جستجوی مقالات مرتبط با کلیدواژه « Preterm Birth » در نشریات گروه « پزشکی »

The association between endometriosis and the outcome of pregnancy is one of the interesting topics. Endometriosis-related pain is alleviated with pregnancy; however, it is known to cause adverse outcomes in pregnancy. The main cause is systemic chronic inflammation caused by higher levels of cytokines, growth factors, and angiogenesis factors.

This study aimed to clarify the relationship between endometriosis, deep endometriosis, adenomyosis, surgical treatment, and poor maternal consequences.

In this case-control study, data from 250 women who gave birth in Hazrat Rasoul Akram hospital, Tehran, Iran from February 2015 to December 2019 was extracted from the hospital information system in January 2020. Participants were divided into 2 groups: 125 women with endometriosis and 125 women without endometriosis. We looked at how endometriosis affected mothers and newborn babies. Data on pregnancy, delivery, and newborns of both groups was extracted.

The mean age of participants was 32.74 ± 4.10 and 31.7 ± 5.53 yr in endometriosis and control group, respectively. In terms of pregnancy complications, placenta previa, placenta accreta, placenta abruption, pre-eclampsia, gestational diabetes mellitus, and postpartum hemorrhage remarkably increased in the endometriosis group compared to the control group. Small for gestational age was significantly higher in rectal endometriosis than women without rectal endometriosis (p = 0.03). The neonatal intensive care unit admission rate was notably higher in infants of the endometriosis group compared to controls (40.7% vs. 24.8%, p = 0.009).

Our findings showed women with endometriosis are at a higher risk for important adverse maternal outcomes.

Several observational studies have suggested that maternal exposure during pregnancy to arsenic is associated with the risk of preterm birth (PTB); however, available evidence is inconsistent. Therefore, we aimed to explore the relation of maternal exposure to arsenic to PTB risk.

A comprehensive systematic search was carried out from inception to April 2023 in PubMed and Scopus to retrieve all relevant studies. A pooled odds ratio (OR) with corresponding 95% confidence interval (CI) was employed using a random effects model to test the association.

As a result, 14 eligible studies, with 12,619 participants, were included in the meta-analysis. Overall, the pooled OR of all analyzed studies indicated that higher maternal arsenic exposure is significantly related to the 1.12-fold increased odds of PTB (OR = 1.12, 95% CI = 1.04-1.21), with a remarkable heterogeneity across studies (P = <0.001, I2 = 70.9%). This association was found in prospective cohort studies (OR = 1.15, 95% CI = 1.05-1.26), but not in non-cohort studies. In the stratified analysis, the majority of subgroups supported the association of arsenic with PTB.

Maternal exposure to arsenic during pregnancy is directly linked to the odds of PTB. Future studies are suggested to investigate the effectiveness of specific measures to decrease exposure to arsenic in high-risk communities, particularly in pregnant women.

This study aimed to assess the diagnostic value of novel ultrasonographic markers, Anterior Uterocervical Angle (AUA), Cervical Consistency Index (CCI) and Cervical Glandular Area (CGA) in the Prediction of Preterm Birth (PTB), in a general population.
We conducted a prospective cohort study on singleton gestations between 16 -24 weeks undergoing transvaginal sonography for Cervical Length (CL) screening. AUA, CCI and CGA were evaluated. The primary outcome was prediction of spontaneous PTB before 37 weeks’ gestation by UCA, CCI and CGA. The secondary outcome was evaluating performance of these markers alone and in combination with CL to predict PTB.
A total of 310 women were studied. The rate of PTB in this population was 10.6 % for delivery before 37 weeks. In the PTB group, the shorter CL, the wider AUA and the lower CCI were significant, but the CGA width and area were not significantly different in term and PTB groups. The optimal cut-off based on the ROC curve was 33.15 mm for CL (sensitivity: 57%; specificity: 68%), 102.5 degrees for AUA (sensitivity: 50%; specificity: 80%), and 60.3% for CCI (sensitivity: 43%; specificity: 68%).
Our data indicate that the combination of CL and CCI (positive likelihood ratio:3; negative likelihood ratio:0.7) and the combination of CL and AUA (positive likelihood ratio:4.8; negative likelihood ratio:0.76) are better methods for the prediction of spontaneous PTB before 37 weeks; and can be used as a screening tool in the second trimester.

