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At least 19 recordsLinked to original sources
PubMed2005

Role of progestogens for the prevention of premature birth.

Premature birth represents a major cause of perinatal morbidity and mortality. The short- and long-term sequelae of prematurity have serious consequences for newborn survival and health in later life. In addition, prematurity is a major problem with regard to health expenditure. Despite major progress in obstetrics, perinatology and neonatology, the percentage of premature birth persists and there is even a tendency towards a slight increase. Therefore, besides screening programmes for the detection of vaginal infections, additional therapeutic opportunities must be sought. According to previously published data, vaginal progesterone and intramuscular 17alpha-hydroxyprogesterone caproate should be considered possible treatment options for the prevention of preterm delivery.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1990

Anesthetic considerations in premature birth.

Premature birth still accounts for about 75% of perinatal mortality. Although great strides have been made in the care of premature babies over the past two decades, markedly decreasing mortality, the prevention of premature birth has not been greatly improved. Although tocolysis, particularly with the beta-2 agonists and magnesium sulfate, may delay birth and allow fetal maturation, it poses several risks which, if not recognized, can cause serious morbidity and even mortality. The use of these drugs and other less widely used tocolytics has important implications for the anesthesiologist. The premature infant itself is subjected to such risks as RDS, IVH, NEC, asphyxia, hypothermia, increased incidence of breech presentation, metabolic disturbances, and predisposition for trauma. To ensure safe delivery, premature babies should be delivered in a tertiary care center equipped and ready to attend to their needs. Major conduction block, particularly continuous lumbar epidural analgesia, is an ideal form of analgesia for the delivery of most premature neonates. Properly administered, it maintains maternal physiology, is not associated with drug depression in the newborn, enables a controlled, atraumatic vaginal delivery, and has little interaction with tocolytics (and indeed may protect against some of their side effects). It is ideal for a trial of labor and, if initiated early, allows for an emergency cesarean section. Continuous lumbar epidural block and subarachnoid block are both superb for elective or urgent cesarean section. However, when their use is contraindicated, inhalation analgesia for vaginal delivery or general anesthesia for cesarean section can be safely administered from the standpoint of both mother and child. Expertly administered anesthesia is not a luxury but is indeed indispensable for successful premature delivery.

Adrenergic beta-Agonists↗
PubMedDate not supplied

[Degree of placental maturity and histopathologic finding: clinical prospective studies of a sample of term births and premature births].

By analogy with Grannum et al.'s sonographic classification of the placenta (1979), macroscopic observation of the cut surfaces of the afterbirth enables the extent of placental segmentation to be determined and macroscopic maturity to be established in accordance with sonographic findings. Out of a total of 767 clinically-prospectively documented obstetrical cases, 674 were identified as term births and 93 as premature. For the purposes of comparison they were subdivided into two groups: term births with stage 0 to II and stage III maturity; and premature births with stage 0 to II and stage III maturity. Proceeding from this morphological classification and grouping, the clinical data, such as age of the mother, parity, gravidity, diseases during pregnancy, premature labour, type of delivery, fetal outcome, and biometric data of the newborn, as well as histologic findings regarding villous maturity, were recorded and statistically analyzed. The findings revealed no significant differences between term births with stage III maturity and those in the control group of placentas with stage 0 to II maturity and the same gestation time. Therefore, stage III maturity at term corresponds chronopathologically to a normal temporal development of fetomaternal flow units of the mature human placenta at term and does not imply any perinatological risk. Histopathologically, placentas with stage III maturity manifest a significantly advanced degree of villous maturity, with lower mean placental weight as the morphological correlate to threshold placental function, which is reflected in the clinical data of perinatological complications. Therefore, premature detection of a stage III placenta before term indicates a risk that should be kept in mind in the overall concept of prenatal monitoring parameters.

Chorionic Villi↗
PubMed1983

[Premature birth. Retrospective study of 2000 premature births at the Gynecological Clinic of the University of Mannheim. 2: Postpartum period, morbidity and mortality of premature infants].

During a period from 1966 to 1977 a retrospective study on 1982 premature births was conducted. 9,4% of the premature births were dead born; from the births, who died in the postnatal period, 94% died within the first 7 days, perinatal mortality was 27%. Most common cause of death was immaturity (25%), followed by respiratory distress syndrome (16%), in 31% cause of death was unknown. The most common complications of the immature births were icterus neonatorum (25,3%), aspiration (21,3%) and asphyxia (8,9%).

