducted with 165 pregnant women referred to the prenatal care clinic at Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran, in 2021 - 2022. Participants were selected through convenience sampling. Cervical parameters, including UCA, length, and width, were measured via vaginal ultrasound during each trimester. All women were followed until delivery to determine PB incidence. Data were analyzed using descriptive and analytical statistical tests, including the chi-square or Fisher’s exact test and the independent samples t-test or Mann-Whitney U test. Results: Among the participants, 12 (7.3%) experienced preterm delivery. Cervical length was significantly shorter in women with PB during the second trimester (32.58 ± 4.77 mm vs. 34.68 ± 3.80 mm, P = 0.042) and third trimester (30.00 ± 4.74 mm vs. 32.77 ± 3.88 mm, P = 0.022). The mean UCA in women with preterm delivery was higher than in those with term delivery during both the second (90.58 ± 17.21° vs. 88.66 ± 16.76°) and third (100.25 ± 14.56° vs. 98.89 ± 17.78°) trimesters (P &gt; 0.05). A UCA greater than 105° in the second trimester had a sensitivity of 16.7% and specificity of 81.5% for predicting PB. In the third trimester, a UCA greater than 105° showed a sensitivity of 58.3% and specificity of 60.7% for predicting PB. Conclusions: This study emphasizes the importance of regular cervical parameter measurements throughout pregnancy. A UCA greater than 105° in the third trimester appears to be a potential predictor of PB.

Effect of Intrinsic Factors on the Incidence of Preterm Birth in Mothers with High-Risk Pregnancies

One of the problems caused by high-risk pregnancies is that babies are born preterm. Preterm birth is currently not known for sure, but it is thought to be triggered by a variety of mechanisms, including infection or inflammation, uteroplacental ischemic or bleeding, uterine overdistension, stress, and other immunological processes. Various factors are also associated with the occurrence of premature delivery, but the route of the mechanism is still being sought. The purpose of this study is to analyze the influence of intrinsic factors on the incidence of preterm birth in mothers with high-risk pregnancies at Waluyo Jati Hospital, Probolinggo Regency. This study is quantitative research with a cross-sectional approach. Sampling took place from January to June 2024 at Waluyo Jati Hospital, Probolinggo Regency. Sampling used the accidental sampling technique with a sample of 222 respondents who participated in this study. The results of this study showed that the most respondents with the criteria of the age range of 26-35 years were 103 respondents (46.4%), the last education was junior high school as many as 115 respondents (51.8%), the first pregnancy as many as 64 respondents (28.8%), never had an abortion as many as 183 respondents (82.4%), spontaneous childbirth as many as 114 respondents (51.4%), had a history of previous comorbidities as many as 139 respondents (62.6%), normal BMI as many as 94 respondents (42.3%), normal Hb levels were 168 respondents (75.7%), and preterm labor was 150 respondents (67.6%). The results of the double liner regression statistical test obtained a P-value of 0.000. The conclusion of this study is that there is an influence of intrinsic factors on the incidence of preterm birth in mothers with high-risk pregnancies at Waluyo Jati Hospital, Probolinggo Regency.

Seasonal variation in the incidence of preterm births

ObjectivesTo examine the influence of the season of conception, and the season of birth on the incidence of preterm birth (PTB) and neonatal outcomes. Study designThis is a single center, retrospective cohort study of singleton births that took place in The Coombe Hospital in Dublin, Ireland, between January 2013 and December 2022. A comprehensive database was analyzed to determine the incidence of PTB per season of conception and season of birth. Overall neonatal outcomes were reported and stratified per the occurrence of PTB or term birth. ResultsFollowing exclusions, 76,988 births were analyzed. Women who conceived in winter between December-February had significantly lower rates of PTBs when compared to other seasons (5.4 % vs 6.5 % (spring) vs 5.6 % (summer) and 5.4 % (autumn), p < 0.001). When considering only spontaneous preterm labor, this trend persists with most women experiencing spontaneous PTBs conceiving during spring (6.7 % vs 5.5 % (winter) vs 5.7 % (summer) vs 5.5 % (autumn), p = 0.001). Conversely, women who gave birth in December-February had significantly higher rates of premature births when compared to other seasons (6.2 vs 5.8, 5.5 %. and 5.5 %, p < 0,01). PTBs of spontaneous onset were highest between December and February, however no statistical significance was found (6.2 % vs 6.1 % (spring), 5.7 % (summer) and 5.4 % (autumn), p = 0.13). No significant variation in maternal risk factors or neonatal outcomes were identified between the seasons. ConclusionsThis study has shown that there is a seasonal variation in the incidence of preterm births in this Irish-based cohort. A low prevalence of PTB was demonstrated when conceptions occurred in the winter months. However, there was a greater incidence of preterm births between December and February. This is suggestive that there are potential risk factors associated with seasonal patterns that may be modifiable. Further research to identify these specific risks is warranted.