Changes of physical activity before and during three trimesters of pregnancy known as pattern of physical activity and anxiety during pregnancy can be two concerns of pregnant women about preterm birth which require clarification. So, this retrospective study aimed to assess the effect of pattern of physical activity, and anxiety on preterm birth in Iranian pregnant women.

This study was a kind of descriptive correlation which was performed retrospectively. Participants of this study (2019-2020) included 118 pregnant women with preterm (n=62) and term (n=56) birth who participated in the study voluntarily and were selected according to the study inclusion criteria. The energy cost of physical activity before and during three trimesters of pregnancy, and anxiety level were recorded through interview using pregnancy physical activity (PPAQ) and Hospital Anxiety and Depression Rating Scale Anxiety (HADS) questionnaires respectively.

There was no significant difference between preterm and term birth groups regarding total physical activity, and sedentary behavior energy expenditure before and during pregnancy as well as anxiety during pregnancy(P>0.05). Physical activity pattern was not significantly different between the two groups (P>0.05). However, physical activity before pregnancy was significantly higher than all trimesters of pregnancy in both groups of the study (P<0.001). In two groups of preterm and term deliver, physical activity reduced in the third compared to the second trimester of pregnancy similarly.

Physical activity reduced during pregnancy in preterm and term birth women similarly. In this study, physical activity, sedentary behavior and anxiety during pregnancy and before it were not effective on the pre-term birth.

Preterm Birth (PTB) is one of the leading causes of infant morbidity and mortality. Prenatal care is an effective way to improve pregnancy outcomes but there is limited evidence of effective interventions to improve perinatal outcomes in disadvantaged pregnant women. This review was conducted with the aim to assess the effectiveness of prenatal care programs in reducing PTB in socioeconomically disadvantaged women.

We searched the Scopus, PubMed, Web of Science, and Cochrane Library databases from January 1, 1990 to August 31, 2021. The inclusion criteria included clinical trials and cohort studies focusing on prenatal care in deprived women with the primary outcome of PTB (< 37 weeks). Risk of bias was assessed using the Cochrane Collaboration’s tool for assessing risk of bias and the Newcastle–Ottawa Scale. Heterogeneity was evaluated using the Q test and I2 statistics. The pooled odds ratio was calculated using random‑effects models.

In total, 14 articles covering 22,526 women were included in the meta‑analysis. Interventions/exposures included group prenatal care, home visits, psychosomatic programs, integrated intervention on socio‑behavioral risk factors, and behavioral intervention through education, social support, joint management, and multidisciplinary care. The pooled results showed that all types of interventions/exposure were associated with a reduction in the risk of PTB [OR = 0.86; 95% confidence interval: (0.64, 1.16); I</em>2 = 79.42%].

Alternative models of prenatal care reduce PTB in socioeconomically disadvantaged women compared with standard care. The limited number of studies may affect the power of this study.

There is a high prevalence of infant mortality in South Asia and other parts of Asia, but overall, the bulk of neonatal deaths occur in developing countries. Although Pakistan has made great strides in the past decade to reduce child mortality with the help of foreign donors and the government, very little progress has been made in reducing neonate and infant mortality. Several studies have demonstrated the potential for low-cost therapies to greatly reduce neonatal mortality by helping pregnant mothers and their newborns. We need to shed light on the efforts and problems surrounding this topic in order to find and implement solutions backed by research to lower newborn mortality. This brief overview was produced using international standards for conducting reviews. Researchers opted for an explanatory methodology. Our findings were based on research conducted through PubMed, Google’s literature database, Journals Online, and the Internet Library. All of the works consulted primary sources, such as the World Health Organization (WHO) and the World Bank. The desired findings were obtained by using the term “neonatal mortality.” The study’s authors were interested in tracking variations in neonatal mortality over time. The increasing prevalence of neonatal death in Pakistan emphasizes the need for policies and programs that prioritized the health of children. Neonatal survival can be improved with the help of basic obstetric and newborn care in Pakistan.

