| 1. |
- Backes, Carl, et al.
(författare)
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Outcomes Following a Comprehensive versus a Selective Approach for Infants Born at 22 Weeks of Gestation.
- 2019
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Ingår i: Journal of Perinatology. - : Springer Science and Business Media LLC. - 0743-8346 .- 1476-5543. ; 39:1, s. 39-47
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine outcomes at two institutions with different approaches to care among infants born at 22 weeks of gestation.Study design: Retrospective, cohort study (2006–2015). Enrollment was limited to mother–infant dyads at 22 weeks of gestation. Proactive care was defined as provision of antenatal corticosteroids and neonatal resuscitation and intensive care. One center (Uppsala, Sweden; UUCH) provided proactive care to all mother–infant dyads (comprehensive center); the other center (Nationwide Children’s Hospital, USA; NCH) initiated or withheld treatment based on physician and family preferences (selective center). Differences in outcomes between the two centers were evaluated.Result: Among 112 live-born infants at 22 weeks of gestation, those treated at UUCH had in-hospital survival rates higher than those at NCH (21/40, 53% vs. 6/72, 8%; P < 0.01). Among the subgroup of infants receiving proactive care (UUCH: 40/40, 100%; NCH: 16/72, 22%) survival was higher at UUCH than at NCH (21/40, 53% vs. 3/16, 19%; P < 0.05).Conclusion: Even when mother–infant dyads were provided proactive care at NCH (selective center), survival was lower than infants provided proactive care at UUCH (comprehensive center). Differences between the approaches to care at the two centers at 22 weeks of gestation merits further investigation.
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| 2. |
- Baker, Jillian M., et al.
(författare)
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Postnatal intervention for the treatment of FNAIT : a systematic review
- 2019
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Ingår i: Journal of Perinatology. - : Springer Science and Business Media LLC. - 0743-8346 .- 1476-5543. ; 39:10, s. 1329-1339
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Forskningsöversikt (refereegranskat)abstract
- Objective: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is associated with life-threatening bleeding. This systematic review of postnatal management of FNAIT examined transfusion of human platelet antigen (HPA) selected or unselected platelets, and/or IVIg on platelet increments, hemorrhage and mortality. Study design: MEDLINE, EMBASE and Cochrane searches were conducted until 11 May 2018. Result: Of 754 neonates, 382 received platelet transfusions (51%). HPA-selected platelets resulted in higher platelet increments and longer response times than HPA-unselected platelets. However, unselected platelets generally led to sufficient platelet increments to 30 × 10 9 /L, a level above which intracranial hemorrhage or other life-threatening bleeding rarely occurred. Platelet increments were not improved with the addition of IVIg to platelet transfusion. Conclusion: Overall, HPA-selected platelet transfusions were more effective than HPA-unselected platelets but unselected platelets were often effective enough to achieve clinical goals. Available studies do not clearly demonstrate a benefit for addition of IVIg to platelet transfusion.
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| 7. |
- Curstedt, T
(författare)
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Surfactant protein C: basics to bedside
- 2005
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Ingår i: Journal of perinatology : official journal of the California Perinatal Association. - : Springer Science and Business Media LLC. - 0743-8346. ; 25 Suppl 2, s. S36-8
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Tidskriftsartikel (refereegranskat)
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| 8. |
- Curtiss, Jennifer, et al.
(författare)
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The Optimal State Scoring Tool : guidance for interdisciplinary care of infants with severe bronchopulmonary dysplasia and its relation to linear growth
- 2023
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Ingår i: Journal of Perinatology. - : Springer Nature. - 0743-8346 .- 1476-5543. ; 43, s. 1301-1307
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Infants with severe bronchopulmonary dysplasia (sBPD) have complex medical courses. We developed the clinician-rated Optimal State Scoring Tool (OSST) that measures factors relevant to clinical improvement of sBPD and investigated preliminary validity using linear growth outcome and OSST scores in sBPD patients.Methods: Tool development process and pilot findings are provided for 13 patients evaluated longitudinally. OSST scores, length measurements, and steroid dependency values were obtained. Changes in OSST scores and lengths were examined using linear mixed-effect models.Results: OSST scores were significantly correlated with linear growth (95% CI 0.36, 0.57). The steroid-dependent group showed significantly slower rate of linear growth (95% CI 0.74, 1.05) and slower rate of increase in OSST scores (95% CI 0.99, 2.13) compared to the non-steroid-dependent group, with the OSST showing the largest effect size.Conclusion: Pilot data reflect promising evidence for OSST construct validity in monitoring clinical outcomes in sBPD patients.
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| 9. |
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| 11. |
- Galvan-Valencia, Oscar, et al.
