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  1. Preterm Labor

    Science.gov (United States)

    Preterm labor is labor that starts before 37 completed weeks of pregnancy. It can lead to premature birth. Premature babies may face serious health risks. Symptoms of preterm labor include Contractions every 10 minutes or more often ...

  2. Preterm labor

    DEFF Research Database (Denmark)

    Jørgensen, Jan Stener; Weile, Louise Katrine Kjær; Lamont, Ronald Francis

    2014-01-01

    While tocolytic therapy may not be indicated in all cases of spontaneous preterm labor (SPTL), the evidence that they are superior to placebo is robust. The perfect tocolytic that is 100% efficacious and 100% safe does not exist and efforts should continue to develop and introduce safer and more...... and arrange in utero transfer to a center with neonatal intensive care facilities, both of which reduce neonatal mortality and morbidity. Few tocolytics (β₂-agonists and atosiban) are licensed for use as tocolytics and only one was developed specifically to treat preterm labor (atosiban). Accordingly, most...

  3. Lewis Phenotype in Women With Preterm Labor and Premature Rupture of the Membranes

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    William F. O'Brien

    1995-01-01

    Full Text Available Objective: The purpose of this study was to evaluate the possible association between Lewis phenotype status in pregnant women and preterm labor (PTL or preterm rupture of the membranes (PROM.

  4. Role of Perceived Stress on the Occurrence of Preterm Labor and Preterm Birth among Urban Women

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    Seravalli, Laura; Patterson, Freda; Nelson, Deborah B.

    2013-01-01

    Introduction This study examined whether prenatal perceived stress levels during pregnancy were associated with preterm labor (PTL) or preterm birth (PTB). Methods Perceived stress levels were measured at 16 weeks gestation or less and between 20 and 24 weeks gestation in a sample of 1,069 low-income pregnant women attending Temple University prenatal care clinics. Scores were averaged to create a single measure of prenatal stress. PTB was defined as the occurrence of a spontaneous birth prior to 37 weeks gestation. PTL was defined as the occurrence of regular contractions between 20 and 37 weeks of pregnancy that were associated with changes in the cervix. Results Independent of potential confounding factors, prenatal perceived stress was not associated with PTL (OR 1.10; 95% CI 0.69-1.78, P = .66); however, prenatal stress trended toward an association with PTB (OR 1.49; 95% CI: 1.00-2.23, P =.05). The strongest predictor of preterm labor was a history of preterm labor in a prior pregnancy. Women with a history of PTL were two times more likely to experience PTL in the current pregnancy than women who did not have a PTL history (OR 2.16; 95% CI 1.05-4.41, P =.04). Historical risk factors of PTB, such as African American race, a history of abortion or a history of PTB were not related to PTL. The strongest predictor of PTB was having a history of PTB in a prior pregnancy (OR 2.55; 95% CI 1.54-4.24, P stress levels may be a risk factor for PTB independent of PTL; however, prenatal stress was not associated with PTL. Risk factors for PTL may be different from those of PTB. PMID:24890400

  5. Preterm Labor and Birth

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    ... Facebook Twitter Pinterest Email Print Preterm Labor and Birth In general, a normal human pregnancy lasts about ... is called preterm labor (or premature labor). A birth that occurs before 37 weeks is considered a ...

  6. Prevention of preterm birth based on short cervix: symptomatic women with preterm labor or premature prelabor rupture of membranes.

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    Ness, Amen

    2009-10-01

    The diagnosis of preterm labor (PTL) is challenging, especially in women whose cervical dilatation is 15 mm. Transvaginal ultrasound CL can also be performed in the presence of ruptured membranes and predicts latency. Although additional data are needed, the evidence so far suggests that the use of transvaginal ultrasound CL and fetal fibronectin can be used to better identify and manage women with PTL likely to have an imminent preterm delivery, and to avoid interventions in women who would not.

  7. Preterm Labor and Birth

    Science.gov (United States)

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... Pinterest Email Print Preterm Labor and Birth In general, a normal human pregnancy lasts about 40 weeks, ...

  8. Antibiotic Therapy Increases the Risk of Preterm Birth in Preterm Labor without Intra-Amniotic Microbes, but may Prolong the Gestation Period in Preterm Labor with Microbes, Evaluated by Rapid and High-Sensitive PCR System.

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    Yoneda, Satoshi; Shiozaki, Arihiro; Yoneda, Noriko; Ito, Mika; Shima, Tomoko; Fukuda, Kaori; Ueno, Tomohiro; Niimi, Hideki; Kitajima, Isao; Kigawa, Mika; Saito, Shigeru

    2016-04-01

    To examine the efficacy of the use of antibiotics in preterm labor (PTL) with intact membranes, after evaluating intra-amniotic microbes by our rapid and bacteria-free polymerase chain reaction (PCR) system. One hundred and four PTL patients before 32 weeks of gestation were recruited. Until 2012, antibiotics were empirically prescribed based on the clinical severity of PTL. Intra-amniotic microbes in stored samples were evaluated later by our newly established PCR system, and the efficacy of the use of antibiotics in PTL was evaluated. In the amniotic fluid (AF) microbe-negative patients (n = 67), antibiotic therapy significantly shortened the gestation period (P antibiotic therapy (proper antibiotic selection against identified AF microbes) was significantly associated with an increase in gestation period (P antibiotic therapy in PTL with intact membranes prolonged the gestation period. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Value of amniotic fluid IL-8 and Annexin A2 in prediction of preterm delivery in preterm labor and preterm premature rupture of membranes.

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    Jia, Xiaohui

    2014-01-01

    To investigate the clinical significance and value in the prediction of preterm delivery of combined amniotic fluid IL-8 and Annexin A2 levels in preterm premature rupture of membranes (PPROM) and preterm labor (PTL). Sixty pregnant women at < 32 gestational weeks who developed PTL were divided into a PPROM group and a non-PPROM group. Ten normal pregnant women served as a control group. IL-8 and Annexin A2 levels were measured in amniotic fluid samples from each patient. Amniotic fluid IL-8 and Annexin-A2 levels in PTL (PPROM and non-PPROM groups) were significantly higher than those of the controls (p < 0.05). The PPROM group displayed higher amniotic fluid Annexin-A2 levels than did the non-PPROM group, with a statistically significant difference (p < 0.05). The PPROM group showed higher amniotic fluid IL-8 levels than did the non-PPROM group; however, this was statistically insignificant (p = 0.56). Combined detection of amniotic fluid IL-8 and Annexin-A2 in the prediction of preterm delivery within 2 weeks of measurement showed sensitivity of 81.25%, specificity of 88.89% and PPV of 92.86%. Amniotic fluid IL-8 and Annexin-A2 levels are associated with the occurrence of PPROM and PTL. Combined detection of IL-8 and Annexin-A2 levels in identifying preterm delivery within 2 weeks in PTL and PPROM is of possible clinical and predictive value.

  10. Human cervicovaginal fluid biomarkers to predict term and preterm labor

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    Heng, Yujing J.; Liong, Stella; Permezel, Michael; Rice, Gregory E.; Di Quinzio, Megan K. W.; Georgiou, Harry M.