Preterm birth (PB) is a worldwide gestational problem. Poor sleep quality and short duration have been reported as possible predisposing factors of PB in some studies.

This study was conducted to investigate the roles of sleep quality/duration in the occurrence of PB.

This longitudinal study was performed on pregnant women with gestational age ≤14 weeks. The sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI) at the first visit and women were followed until delivery. A total of 76 women with preterm and 441 women with term delivery were compared regarding the sleep quality components, sleep duration, and long or short sleep duration. The multivariate logistic regression was performed to examine the independent association of sleep quality/duration with PB.

Data from 517 participants were analyzed. PB occurred in 14.7% of participants. No significant difference of 7 items of sleep quality was observed between preterm and non-preterm groups (P>0.05 for each comparison). The total PSQI score in the preterm group was significantly higher (poorer quality) compared to the non-preterm group (5.6±2.1 vs 5.3±2.4, P=0.076). In multivariate logistic regression, each unit of worsening PSQI was independently associated with a 20% higher risk of PB occurrence. Sleep duration was not associated with PB either in unadjusted or adjusted models.

No relationship was observed between poor sleep quality (defined as PSQI>5) and PB; however, based on our results, poorer sleep quality (as a continuous variable) can be an independent risk factor for PB.

Preterm delivery is one of the main causes of newborn mortality, signifying the inequality of conditions in receiving the necessary prenatal care. 

The present systematic review was conducted to investigate the relationship between preterm delivery and socio-structural determinants of health with an emphasis on occupation, education, and income in Iranian society based on the World Health Organization model.

In this systematic review, all observational articles published from 2000 to November 2021 were examined by searching the international and Persian databases of Scopus, PubMed, Google Scholar, Web of Science, Embase, ProQuest, Cochrane, IranDoc, and SID. Keywords were extracted through the MESH. The articles were searched using English and Persian keywords of occupation, education, income, social and economic status, and preterm delivery and appropriate operators, such as AND, OR, as well as a combination of the search strategy of each database, and all related articles were collected.

In the initial search, 1456 articles were found, and a total number of 17 articles were finally included in the study, of which 12 articles were on occupation, ten articles on education, four studies on income, two studies on socio-economic status, seven studies on occupation, and eight studies on education. All studies on income and socio-economic status had shown a statistically significant relationship between these structural determinants and preterm delivery. 

Preterm delivery is a prevalent problem with critical complications in Iran and there is a significant relationship between structural determinants and preterm delivery. Appropriate interventions, such as life skills training, self-care, and prenatal care can help mitigate pregnancy outcomes.

Context:

 There are some discrepancies regarding the association between periodontal disease and preterm in the literature. Considering all periodontal pathogens, Porphyromonas gingivalis (Pg) is the most invasive bacterium in connective tissues, and the impact of its presence in the diverse microbial community of periodontal pathogens with a lower frequency is much greater than expected.

This study investigated the association of Pg in infra-gingival plaque of preterm and low birth weight (PTLBW) mothers.

Setting and Design: 

This descriptive correlational study was conducted on 89 women, who were referred to Imam Khomeini Hospital in Sari, Iran, in 2017.

The samples were assigned by purposive method with 30 mothers had PTLBW newborns and 59 mothers had normal term and normal birth weight (NTNBW) neonates. The probing depth, bleeding on probing clinical attachment levels, plaque index, and gingival index were measured. A sample from the periodontal pocket was collected to distinguish the Pg in subgingival plaque by polymerase chain reaction. Statistical Analysis Used: The data were analyzed using descriptive statistics and the Mann–Whitney U and Chi-square test.

According to the periodontal indexes, 37.3% and 26.7% of the mothers in the NTNBW and PTLBW were diagnosed with periodontitis, respectively. Furthermore, Pg was detected in 30% and 20.3% of the cases in the PTLBW of NTLBW mothers. The amount of Pg in infra-gingival plaque was significantly higher in the PTLBW mothers than in the NTNBW (P = 0.016).

The results indicated that the quantity of Pg could be considered a risk factor for PTLBW delivery.