(författare)
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Associations of salivary aldosterone levels during pregnancy with maternal blood pressure and birth weight-for-gestational age in a Mexico City birth cohort
- 2024
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Ingår i: Journal of Perinatology. - : Springer Nature. - 0743-8346 .- 1476-5543. ; 44:5, s. 643-649
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo determine associations of maternal salivary aldosterone with blood pressure (BP) in pregnancy and infant birth weight-for-gestational age (BWGA).MethodsWe measured maternal salivary aldosterone, BP and BWGA z-scores in 471 Mexico City pregnancy cohort participants and performed multivariable linear regression of BP and BWGA on log-aldosterone levels.ResultsLog-aldosterone was positively associated with diastolic BP (beta = 0.12 95% CI: 0.04, 0.21). There were no main effects of log-aldosterone on BWGA. However, we detected an interaction between log-aldosterone and BP in association with BWGA; higher log-aldosterone was associated with lower BWGA in the lowest (beta = -0.12, 95% CI: -0.26, 0.02) and highest (beta = -0.12, 95% CI: -0.29, 0.06) BP tertiles. In contrast, in the middle BP tertile the association was positive (beta = 0.09, 95% CI: -0.02, 0.20), p for interaction = 0.03.ConclusionHigher maternal salivary aldosterone is positively associated with diastolic BP and may affect fetal growth differently depending on concurrent maternal blood pressure.
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| 12. |
- Gemmell, L., et al.
(författare)
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Hypertensive disorders of pregnancy and outcomes of preterm infants of 24 to 28 weeks' gestation
- 2016
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Ingår i: Journal of Perinatology. - : Springer Science and Business Media LLC. - 0743-8346 .- 1476-5543. ; 36:12, s. 1067-1072
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the relationship between hypertensive disorders of pregnancy (HDPs) and mortality and major morbidities in preterm neonates born at 24 to 28 weeks of gestation.STUDY DESIGN: Using an international cohort, we retrospectively studied 27 846 preterm neonates born at 24 to 286 weeks of gestation during 2007 to 2010 from 6 national neonatal databases. The incidence of HDP was compared across countries, and multivariable logistic regression analyses were conducted to examine the association of HDP and neonatal outcomes including mortality to discharge, bronchopulmonary dysplasia, severe brain injury, necrotizing enterocolitis and treated retinopathy of prematurity.RESULTS: The incidence of HDP in the entire cohort was 13% (range 11 to 16% across countries). HDP was associated with reduced odds of mortality (adjusted odds ratio (aOR) 0.77; 95% confidence interval (CI) 0.67 to 0.88), severe brain injury (aOR 0.74; 95% CI 0.62 to 0.89) and treated retinopathy (aOR 0.82; 95% CI 0.70 to 0.96), but increased odds of bronchopulmonary dysplasia (aOR 1.16; 95% CI 1.05 to 1.27).CONCLUSIONS: In comparison with neonates born to mothers without HDP, neonates of HDP mothers had lower odds of mortality, severe brain injury and treated retinopathy, but higher odds of bronchopulmonary dysplasia. The impact of maternal HDP on newborn outcomes was inconsistent across outcomes and among countries; therefore, further international collaboration to standardize terminology, case definition and data capture is warranted.
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| 15. |
- KC, Ashish, 1982-, et al.
(författare)
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Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth
- 2023
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Ingår i: Journal of Perinatology. - : Springer Nature. - 0743-8346 .- 1476-5543. ; 43, s. 709-715
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo compare HR pattern of vigorous newborns during the first 180 s with early (≤60 s, ECC) or delayed (>60 s, DCC) cord clamping.Study designObservational study including dry-electrode ECG monitoring of 610 vaginally-born singleton term and late-preterm (≥34 weeks) who were vigorous after birth.Results198 received ECC while 412 received DCC with median cord clamping at 37 s and 94 s. Median HR remained stable from 30 to 180 s with DCC (172 and 170 bpm respectively) but increased with ECC (169 and 184 bpm). The proportion with bradycardia was higher among ECC than DCC at 30 s and fell faster in the DCC through 60 s. After adjusting for factors affecting timing of cord clamping, ECC had significant risk of bradycardia compared to DCC (aRR 1.51; 95% CI; 1.01–2.26).ConclusionEarly heart instability and higher risk of bradycardia with ECC as compared to DCC supports the recommended clinical practice of DCC.
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| 16. |
- KC, Ashish, 1982, et al.
(författare)
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Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth.