    2015-01-01

    Preterm birth (PTB; birth before 37 completed weeks of gestation) remains the major cause of neonatal morbidity and mortality. The current generation of biomarkers predictive of PTB have limited utility. In pregnancy, the human cervicovaginal fluid (CVF) proteome is a reflection of the local biochemical milieu and is influenced by the physical changes occurring in the vagina, cervix and adjacent overlying fetal membranes. Term and preterm labor (PTL) share common pathways of cervical ripening, myometrial activation and fetal membranes rupture leading to birth. We therefore hypothesize that CVF biomarkers predictive of labor may be similar in both the term and preterm labor setting. In this review, we summarize some of the existing published literature as well as our team's breadth of work utilizing the CVF for the discovery and validation of putative CVF biomarkers predictive of human labor. Our team established an efficient method for collecting serial CVF samples for optimal 2-dimensional gel electrophoresis resolution and analysis. We first embarked on CVF biomarker discovery for the prediction of spontaneous onset of term labor using 2D-electrophoresis and solution array multiple analyte profiling. 2D-electrophoretic analyses were subsequently performed on CVF samples associated with PTB. Several proteins have been successfully validated and demonstrate that these biomarkers are associated with term and PTL and may be predictive of both term and PTL. In addition, the measurement of these putative biomarkers was found to be robust to the influences of vaginal microflora and/or semen. The future development of a multiple biomarker bed-side test would help improve the prediction of PTB and the clinical management of patients. PMID:26029118

  11. Differing prevalence and diversity of bacterial species in fetal membranes from very preterm and term labor.

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    Hannah E Jones

    Full Text Available BACKGROUND: Intrauterine infection may play a role in preterm delivery due to spontaneous preterm labor (PTL and preterm prolonged rupture of membranes (PPROM. Because bacteria previously associated with preterm delivery are often difficult to culture, a molecular biology approach was used to identify bacterial DNA in placenta and fetal membranes. METHODOLOGY/PRINCIPAL FINDINGS: We used broad-range 16S rDNA PCR and species-specific, real-time assays to amplify bacterial DNA from fetal membranes and placenta. 74 women were recruited to the following groups: PPROM <32 weeks (n = 26; 11 caesarean; PTL with intact membranes <32 weeks (n = 19; all vaginal birth; indicated preterm delivery <32 weeks (n = 8; all caesarean; term (n = 21; 11 caesarean. 50% (5/10 of term vaginal deliveries were positive for bacterial DNA. However, little spread was observed through tissues and species diversity was restricted. Minimal bacteria were detected in term elective section or indicated preterm deliveries. Bacterial prevalence was significantly increased in samples from PTL with intact membranes [89% (17/19 versus 50% (5/10 in term vaginal delivery p = 0.03] and PPROM (CS [55% (6/11 versus 0% (0/11 in term elective CS, p = 0.01]. In addition, bacterial spread and diversity was greater in the preterm groups with 68% (13/19 PTL group having 3 or more positive samples and over 60% (12/19 showing two or more bacterial species (versus 20% (2/10 in term vaginal deliveries. Blood monocytes from women with PTL with intact membranes and PPROM who were 16S bacterial positive showed greater level of immune paresis (p = 0.03. A positive PCR result was associated with histological chorioamnionitis in preterm deliveries. CONCLUSION/SIGNIFICANCE: Bacteria are found in both preterm and term fetal membranes. A greater spread and diversity of bacterial species were found in tissues of women who had very preterm births. It is unclear to what extent the greater bacterial prevalence

  12. Association of glutathione S-transferase M1 and T1 gene polymorphisms and oxidative stress markers in preterm labor.

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    Mustafa, M D; Pathak, Rahul; Ahmed, Tanzeel; Ahmed, Rafat S; Tripathi, A K; Guleria, Kiran; Banerjee, B D

    2010-09-01

    Oxidative stress and related gene polymorphism may be associated with the etiology of preterm labor (PTL). The present study was designed to investigate association of GSTM1 and GSTT1 gene polymorphisms with PTL and their relationship with oxidative stress markers. Sixty cases of PTL and sixty three subjects of full term labor (FTL) were included in the study. Multiplex PCR was performed for GSTM1 and GSTT1 genes polymorphism and oxidative stress markers were analyzed. MDA and 8-OHdG levels were increased, while GSH was decreased in PTL than FTL subjects. Frequency of GSTM1-/GSTT1-(null) was significantly higher in PTL in comparison to FTL (p=0.028, OR=3.4). Subjects with GSTM1-/GSTT1+, GSTM1+/GSTT1-, GSTM1-/GSTT1- have significant differences of oxidative stress markers as compared to GSTM1+/GSTT1+ genotype. GSTM1-/GSTT1- (null) genotype may be one of the associated genetic factor for the increased risk of PTL. Copyright (c) 2010 The Canadian Society of Clinical Chemsits. Published by Elsevier Inc. All rights reserved.

  13. Ancestry informative markers and selected single nucleotide polymorphisms in immunoregulatory genes on preterm labor and preterm premature rupture of membranes: a case control study.

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    Ramos, Bruna Ribeiro de Andrade; Mendes, Niele Dias; Tanikawa, Aline Aki; Amador, Marcos Antônio Trindade; dos Santos, Ney Pereira Carneiro; dos Santos, Sidney Emanuel Batista; Castelli, Erick C; Witkin, Steven S; da Silva, Márcia Guimarães

    2016-02-05

    A genetic predisposition to Preterm Labor (PTL) and Preterm Premature Rupture of Membranes (PPROM) has been suggested; however the relevance of polymorphisms and ancestry to susceptibility to PTL and PPROM in different populations remains unclear. The aim of this study was to evaluate the contribution of maternal and fetal SNPs in the IL1B, IL6, IL6R, TNFA, TNFR, IL10, TLR2, TLR4, MMP9, TIMP1 and TIMP2 genes and the influence of ancestry background in the susceptibility to PTL or PPROM in Brazilian women. Case-control study conducted at a tertiary hospital in São Paulo State, Brazil. We included women with PTL or PPROM and their babies (PTL: 136 women and 88 babies; PPROM: 65 women and 44 babies). Control group included 402 mother-babies pairs of term deliveries. Oral swabs were collected for identification of AIMs by fragment analysis and SNPs by Taqman® SNP Genotyping Assays and PCR. Linkage Disequilibrium and Hardy-Weinberg proportions were evaluated using Genepop 3.4. Haplotypes were inferred using the PHASE algorithm. Allele, genotype and haplotype frequencies were compared by Fisher's exact test or χ (2) and Odds Ratio. Logistic regression was performed. Clinical and sociodemographic data were analyzed by Fisher's exact test and Mann-Whitney. PTL was associated with European ancestry and smoking while African ancestry was protective. The fetal alleles IL10-592C (rs800872) and IL10-819C (rs1800871) were also associated with PTL and the maternal haplotype TNFA-308G-238A was protective. Maternal presence of IL10-1082G (rs1800896) and TLR2A (rs4696480) alleles increased the risk for PPROM while TNFA-238A (rs361525) was protective. Family history of PTL/PPROM was higher in cases, and time to delivery was influenced by IL1B-31T (rs1143627) and TLR4-299G (rs4986790). There is an association between European ancestry and smoking and PTL in our Brazilian population sample. The presence of maternal or fetal alleles that modify the inflammatory response increase the