Vaginal discharge caused by infection and inflammation could lead to premature rupture of the membranes, which increases the risk of premature labor. If not handled properly, preterm delivery elevates the neonatal mortality risk and morbidity rate. This study aims to know the relationship between uterine contractions with preterm.

Observational research and cross-sectional design on pregnant women with vaginal discharge and without vaginal discharge based on criteria inclusion was gestational age 16–37 weeks, and exclusion criteria were pregnant women with a history of sexually transmitted diseases.

The results showed that there were 130 pregnant women, of whom 77 (59.23%) have vaginal discharge complaints, and 53 (40.77%) do not have vaginal discharge complaints. Most pregnant women were in their first pregnancy (primigravida) and with 29–36 weeks gestational age. Uterine contractions (his) occurred in 68.8% (P=0.000) of pregnant women with vaginal discharge complaints but did not occur in pregnant women without vaginal discharge complaints.

Vaginal discharge in pregnancy carries the risk of uterine contractions, which may increase the incidence of preterm birth. To conclude, vaginal discharge in pregnancy has a relationship with preterm birth.

The recent coronavirus disease 2019 (COVID-19) outbreak became a global health concern in 2020 and the effect this novel coronavirus disease is still unclear on pregnant women. The present systematic review aimed to study the relationship between COVID-19 in pregnant women and development of preterm birth.

A systematic search of the published literature in PubMed, Scopus, and Google scholar was performed on every article addressing pregnant women regardless of the age or gestational age who were confirmed or suspected case of COVID-19 who gave birth and developed any type of neonatal adverse outcomes were included.

Seventeen studies entered the present systematic review from America, Europe, and Asia. A total number of 6251 deliveries from COVID-19 women were evaluated by these studies before excluding the possible studies with overlapping populations. The most common neonatal complication was preterm labor (11.9%). Other complications reported in more than one study included stillbirth (0.7%), PROM (12%), SGA (4%), and PPROM (5.4%). Moreover, the overall NICU admission was 173 neonates (25.2%).

Without considering the COVID-19 severity in pregnant women, the rate of preterm delivery as the most common neonatal complication is approximately 12% of live births which slightly greater than the previously reported global preterm rate in 2020.

 Few studies have been performed to investigate the association between vitamin D and respiratory problems in premature neonates.

 In this cohort study, a low serum level of vitamin D was considered as exposure and respiratory problems and associated interventions were considered as outcome. All patients were followed during their hospital stay. All preterm neonates admitted to the neonatal intensive care unit of a general hospital in Iran during one-year period from January 2018 were enrolled in this study. Serum vitamin D level was measured in the first 24 hours of life by liquid chromatography-spectrometry. Then, respiratory complications were compared between neonates with and without vitamin D insufficiency.

 Among the 113 preterm newborns, 65 (58%) had a low and 48 (42%) had a normal level of vitamin D who were classified into two groups I and II, respectively. Respiratory distress syndrome (RDS) and requirement for surfactant administration was found in 40 cases (61.5%) in group I and in 20 cases (41.7%) in group II (P=0.036). Also, 46 newborns (70.8%) in the first group and 22 (45.8%) in the second group needed non-invasive ventilation (NIV) (P=0.007). Multiple logistic regression showed a significant association between vitamin D status and RDS (OR, 95% CI=2.840 (1.083–7.447), P=0.034), need for surfactant (OR, 95% CI=2.840 (1.083–7.447), P=0.034) and need for NIV (OR, 95% CI=3.929 (1.526–10.113), P=0.005).

 The incidence of RDS, need for surfactants, and need for NIV in newborns with vitamin D insufficiency were higher than the neonates with normal levels.

Evaluation of insulin‑like growth factor‑1 (IGF‑1) association with retinopathy of prematurity (ROP) is our object.

This study was conducted on IGF‑1 levels of 40 neonates <34 weeks gestational age and 2000 g at 1st week
and 4–6 weeks after birth. All participants were evaluated for ROP after 31 weeks of gestation.

IGF‑1 levels showed a
significant difference between neonates ≤1500 and 1500–2000 g (1 and 4–6 weeks,P = 0.008, P = 0.039, respectively). No significant
association was found between IGF‑1 and ROP.

