Pub Date : 2019-05-01DOI: 10.33118/OAJ.PREG.2019.01.005
B. Sobaih
Background: Advancements in perinatal-neonatal care in the last decades has led to improved survival rates of very-low birth weight (VLBW) infants. An association between the level of maternal education and neurodevelopmental outcome has been demonstrated in many European studies. This study evaluates the influence of maternal education level and socio-demographic status on the long-term development of Saudi VLBW infants with birth weight of 1000-1500 grams at a corrected gestational age of 21-24 months. Method: This retrospective cohort study examined prospectively collected data from the period of 2005 to 2016 from the Neonatal Follow-up Program (NFP) at King Khalid University Hospital in Riyadh, Saudi Arabia. Results: A total of 122 VLBW infants with a mean gestational age of 29.57 weeks and mean birth weight 1265 grams were enrolled. There was no statistically significant association between the level of maternal education and neurodevelopmental screening outcome at the age of 21-24 months according to the Bayley Infant Neurodevelopmental Screener (BINS) (p=0.149). Bronchopulmonary dysplasia (BPD) was highly associated with cerebral palsy (p=0.001) and an abnormal BINS score (p=0.010). Conclusion: There was no significant influence of the level of maternal education on the neurodevelopmental screening outcome of VLBW infants at the corrected age of 21-24 months. BPD was the strongest predictor of adverse neurodevelopmental outcome. Keywords: Bayley Infant Neurodevelopmental Screener (BINS), Neurodevelopmental Outcome, Maternal educational level, Neonatal follow-up program (NFP), Very Low Birth Weight (VLBW) infant.
{"title":"Influence of the level of maternal education on the long-term neurodevelopmental outcome of Saudi infants with birth weight of 1000-1500 grams at the age of 21-24 months","authors":"B. Sobaih","doi":"10.33118/OAJ.PREG.2019.01.005","DOIUrl":"https://doi.org/10.33118/OAJ.PREG.2019.01.005","url":null,"abstract":"Background: Advancements in perinatal-neonatal care in the last decades has led to improved survival rates of very-low birth weight (VLBW) infants. An association between the level of maternal education and neurodevelopmental outcome has been demonstrated in many European studies. This study evaluates the influence of maternal education level and socio-demographic status on the long-term development of Saudi VLBW infants with birth weight of 1000-1500 grams at a corrected gestational age of 21-24 months.\u0000Method: This retrospective cohort study examined prospectively collected data from the period of 2005 to 2016 from the Neonatal Follow-up Program (NFP) at King Khalid University Hospital in Riyadh, Saudi Arabia.\u0000Results: A total of 122 VLBW infants with a mean gestational age of 29.57 weeks and mean birth weight 1265 grams were enrolled. There was no statistically significant association between the level of maternal education and neurodevelopmental screening outcome at the age of 21-24 months according to the Bayley Infant Neurodevelopmental Screener (BINS) (p=0.149). Bronchopulmonary dysplasia (BPD) was highly associated with cerebral palsy (p=0.001) and an abnormal BINS score (p=0.010).\u0000Conclusion: There was no significant influence of the level of maternal education on the neurodevelopmental screening outcome of VLBW infants at the corrected age of 21-24 months. BPD was the strongest predictor of adverse neurodevelopmental outcome.\u0000Keywords: Bayley Infant Neurodevelopmental Screener (BINS), Neurodevelopmental Outcome, Maternal educational level, Neonatal follow-up program (NFP), Very Low Birth Weight (VLBW) infant.","PeriodicalId":93345,"journal":{"name":"OA journal of pregnancy and child care","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79678743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-03DOI: 10.33118/OAJ.PREG.2019.01.004
E. White
Background: Mothers often experience muscle soreness following labor and delivery; however, this has yet to be examined. Purpose: To determine the effects of resistance bands on maternal muscle soreness when performed during the second and third trimesters of pregnancy. Methods: Women were randomized to an exercise (n = 12) or standard-care (n = 13) groups and completed surveys regarding muscle soreness. The exercise group performed a 15 week resistance band program 3 times/wk. Maternal, newborn, and delivery outcomes were measured. Change scores were calculated and comparisons were made using independent t-tests and chi-square tests. Results: Twenty-five women participated, mean age was 26.5 ± 3.4 years. There were no significant differences (p > 0.05) in muscle soreness and maternal and newborn outcomes. Mode of delivery was significantly different (p = 0.05) with the exercise group having more vaginal births (91.7%) compared to the standard care group (61.5%). Conclusions: Muscle soreness was not significantly different, however, the mean values were in the expected direction. Further, there was a higher percentage of women in the exercise group having vaginal deliveries. Thus, while the sample size was small, these pilot findings have clinical importance, even if they are not statistically significant due to limited power. The use of resistance bands may be a practical intervention to increase the percentage of vaginal deliveries, the preferred mode of delivery. Confirming these results with a larger sample size is necessary. Keywords: Exercise, Gestation, Vaginal birth, Pain management, Muscle soreness, Cesarean section, Pregnancy, Resistance training.