- 2023
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Ingår i: Journal of perinatology : official journal of the California Perinatal Association. - : Springer Science and Business Media LLC. - 1476-5543 .- 0743-8346. ; 43:6, s. 709-715
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Tidskriftsartikel (refereegranskat)abstract
- To compare HR pattern of vigorous newborns during the first 180 s with early (≤60 s, ECC) or delayed (>60 s, DCC) cord clamping.Observational study including dry-electrode ECG monitoring of 610 vaginally-born singleton term and late-preterm (≥34 weeks) who were vigorous after birth.198 received ECC while 412 received DCC with median cord clamping at 37 s and 94 s. Median HR remained stable from 30 to 180 s with DCC (172 and 170 bpm respectively) but increased with ECC (169 and 184 bpm). The proportion with bradycardia was higher among ECC than DCC at 30 s and fell faster in the DCC through 60 s. After adjusting for factors affecting timing of cord clamping, ECC had significant risk of bradycardia compared to DCC (aRR 1.51; 95% CI; 1.01-2.26).Early heart instability and higher risk of bradycardia with ECC as compared to DCC supports the recommended clinical practice of DCC.
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| 17. |
- Kelly, L E, et al.
(författare)
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Perinatal health services organization for preterm births : a multinational comparison
- 2017
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Ingår i: Journal of Perinatology. - : Nature Publishing Group. - 0743-8346 .- 1476-5543. ; 37:7, s. 762-768
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore population characteristics, organization of health services and comparability of available information for very low birth weight or very preterm neonates born before 32 weeks' gestation in 11 high-income countries contributing data to the International Network for Evaluating Outcomes of Neonates (iNeo).STUDY DESIGN: We obtained population characteristics from public domain sources, conducted a survey of organization of maternal and neonatal health services and evaluated the comparability of data contributed to the iNeo collaboration from Australia, Canada, Finland, Israel, Italy, Japan, New Zealand, Spain, Sweden, Switzerland and UK.RESULTS: All countries have nationally funded maternal/neonatal health care with >90% of women receiving prenatal care. Preterm birth rate, maternal age, and neonatal and infant mortality rates were relatively similar across countries. Most (50 to >95%) between-hospital transports of neonates born at non-tertiary units were conducted by designated transport teams; 72% (8/11 countries) had designated transfer and 63% (7/11 countries) mandate the presence of a physician. The capacity of 'step-down' units varied between countries, with capacity for respiratory care available in <10% to >75% of units. Heterogeneity in data collection processes for benchmarking and quality improvement activities were identified.CONCLUSIONS: Comparability of healthcare outcomes for very preterm low birth weight neonates between countries requires an evaluation of differences in population coverage, healthcare services and meta-data.
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| 18. |
- Klemming, Stina, et al.
(författare)
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Mother-newborn couplet care : Nordic country experiences of organization, models and practice
- 2023
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Ingår i: Journal of Perinatology. - : Springer Nature. - 0743-8346 .- 1476-5543. ; 43:SUPPL 1, s. 17-25
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Tidskriftsartikel (refereegranskat)abstract
- Mother-Newborn Couplet Care is a concept and is defined as the provision of care for a sick or preterm newborn in close proximity to and coupled with the care for the mother from the birth of the infant and for as long as the mother needs hospital care. This concept of care requires system change in both obstetrics and pediatrics in terms of the planning and organization of care, equipment and design of units. Accordingly, strong leadership setting clear goals and emphasizing a culture of cohesive care, supported by targeted education and training is crucial to ensure high-quality care of all mother-newborn dyads without separation. We describe various organizational models of Mother-Newborn Couplet Care used in Sweden and Finland and implementation processes. We envision a future where newborns and mothers are always together, irrespective of medical needs, and form an inseparable center around which healthcare services and providers are organized.
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| 19. |
- Lynch, Kristian, et al.
(författare)
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Cord blood islet autoantibodies and seasonal association with the type 1 diabetes high-risk genotype.
- 2008
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Ingår i: Journal of Perinatology. - : Springer Science and Business Media LLC. - 0743-8346 .- 1476-5543. ; 28:3, s. 211-217
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Tidskriftsartikel (refereegranskat)abstract
- Objective:Human leukocyte antigen DQ (HLA-DQ) genetic factors and islet autoantibodies are strongly associated with type 1 diabetes (T1D) and are currently used to predict T1D. This study examined whether islet autoantibodies in the cord blood of newborns to nondiabetic mothers were associated with the (T1D) high-risk genotype HLA-DQ2/8, gestational infections or both.Study Design:Cord blood samples were taken from 33 683 newborns and used for HLA typing and analyses of islet autoantibodies. Parents completed questionnaires when the child was 2 months of age.Result:The prevalence of newborn islet autoantibodies consistently varied with season over 4 years (P<0.0001); lowest in first quarter (1.2%) and highest in third (2.4%). Cord blood islet autoantibodies were associated with HLA-DQ2/8 in the second (OR, 2.30; P=0.02), third (OR, 2.12; P=0.008) and fourth quarters (OR, 2.49; P=0.007), but not in the first (OR, 1.13). Reported gastroenteritis was additionally associated with islet autoantibodies in the third quarter (OR, 1.80, P=0.04).Conclusion:An association between HLA and islet autoimmunity may depend on environmental exposure during pregnancy. Follow-up of mothers and children will determine risk of T1D.Journal of Perinatology (2008) 28, 211-217; doi:10.1038/sj.jp.7211912; published online 14 February 2008.
