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J Matern Fetal Neonatal Med 2021 May 12:1-3. Epub 2021 May 12.

Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland.

Introduction: Centralization of very preterm deliveries to level 3 hospitals is recommended to improve infant survival and prevent brain injury. We studied the clinical practices of centralization from level 2 to level 3 hospitals in cases of threatening very preterm delivery in Finland.

Materials And Methods: Obstetricians in all 16 level 2 hospitals in Finland were invited to participate in an online survey regarding antenatal transfer to level 3 hospitals among women with threatened delivery below 32 gestational weeks. Read More

Gynakologe 2021 May 7:1-11. Epub 2021 May 7.

Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten und Immenstadt, Klinikverbund Allgäu, Robert-Weixler-Str. 50, 87439 Kempten, Deutschland.

Background: The prevention of infections in the obstetric care of pregnant women is paramount, on the one hand with regard to pathogens of congenital infections and on the other hand due to the association of maternal infections with premature delivery.

Objectives: Which measures are recommended for effective prevention of bacterial and viral diseases relevant to obstetrics?

Materials And Methods: Literature search on hygiene measures in terms of preventing transmission of infection.

Results: The physiological vaginal flora of the pregnant woman is a fundamental factor in natural defence against infection. Read More

JAMA Netw Open 2021 May 3;4(5):e219382. Epub 2021 May 3.

Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

Importance: Extreme prematurity is associated with a substantial burden on health care systems worldwide. However, little is known about the prognosis of infants born extremely preterm in developing countries, such as China.

Objective: To describe survival and major morbidity among infants born extremely preterm in China over the past decade. Read More

Arch Womens Ment Health 2021 May 10. Epub 2021 May 10.

Center for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Canada.

Obsessive-compulsive disorder (OCD) is a mental disorder linked to functional impairments and adverse health outcomes. We sought to examine the association between pregnant women with OCD and obstetrical and neonatal outcomes in the USA. A retrospective population-based cohort study was conducted using data provided by pregnant women from the Nationwide Inpatient Sample, a nationally representative database of hospitalizations in the USA, from 1999 to 2015. Read More

BMC Endocr Disord 2021 May 6;21(1):95. Epub 2021 May 6.

Department of Endocrinology and Metabolism, Institute/University/Hospital: Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, No. 105 Jiefang Road, Jinan City, 250013, Shandong Province, China.

Background: Uric acid has strong antioxidant activity, whereas its oxidative damage is closely related to many diseases. We assessed the association between serum uric acid (SUA) levels and premature rupture of membranes (PROM) in pregnant women with gestational diabetes (GDM) in China.

Methods: In this cross-sectional study, a total of 456 pregnant women were enrolled. Read More

Paediatr Perinat Epidemiol 2021 May 6. Epub 2021 May 6.

Obstetrical, Perinatal, and Pediatric Epidemiology Team, Center of Research in Epidemiology and Statistics (U1153), Université de Paris, INSERM, Paris, France.

Background: Regionalisation programmes aim to ensure that very preterm infants are born in level III units (inborn) through antenatal referral or transfer. Despite widespread knowledge about better survival without disability for inborn babies, 10%-30% of women deliver outside these units (outborn).

Objective: To investigate risk factors associated with outborn deliveries and to estimate the proportion that were probably or possibly avoidable. Read More

J Obstet Gynaecol Res 2021 May 5. Epub 2021 May 5.

Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Aim: Whether the use of dinoprostone pessary increased the vaginal delivery rate of labor induction in Chinese nulliparous women with term premature rupture of membranes (PROM) and unfavorable cervices?

Methods: PROM women at term with singleton pregnancies and Bishop scores ≤4 who needed labor induction were enrolled in this retrospective study. They received either the dinoprostone pessary followed by oxytocin infusion if necessary (n = 102, PGE2 group) or oxytocin infusion alone (n = 103, oxytocin group).

Results: Compared with oxytocin infusion alone, vaginal delivery within 12 h and total vaginal delivery were higher in the PGE2 group (28. Read More

Am J Perinatol 2021 May 2. Epub 2021 May 2.

Department of Pediatrics, Stanford University, Stanford, California.

Objective:  The study aimed to describe preterm birth (PTB) rates, subtypes, and risk factors in twins compared with singletons to better understand reasons for the decline in PTB rate between 2007 and 2011.