{"title":"Effects of a practical resistance band training intervention on muscle soreness during pregnancy: A pilot study","authors":"E. White","doi":"10.33118/OAJ.PREG.2019.01.004","DOIUrl":"https://doi.org/10.33118/OAJ.PREG.2019.01.004","url":null,"abstract":"Background:\u0000Mothers often experience muscle soreness following labor and delivery; however, this has yet to be examined. Purpose: To determine the effects of resistance bands on maternal muscle soreness when performed during the second and third trimesters of pregnancy.\u0000\u0000Methods:\u0000Women were randomized to an exercise (n = 12) or standard-care (n = 13) groups and completed surveys regarding muscle soreness. The exercise group performed a 15 week resistance band program 3 times/wk. Maternal, newborn, and delivery outcomes were measured. Change scores were calculated and comparisons were made using independent t-tests and chi-square tests.\u0000\u0000Results:\u0000Twenty-five women participated, mean age was 26.5 ± 3.4 years. There were no significant differences (p > 0.05) in muscle soreness and maternal and newborn outcomes. Mode of delivery was significantly different (p = 0.05) with the exercise group having more vaginal births (91.7%) compared to the standard care group (61.5%).\u0000\u0000Conclusions:\u0000Muscle soreness was not significantly different, however, the mean values were in the expected direction. Further, there was a higher percentage of women in the exercise group having vaginal deliveries. Thus, while the sample size was small, these pilot findings have clinical importance, even if they are not statistically significant due to limited power. The use of resistance bands may be a practical intervention to increase the percentage of vaginal deliveries, the preferred mode of delivery. Confirming these results with a larger sample size is necessary.\u0000\u0000Keywords:\u0000Exercise, Gestation, Vaginal birth, Pain management, Muscle soreness, Cesarean section, Pregnancy, Resistance training.","PeriodicalId":93345,"journal":{"name":"OA journal of pregnancy and child care","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80740189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01Epub Date: 2018-11-26DOI: 10.33118/oaj.preg.2019.01.002
Phillip K Huynh, Nobuyuki Takahashi, Nobuyo Maeda-Smithies, Feng Li
Preeclampsia (PE) is a pregnancy related disorder that is characterized by hypertension and proteinuria in the mother. It is associated with impaired coagulation and liver function, and a variety of other detrimental effects. In severe cases without treatment, PE can progress to eclampsia and result in seizures, a life-threatening condition. Although the etiology of PE is largely unknown, sFlt-1 (soluble vascular endothelial growth factor receptor 1) released by the impaired placenta resulting from insufficient perfusion plays a critical role in PE, and phenotypes of PE can be induced by experimentally increasing sFlt-1. We and other investigators have proposed that endothelin-1 (ET-1) system is the mediator of the pathological effects of excess sFlt-1, and antagonists of ET-1 receptor block the effects of sFlt-1. Unfortunately, this class of drugs is teratogenic and unsuitable for treating pregnant women. Nicotinamide is a naturally occurring derivative of vitamin B3 in the body and inhibits ADP-ribosyl cyclase, which is activated by the ET-1 receptor. Therefore, if utilized, it would be expected to play a beneficial role in PE. In mouse models of PE, a high dose of nicotinamide shows great success in lowering blood pressure, correcting renal function and structure, prolonging pregnancy as well as increasing fetal weight/number. Nicotinamide, being generally regarded as safe, could be a promising substance to further investigate for use in clinical trials.
