PubMed Health⌕ Search

Biomedical subjects

B H Frentzen

Publications and source records attributed to B H Frentzen.

8 recordsLinked to original sources
PubMed1996

Risk factors for neonatal sepsis.

OBJECTIVE: To determine the associations between maternal characteristics, intrapartum events, and neonatal sepsis by multivariate analysis. METHODS: We enrolled 823 women from a high-risk population and analyzed maternal and neonatal demographic and outcome variables with univariate analysis and multivariate logistic modeling. RESULTS: Two-hundred sixteen women (26%) were colonized with group B streptococci, 82 (10%) developed chorioamnionitis, and 141 (17%) delivered prematurely. Culture-proven neonatal sepsis or meningitis was found in 15 of 833 (1.8%) neonates, and 101 of the remaining 818 (12.3%) infants were suspected to have sepsis or pneumonia. Multivariate analysis of risk factors for proven neonatal sepsis demonstrated a statistically significant association with decreasing gestational age, duration of internal monitoring for more than 12 hours (odds ratio [OR] 7.2, 95% confidence interval [CI] 1.6-32.2), maternal group B streptococcal infection (OR 4.2, 95% CI 1.4-13.1), chorioamnionitis (OR 4.4, 95% CI 1.2-16.1), and endometritis (OR 6.4, 95% CI 1.2-34.2). CONCLUSION: Through the use of multivariate modeling, we determined that chorioamnionitis or endometritis, preterm delivery, group B streptococcal colonization, and a prolonged duration of internal monitoring are independent risk factors for neonatal sepsis. We postulate that the presence of a foreign body that traverses the birth canal may facilitate ascending peripartal infection.

Confidence Intervals↗
PubMed1994

Peripartum infection associated with vaginal group B streptococcal colonization.

OBJECTIVE: To determine the frequency of peripartum infection in parturients colonized with group B streptococci. METHODS: We screened 915 obstetric patients for group B streptococcal colonization using selective broth media; 823 had vaginal cultures performed within 2 weeks preceding delivery and received complete follow-up. Vaginal group B streptococcal colonization and other risk factors for peripartum maternal infection were assessed using univariate and multivariate logistic modeling. RESULTS: Two hundred sixteen women (26%, 95% confidence interval [CI] 23-29) were colonized with group B streptococci. Chorioamnionitis or endometritis occurred in 45 of 216 colonized women (21%, 95% CI 15.6-26.4) and 72 of 607 women who were not colonized (12%, 95% CI 9-15; P < .01). When confounding variables were controlled in a multivariate analysis, the association between group B streptococcal colonization and chorioamnionitis, but not endometritis, was confirmed (odds ratio 3.6, 95% CI 2.1-6.2). The risk of chorioamnionitis increased in a stepwise fashion with light (odds ratio 1.9, 95% CI 1.0-3.7), moderate (odds ratio 2.6, 95% CI 1.3-5.2), and heavy (odds ratio 3.2, 95% CI 1.5-6.6) colonization. CONCLUSION: Intrapartum vaginal colonization with group B streptococci is an important independent risk factor for chorioamnionitis.

Chorioamnionitis↗
PubMed1991

Ultrasonographic diagnosis of congenital anomalies in twins.

To determine whether serial ultrasonographic examinations with basic anatomic surveys provide an adequate screen for congenital abnormalities that are more common in twins, we compared the results of prenatal sonograms and neonatal examinations for 314 twins (157 pairs) delivered during a recent 42-month period. An anomaly was defined as major if it potentially required surgical repair or precluded normal life expectancy; otherwise it was defined as minor. Thirty-three twins (9.5%) had 40 anomalies; 28 (9%) were major and 12 (4%) were minor. Prenatal ultrasonography with cardiac screening limited to the four-chamber view provided detection of 39% of all major anomalies, 55% of noncardiac major anomalies but none of the cardiac lesions, and 69% of the major anomalies for which routine prenatal management should be altered. No false-positive diagnoses incorrectly altered management. We conclude that serial prenatal ultrasonographic examinations are useful in detecting noncardiac anomalies for which twins are at increased risk, but the four-chamber view is not an adequate screen for the cardiac malformations of twins.