  14. Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor

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    Blackwell, Sean C; Sullivan, Erin M; Petrilla, Allison A; Shen, Xian; Troeger, Kathleen A; Byrne, James D

    2017-01-01

    Objectives To identify pregnant health plan members triaged through the emergency department (ED), including labor and delivery (ELD) units, with symptoms of preterm labor (PTL), and evaluate the use of fetal fibronectin (fFN) testing; and to calculate the rate of hospitalization and timing of delivery in relation to the ED visit. Methods Retrospective cohort study using Medical Outcomes Research for Effectiveness and Economics Registry®, a national multipayer claims database. A cohort of pregnant women evaluated in an ELD with a diagnosis of PTL from June 2012 through November 2015 was identified. The proportion of women with PTL who received fFN testing was calculated. Results A total of 23,062 patients met the criteria for inclusion in the study. The rate of fFN testing prior to delivery was 12.0%. Of the 23,062 patients included in the analysis, 75.9% were discharged home. Of those who were discharged from the emergency room, one in five went on to deliver within 3 days and almost 96% of this group was not screened for the presence of fFN. Of the remaining 24.1% of patients admitted to the hospital, 91.3% delivered during their stay. In a sensitivity analysis, the percentage of women who delivered within 3 days of the ELD encounter was lower for women who received fFN testing only (6.6%) versus those who had a history of transvaginal ultrasound (TVUS) only (21.6%). Furthermore, the rate of delivery within 3 days was lowest among patients who had both fFN testing and TVUS (4.7%). Conclusion The utilization of fFN testing is 12%. The majority of pregnant patients triaged through the ELD with symptomatic PTL do not receive an fFN test. As part of PTL evaluation, fFN testing may identify women at increased risk for preterm delivery and help determine appropriate patient management. PMID:29042802

  15. Immune cells in term and preterm labor

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    Gomez-Lopez, Nardhy; StLouis, Derek; Lehr, Marcus A; Sanchez-Rodriguez, Elly N; Arenas-Hernandez, Marcia

    2014-01-01

    Labor resembles an inflammatory response that includes secretion of cytokines/chemokines by resident and infiltrating immune cells into reproductive tissues and the maternal/fetal interface. Untimely activation of these inflammatory pathways leads to preterm labor, which can result in preterm birth. Preterm birth is a major determinant of neonatal mortality and morbidity; therefore, the elucidation of the process of labor at a cellular and molecular level is essential for understanding the pathophysiology of preterm labor. Here, we summarize the role of innate and adaptive immune cells in the physiological or pathological activation of labor. We review published literature regarding the role of innate and adaptive immune cells in the cervix, myometrium, fetal membranes, decidua and the fetus in late pregnancy and labor at term and preterm. Accumulating evidence suggests that innate immune cells (neutrophils, macrophages and mast cells) mediate the process of labor by releasing pro-inflammatory factors such as cytokines, chemokines and matrix metalloproteinases. Adaptive immune cells (T-cell subsets and B cells) participate in the maintenance of fetomaternal tolerance during pregnancy, and an alteration in their function or abundance may lead to labor at term or preterm. Also, immune cells that bridge the innate and adaptive immune systems (natural killer T (NKT) cells and dendritic cells (DCs)) seem to participate in the pathophysiology of preterm labor. In conclusion, a balance between innate and adaptive immune cells is required in order to sustain pregnancy; an alteration of this balance will lead to labor at term or preterm. PMID:24954221

  16. Risk factor for preterm labor in Haji Adam Malik General Hospital, Pirngadi General hospital and satellite hospitals in Medan from January 2014 to December 2016

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    Sukatendel, K.; Hasibuan, C. L.; Pasaribu, H. P.; Sihite, H.; Ardyansah, E.; Situmorang, M. F.

    2018-03-01

    In 2010, Indonesia was ranked fifth in the world for the number of premature birth. Prematurity is a multifactorial problem. Preterm Labor (PTL) can occur spontaneously without a clear cause. Preventing PTL, its associated risk factors must be recognized first. To analyze risk factors associated with the incidence of PTL. It is a cross sectional study using secondary data obtained from medical records in Haji Adam Malik general hospital, Pirngadi general hospital and satellite hospitals in Medan from January 2014 to December 2016. Data were analyzed using chi-square method and logistic regression test. 148 cases for each group of preterm labor and obtained term laborin this study. Using the logistic regression test, three factors with astrong association to the incidence of identifiedpreterm labor. Antenatal Care frequency (OR 2,326; CI 95%), leucorrhea (OR 6,291; 95%), and premature rupture of membrane (OR 9,755; CI 95%). In conclusion, antenatal care frequency, leucorrhea, and history of premature rupture of themembrane may increase the incidence of Preterm Labor (PTL).

  17. Timing of Histologic Progression from Chorio-Deciduitis to Chorio-Deciduo-Amnionitis in the Setting of Preterm Labor and Preterm Premature Rupture of Membranes with Sterile Amniotic Fluid.

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    Park, Chan-Wook; Park, Joong Shin; Norwitz, Errol R; Moon, Kyung Chul; Jun, Jong Kwan; Yoon, Bo Hyun

    2015-01-01

    Histologic chorio-deciduitis and chorio-deciduo-amnionitis (amnionitis) in extra-placental membranes are known to represent the early and advanced stages of ascending intra-uterine infection. However, there are no data in humans about the time required for chorio-deciduitis to develop and for chorio-deciduitis without amnionitis to progress to chorio-deciduitis with amnionitis, and the effect of prolongation of pregnancy on the development of chorio-deciduitis and amnionitis in patients with preterm labor and intact membranes (PTL) and preterm premature rupture of membranes (preterm-PROM). We examined these issues in this study. The study population consisted of 289 women who delivered preterm (133 cases with PTL, and 156 cases with preterm-PROM) and who had sterile amniotic fluid (AF) defined as a negative AF culture and the absence of inflammation as evidenced by a matrix metalloproteinase-8 (MMP-8) level membranes (i.e., inflammation-free extra-placental membranes, choroi-deciduitis only, and chorio-deciduitis with amnionitis) in patients with PTL and preterm-PROM. Amniocentesis-to-delivery interval was longer in cases of chorio-deciduitis with amnionitis than in cases of chorio-deciduitis only in both PTL (median [interquartile-range (IQR)]; 645.4 [319.5] vs. 113.9 [526.9] hours; P = 0.005) and preterm-PROM (131.3 [135.4] vs. 95.2 [140.5] hours; Pmembranes. Moreover, prolongation of pregnancy is an independent predictor of the development of both chorio-deciduitis and amnionitis in cases of PTL with sterile AF.

  18. Timing of Histologic Progression from Chorio-Deciduitis to Chorio-Deciduo-Amnionitis in the Setting of Preterm Labor and Preterm Premature Rupture of Membranes with Sterile Amniotic Fluid.