Different interventions to prevent preterm birth in pregnant women with cervical shortening during pregnancy: a protocol for a network meta-analysis

IntroductionPremature birth is the leading cause of neonatal mortality. Cervical length shortening during pregnancy serves as the gold standard for predicting preterm birth. Although several interventions have been applied to...

Secular variation and risk factors of preterm birth in Hainan, the Free Trade Port in China from 2010 to 2021

ObjectivesPreterm delivery rates have increased obviously worldwide over the past decade, yet reliable epidemiological studies on the incidence of preterm birth and temporal trends are not available in Hainan, The Free Trade Port in China. We aimed to describe the rate of preterm birth and trends between 2010 and 2021 and to primarily explore risk factors associated with preterm birth in Hainan, China.MethodsThis was an observational study was based on data from the Hainan Provincial Birth Certificate System (HPBCS) for live births between 1 January 2010 and 31 December 2021. We included pregnancies resulting in at least one live birth, with newborns born at a gestational age of 28 weeks or greater, or with a birth weight of 1000 g or more. The outcome were preterm birth rates and their trends over time. Potential risk factors were collected, including infant gender, maternal age, paternal age, maternal ethnicity, paternal ethnicity, home address, and single or multiple pregnancies. The logistic regression model was used to assess the relationship between preterm birth and potential risk factors.ResultsA total of 1,537,239 live births and 86,328 preterm births were investigated, giving a total preterm birth rate of 5.62%. The overall preterm birth rate increased from 4.47% in 2010 to 7.12% in 2021 (compound annual growth rate [CAGR] 4.32). The CAGR of late preterm birth is consistent with the overall preterm birth rate (4.32%). The fastest growth is observed in the rate of very preterm births (5.53%), while the rate of moderate preterm births exhibits the slowest growth (3.87%). Infant gender, multiple pregnancy, home address, parental age, and ethnicity had significant effects on preterm birth.ConclusionThe preterm birth rate was increasing year by year from 2010 to 2021 in Hainan, The Free Trade Port in China. Incidence of preterm births in Hainan Province in relation to multiple pregnancies, infant sex, parental age, parental race and residential address.

Associations between birthweight and preterm birth and the ages at menarche and menopause

BackgroundWomen who reach menarche and menopause at earlier ages have been shown to be at increased risk for numerous conditions including cardiovascular disease, cancer, depression, and obesity; however, risk factors for earlier ages of menarche and menopause are not fully understood. Therefore, we aimed to perform a retrospective investigation of the associations between a personal birthweight and/or being born preterm and the age of and menarche and menopause and related events in the Women’s Health Initiative, a large, racially and ethnically diverse cohort of postmenopausal women.MethodsAt study entry, women reported their birthweight by category (< 6 lbs., 6–7 lbs. 15 oz, 8–9 lbs. 15 oz, or ≥ 10 lbs.) and preterm birth status (4 or more weeks premature). Ages at events related to menarche and menopause were also self-reported. Linear regression and logistic regression models were used to estimate unadjusted and adjusted effect estimates (β) and odds ratios (OR), respectively (n ≤ 86,857). Individuals born preterm were excluded from all birthweight analyses.ResultsAfter adjustments, individuals born weighing < 6lbs. were more likely to reach natural menopause at an earlier age (adjusted β=-0.361, SE = 0.09, P = < 0.001) and have a shorter reproductive window (adjusted β = -0.287, SE = 0.10, p < 0.004) compared to individuals weighing 6–7 lbs. 15 oz. Individuals born preterm were also more likely to reach natural menopause at an earlier age (adjusted β=-0.506, SE = 0.16, P = 0.001) and have a shorter reproductive window (adjusted β = -0.418, SE = 0.17, p < 0.006).ConclusionsThese findings raise concerns that, as more preterm and low birthweight individuals survive to adulthood, the prevalence of earlier-onset menarche and menopause may increase. Clinical counseling and interventions aimed at reducing the incidence of preterm and low birthweight births, as well as intensification of lifestyle modifications to reduce CVD risk among women with these early-life risk factors, should be prioritized.