Finding a meaningful association between IGF‑1 and ROP requires
consideration of factors affecting the IGF‑1.

The aim of this meta-analysis was to estimate the prevalence of cesarean section (CS), preterm birth, stillbirth, and low birth weight deliveries (LBWD) in pregnant women with SARS-COV-2 infection.

All relevant studies were searched up to 30 February 2021.

A total of 47 studies with 5970 infected pregnant women were included. There were 1010 CS, 55 stillbirths, 524 preterm birth, and 82 with LBWD. Pooled data showed that the prevalence of CS, preterm birth, stillbirth, and LBWD among women with SARS-COV-2 infection was 29.6% (95% CI 0.081-0.160), 2.1% (95% CI 0.081-0.160), 11.5% (95% CI 0.081-0.160), and 2.1% (95% CI 0.081-0.160), respectively. Stratified analysis revealed that these pregnancy outcomes among Asian women were higher than Caucasians.

Our combined data revealed that the CS prevalence (29.6%) was the highest followed by preterm birth (11.5%), stillbirth (2.1%), and LBWD (2.1%) among women with COVID-19.

Preterm birth can cause high morbidity and mortality in women. Previous evidence has confirmed the association between zinc (Zn) deficiency in x women and some pregnancy complications. This study investigated the association between serum Zn concentration in pregnant women and preterm birth.

This case-control study focused on evaluating 76 pregnant women with preterm birth (case group) and 62 pregnant women with term birth (control group) and was conducted in the obstetrics ward of Hajar hospital, Shahrekord, Iran in 2014. The Zn level was measured by spectrophotometry and data were analyzed by SPSS, version 15.

The prevalence of Zn deficiency was 95.6%. The mean of serum Zn concentration was 39.62±11.83 and 59.81±8.8 in the preterm and term delivery groups, respectively (P < 0.001). Similarly, the mean of serum Zn concentrations was 43.06±15.6 and 50.46±13.8 in women with and without the rupture of pregnancy membranes, respectively (P = 0.01). Based on the findings, the serum Zn concentration was not significantly associated with parity (P = 0.634).

Although a decrease in the serum Zn concentration could lead to premature rupture of membranes during pregnancy and preterm birth, it could not be considered as the main factor for preterm birth. In addition, Zn deficiency was highly prevalent in pregnant women. Therefore, nutritional interventions should be performed to prevent complications due to the deficiency of micronutrients such as Zn so that to increase health maintenance in mothers and children.

The need to care for premature infants causes a lot of anxiety and stress in their mothers. This study aimed to compare the effect of kangaroo mother care and Preterm infant massage on pain score, stress, anxiety, depression, and stress coping strategies of their mothers. This double-blind three-group clinical trial study was conducted in Bahar Hospital in Shahroud, Iran, in 2019. 90 Mothers with preterm infants were assigned randomly to one of the three groups. Each group consisted of 30 mothers. The massage group received three 5-min massages each day for five consecutive days. In the Kangaroo Mother Care group, the baby remained in skin to skin condition for at least 15 minutes or more during five consecutive days. The control group received only routine care in the neonatal intensive care unit. Data in all three groups were collected before and after the interventions using the Coping Responses Inventory for Adult (CRI-A), the Depression, Anxiety, Stress Scale 21, and Neonatal Infant Pain Scale. The Paired Sample T-Test revealed that the mean score of infant pain in both intervention groups before and after the intervention was statistically significant (P<0.001). The ANOVA test and The Paired Sample T-Test also showed that the mean scores of depression, Emotion-focused coping, and problem solving-based coping in mothers in all three groups, were significantly different before and after the intervention (P<0.001). Kangaroo mother care and massage can reduce the pain in preterm infants, as well as the level of anxiety, depression, and stress of mothers; and increase the strategies to deal with stress in mothers. Due to the high prevalence of birth trauma in infants in Iran, therefore, interventions are recommended to reduce it. Further studies on the factors affecting it need to be done to appropriate interventions to reduce it

Estimation of the survival of very preterm infants is necessary to make decisions and design interventions in order to improve their quality of care. This survey aimed to estimate the survival of very preterm infants born at 23 up to 33 weeks of gestational age (GA) in Iran.