Study Design:  This was a retrospective population-based analysis using the California linked birth certificates and maternal-infant hospital discharge records from 2007 to 2011. The main outcomes were overall, spontaneous (following spontaneous labor or preterm premature rupture of membranes), and medically indicated PTB at various gestational age categories: <37, <32, and 34 to 36 weeks in twins and singletons. Read More

J Matern Fetal Neonatal Med 2020 Dec 1:1-8. Epub 2020 Dec 1.

Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel.

Objective: Among deliveries <34 weeks, there is inconclusive evidence regarding the preferred route of delivery when there is a need to expedite delivery during the second stage of labor. As it is unreasonable that future randomized controlled trials will be conducted to settle this query, every clinical data concerning this topic, may be helpful. We aim to compare neonatal outcomes among women undergoing emergent cesarean delivery (ECD) versus vacuum-assisted delivery (VAD) during the second stage of labor among singleton gestations <34 weeks. Read More

J Matern Fetal Neonatal Med 2021 Apr 29:1-8. Epub 2021 Apr 29.

Gynecologic Practice, Wiesbaden, Neu-Isenburg, Germany.

Objective: To compare pregnancy outcomes of patients undergoing either McDonald or Shirodkar cervical cerclage.

Methods: PubMed, Web of Science, Scopus, and Google scholar were systematically searched up to June 2020. Inter-study heterogeneity was assessed using Cochrane's test and the statistic. Read More

Int J Mol Sci 2021 Apr 14;22(8). Epub 2021 Apr 14.

Institute for the Care of the Mother and Child, Third Faculty of Medicine, Charles University, 14700 Prague, Czech Republic.

This prospective cross-sectional case-control study investigated the postpartal gene expression of microRNAs associated with diabetes/cardiovascular/cerebrovascular diseases in the peripheral white blood cells of women with anamnesis of preterm prelabor rupture of membranes ( = 58), spontaneous preterm birth ( = 55), and term delivery ( = 89) by a quantitative reverse transcription polymerase chain reaction. After pregnancies complicated by preterm prelabor rupture of membranes or spontaneous preterm birth, mothers showed diverse expression profiles for 25 out of 29 tested microRNAs (miR-1-3p, miR-16-5p, miR-17-5p, miR-20a-5p, miR-20b-5p, miR-21-5p, miR-23a-3p, miR-24-3p, miR-26a-5p, miR-29a-3p, miR-100-5p, miR-103a-3p, miR-125b-5p, miR-126-3p, miR-130b-3p, miR-133a-3p, miR-143-3p, miR-145-5p, miR-146a-5p, miR-181a-5p, miR-195-5p, miR-199a-5p, miR-221-3p, miR-499a-5p, and miR-574-3p). The earliest gestational ages at delivery and the lowest birth weights of newborns were associated with the highest postpartal levels of the previously mentioned microRNAs in maternal peripheral white blood cells. Read More

J Gynecol Obstet Hum Reprod 2021 Apr 26:102155. Epub 2021 Apr 26.

Sorbonne University, AP-HP, Trousseau Hospital, DMU ORIGYNE, Department of Fetal Medicine, 26 Avenue du Dr Arnold Netter, 75012 Paris, France.; National Reference Center for Rare Disease: Vertebral and Spinal Cord Anomalies (MAVEM Center), AP-HP, Trousseau Hospital, 26 Avenue du Dr Arnold Netter, 75012 Paris, France.

Introduction: - Open fetal myelomeningocele (MMC) surgery is currently the standard of care option for prenatal MMC repair. We described the population referred to our center and reviewed outcome after open fetal MMC repair.

Material And Methods: - All patients referred to our center for MMC were reviewed from July 2014 to June 2020. Read More

Ginekol Pol 2021 Apr 29. Epub 2021 Apr 29.

Department of Obstetrics and Gynecology, Women's Hospital Zhejiang University School of Medicine, China.

Objectives: Cervical conization could increase the risk of cervical insufficiency. This study systematically evaluated the value of prophylactic transvaginal cervical cerclage following cervical conization with regards to pregnancy outcome.

Material And Methods: We performed a systematic review of the literature, using Web of Science, and Embase, the published time ranged from the date that database established to December 2019. Read More

J Matern Fetal Neonatal Med 2021 Apr 28:1-6. Epub 2021 Apr 28.

Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Objective: To evaluate the impact of prolonged exposure to meconium-stained amniotic fluid (MSAF), in women with term pre-labor spontaneous rupture of membranes (PROM), on pregnancy outcome.

Methods: A retrospective cohort study of women who gave birth in a single university-affiliated tertiary medical center (2011-2019). Eligibility was limited to singleton pregnancies at term who presented with PROM. Read More

BMC Health Serv Res 2021 Apr 26;21(1):390. Epub 2021 Apr 26.