Congenital Abnormalities↗
PubMed1988

Maternal weight gain: effect on infant birth weight among overweight and average-weight low-income women.

A study was performed to compare the influence of pregnancy weight gain on infant birth weight and outcome among two groups of indigent women from the rural South: those who were highly overweight before pregnancy (greater than or equal to 135%) and those who were of average weight (90% to 120% of standard weight for height). The groups had comparable numbers of black and white subjects. Pregnancy weight gain affected birth weight in the average-weight group but did not significantly affect birth weight in the highly overweight group. Infant outcomes for both groups were similar. These findings suggest that consideration should be given to not requiring a minimum weight gain for women whose degree of overweight equals or exceeds 135% of standard body weight for height.

Birth Weight↗
PubMed1988

Continuous-wave Doppler ultrasound and decreased amniotic fluid volume in pregnant women with intact or ruptured membranes.

The cause(s) of decreased amniotic fluid in the absence of fetal anomalies and intrauterine growth retardation is not clear. A prospective study was performed to evaluate umbilical and uterine artery Doppler velocimetric results in pregnancies complicated by decreased amniotic fluid. Three medically high-risk groups were studied: women with (1) normal fluid and intact membranes, (2) decreased fluid and intact membranes, and (3) decreased fluid and ruptured membranes. The decreased fluid/intact membranes group had a significantly increased incidence of abnormal uterine artery waveforms (diastolic notching or absence of end-diastolic velocity); however, uterine systolic/diastolic ratios were not significantly different. The umbilical systolic/diastolic ratios were marginally higher in the intact membranes/decreased fluid group when compared with the ruptured membranes group. This study suggests that problems with maternal blood supply to the placenta may be related to decreased amniotic fluid when membranes are intact.

Adult↗
PubMed1987

Hepatitis B: a case for prenatal screening of all patients.

Evaluation of a mass screening program to detect hepatitis B surface antigen in the obstetric population of Shands Hospital, University of Florida in Gainesville, from January 1, 1983, through December 31, 1985, was undertaken. Prevalence of hepatitis B surface antigen seropositivity was 0.54%. Review of medical records revealed that 67% of patients with positive hepatitis B surface antigen screens had no risk factors identifiable by routine prenatal history. Although all patients were screened on admission to the hospital, the results of the immunoassay were not available in time for staff to institute isolation procedures for the laboring mother or unwashed neonate. In 82% of the cases, treatment of neonates occurred later than 12 hours after delivery (the current Centers for Disease Control recommendation). It is recommended that prenatal screening of all patients with a hepatitis B surface antigen immunoassay be done by 34 weeks' gestation where the patient population is of predominantly low socioeconomic status to ensure appropriate isolation and timely neonatal immunoprophylaxis.

Enzyme-Linked Immunosorbent Assay↗
PubMed1987

Nutrition and hydration: relationship to preterm myometrial contractility.

Although the mechanisms responsible for the onset of preterm labor in human pregnancy are unclear, animal studies have demonstrated that decreased nutrient intake is associated with increased uterine prostaglandin F metabolite production and spontaneous uterine contractions. The purpose of this study was to assess the association of maternal nutrition and dehydration with preterm uterine contractility. Pregravid weight-for-height, pregnancy weight gain at 30 weeks' gestation, urine specific gravity, ketonuria, and dependent and generalized edema were measured in 30 women who had preterm uterine contractions and in 30 women matched for race, gestational age, socioeconomic status, and smoking who reported no symptoms of preterm contractility. Data were analyzed with the paired-difference t test, Fisher's exact test, and the Cochran-Mantel-Haenszel test. No statistical association was found for dehydration (high urine specific gravity) and preterm contractility. However, pregravid weight below standard body weight-for-height was statistically associated with preterm contractions (P less than .001), as was low weight gain at 30 weeks' gestation (P = .04). There was an association between preterm contractions and both ketonuria (P less than .0001) and the absence of edema (P = .02). Inexpensive clinical measurements of nutritional status may help to identify women at risk for preterm uterine contractility.

Adolescent↗