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| 20. |
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| 21. |
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| 22. |
- Persson, Christine, et al.
(författare)
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Quality of couple relationship and associated factors in parents of NICU-cared infants during the first year after birth
- 2024
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Ingår i: Journal of Perinatology. - : Springer Nature. - 0743-8346 .- 1476-5543.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe factors associated with quality of couple relationships among parents of infants cared for in neonatal intensive care units (NICUs) 1 year after birth and examine the trajectory of the relationship quality compared to parents from maternity units (MUs).Study design: Longitudinally comparative cohort design. Parents answered surveys during the first year after discharge about the couple relationship, social support, and depressive symptoms.Results: Better social support and a hospital stay of 7–14 days were positively associated with the couple relationship in NICU mothers, whereas not having slept together with the partner and infant during hospitalization were negatively associated. Depressive symptoms were negatively associated with the relationship among NICU fathers. There were no differences in trajectory of the relationship quality between NICU and MU parents.Conclusion: To strengthen couple relationships, it could be important to improve social support, facilitate space and time for support, and enable togetherness during hospitalization.
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| 26. |
- Sterner, Y, et al.
(författare)
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Country-specific birth weight and length in type 1 diabetes high-risk HLA genotypes in combination with prenatal characteristics.
- 2011
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Ingår i: Journal of Perinatology. - : Springer Science and Business Media LLC. - 0743-8346 .- 1476-5543. ; 31, s. 764-769
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To examine the relationship between high-risk human leukocyte antigen (HLA) genotypes for type 1 diabetes and birth size in combination with prenatal characteristics in different countries.Study Design:Four high-risk HLA genotypes were enrolled in the Environmental determinants of Diabetes in the Young study newborn babies from the general population in Finland, Germany, Sweden and the United States. Stepwise regression analyses were used to adjust for country, parental physical characteristics and environmental factors during pregnancy.Result:Regression analyses did not reveal differences in birth size between the four type 1 diabetes high-risk HLA genotypes. Compared with DQ 4/8 in each country, (1) DQ 2/2 children were heavier in the United States (P=0.028) mostly explained however, by parental weight; (2) DQ 2/8 (P=0.023) and DQ 8/8 (P=0.046) children were longer in Sweden independent of parents height and as well as (3) in the United States for DQ 2/8 (P=0.023), but again dependent on parental height.Conclusion:Children born with type 1 diabetes high-risk HLA genotypes have comparable birth size. Longitudinal follow-up of these children should reveal whether birth size differences between countries contribute to the risk for islet autoimmunity and type 1 diabetes.Journal of Perinatology advance online publication, 28 April 2011; doi:10.1038/jp.2011.26.
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| 27. |
- Söderström, Fanny, et al.
(författare)
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Reduced rate of retinopathy of prematurity after implementing lower oxygen saturation targets.
- 2019
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Ingår i: Journal of Perinatology. - : Springer Science and Business Media LLC. - 0743-8346 .- 1476-5543. ; 39, s. 409-414
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate an implementation of lower oxygen saturation targets with retinopathy of prematurity (ROP) as primary outcome, in infants at the lowest extreme of prematurity.Study design: Retrospective cohort including infants born at 22-25 weeks of gestation in 2005-2015 (n = 325), comparing high (87-93%) and low (85-90%) targets; infants transferred early were excluded from the main analysis to avoid bias.Results: Overall survival was 76% in high saturation era, and 69% in low saturation era (p = .17). Treatment-requiring ROP was less common in low saturation group (14% vs 28%, p < .05) with the most prominent difference in the most immature infants. Including deceased infants in the analysis, necrotizing enterocolitis was more frequent in low saturation era (21% vs 10%, p < .05).Conclusions: Implementing lower saturation targets resulted in a halved incidence of treatment-requiring ROP; the most immature infants seem to benefit the most. An association between lower oxygenation and necrotizing enterocolitis cannot be excluded.
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