Female↗
PubMed1994

Postnatal care following premature birth.

There is a growing awareness that women who give birth prematurely have a particular need for specialist after-care and support. Jane Littlewood and Lesley Taylor report the findings of a study to examine the differing experiences of postnatal care reported by women following full-term and premature birth.

Female↗
PubMed1992

A review of premature birth and subclinical infection.

Premature birth causes high rates of neonatal morbidity and mortality. There are multiple causes of preterm birth. This article reviews the evidence linking subclinical infection and premature birth. Although maternal genital tract colonization with specific organisms has been inconsistently associated with preterm birth and/or premature rupture of membranes, some infections have been consistently associated with preterm delivery. The association of histologic chorioamnionitis with prematurity is a consistent finding, but the mechanisms require further study. The relationship between histologic chorioamnionitis infection and the chorioamnionitis of prematurity requires additional research. A varying number of patients in "idiopathic" preterm labor have positive amniotic fluid cultures (0% to 30%), but it is not clear whether infection preceded labor or occurred as a result of labor. Evidence of subclinical infection as a cause of preterm labor is raised by finding elevated maternal serum C-reactive protein and abnormal amniotic fluid organic acid levels in some patients in preterm labor. Biochemical mechanisms for preterm labor in the setting of infection are suggested by both in vitro and in vivo studies of prostaglandins and their metabolites, endotoxin and cytokines. Some, but by no means all, antibiotic trials conducted to date have reported decreases in prematurity. These results support the hypothesis that premature birth results in part from infection caused by genital tract bacteria. In the next few years, research efforts must be prioritized to determine the role of infection and the appropriate prevention of this cause of prematurity.

Anti-Bacterial Agents↗
PubMed2002

Association between the Asp299Gly polymorphisms in the Toll-like receptor 4 and premature births in the Finnish population.

Premature birth causes significant health risks of the neonate and increases the cost for neonatal care. Urogenital infection, often caused by Gram-negative bacteria, is a known risk factor. Toll-like receptor-4 (TLR4) is the major endotoxin-signaling receptor and as such is crucial for the initiation of the innate immune response against Gram-negative bacteria. Recently, a variant in the human TLR4 gene was shown to be associated with impaired receptor function and an increased likelihood of Gram-negative sepsis. In the present study, we determined whether the same polymorphism in TLR4 gene is associated with an increased risk for premature birth. We analyzed genotypes for a Finnish study population consisting of a total of 351 term infants and 440 premature infants (gestational age <35 wk; 282 singletons, 158 multiples) and 94 mothers for the presence of the TLR4 polymorphisms Asp299Gly and Thr399Ile. These polymorphisms were in linkage disequilibrium. The 299Gly allele frequencies were 10.6% (93 of 880) in premature infants and 8.3% (58 of 72) in term infants. Excluding multiple pregnancies that often result in premature births, 23.8% (67 of 282) of premature infants and 24.2% (15 of 62) of the mothers of premature infants compared with 15.9% (55 of 345) of term infants and 15.0% (3 of 20) of the mothers delivering at term were carriers of the TLR4 variant. The frequencies of 299Gly allele and Asp/Gly or Gly/Gly genotype carrier status in premature singleton infants were higher than in term singleton infants (p = 0.024, p = 0.028, respectively) or in premature multiples (p = 0.036, p = 0.044, respectively). According to the present results an allelic variation in the TLR4 receptor was associated with increased risk of premature birth.

Aspartic Acid↗
PubMedDate not supplied

[Formation of cerebral cortex relief in newborns with extremely low birth weight in the physiologic pregnancy and premature birth].

The course of cortical gyrification of the brain hemispheres in foetuses and newborns with an extremely low body weight in physiological pregnancy and premature birth. Topographical formation of the hemisphere cortex is completed by the 28th week of the intrauterine life. There exists a direct correlation between the period of the pregnancy and a certain spectrum of gyri. Two-three weeks retardation in the gyri and cortex relief formation in premature birth is observed. The results obtained can be used as additional criterion for determination of the gestational periods in foetuses and diagnosis of the disturbances in the brain formation in foetuses and newborns.