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    Chan-Wook Park

    Full Text Available Histologic chorio-deciduitis and chorio-deciduo-amnionitis (amnionitis in extra-placental membranes are known to represent the early and advanced stages of ascending intra-uterine infection. However, there are no data in humans about the time required for chorio-deciduitis to develop and for chorio-deciduitis without amnionitis to progress to chorio-deciduitis with amnionitis, and the effect of prolongation of pregnancy on the development of chorio-deciduitis and amnionitis in patients with preterm labor and intact membranes (PTL and preterm premature rupture of membranes (preterm-PROM. We examined these issues in this study.The study population consisted of 289 women who delivered preterm (133 cases with PTL, and 156 cases with preterm-PROM and who had sterile amniotic fluid (AF defined as a negative AF culture and the absence of inflammation as evidenced by a matrix metalloproteinase-8 (MMP-8 level <23 ng/ml. We examined the association between amniocentesis-to-delivery interval and inflammatory status in the extra-placental membranes (i.e., inflammation-free extra-placental membranes, choroi-deciduitis only, and chorio-deciduitis with amnionitis in patients with PTL and preterm-PROM.Amniocentesis-to-delivery interval was longer in cases of chorio-deciduitis with amnionitis than in cases of chorio-deciduitis only in both PTL (median [interquartile-range (IQR]; 645.4 [319.5] vs. 113.9 [526.9] hours; P = 0.005 and preterm-PROM (131.3 [135.4] vs. 95.2 [140.5] hours; P<0.05. Amniocentesis-to-delivery interval was an independent predictor of the development of both chorio-deciduitis and amnionitis after correction for confounding variables such as gestational age at delivery in the setting of PTL, but not preterm-PROM.These data confirm for the first time that, in cases of both PTL and preterm-PROM with sterile AF, more time is required to develop chorio-deciduitis with amnionitis than chorio-deciduitis alone in extra-placental membranes. Moreover

  19. Preterm labor and preterm premature rupture of membranes have a different pattern in the involved compartments of acute histologoic chorioamnionitis and/or funisitis: Patho-physiologic implication related to different clinical manifestations.

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    Park, Chan-Wook; Park, Joong Shin; Moon, Kyung Chul; Jun, Jong Kwan; Yoon, Bo Hyun

    2016-06-01

    It is unknown whether histo-topographic findings about the involved compartments (i.e., choriodecidua, amnion, chorionic-plate) of acute-histologic chorioamnionitis (acute-HCA) and/or funisitis according to the presence or absence of intra-amniotic inflammation (IAI) and/or fetal inflammatory response syndrome (FIRS) are different between preterm labor and intact membranes (PTL) and preterm premature rupture of membranes (preterm-PROM). The involved compartments of acute-HCA and/or funisitis were examined in 161 singleton preterm-births ( 0.1). However, IAI(+)/FIRS(+) group had a significantly higher rate of inflammation in each compartment than IAI(+)/FIRS(-) group in both PTL and preterm-PROM (each-for P < 0.05). We first demonstrated that PTL and preterm-PROM had a different pattern in the involved compartments of acute-HCA and/or funisitis in the IAI(-)/FIRS(--) group and in the change of involved compartments from IAI(-)/FIRS(-) to IAI(+)/FIRS(-). © 2016 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

  20. Maternal plasma nitric oxide metabolites and cervical length assessment in predicting the tocolytic therapy in preterm labor in Isfahan

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    Zahra Shahshahan

    2016-01-01

    Full Text Available Background: Preterm labor (PTL is the main challenge in prenatal health care, leads to high rate of mortality and increases cost of health services. To evaluate the preterm delivery (PTD-related risk factors, we decided to measure nitrite oxide metabolites and cervical length (CL as the diagnostic and predictive tools for PTD in women and response to tocolytic therapy. Materials and Methods: In this case–control study, sixty women of 18–35 years with first pregnancy during the 24–34 gestational weeks with PTL in case group admitted to the delivery section of Beheshti Hospital, Isfahan, Iran were included. Sixty women in control group have the same specifications. NO and CL level were assessed, and the collected data were analyzed by SPSS software, version 20 and MedCalc software, version 15.1. Results: The two groups were similar regarding maternal and gestational age (P > 0.05. Lower level of NO was observed in PTL women with a mean of 35.30 ± 8.27 μmol/L compared to the normal gestation group with a mean of 39.05 ± 10.17 μmol/L (P = 0.035. In addition, the diagnostic accuracy of both PTL-predicting factors was determined (NO ≤31, sensitivity 99.7%, specificity 82.5% and CL ≤22, sensitivity 80%, specificity 99.9%. Conclusion: As the previous investigations stated, it can be claimed that NO might be the reliable marker for predicting the PTL, and administration of NO synthesis could be a candidate for the future therapeutic target.

  1. Role of perceived stress in the occurrence of preterm labor and preterm birth among urban women.

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    Seravalli, Laura; Patterson, Freda; Nelson, Deborah B

    2014-01-01

    This study examined whether prenatal perceived stress levels during pregnancy were associated with preterm labor or preterm birth. Perceived stress levels were measured at 16 weeks' gestation or less and between 20 and 24 weeks' gestation in a sample of 1069 low-income pregnant women attending Temple University prenatal care clinics. Scores were averaged to create a single measure of prenatal stress. Preterm birth was defined as the occurrence of a spontaneous birth prior to 37 weeks' gestation. Preterm labor was defined as the occurrence of regular contractions between 20 and 37 weeks' gestation that were associated with changes in the cervix. Independent of potential confounding factors, prenatal perceived stress was not associated with preterm labor (odds ratio [OR], 1.10; 95% confidence interval [CI], 0.69-1.78; P = .66); however, prenatal stress trended toward an association with preterm birth (OR, 1.49; 95% CI, 1.00-2.23; P = .05). The strongest predictor of preterm labor was a history of preterm labor in a prior pregnancy. Women with a history of preterm labor were 2 times more likely to experience preterm labor in the current pregnancy than women who did not have a preterm labor history (OR, 2.16; 95% CI, 1.05-4.41; P = .04). Historical risk factors for preterm birth, such as African American race, a history of abortion, or a history of preterm birth, were not related to preterm labor. The strongest predictor of preterm birth was having a history of preterm birth in a prior pregnancy (OR, 2.55; 95% CI, 1.54-4.24; P stress levels may be a risk factor for preterm birth independent of preterm labor; however, prenatal stress was not associated with preterm labor. Risk factors for preterm labor may be different from those of preterm birth. © 2014 by the American College of Nurse-Midwives.

  2. How to diagnose preterm labor: a clinical dilemma.

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    Hayashi, R H; Mozurkewich, E L

    2000-12-01

    The clinician is faced with many dilemmas in the diagnosis of preterm labor. The tools at hand (no pun intended) yield subjective information and it is difficult to distinguish true labor from false labor. Because preterm labor is multifactorial in cause and can occur in primiparas, estimating risk for the individual patient is difficult. The cause of the preterm labor in the majority of patients is idiopathic; in this group, the use of salivary estriol as a biochemical marker for preterm labor can increase the accuracy of the diagnosis of true labor. It may also lend confidence to the diagnosis of false labor and may allay anxiety and prevent unnecessary interventions. On the horizon are two noninvasive methods: the EMG, to evaluate uterine contractility, and the collascope, to evaluate the cervix. Both show promise and may provide a more objective assessment of risk for preterm delivery among women with symptoms of preterm labor.