This population-based retrospective cohort study included 8536 infants born before 33 weeks of GA, from March 21st to December 22nd  2013 in Iran. The primary data were extracted from the Iranian national maternal and neonatal registration network (IMAN). All infants who have been discharged alive, followed up by telephone contact up to one year after birth. The Kaplan-Meier and Log-rank tests were performed to estimate survival and to compare survivals, respectively, using SPSS version 26 and R 3.5.2 softwares.

The overall survival was estimated at 56.70% (95% C.I: 55.60%-57.80%) at the end of the follow-up period. Total death rate was estimated at 43.30% and was significantly decreased with increasing birth weight (p<0.0001). Survival was increased significantly with increasing GA (p<0.0001), from 5.7% at 23 weeks to 79.6% at 32 weeks. The estimated cumulative proportion of death until the end of the neonatal period had a decreasing trend and then had a steady trend until the end of the follow-up period. The hazard ratio of quadruple or more birth and GA were 1.46 (p=0.021) and 0.83 (p<0.001), respectively.

The overall estimated survival of very preterm infants was not high. Even with modern perinatal technology and care, early deaths of very preterm infants were still common.

Preterm birth (PTB) is one of the most important factors that increase the risk of chronic diseases and postpartum death in infants. The aim of this study was to determine the maternal factors that affect the birth of preterm infants in the city of Bandar Abbas.

This is a case–control study that was performed on 400 preterm infants. Sampling was done by a simple method, and information was gathered by interviewing the mothers and their medical records. Data were collected by SPSS software version 16. To compare risk factors in the two groups, conditional logistic regression was used, and P < 0.05 was considered statistically significant.

Results showed that factors such as type of delivery (odds ratio [OR] = 3.584, 95% confidence interval [CI]: 1.981–6.485), preeclampsia (OR = 2.688, 95% CI: 1.164–6.207), history of PTB (OR = 4.171, 95% CI: 1.483–11.728), premature rupture of membranes (OR = 3.273, 95% CI: 1.745–6.137), care during prenatal (OR = 0.334, 95% CI: 0.159–0.701), placental abruption (OR = 3.209, 95% CI: 1.209–8.519), placenta previa (OR = 9.333, 95% CI: 2.086–41.770), and cervical insufficiency (OR = 11, 95% CI: 1.381–87.641) were independent risk factors of preterm infant birth.

The PTB risk is higher for women with cervical insufficiency, history of placenta previa, and history of preterm. Early recognition and management of these high‑risk conditions among pregnant women may lead to a reduction in PTB rates.

Preterm birth is one of the main contributors to newborn mortality, morbidity, and hospitalization in the first year of life globally. To date, several numbers of studies have reported that Angiotensin-Converting enzyme Insertion/Deletion polymorphism (ACE I/D) is linked with preterm birth. But those results are conflicting. Thus, we carried out this meta-analysis to summarize the existing data and evaluated the association.

All eligible studies were collected from PubMed, Scopus, SciELO, MedRxiv, SID, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Literature Database (CBLD) up to 01 March 2021. The pooled odds ratios (ORs) and 95% confidence interval (CIs) under all five genetic models were calculated using either random-effects or fixed-effects models dependent on study heterogeneity.

A total of five case-control studies with 480 preterm birth cases and 702 healthy subjects were included. Pooled data showed that the ACE I/D polymorphism was significantly associated with increased risk of preterm birth under the allele model (I vs. D: OR = 1.219, 95% CI 1.023-1.453, P = 0.027), homozygote model (II vs. DD: OR = 0.662, 95% CI 1.149-2.385, P = 0.007), and recessive model (DD vs. DI+II: OR = 0.707, 95% CI 1.082-1.948, P = 0.013). Stratified analysis by ethnicity indicated that the ACE I/D polymorphism was significantly associated with preterm birth in Caucasian descendants.

Our pooled data revealed that ACE I/D polymorphism is associated with the risk of preterm birth. However, larger and more rigorous studies among different populations are needed to evaluate the association with preterm birth.