Association of Anti-Annexin A5 Antibody With Pregnancy Outcomes: A Cohort Study: Anti-annexinA5antibody with pregnancy outcomes.

This study aims to evaluate the correlation between anti-annexinA5 (aANXA5) antibody in the blood and pregnancy outcomes . This study is a retrospective cohort study based on singleton pregnancies of the Third Affiliated Hospital of Wenzhou Medical University from May 2018 to December 2022. Baseline characteristics were collected from all participants. Logistic regression and interaction effect analyses were utilized to examine the risk impact of aANXA5 on pregnancy complications, adjusting for age, BMI, abortion, ANA, and aCL. Restricted cubic spline (RCS) and threshold effect analysis were applied to explore the relationship between aANXA5 levels and preterm birth (PTB), as well as pregnancy-induced hypertension (PIH). The study included 501 participants, with 51 (10.2%) testing positive for aANXA5 and 450 (89.8%) testing negative. The aANXA5 positive group exhibited higher rates of ANA and antibodies to thyroglobulin (TGAb), along with increased incidences of PTB and PIH. Positive aANXA5 status was independently linked to an elevated risk of PTB (OR: 2.53, 95% CI: 1.30-4.94) and PIH (OR: 4.23, 95% CI: 1.54-11.62). Subsequent subgroup analysis indicated no significant interaction between the groups (p > 0.05). Threshold analysis revealed that the OR for PTB was 1.20 (95% CI: 1.03-1.39) in participants with aANXA5 levels ≥ 32.77ng/mL, and the OR for PIH was 1.62 (95% CI: 1.15-2.28) in those with aANXA5 levels ≥ 33.20ng/mL. AANXA5 is independently associated with an increased risk of PTB and PIH. The identified optimal predictive cutoff values are 32.77ng/mL for PTB and 33.20ng/mL for PIH.

The association of early pregnancy dyslipidemia with preterm birth in twin pregnancies: a retrospective cohort study

BackgroundMaternal lipid metabolism has been implicated in elevating the risk of adverse pregnancy outcomes, which is a particularly significant concern in twin pregnancies. However, the precise relationship between early pregnancy dyslipidemia and the risk of preterm birth (PTB) in twin pregnancies remains unclear.MethodsThis retrospective cohort study included women with twin pregnancies between January 2018 and December 2023. Early pregnancy blood lipid profiles, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C), were examined. Dyslipidemia was diagnosed based on the diagnostic criteria outlined in the 2016 guidelines for the prevention and treatment of dyslipidemia in Chinese adults. PTB was defined as birth occurring before 37 weeks of pregnancy. Logistic regression models were used to evaluate the association of early pregnancy dyslipidemia with PTB in twin pregnancies.ResultsA total of 613 women with twin pregnancies were included, and 141 women were complicated with dyslipidemia. The incidence of PTB < 37 weeks was significantly higher in the dyslipidemia group compared to the group without dyslipidemia (64.5% vs. 50.4%, P = 0.003). After adjusting for confounding factors, dyslipidemia was positively associated with PTB < 37 weeks (adjusted odds ratio: 1.71; 95% confidence interval: 1.13–2.58). However, these associations varied depending on the chorionicity and mode of conception of the twins. The positive associations between early pregnancy dyslipidemia and PTB < 37 weeks remained significant only in spontaneously conceived (SC) or dichorionic diamniotic (DCDA) twin pregnancies. No statistically significant associations were observed between dyslipidemia and the other secondary outcomes.ConclusionEarly pregnancy dyslipidemia was positively associated with PTB < 37 weeks in twin pregnancies, and this association remained significant in SC or DCDA twin pregnancies. Comprehensive lipid profile assessment in the first trimester may be beneficial for patients’ monitoring and implementing interventions to mitigate adverse pregnancy outcomes.