  3. Management of preterm labor: atosiban or nifedipine?

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    Roel de Heus

    2010-05-01

    Full Text Available Roel de Heus, Eduard J H Mulder, Gerard H A VisserDepartment of Woman and Baby, University Medical Centre Utrecht, The NetherlandsAbstract: Preterm birth is strongly associated with neonatal death and long-term neurological morbidity. The purpose of tocolytic drug administration is to postpone threatening preterm delivery for 48 hours to allow maximal effect of antenatal corticosteroids and maternal transportation to a center with specialized neonatal care facilities. There is uncertainty about the value of atosiban (oxytocin receptor antagonist and nifedipine (calcium channel blocker as first-line tocolytic drugs in the management of preterm labor. For nifedipine, concerns have been raised about unproven safety, lack of placebo-controlled trials, and its off-label use. The tocolytic efficacy of atosiban has also been questioned because of a lack of reduction in neonatal morbidity. This review discusses the available evidence, the pros and cons of either drug and aims to provide information to support a balanced choice of first-line tocolytic drug: atosiban or nifedipine?Keywords: atosiban, oxytocin receptor antagonist, nifedipine, calcium channel blocker, preterm birth, tocolytic drugs, preterm labor

  4. Maintenance Therapy by Vaginal Progesterone after Threatened Idiopathic Preterm Labor: A Randomized Placebo-Controlled Double-blind Trial

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    Seyede Hajar Sharami

    2010-01-01

    Full Text Available Background: Patients with arrested preterm labor (PTL are at increased risk for recurrence ofpreterm birth (PTB. Maintenance tocolysis after arrest of acute PTL is of questionable value. Theobjective of this study was to evaluate the efficacy of 200 mg vaginal progesterone in order toprevent PTB in women with episodes of threatened PTL.Materials and Methods: This is a randomized double blind clinical trial study.Women with singletonpregnancies between 28-36 weeks of gestation, who were hospitalized for PTL were included. Atotal of 173 pregnant patients were randomly allocated to receive 200 mg vaginal progesteronesuppositories (n=86 or placebo (n=87 daily until the 36th gestational week. The two groups werecompared relative to demographic characteristics, incidence of PTB before 34 and 37 weeks, andmaternal and neonatal complications. Data were analyzed by chi-square and Fisher’s exact tests.Results: Mean latency until delivery in the cases was longer than the control group (23.88 ± 18.01vs. 16.67 ± 12.9; p=0.004.Treatment with progesterone was not associated with a reduction inthe rate of PTB before 34 weeks [cases: 9 (10.8% vs. controls: 8 (10%] and 37 weeks [cases: 45(54.2% vs. controls: 33 (41.2%]. Log rank analysis revealed a significant difference for mean timeto delivery between the two groups (p=0.028. There were no significant differences for neonataland maternal complications in the two groups.Conclusion: Prophylactic administration of 200 mg vaginal progesterone suppositories aftersuccessful tocolysis in patients with threatened idiopathic PTL is associated with a longer latencyto delivery, but failed to reduce the rate of PTB (Registeration Number: IRCT138706051096N1.

  5. Ethanol for preventing preterm birth in threatened preterm labor.

    Science.gov (United States)

    Haas, David M; Morgan, Amanda M; Deans, Samantha J; Schubert, Frank P

    2015-11-05

    Preterm birth is the leading cause of death and disability in newborns worldwide. A wide variety of tocolytic agents have been utilized to delay birth for women in preterm labor. One of the earliest tocolytics utilized for this purpose was ethanol infusion, although this is not generally used in current practice due to safety concerns for both the mother and her baby. To determine the efficacy of ethanol in stopping preterm labor, preventing preterm birth, and the impact of ethanol on neonatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2015) and reference lists of retrieved studies. We included randomized and quasi-randomized studies. Cluster-randomized trials and cross-over design trials were not eligible for inclusion. We only included studies published in abstract form if there was enough information on methods and relevant outcomes. Trials were included if they compared ethanol infusion to stop preterm labor versus placebo/control or versus other tocolytic drugs. At least two review authors independently assessed studies for inclusion and risk of bias. At least two review authors independently extracted data. Data were checked for accuracy. Twelve trials involving 1586 women met inclusion criteria for this review. One trial did not report on the outcomes of interest in this review.Risk of bias of included studies: The included studies generally were of low quality based on inadequate reporting of methodology. Only three trials had low risk of bias for random sequence generation and one had low risk of bias for allocation concealment and participant blinding. Most studies were either high risk of bias or uncertain in these key areas. Comparison 1: Ethanol versus placebo/control (two trials, 77 women) Compared to controls receiving pain medications and dextrose solution, ethanol did not improve any of the primary outcomes: birth confidence interval (CI) 0.43 to 2.00), or neonatal mortality (one trial, 35 women; RR

  6. Cervicometry in the evaluation of preterm labor

    International Nuclear Information System (INIS)

    Napoles Mendez, Danilo

    2012-01-01

    One of the current problems of greater importance in perinatal medicine is the preterm labor, because besides elevating the perinatal morbidity and mortality, it causes neurological damage and affects growing in the newborns. In this paper not only the value of cervicometry is highlighted as a screening method in population with high risk of preterm newborns, but also its importance to predict the occurrence threat of the last condition when uterine contractions exist, reason why the appropriate technique, approaches, indications and the advantages of this procedure are described, as well as the cut level for the cervical length is determined in its different modalities. As a result, a care protocol for pregnants with prematurity risk based on the use of cervicometry was introduced, which is considered a valuable screening tool in the selected population

  7. Immunology of term and preterm labor

    Directory of Open Access Journals (Sweden)

    Peltier Morgan R

    2003-12-01

    Full Text Available Abstract During pregnancy there is an alteration in maternal immunity within the uterus where innate, proinflammatory immune responses are tightly regulated to prevent immunological rejection of the fetal allograft. Disruption of the delicate balance of cytokines by bacteria or other factors increases the production of proinflammatory cytokines at the maternal-fetal interface and activates the parturition mechanism prematurely. Despite years of searching, there is still no broadly effective strategy for preventing preterm labor and most therapies are directed at inhibiting myometrial contractions and improving neonatal outcome. Recent studies with progestins and interleukin-10 (IL-10, however, are showing promise in randomized clinical trials and animal studies. Furthermore, the identification of the Toll-like receptors as upstream mediators of inflammation may offer alternative therapeutic targets for preventing this common pregnancy complication.

  8. PTL: A Propositional Typicality Logic

    CSIR Research Space (South Africa)

    Booth, R

    2012-09-01

    Full Text Available relations on the language of PTL itself, thereby moving beyond the propositional setting. Building on the existing link between propositional rational consequence and belief revision, we show that the same correspondence holds for rational consequence...

  9. Maternal plasma total antioxidant status in preterm labor.

    Science.gov (United States)

    Cinkaya, Aysegül; Keskin, Hüseyin Levent; Buyukkagnici, Umran; Gungor, Tayfun; Keskin, Esra Aktepe; Avsar, Ayse Filiz; Bilge, Umit

    2010-12-01

    To investigate the role of oxidative stress and antioxidant status in preterm labor. Twenty-five cases diagnosed with preterm labor were included in the study group, whereas 25 women with uncomplicated pregnancies at similar stages of pregnancy were included in the control group. Total antioxidant status was measured in maternal plasma using a Hitachi 911 auto analyzer and a total antioxidant status kit (Randox Laboratories, UK) in mmol/L. Mean serum antioxidant status were lower in patients (1.002 ± 0.177 mmol/L) than in controls (1.258 ± 0.147 mmol/L) (P labor have decreased total antioxidant status compared with uncomplicated pregnancies in similar gestational weeks. Future work should clarify whether decreased total antioxidant status precedes preterm labor in a prospective cohort study. © 2010 The Authors. Journal of Obstetrics and Gynaecology Research © 2010 Japan Society of Obstetrics and Gynecology.