{"title":"Beneficial effects of nicotinamide on the mouse model of preeclampsia.","authors":"Phillip K Huynh, Nobuyuki Takahashi, Nobuyo Maeda-Smithies, Feng Li","doi":"10.33118/oaj.preg.2019.01.002","DOIUrl":"https://doi.org/10.33118/oaj.preg.2019.01.002","url":null,"abstract":"<p><p>Preeclampsia (PE) is a pregnancy related disorder that is characterized by hypertension and proteinuria in the mother. It is associated with impaired coagulation and liver function, and a variety of other detrimental effects. In severe cases without treatment, PE can progress to eclampsia and result in seizures, a life-threatening condition. Although the etiology of PE is largely unknown, sFlt-1 (soluble vascular endothelial growth factor receptor 1) released by the impaired placenta resulting from insufficient perfusion plays a critical role in PE, and phenotypes of PE can be induced by experimentally increasing sFlt-1. We and other investigators have proposed that endothelin-1 (ET-1) system is the mediator of the pathological effects of excess sFlt-1, and antagonists of ET-1 receptor block the effects of sFlt-1. Unfortunately, this class of drugs is teratogenic and unsuitable for treating pregnant women. Nicotinamide is a naturally occurring derivative of vitamin B3 in the body and inhibits ADP-ribosyl cyclase, which is activated by the ET-1 receptor. Therefore, if utilized, it would be expected to play a beneficial role in PE. In mouse models of PE, a high dose of nicotinamide shows great success in lowering blood pressure, correcting renal function and structure, prolonging pregnancy as well as increasing fetal weight/number. Nicotinamide, being generally regarded as safe, could be a promising substance to further investigate for use in clinical trials.</p>","PeriodicalId":93345,"journal":{"name":"OA journal of pregnancy and child care","volume":"1 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39189282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-19DOI: 10.33118/OAJ.PREG.2019.01.003
T. Field
This narrative review summarizes publications from the last eight years (2010-2018) on the early interactions, developmental effects and physiological and biochemical profiles of perinatally depressed mothers and their infants. Depressed mothers are nonresponsive with their infants.The depressed mothers’ physiological profiles including low vagal activity, right frontal EEG activation and fMRI activation differences are consistent with the mothers’ lack of responsivity during interactions with their infants. Biomarkers of the mothers that would affect their mood states include elevated cortisol as well as low serotonin, dopamine and oxytocin levels. The infants of depressed mothers come to early interactions with a prenatal history of growth delays and less responsivity to fetal stimulation. At birth they have physiological and biochemical profiles that are similar to those of their mothers. They continue to show these profiles in later development (e.g. depressed vagal activity and elevated cortisol). Although their later behavior problems and cognitive delays have been attributed to the depressed mothers’ lack of responsivity during early interactions, these problems may also relate to their own lingering physiological and biochemical profiles. Keywords: Perinatally depression, Biomarkers
{"title":"Perinatal depression effects: A narrative review","authors":"T. Field","doi":"10.33118/OAJ.PREG.2019.01.003","DOIUrl":"https://doi.org/10.33118/OAJ.PREG.2019.01.003","url":null,"abstract":"This narrative review summarizes publications from the last eight years (2010-2018) on the early interactions, developmental effects and physiological and biochemical profiles of perinatally depressed mothers and their infants. Depressed mothers are nonresponsive with their infants.The depressed mothers’ physiological profiles including low vagal activity, right frontal EEG activation and fMRI activation differences are consistent with the mothers’ lack of responsivity during interactions with their infants. Biomarkers of the mothers that would affect their mood states include elevated cortisol as well as low serotonin, dopamine and oxytocin levels. The infants of depressed mothers come to early interactions with a prenatal history of growth delays and less responsivity to fetal stimulation. At birth they have physiological and biochemical profiles that are similar to those of their mothers. They continue to show these profiles in later development (e.g. depressed vagal activity and elevated cortisol). Although their later behavior problems and cognitive delays have been attributed to the depressed mothers’ lack of responsivity during early interactions, these problems may also relate to their own lingering physiological and biochemical profiles.\u0000\u0000Keywords: Perinatally depression, Biomarkers","PeriodicalId":93345,"journal":{"name":"OA journal of pregnancy and child care","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80701972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-02DOI: 10.33118/OAJ.PREG.2019.01.001