Тип шовного матеріалу при цервікальному серкляжі: загублена частина пазла в лікуванні істміко-цервікальної недостатності

Every year, preterm birth (PTB) causes more than million deaths worldwide. Cervical insufficiency (CI) is a significant risk factor for PTB. Progesterone and cervical cerclage (CC) are used to manage such patients. In this study, the authors analyzed the effect of the type of suture material used for cerclage on the inflammatory status of the birth canal and pregnancy outcomes. The aim of our study is to evaluate the effect of using braided and monofilament sutures on the results of microscopic and microbiological examination and the level of IL-6 and IL-8 in cervical-vaginal fluid (CVF). Materials and methods. During 2021-2024, a prospective cohort study was conducted, which analyzed 51 patients with singleton pregnancy who underwent CC. The braided suture (BS) group included 27 patients, and the monofilament suture (MS) group included 24 patients. Participants were examined twice during the study: 3 weeks after suturing and at suture removal time. Results. The microscopy results (12 vs. 4 patients) and bacteriological examination (15 vs. 6 patients) in the BS group were significantly worse. IL-6 level in the BS group was significantly higher at the time of suture removal than at the beginning (59.67±29.95 vs. 76.6±22.29). The increase of IL-6 levels in the BS group was 2.1, and in the MS group - 1.49. The type of suture material can affect the delivery timing (34.2±2.7 weeks in BS group versus 32.9±3.1 in MS group). Conclusions. The data indicate that CC using BS is associated with vaginal dysbiosis – increase in the frequency of 3-4 grade smear and abnormal levels of opportunistic microflora, CVF IL-6 levels, and with an increased incidence of PTB. The research was carried out in accordance with Helsinki Declaration principles. The study protocol was approved by participating institution’s Local Ethics Committee. The informed consent of the patients was obtained for conducting the studies. Authors declare no conflict of interest.

Cumulative live birth rate of a blastocyst versus cleavage stage embryo transfer policy during in vitro fertilisation in women with a good prognosis: multicentre randomised controlled trial

ObjectivesTo evaluate whether embryo transfers at blastocyst stage improve the cumulative live birth rate after oocyte retrieval, including both fresh and frozen-thawed transfers, and whether the risk of obstetric and...

Clinical efficacy and adverse effects of LMWH combined with ASA in the treatment of RSA: A meta-analysis and systematic review.

The incidence of recurrent spontaneous abortion (RSA) in the clinic shows an increasing trend year by year, and the coagulation status of this group of patients is mostly relatively abnormal. Currently, commonly used drugs in clinical practice include Aspirin (ASA) and low molecular weight heparin (LMWH), but their optimal treatment remains controversial. We aimed to evaluate the clinical efficacy and adverse effects of LMWH combined with ASA in the treatment of RSA. Randomized controlled trials of LMWH combined with ASA for RSA were searched in the databases of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical Literature Service System from the construction of the database to June 2024. Data were analyzed using Review Manager 5.3 and Stata software. Dichotomous variables were analyzed using relative risk (RR) and 95% confidence interval (CI) as their statistics. The included literature was assessed for bias and risk of bias of eligible studies using Cochrane risk of bias tool. The risk of bias was evaluated based on the evaluation criteria recommended by the Cochrane Guidance Manual for Systematic Evaluation. A total of 32 papers with a total of 3397 patients with RSA were finally included. LMWH combined with ASA treatment significantly improved the live birth rate (RR = 1.31, 95% CI: [1.19, 1.45], P < .00001), the rate of preterm stillbirths (RR = 0.23, 95% CI: [0.13, 0.40], P < .00001), rate of term delivery (RR = 1.55, 95% CI: [1.43, 1.67], P < .00001), rate of miscarriage (RR = 0.42, 95% CI: [0.36, 0.48], P < .00001), incidence of petechiae (RR = 0.44, 95% CI: [0.26, 0.72], P = .001), and incidence of thrombocytopenia (RR = 0.61, 95% CI: [0.39, 0.96], P = .03). In contrast, the incidence of preterm live births (RR = 1.07, 95% CI: [0.90, 1.28], P = .44), adverse reactions (RR = 0.77, 95% CI: [0.59, 1.00], P = .05), gingival bleeding (RR = 1.12, 95% CI: [0.65, 1.93], P = .69), and gastrointestinal reactions (RR = 0.87, 95% CI: [0.64, 1.17], P = .35) were not significant. LMWH combined with ASA treatment might improve pregnancy outcomes and reduces the incidence of adverse events in patients with RSA.

A Review of the Literature: Amniotic Fluid "Sludge"-Clinical Significance and Perinatal Outcomes.