Cerebral Cortex↗
PubMedDate not supplied

A systems model of premature birth. Implications for neonatal intensive care.

The literature regarding the birth of a premature infant strongly suggests that it is a crisis-producing event for the parents of such infants. It also suggests that premature infants are poorly parented more frequently than infants born after a normal gestation. The crisis of premature birth and its effect on parent-infant interaction using a systems model of crisis theory is described. Specific intervention strategies that can be used within the neonatal intensive care unit to ameliorate the potentially detrimental effects of the crisis of premature birth on parent-infant interaction are outlined.

Adult↗
PubMed1989

Development and use of a self-administered questionnaire for assessment of psychologic attitudes toward pregnancy and their relation to a subsequent premature birth.

This paper describes both the development of and results of the use of a self-administered questionnaire designed specifically to investigate the relation between the psychologic attitudes of pregnant women toward pregnancy and an eventual subsequent premature birth. The questionnaire (entitled Pregnancy Psychologic Attitudes Test--in relation to Premature Birth [PPAT(p)]) was derived from the synthesis of interviews with women who had given birth prematurely, comprised 40 questions grouped in six dimensions, and was used in a prospective survey. All women who had an antenatal visit in their fifth to sixth month of pregnancy in one of four maternity hospitals in Lyon, France, between October 1983 and March 1985 were asked to complete this questionnaire. A quantitative PPAT(p) score (ranging from 0 to 6) was constructed in a working sample (n = 643), and its relation with a subsequent premature birth was analyzed in a study sample (n = 1,500). Application of the logistic regression model showed, after controlling for personal and medical factors, that this relation was statistically significant. The risk of premature birth increased from 1 to 1.5 when the PPAT(p) score increased one point (p less than 0.001). This study contributes to a better understanding of psychologic factors that may affect pregnant women and be associated with premature birth. This new component must be considered in the development of policies for preventing premature birth.

Adult↗
PubMed2003

Differing risk factors for premature birth in adolescent mothers and adult mothers.

BACKGROUND: Although the survival rate of premature infants has improved, the prevalence of premature birth has not changed or has even increased. The purpose of this study is to analyze the demographic, psychosocial support, family planning, and health behavior risk factors for premature birth. METHODS: This county-based, cross-sectional study collected information on 1,146 first-time mothers, including 556 adolescents (< 20 years old) and 590 adults (20-34 years old). Univariate and multivariate logistic regression analyses were used to study risk factors associated with premature birth. RESULTS: The prevalence of premature birth was 11.4% for adolescent mothers and 8.4% for adult mothers. Younger adolescent mothers (< 18 years old) (14.5%), fewer than 10 prenatal visits (12.5% vs. 6.7%), hypertension (33.3% vs. 8.9%), weight gain less than 10 kg (14.6% vs. 8.8%), drinking alcohol (23.1% vs. 9.5%), unintended pregnancy (13.6% vs. 7.4%), no parental support (16.8% vs. 9.1%), and victim of domestic violence (16.0% vs. 9.3%) were associated with a higher risk of premature birth (p < 0.05). In multivariate logistic regression analysis stratified by mother's age, prenatal visits less than 10 times (OR 2.68; 95% CI [1.38, 5.21]) and drinking alcohol (OR 25.0; 95% CI [1.35-460.49]) were significantly associated with premature birth for adult mothers but unintended pregnancy (OR 2.34; 95% CI [1.28, 4.27]) was the only significant factor for adolescent mothers. CONCLUSIONS: Differing risk factors for premature birth were found between adolescent and adult mothers. Effective family planning before gestation, alcohol abstinence, and regular prenatal visits for screening psychosocial, medical, and obstetric conditions during pregnancy are mandatory for the prevention of premature birth.

Adolescent↗
PubMed2000

Birth dimensions of offspring, premature birth, and the mortality of mothers.

A person's birthweight is inversely related to their cardiovascular disease (CVD) mortality risk, and preliminary data suggest that the birthweights of offspring are also inversely related to parental CVD mortality risk. In a cohort of pregnant Finnish women, we assessed the relation between birth dimensions of the offspring and maternal characteristics, and subsequent mortality. Maternal CVD mortality was inversely related to the birthweight of offspring and women having premature deliveries were also at increased CVD risk. Breast-cancer mortality was positively associated with ponderal index of offspring.

Birth Weight↗