F. Yvonne
Objective: This study aims to explore women’s traumatic childbirth experiences in order to make maternity care professionals more aware of women’s intrapartum care needs to prevent traumatic experiences. Methods: A qualitative exploratory study with a constant comparison/ grounded theory design was performed. Thirty-six interviews were conducted with women who had given birth in a Dutch birth setting. Findings: Four themes, playing a profound role in the occurrence of traumatic birth experiences, emerged: 1 Midwife-LED care – Maternity care professionals’ unilateral decision making during intrapartum care. 2. Alienation – Women’s experiences of feeling distant and estranged from the childbirth event and the experience. 3. Situatedness – The difference of the impact of interventions in situations when complications or emergencies are present in contrast to when interventions are performed without an emergency reason. 4. Discrepancies - Paradoxes between expectations (ought self) and reality (actual self) - on an interpersonal (woman) and intrapersonal (woman-midwife) level. Implications for practice: Intrapartum care needs to include informed-consent and shared-decision making. Practitioners need to continuously evaluate if the woman is consistently part of her own childbearing process. Practitioners need to provide personalised care, make an effort to explain (emergency) situations, be conscious of their non-verbal communication and maintain an ongoing dialogue with the woman. Conclusion: Intrapartum care can be adapted, adopting a woman-centred approach, in order to prevent women’s traumatic childbirth experiences. This study can serve as a valuable assistance for maternity services, midwifery practice, research and for developing guidance in the field of midwifery practitioners’ education. Keywords: Traumatic birth experience, Maternity care, Intrapartum care, Informed-consent, Shared-decision making, Woman-centred care, Qualitative research.
{"title":"Women’s traumatic childbirth experiences: Reflections and implications for practice","authors":"F. Yvonne","doi":"10.33118/OAJ.PREG.2019.01.001","DOIUrl":"https://doi.org/10.33118/OAJ.PREG.2019.01.001","url":null,"abstract":"Objective: This study aims to explore women’s traumatic childbirth experiences in order to make maternity care professionals more aware of women’s intrapartum care needs to prevent traumatic experiences.\u0000\u0000Methods: A qualitative exploratory study with a constant comparison/ grounded theory design was performed. Thirty-six interviews were conducted with women who had given birth in a Dutch birth setting.\u0000\u0000Findings: Four themes, playing a profound role in the occurrence of traumatic birth experiences, emerged:\u0000\u00001 Midwife-LED care – Maternity care professionals’ unilateral decision making during intrapartum care.\u0000\u00002. Alienation – Women’s experiences of feeling distant and estranged from the childbirth event and the experience.\u0000\u00003. Situatedness – The difference of the impact of interventions in situations when complications or emergencies are present in contrast to when interventions are performed without an emergency reason.\u0000\u00004. Discrepancies - Paradoxes between expectations (ought self) and reality (actual self) - on an interpersonal (woman) and intrapersonal (woman-midwife) level.\u0000\u0000Implications for practice: Intrapartum care needs to include informed-consent and shared-decision making. Practitioners need to continuously evaluate if the woman is consistently part of her own childbearing process. Practitioners need to provide personalised care, make an effort to explain (emergency) situations, be conscious of their non-verbal communication and maintain an ongoing dialogue with the woman.\u0000\u0000Conclusion: Intrapartum care can be adapted, adopting a woman-centred approach, in order to prevent women’s traumatic childbirth experiences. This study can serve as a valuable assistance for maternity services, midwifery practice, research and for developing guidance in the field of midwifery practitioners’ education.\u0000\u0000Keywords: Traumatic birth experience, Maternity care, Intrapartum care, Informed-consent, Shared-decision making, Woman-centred care, Qualitative research.","PeriodicalId":93345,"journal":{"name":"OA journal of pregnancy and child care","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83975901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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