Royal Flying Doctor Service of Australia, Canberra, ACT, Australia.

Background: Inequalities in the availability of maternity health services in rural Australia have been documented, but not the impact on aeromedical retrievals. This study aims to examine the prevalence of pregnancy-related aeromedical retrievals, the most common conditions (overall and in specific age groups), and their distribution according to operation area and demographic characteristics.

Methods: Cross-sectional study using administrative data from the Royal Flying Doctors Service (RFDS) including all pregnant women aged 15-49 years retrieved by the RFDS between 2015 and 2019. Read More

Zhonghua Fu Chan Ke Za Zhi 2021 Apr;56(4):244-250

Fetal Medicine Unit and Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, Tongji University, Shanghai 201204, China.

To investigate the feasibility and safety of fetal intravascular transfusion via the intrahepatic vein in the treatment of fetal anemia. This was a retrospective analysis of all fetuses requiring intrauterine transfusion (IUT) in the Shanghai First Maternity and Infant Hospital between January 2010 and December 2019. According to the different ways of IUT, they were divided into intrahepatic venous transfusion group and umbilical venous transfusion group, fetal outcomes and the incidence of procedure-related complications between the two groups were compared. Read More

Gynecol Obstet Invest 2021 Apr 26:1-8. Epub 2021 Apr 26.

Department of Obstetrics and Gynecology, Bozok University Faculty of Medicine, Yozgat, Turkey.

Objectives: The duration of the latent period is uncertain in preterm premature rupture of membranes (PPROM). This time estimate provides information on the time of the corticosteroid to be applied and the time of delivery of the pregnant women. Here, we used transvaginal sonography to determine the relationship between the uterocervical angle (UCA) and PPROM latency and the risk for neonatal complications. Read More

Twin Res Hum Genet 2021 Feb;24(1):42-48

Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.

We evaluated the outcomes and adverse events after fetoscopic laser surgery (FLS) for twin-twin transfusion syndrome (TTTS) using the Solomon technique in comparison to the selective technique. A retrospective analysis of a single-center consecutive cohort of FLS-treated TTTS using the selective (January 2010 to July 2014) and Solomon (August 2014 to December 2017) techniques was performed. Among 395 cases, 227 underwent selective coagulation and 168 underwent the Solomon technique. Read More

Neonatology 2021 Apr 23:1-8. Epub 2021 Apr 23.

Department of Pediatrics, Queen's University and Kingston Health Sciences Centre, Kingston, Ontario, Canada.

Introduction: Late preterm infants (LPIs) are infants born between 340/7 and 366/7 weeks gestation. Morbidities in these infants are commonly considered a result of prematurity; however, some research has suggested immaturity may not be the sole cause of morbidities. We hypothesize that antecedents leading to late preterm birth are associated with different patterns of morbidities and that morbidities are the result of gestational age superimposed by the underlying etiologies of preterm delivery. Read More

Z Geburtshilfe Neonatol 2021 Apr 22. Epub 2021 Apr 22.

Department of Obstetrics and Gynaecology, Universitätsklinikum Schleswig-Holstein - Campus Lübeck, Lübeck, Germany.

Objective: Antenatal steroids improve the neonatal outcome if they are administered within a therapeutic window of seven days before preterm birth. The aim of this study was to evaluate the timing of antenatal steroids for imminent preterm birth at a single center in Germany.

Material And Methods: A 10-year retrospective analysis of 843 preterm births between 24/0 and 33/6 weeks was performed from January 2008 to December 2017 at a German university hospital. Read More

Womens Health Issues 2021 Apr 19. Epub 2021 Apr 19.

The Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, 02453.

Background: Although the literature suggests that women with disabilities are at increased risk for pregnancy complications and adverse birth outcomes, there are few population-based studies of the pregnancy outcomes among deaf and hard of hearing (DHH) women in the United States.

Objective: To compare pregnancy complications and neonatal outcomes between deliveries to DHH and non-DHH women using national hospitalization discharge record data.

Study Design: We used the 2007-2016 Healthcare Cost and Utilization Project National Inpatient Sample to compare pregnancy complications and outcomes among deliveries to DHH women with deliveries to non-DHH women using bivariate and Poisson regressions, controlling for sociodemographic, hospital, and clinical characteristics. Read More

JAMA Netw Open 2021 Apr 1;4(4):e217491. Epub 2021 Apr 1.