  10. A randomized, prospective study of adjunctive Ampicillin in preterm labor

    Directory of Open Access Journals (Sweden)

    Tehranian A

    1999-09-01

    Full Text Available Acute amniotic fluid infection has emerged as a possible cause of many heretofore unexplained preterm births. Our purpose was to determine the effect of ampicillin in the prolongation of pregnancies receiving tocolysis for preterm labor. A blinded, placebo-controlled, randomized trial was conducted to study ampicillin in women hospitalized for preterm labor between 24 and 37 weeks' gestation. A total of 60 patients with intact membranes and without chorioamnionitis who were receiving magnesium sulfate were screened. Thirty women with preterm labor received ampicillin, and 30 received placebos. The primary end point was prolongation of gestation. There was no difference in age of delivery (37.6±9.7 days vs 36.08±3.9 days, P=0.085 and no difference in retardation of delivery (4.7±3.1 vs 4.1±2.1, P=0.39. The mean degree of preterm delivery were 0.62±1.93 and 1.8±3.3 weeks in ampicillin and placebo groups, respectively (not significant, P>0.1. Conclusions: Ampicillin had no effect on interval to delivery or duration of pregnancy in women treated for preterm labor. So rotine clinical use of ampicillin during tocolysis should not be recommended.

  11. Melatonin prevents experimental preterm labor and increases offspring survival.

    Science.gov (United States)

    Domínguez Rubio, Ana P; Sordelli, Micaela S; Salazar, Ana I; Aisemberg, Julieta; Bariani, María V; Cella, Maximiliano; Rosenstein, Ruth E; Franchi, Ana M

    2014-03-01

    Preterm delivery is the leading cause of neonatal mortality and contributes to delayed physical and cognitive development in children. At present, there is no efficient therapy to prevent preterm labor. A large body of evidence suggests that intra-amniotic infections may be a significant and potentially preventable cause of preterm birth. This work assessed the effect of melatonin in a murine model of inflammation-associated preterm delivery which mimics central features of preterm infection in humans. For this purpose, preterm labor was induced in BALB/c mice by intraperitoneal injections of bacterial lipopolysaccharide (LPS) at 10.00 hr (10 μg LPS) and 13.00 hr (20 μg LPS) on day 15 of pregnancy. On day 14 of pregnancy, a pellet of melatonin (25 mg) had been subcutaneously implanted into a group of animals. In the absence of melatonin, a 100% incidence of preterm birth was observed in LPS-treated animals, and the fetuses showed widespread damage. By comparison, treatment with melatonin prevented preterm birth in 50% of the cases, and all pups from melatonin-treated females were born alive and their body weight did not differ from control animals. Melatonin significantly prevented the LPS-induced rises in uterine prostaglandin (PG) E2 , PGF2α, and cyclooxygenase-2 protein levels. In addition, melatonin prevented the LPS-induced increase in uterine nitric oxide (NO) production, inducible NO synthase protein, and tumor necrosis factor-alpha (TNFα) levels. Collectively, our results suggest that melatonin could be a new therapeutic tool to prevent preterm labor and to increase offspring survival. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Progesterone and the Latency Period: Threatened Preterm Labor

    Directory of Open Access Journals (Sweden)

    S Borna

    2008-06-01

    Full Text Available Background: Preterm labor is a major contributor to neonatal morbidity and mortality and results in increased obstetric and pediatric care costs. The purpose of this study was to assess the effects of vaginal progesterone for maintenance therapy following treatment of threatened preterm labor for preventing preterm birth.Methods: The study included 70 singleton pregnant women with preterm labor with intact membranes. Patients were randomized to receive either maintenance vaginal progesterone therapy (n=37 administered (400 mg daily or no treatment (controls, n=33 after discontinuation of acute intravenous tocolysis.Results: The two groups were similar with at respect to maternal age, race, parity, gestational age at admission, bishop score, and preterm delivery risk factors .Compared to the control group, the mean ±SD time gained from initiation of maintenance therapy to delivery (36/1117/9 versus 24/5227/2 (meanSD days, p=0.037 and the gestational age at delivery (36.071.56 vs. 34.51.3 weeks, p=0.041 were higher in the vaginal progesterone maintenance therapy group. No significant differences were found with recurrent preterm labor 13 (35.1% versus 19 (57.6%, p=0.092. Respiratory distress syndrome 4 (10.8% versus 12 (36.4% p=0.021, Low birth weight10 (27% versus, 17 (51.5% p=0.04, birth weight (3101.54±587.9gr versus r 2609.39±662.9gr, p=0.002 were significantly different between the two groups.Conclusion: The gestational age and time gained from initiation of maintenance therapy to delivery were longer in women receiving vaginal maintenance tocolysis with progesterone and improve perinatal outcomes. However, maintenance therapy did not decrease the recurrence of preterm labor episodes.

  13. Determinants of the competing outcomes of intrauterine infection, abruption, or spontaneous preterm birth after preterm premature rupture of membranes.

    Science.gov (United States)

    Hackney, David N; Kuo, Kelly; Petersen, Rebecca J; Lappen, Justin R

    2016-01-01

    Patients with PPROM are at risk for a variety of outcomes, including chorioamnionitis (CA), placental abruption (PA), or preterm labor (PTL). Competing risk regression can analyze a cohort's risk of individual outcomes while accounting for ongoing deliveries secondary to competing events. A secondary analysis of the subjects from MFMU BEAM study of neuroprotection after preterm birth (BEAM) with conservative PPROM management. Deliveries were categorized as: PA, CA, PTL, "elective" or "indicated". The association between outcomes of PA, CA or PTL and clinical predictors of twins, ethnicity, parity, gestational age at rupture, bleeding, contractions, cervical dilation, preterm birth history, weight, and genitourinary infections were evaluated via competing risk regression. 1970 subjects were included. The significance and directionality of predictors varied according to specific outcomes. Patients with twins had an increased PTL hazard (1.85) though reductions in CA- (0.66) or PA-specific (0.56) hazards. Decreased latency in African-Americans was almost entirely due to an increased CA hazard (1.44) without a significant association with PTL. Increasing gestational age at membrane rupture was associated with a decreasing hazard of CA although increasing hazard of PTL. For patients with PPROM, the hazards associated with different clinical predictors vary according to exact outcomes.