Introduction: This paper seeks to report and emphasize the most important aspects from the scientific literature about the diagnostic accuracy of the amniotic fluid "sludge" (AFS), its characterization, its treatment, and its association with premature birth. AFS is defined as a floating freely hyperechogenic material within the amniotic cavity in the proximity of the internal os. Materials and Methods: We conducted a search on Pubmed and Google Scholar for relevant articles on the subject of amniotic fluid "sludge" published until January 2024. Searches were focused on articles about diagnosis, treatment, maternal and neonatal outcomes, risk of preterm birth, and case reports. The full-text reading stage resulted in the inclusion of 51 studies. Results: AFS is independently associated with chorioamnionitis, preterm delivery, short cervix, increased risk of neonatal morbidity, and cervical insufficiency. This hyperechogenic free-floating material is linked with preterm birth before 32 weeks of gestation, especially when it is associated with short cervical length. Discussion: Present studies identify some controversial benefits of antibiotics in reducing the incidence of preterm birth in women with AFS. Nevertheless, in this review, we can conclude that the presence of AFS in pregnancy is a marker for the microbial invasion of the amniotic cavity, as it is associated with preterm birth. Further studies on a larger group of patients are necessary to clarify and exactly define the terms of managing these cases.

Elizabethkingia meningoseptica: A Rare Cause of Infection in Neonates

Elizabethkingia meningoseptica is known to cause nosocomial infection, particularly among preterm neonates, causing high rates of mortality and significant neurological morbidity amid survivors. The disease presents several challenges in diagnosis and management due to its rarity and multidrug resistance. With the increasing incidence of preterm births in Middle East; and consequently, prolonged NICU admissions and hospital acquired infections, it is essential for the physicians to have knowledge on diagnostic and therapeutic strategies about an organism that could possibly affect such infants and cause devastating outcomes. Our study’s primary objective is to give neonatologists a comprehensive overview of E.meningoseptica with its presenting features, risk factors, diagnostic modalities, management protocols and complications. We conducted a literature search on E.meningoseptica infection in neonates, and included a total of 19 reports of this disease, published between 2018-2023 in our study. The cases we reviewed consisted of both preterm and term neonates showing various presentations of the infection with the most common being meningitis. Rapid diagnosis through blood and CSF cultures or utilizing automated systems, together with the initiation of appropriate combination antibiotic therapy is indispensable. In addition, practicing rigorous infection control policies, and having a high index of suspicion when dealing with cases of neonatal sepsis and/ or meningitis is the cornerstone of management.

Comparison of perinatal outcomes of women with gestational diabetes mellitus according to type of treatment for glycemic control

ObjectiveTo compare the perinatal outcomes of women with Gestational Diabetes Mellitus (GDM), between pregnant treated only with lifestyle changes and pregnant treated with insulin and lifestyle changes. MethodsProspective cohort study with follow-up of 64 women with GDM during the prenatal care and postpartum period until hospital discharge, divided into a control group (43) and an insulin group (21), with collection of sociodemographic, clinical, glycemic control and perinatal outcome data. Fetal macrosomia (≥ 4 Kg), or large-for-gestational-age newborns were considered the primary outcome of the research. ResultsPre-pregnancy BMI (31.2 ± 3.9 versus 28.8 ± 5.5), diastolic blood pressure (75 ± 8.7 versus 69 ± 6.9) and postprandial blood glucose (136.6 versus 115.4) ​​were higher in the insulin group, respectively. The control group had an average birth weight of 3058 g and an incidence of preterm birth of 11.6 %, while the insulin group had an average birth weight of 3203 g, with an incidence of preterm birth of 4.8 %. The majority of newborns had an adequate weight for their gestational age. Even all participants met glycemic goals, in the insulin group the Apgar score at the 5th minute and exclusive breastfeeding was lower, had 100 % of resuscitation cases, and a longer inpatient period. ConclusionThese data reinforce that even during prenatal care with lifestyle changes, newborns of women with GDM treated with insulin had worse outcomes, including clinical complications and less exclusive breastfeeding. It is important in prenatal care to identify neonates with risk for prevention and health promotion measures.

Impact of a Stage-Based Classification on the Incidence of Fetal Growth Restriction, Preterm Birth Rates, and Birthweight in a Rural Community of Central India