Department of Health Policy and Management, University of California, Los Angeles Fielding School of Public Health.

Importance: Women and families constitute the fastest-growing segments of the homeless population. However, there is limited evidence on whether women experiencing homelessness have poorer childbirth delivery outcomes and higher costs of care compared with women not experiencing homelessness.

Objective: To compare childbirth delivery outcomes and costs of care between pregnant women experiencing homelessness vs those not experiencing homelessness. Read More

Am J Perinatol 2021 Apr 20. Epub 2021 Apr 20.

Department of Obstetrics and Gynecology, New York Presbyterian Hospital-Columbia University Irving Medical Center, New York, New York.

Objective:  Several studies have evaluated the differences in duration of latency and clinical outcomes between singleton and twin pregnancies after preterm premature rupture of membranes (PPROM); however, these data are limited to single-institution analyses and based on small sample sizes. The aim of this study was to assess differences in latency and clinical outcomes in singletons versus twin gestations affected by PPROM in a large, diverse cohort of women.

Study Design:  This is a secondary analysis of a multicenter trial of magnesium for neuroprotection in women at high risk of preterm birth. Read More

Zhonghua Fu Chan Ke Za Zhi 2021 Mar;56(3):161-170

Department of Obstetrics, Nanjing Maternal and Child Health Hospital, Nanjing 210000, China.

To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy. A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. Read More

Front Pediatr 2021 31;9:631765. Epub 2021 Mar 31.

Neonatal Perinatal Section, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.

Inhaled nitric oxide (iNO) use in premature newborns remains controversial among clinicians. In 2014, the American Academy of Pediatrics, Committee on Fetus and Newborn released a statement that the available data do not support routine iNO use in pre-term newborns. Despite the absence of significant benefits, 2016 California data showed that clinicians continue to utilize iNO in pre-term infants. Read More

Ann Med Surg (Lond) 2021 Apr 26;64:102235. Epub 2021 Mar 26.

Department of Child Health, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Objective: Determining neonatal and maternal factors that are associated with the incidence of OFP.

Methods: This study employed a cross-sectional design, in which the participants were identified for clinical variables (sex, gestational age, birth weight, etc.), neonatal morbidity (sepsis, necrotizing enterocolitis (NEC), etc. Read More

J Coll Physicians Surg Pak 2021 Apr;30(4):383-387

Department of Chemical Pathology, Ziauddin Medical University and Hospital, Karachi, Pakistan.

Objective: To ascertain the diagnostic accuracy of serum PCT as an early biomarker of neonatal sepsis using blood culture as gold standard, so that the condition could be diagnosed and managed early to prevent and reduce morbidity and mortality in neonates.  Study Design: Cross-sectional study.

Place And Duration Of Study: Dr. Read More

Int J Womens Health 2021 9;13:369-377. Epub 2021 Apr 9.

Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, 682041, Kerala, India.

Background: Preterm delivery is a major obstetric complication and a leading cause of neonatal mortality and morbidity. It is also associated with significant costs in terms of psychological and financial hardship, to the families.

Objective: The primary objective of this study was to determine the risk factors associated with all preterm deliveries in singleton pregnancy in a tertiary care hospital and the secondary objective was to determine the fetal outcomes among women with preterm delivery. Read More

Eur J Obstet Gynecol Reprod Biol 2021 Apr 1;261:1-6. Epub 2021 Apr 1.

Obstetrics and Gynecology, University of Milano-Bicocca, FMBBM Monza, Carate Hospital, Lecco Hospital, Italy.

Objective: Expectant management in patients with prelabor preterm rupture of membranes between between 34 and 36 weeks (late preterm pPROM or LpPROM) has been shown to decrease the burden of prematurity, when compared to immediate delivery. As the severity of prematurity depends on gestational age (GA) at PROM, and PROM to delivery interval, we first investigated how such variables affect neonatal outcomes (NO). Second, we assessed the risk of neonatal sepsis. Read More

Lupus 2021 Jun 15;30(7):1163-1174. Epub 2021 Apr 15.

Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, China.

Objectives: This meta-analysis aimed to evaluate the effectiveness of HCQ in improving the maternal and fetal outcomes in pregnancies with SLE.

Methods: A literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane database for relevant English language articles, and Wanfang, CNKI and VIP for Chinese articles, from the databases' inception to April 30, 2020. These studies compared the maternal and/or fetal outcomes between pregnant patients with SLE who were administered HCQ during pregnancy (HCQ+ group) and those who were not administered HCQ (HCQ- group). Read More