  14. Allergy-induced preterm labor after the ingestion of shellfish.

    Science.gov (United States)

    Romero, Roberto; Kusanovic, Juan Pedro; Muñoz, Hernan; Gomez, Ricardo; Lamont, Ronald F; Yeo, Lami

    2010-04-01

    Preterm parturition is a syndrome caused by several mechanisms of disease, including intrauterine infection/inflammation, uteroplacental ischemia, uterine overdistension, cervical disease, maternal/fetal stress, abnormal allogeneic responses, allergic reactions, and unknown insults. An allergic-like mechanism was proposed as a potential etiology for the preterm parturition syndrome, based on the observation that eosinophils were present in the amniotic fluid in a fraction of women with preterm labor and a history of allergy, coupled with the observation that conditioned media from degranulated mast cells (the effector cells of type 1 hypersensitivity) induced contractility of human myometrial strips. This communication describes a case of a pregnant woman who had an allergic reaction and regular uterine contractions after the ingestion of lobster meat, to which she was known to be allergic. Preterm labor subsided after the treatment of antihistamines and steroids. The patient subsequently delivered at term. At follow-up, the child was diagnosed with atopy and asthma, and required frequent use of inhaled corticosteroids and beta-2 adrenergic agents. The immunological basis for preterm labor induced by an allergic-like reaction (hypersensitivity) is reviewed.

  15. Stress and preterm labor and birth in Black women.

    Science.gov (United States)

    Gennaro, Susan; Shults, Justine; Garry, David J

    2008-01-01

    To examine (a) 3 commonly used measures of stress during pregnancy, (b) changes in stress over time to determine when stress is highest, and (c) whether any of the stress measures predict who will deliver preterm in pregnant Black women. Prospective descriptive study. Perinatal evaluation center and outpatient clinics of a teaching hospital in the northeast. Fifty-nine Black women: 39 were recruited in preterm labor from a Perinatal Evaluation Center, and 20 experiencing healthy pregnancies were recruited from the prenatal clinic. Stress was measured using 2 paper and pencil tests (the Prenatal Distress Questionnaire and the Perceived Stress Scale) and corticotropin-releasing hormone. There was not a high correlation between stress measures. Stress at 28 weeks as measured by Prenatal Distress Questionnaire and Perceived Stress Scale was at its highest, but corticotropin-releasing hormone increased to 32 weeks and then decreased. Perceived stress, prenatal distress, and corticotropin-releasing hormone do not all appear to be measuring the same phenomenon. Screening for stress in Black women at 28 weeks requires further research as perceived stress levels in Black women experiencing preterm labor around 28 weeks differentiated women who delivered preterm infants from Black women who delivered at term.

  16. Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta-analysis of randomized controlled trials using individual patient-level data.

    Science.gov (United States)

    Berghella, V; Palacio, M; Ness, A; Alfirevic, Z; Nicolaides, K H; Saccone, G

    2017-03-01

    Cervical length screening by transvaginal sonography (TVS) has been shown to be a good predictive test for spontaneous preterm birth (PTB) in symptomatic singleton pregnancy with threatened preterm labor (PTL). The aim of this review and meta-analysis of individual participant data was to evaluate the effect of knowledge of the TVS cervical length (CL) in preventing PTB in singleton pregnancies presenting with threatened PTL. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Complementary Medicine Field's Trials Register (May 2016) and reference lists of retrieved studies. Selection criteria included randomized controlled trials of singleton gestations with threatened PTL randomized to management based mainly on CL screening (intervention group), or CL screening with no knowledge of results or no CL screening (control group). Participants included women with singleton gestations at 23 + 0 to 36 + 6 weeks with threatened PTL. We contacted corresponding authors of included trials to request access to the data and perform a meta-analysis of individual participant data. Data provided by the investigators were merged into a master database constructed specifically for the review. The primary outcome was PTB DE PARTO PREMATURO: REVISIÓN SISTEMÁTICA Y METAANÁLISIS DE ENSAYOS CONTROLADOS ALEATORIZADOS HACIENDO USO DE LOS DATOS INDIVIDUALES DE LAS PACIENTES: RESUMEN OBJETIVO: El cribado mediante la longitud cervical obtenida con ecografía transvaginal (ETV) ha demostrado ser una buena prueba para la predicción del parto pretérmino espontáneo (PPTE) en embarazos con feto único sintomáticos debido a la amenaza de parto pretérmino (PPT). El objetivo de esta revisión y metaanálisis de los datos de participantes individuales fue evaluar el efecto de medir la longitud cervical (LC) mediante ETV con el fin de prevenir el parto prematuro en embarazos únicos con amenaza de PPT. MÉTODOS: Se realizaron búsquedas en los ficheros

  17. What Treatments Can Reduce the Chances of Preterm Labor and Birth?

    Science.gov (United States)

    ... treatments can reduce the chances of preterm labor & birth? If a pregnant woman is showing signs of ... to stop labor (tocolytics) and medications administered before birth to improve outcomes for the infant if born ...

  18. Efficacy of an internet-based cognitive behavioral stress management training in women with idiopathic preterm labor: A randomized controlled intervention study.

    Science.gov (United States)

    Urech, Corinne; Scherer, Sandra; Emmenegger, Martina; Gaab, Jens; Tschudin, Sibil; Hoesli, Irène; Berger, Thomas; Alder, Judith

    2017-12-01

    This randomized controlled trial aimed at evaluating the efficacy of an internet-based cognitive behavioral stress management program (IB-CBSM) for pregnant women with preterm labor (PTL) on birth outcome and stress-related psychological and biological parameters. 93 pregnant women with PTL (gestational age 18-32) were assigned to either the IB-CBSM (n=50) or a control group (CG) based on distraction (n=43). Participants in both groups worked through six weekly modules. Birth outcome measures included gestational age, neonatal weight and length at birth and the rate of preterm birth (PTB). Questionnaires assessed psychological wellbeing and the activity of the HPA-axis was measured with the cortisol awakening reaction (CAR), both before (T1) and after the intervention (T2). Birth outcome and psychological wellbeing did not differ between IB-CBSM and CG. However, psychological wellbeing was higher after both interventions (PSS: η p 2 =0.455, STAIX1: η p 2 =0.455, STAIX2: η p 2 =0.936, PRAT: η p 2 =0.465, EPDS: η p 2 =0.856). Cortisol levels were stable and did not alter differently between groups from T1 to T2. Higher cortisol levels were associated with lower gestational age at birth, whereas no significant correlations were found between weight and length at birth. Although there were no significant differences between the two groups and birth outcome, psychological and biological parameters, both interventions (CBSM and CG) showed equivalent effects and proved to be beneficial with regard to psychosocial distress and well-being. Further research is needed to investigate CBSM and distraction interventions for pregnant women at risk for PTB together with a non-intervention control condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Term induction of labor and subsequent preterm birth.

    Science.gov (United States)

    Levine, Lisa D; Bogner, Hillary R; Hirshberg, Adi; Elovitz, Michal A; Sammel, Mary D; Srinivas, Sindhu K

    2014-04-01

    Although the rate of inductions continues to rise, there is a paucity of data investigating subsequent pregnancy outcomes after induction. Our objective was to compare term inductions with term spontaneous labor and evaluate the rate of subsequent spontaneous preterm birth (sPTB). A retrospective cohort study of women with 2 consecutive deliveries from 2005 through 2010 was performed. Term inductions or term spontaneous labor in the index pregnancy was included, and those with a prior sPTB were excluded. Data were obtained through chart abstraction. The primary outcome was sPTB (Term inductions were less likely to have a subsequent sPTB compared with term spontaneous labor (6% vs 11%; odds ratio [OR], 0.49; 95% confidence interval, 0.29-0.81; P = .005). This remained after adjusting for confounders (adjusted OR, 0.55; P = .04). The sPTB risk depended on gestational age of index delivery. At 37-38.9 weeks, the sPTB rate after spontaneous labor was 24% vs 9% after induction (OR, 3.0; 95% confidence interval, 1.44-6.16; P = .003). This was not significant for 39-39.9 weeks (P = .2) or 40 weeks or longer (P = .8). Induction is not a risk factor for subsequent sPTB. Spontaneous labor, however, in the early term period is associated with subsequent sPTB. Further investigation among early term deliveries is warranted to evaluate the risk of sPTB and target interventions in this cohort. Copyright © 2014 Mosby, Inc. All rights reserved.

