Talk:Birth - Preterm
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Cite this page: Hill, M.A. (2024, May 19) Embryology Birth - Preterm. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Birth_-_Preterm |
2012
WHO Report
The first-ever country-by-country estimate of premature births finds that 15 million babies a year are born preterm - more than one in 10 live births. Although more than 60% of preterm births are in sub-Saharan Africa and south Asia, they are also a problem for some high-income countries, including the USA and Brazil. Both rank among the 10 countries with the highest number of preterm births. In the USA, about 12% of all births are preterm, a percentage far higher than in Europe or other developed countries. ...
The Partnership (PMNCH) - joins the maternal, newborn and child health (MNCH) communities into an alliance of more than 350 members to ensure that all women, infants and children not only remain healthy, but thrive. Born Too Soon: The Global Action Report on Preterm Birth
Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study
BMJ. 2012 Mar 1;344:e896. doi: 10.1136/bmj.e896.
Boyle EM, Poulsen G, Field DJ, Kurinczuk JJ, Wolke D, Alfirevic Z, Quigley MA. Source Department of Health Sciences, University of Leicester, Leicester LE1 6TP, UK. eb124@le.ac.uk Abstract OBJECTIVE: To investigate the burden of later disease associated with moderate/late preterm (32-36 weeks) and early term (37-38 weeks) birth. DESIGN: Secondary analysis of data from the Millennium Cohort Study (MCS). SETTING: Longitudinal study of infants born in the United Kingdom between 2000 and 2002. PARTICIPANTS: 18,818 infants participated in the MCS. Effects of gestational age at birth on health outcomes at 3 (n = 14,273) and 5 years (n = 14,056) of age were analysed. MAIN OUTCOME MEASURES: Growth, hospital admissions, longstanding illness/disability, wheezing/asthma, use of prescribed drugs, and parental rating of their children's health. RESULTS: Measures of general health, hospital admissions, and longstanding illness showed a gradient of increasing risk of poorer outcome with decreasing gestation, suggesting a "dose-response" effect of prematurity. The greatest contribution to disease burden at 3 and 5 years was in children born late/moderate preterm or early term. Population attributable fractions for having at least three hospital admissions between 9 months and 5 years were 5.7% (95% confidence interval 2.0% to 10.0%) for birth at 32-36 weeks and 7.2% (1.4% to 13.6%) for birth at 37-38 weeks, compared with 3.8% (1.3% to 6.5%) for children born very preterm (<32 weeks). Similarly, 2.7% (1.1% to 4.3%), 5.4% (2.4% to 8.6%), and 5.4% (0.7% to 10.5%) of limiting longstanding illness at 5 years were attributed to very preterm birth, moderate/late preterm birth, and early term birth. CONCLUSIONS: These results suggest that health outcomes of moderate/late preterm and early term babies are worse than those of full term babies. Additional research should quantify how much of the effect is due to maternal/fetal complications rather than prematurity itself. Irrespective of the reason for preterm birth, large numbers of these babies present a greater burden on public health services than very preterm babies.
PMID 22381676
Patterns and outcomes of preterm hospital admissions during pregnancy in NSW, 2001-2008
Med J Aust. 2012 Mar 5;196(4):261-5.
Badgery-Parker T, Ford JB, Jenkins MG, Morris JM, Roberts CL.
Source
Centre for Epidemiology and Research, NSW Ministry of Health, Sydney, NSW, Australia. clroberts@med.usyd.edu.au.
Abstract
OBJECTIVE: To assess the frequency and outcomes of preterm hospital admissions during pregnancy, with a focus on transfers to higher levels of care.
DESIGN: Population-based cohort study using linked population data.
SETTING AND SUBJECTS: Women who were admitted to hospital in weeks 20-36 of pregnancy (preterm) and gave birth to a liveborn singleton infant in New South Wales during 2001-2008.
MAIN OUTCOME MEASURE: Numbers of preterm admissions of pregnant women who were discharged without giving birth, were transferred to higher care, or who gave birth.
RESULTS: 110 439 pregnancies (16.0%) involved at least one preterm admission. After their initial preterm admission, 71.9% of women were discharged, 6.3% were transferred and 21.8% gave birth. Median gestational age at admission was 33 weeks and median time to discharge, transfer or giving birth was 1 day. Most women who were transferred or who gave birth had been admitted for preterm rupture of membranes or preterm labour. Of the women who were admitted or were transferred with suspected preterm labour, only 29% and 38%, respectively, gave birth. Compared with other admitted women, women having a first birth, public patients and those living in areas of low socioeconomic status were more likely to be transferred or to give birth. As gestational age increased, the proportion of women transferred decreased and the proportion giving birth increased. Infants born after maternal transfer had lower gestational age and more adverse outcomes than those born without maternal transfer.
CONCLUSIONS: Preterm hospital admission affects one in six women with singleton pregnancies. Methods that could improve assessment of labour status have a large potential to reduce the burden on maternity services. The increased morbidity for infants born after maternal transfer suggests women with high-risk pregnancies are being appropriately identified.
PMID 22409693
2011
Children's Brain Development Benefits from Longer Gestation
Front Psychol. 2011;2:1. Epub 2011 Feb 9.
Davis EP, Buss C, Muftuler LT, Head K, Hasso A, Wing DA, Hobel C, Sandman CA. Source Women and Children's Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California Irvine Orange, CA, USA. Abstract Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging in 100 healthy right-handed 6- to 10-year-old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in gray matter density. Further, the benefit of longer gestation for brain development was present even when only children born full term were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.
PMID: 21713130 [PubMed - in process] PMCID: PMC3111445 http://www.ncbi.nlm.nih.gov/pubmed/21713130