Introduction: The objective of this study was to determine the impact of the stage-based classification of fetal growth restriction (FGR) on the magnitude of FGR, preterm births (PTBs), and birthweight (BW) in a rural population of Madhya Pradesh in Central India. Methods: The program covered 168 public sector centers for pregnant women and infants that provided services to nearly 220,000 people. The third-trimester assessments included fetal biometry, growth and environment assessments, and Doppler assessments. Fetal growth was staged using the Barcelona protocol as stages 1–4 FGR, small for gestational age, and no FGR. The data from the last ultrasound assessment before childbirth were considered. Regular training programs covering preconception care, antenatal and postnatal care were organized in the local language for the public sector community health workers of the program district. Childbirth outcomes were collected from the obstetric service of the local public sector hospital. Results: The analysis included 1,229 pregnancies from 2019 to 2023. The overall magnitude of FGR using estimated fetal weight <10th centile was 19.61% and reduced to 13.34% with the stage-based classification. The magnitude of FGR using the stage-based classification reduced from 27.59% in 2019 to 8.95% in 2023. The PTB in the stage-based FGR subgroup declined from 35.0% in 2019 to 3.45% in 2023 and 96.55% of the stage 1 FGR babies in 2023 were delivered at term. The overall mean BW in the program area improved from 2,772.41 (357.11) g in 2019 to 2,819.68 (377.31) g in 2023. The perinatal mortality rate (8.95 per 1,000 pregnancies) in the program area for 2019–2023 was much lower than the 31.9 per 1,000 pregnancies reported for Madhya Pradesh. Conclusion: The change to a stage-based classification of FGR integrated with low-dose aspirin and fetal Doppler studies reduced the incidence of FGR and PTB and perinatal mortality and increased BW in this rural community.

Black Women and the Preemie Prep for Parents (P3) Program: Exploratory Analysis of a Clinical Trial.

The smartphone Preemie Prep for Parents (P3) program was developed to address the gap in prenatal education of preterm birth in high-risk pregnancies. Despite a higher incidence of preterm birth, Black women are less likely to receive prenatal education. Pregnant women with medical conditions that predisposed them to preterm birth were randomized to receive the P3 program or links to American College of Obstetricians and Gynecologists webpages (control). The P3 group received periodic text messages, starting as early as 18 weeks gestational age, each with a link to a short, animated educational video. Participants completed the Parent Prematurity Knowledge Questionnaire, PROMIS Anxiety scale, and a feedback survey. This is a subgroup analysis of the Black, non-Hispanic participants in the P3 trial. Of the 26 Black non-Hispanic women enrolled, the P3 group (n=14) had higher knowledge scores than the control group (n=12), 67.5% correct vs. 43.6% (difference 24.0; 95% CI, 7.4 to 40.6), without experiencing an increase in anxiety. More P3 participants reported discussing preterm birth with their partner (100%) than control participants (57%; difference 43; 95% CI, 6 to 80). The P3 program appears to be an effective method of providing preterm birth education to Black pregnant women.

Epidemiological characteristics and clinical antibiotic resistance analysis of Ureaplasma urealyticum infection among women and children in southwest China

BackgroundThe aim of this study was to investigate the epidemiological characteristics and antibiotic resistance patterns of Ureaplasma urealyticum (UU) infection among women and children in southwest China.MethodsA total of 8,934 specimens, including urogenital swabs and throat swabs were analyzed in this study. All samples were tested using RNA-based Simultaneous Amplification and Testing (SAT) methods. Culture and drug susceptibility tests were performed on UU positive patients.ResultsAmong the 8,934 patients, the overall positive rate for UU was 47.92%, with a higher prevalence observed among women of reproductive age and neonates. The majority of UU positive outpatients were women of reproductive age (88.03%), while the majority of UU positive inpatients were neonates (93.99%). Overall, hospitalization rates due to UU infection were significantly higher in neonates than in women. Further analysis among neonatal inpatients revealed a higher incidence of preterm birth and low birth weight in UU positive inpatients (52.75% and 3.65%, respectively) than in UU negative inpatients (44.64% and 2.89%, respectively), especially in very preterm and extremely preterm neonates. Moreover, the incidence rate of bronchopulmonary dysplasia (BPD) among hospitalized neonatal patients was significantly higher in the UU positive group (6.89%) than in the UU negative group (4.18%). The drug susceptibility tests of UU in the neonatology, gynecology and obstetrics departments exhibited consistent sensitivity patterns to antibiotics, with high sensitivity to tetracyclines and macrolides, and low sensitivity to fluoroquinolones. Notably, UU samples collected from the neonatology department exhibited significantly higher sensitivity to azithromycin and erythromycin (93.8% and 92.9%, respectively) than those collected from the gynecology and obstetrics departments.ConclusionsThis study enhances our understanding of the current epidemiological characteristics and antibiotic resistance patterns of UU infection among women and children in southwest China. These findings can aid in the development of more effective intervention, prevention and treatment strategies for UU infection.