  20. The Prevalence of Urogenital Infections in Pregnant Women Experiencing Preterm and Full-Term Labor

    OpenAIRE

    Paulo César Giraldo; Edilson D. Araújo; José Eleutério Junior; Rose Luce Gomes do Amaral; Mauro R. L. Passos; Ana Katherine Gonçalves

    2012-01-01

    Urogenital infections are extremely prevalent during pregnancy and are an important cause of premature labor. However, the prevalence of urogenital infections during childbirth is not well known. Objective. Identify urogenital infections present at the beginning of labor in both full-term and preterm pregnancies. Study Design. Ninety-four women were admitted to the inpatient maternity clinic of the Federal University of Rio Grande do Norte (UFRN). In total, 49 women in preterm labor and 45 wo...

  1. Toll-Like Receptor-2 and -4 Expression by Maternal Neutrophils in Preterm Labor.

    Science.gov (United States)

    Prearo Moço, Natália; Camargo Batista, Renata Aparecida; Fernandes Martin, Laura; de Oliveira, Leandro Gustavo; Garcia de Lima Parada, Cristina Maria; Alarcão Dias-Melicio, Luciane; de Assis Golim, Marjorie; Guimarães da Silva, Márcia

    2018-01-01

    The inflammatory response in preterm parturition is regulated by the innate immune system. Toll-like receptors (TLR)-2 and TLR-4 are innate immune receptors that recognize the microorganisms most frequently involved in amniotic cavity infections, which are associated with activating the inflammatory response at the maternal-fetal interface during preterm labor. This study aimed to evaluate the expression of TLR-2 and TLR-4 in maternal neutrophils in preterm labor. A cross-sectional study was conducted in the Obstetrics Care Unit of Botucatu Medical School, UNESP, Brazil. The preterm group was composed of 20 pregnant women who presented preterm labor and preterm delivery. The control group was composed of 20 nonlaboring pregnant women matched to the preterm group by gestational age. Neutrophils were isolated from peripheral blood and TLR expressions were performed by real-time polymerase chain reaction and flow cytometry. Gene expressions of TLR-2 and TLR-4 in neutrophils from the preterm group were statistically higher than expressions in neutrophils from the matched control group. The percentage of TLR-4+ neutrophils was higher in the preterm group than the matched control group, while the percentage of TLR-2+ neutrophils did not differ between groups. TLR-4 expression in maternal neutrophils is associated with spontaneous preterm labor. © 2017 S. Karger AG, Basel.

  2. Ubiquitin-Proteasome-Collagen (CUP Pathway in Preterm Premature Rupture of Fetal Membranes

    Directory of Open Access Journals (Sweden)

    Xinliang Zhao

    2017-06-01

    Full Text Available Spontaneous preterm birth (sPTB occurs before 37 gestational weeks, with preterm premature rupture of the membranes (PPROM and spontaneous preterm labor (sPTL as the predominant adverse outcomes. Previously, we identified altered expression of long non-coding RNAs (lncRNAs and message RNAs (mRNAs related to the ubiquitin proteasome system (UPS in human placentas following pregnancy loss and PTB. We therefore hypothesized that similar mechanisms might underlie PPROM. In the current study, nine pairs of ubiquitin-proteasome-collagen (CUP pathway–related mRNAs and associated lncRNAs were found to be differentially expressed in PPROM and sPTL. Pathway analysis showed that the functions of their protein products were inter-connected by ring finger protein. Twenty variants including five mutations were identified in CUP-related genes in sPTL samples. Copy number variations were found in COL19A1, COL28A1, COL5A1, and UBAP2 of sPTL samples. The results reinforced our previous findings and indicated the association of the CUP pathway with the development of sPTL and PPROM. This association was due not only to the genetic variation, but also to the epigenetic regulatory function of lncRNAs. Furthermore, the findings suggested that the loss of collagen content in PPROM could result from degradation and/or suppressed expression of collagens.

  3. Plasma C16-Cer levels are increased in patients with preterm labor.

    Science.gov (United States)

    Laudanski, Piotr; Charkiewicz, Karol; Kisielewski, Rafal; Kuc, Pawel; Koc-Zorawska, Ewa; Raba, Grzegorz; Kraczkowski, Janusz; Dymicka-Piekarska, Violetta; Chabowski, Adrian; Kacerovsky, Marian; Jacobsson, Bo; Zabielski, Piotr; Blachnio-Zabielska, Agnieszka

    2016-03-01

    The pathogenesis of preterm labor is fragmentarily explained. The most widely accepted theory points out to infection and inflammation as possible causes, which can be mediated by potentially different factors, including sphingolipid mediators. Sphingolipids are a class of lipids that have been shown as important mediators in various cell processes such as: proliferation, growth, apoptosis, stress response, necrosis and inflammation. The aim of the study was to assess plasma concentrations of selected sphingolipids in patients with preterm labor. We used ultra-high performance liquid chromatography with triple mass spectrometry (UHPLC-ESI-MS/MS) to assess plasma concentrations of the 11 sphingolipids in patients presenting with symptoms of preterm labor (n=61) and threatened preterm labor (n=40). We observed a statistically significant increase (p-valuelabor as compared to the control group. We also found C16-Cer to be the best predictor of preterm labor in the group of patients with symptoms occurring after 32 weeks of gestation. Our findings show a possible involvement of selected sphingolipids, especially C16-Cer, in the pathogenesis of preterm labor. Their role as predictors of preterm delivery needs to be validated in the future on larger group of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. The Prevalence of Urogenital Infections in Pregnant Women Experiencing Preterm and Full-Term Labor

    Directory of Open Access Journals (Sweden)

    Paulo César Giraldo

    2012-01-01

    Full Text Available Urogenital infections are extremely prevalent during pregnancy and are an important cause of premature labor. However, the prevalence of urogenital infections during childbirth is not well known. Objective. Identify urogenital infections present at the beginning of labor in both full-term and preterm pregnancies. Study Design. Ninety-four women were admitted to the inpatient maternity clinic of the Federal University of Rio Grande do Norte (UFRN. In total, 49 women in preterm labor and 45 women in full-term labor were included in the study, and samples of urinary, vaginal, and perianal material were collected for microbiological analysis. Results. The prevalences of general infections in the preterm labor group and the full-term labor group were 49.0% and 53.3% (P=0.8300, respectively. Urogenital infections in the preterm and full-term labor groups included urinary tract infection in 36.7% and 22.2% of women, vaginal candidiasis in 20.4% and 28.9% of women, bacterial vaginosis in 34.7% and 28.9% of women, and group B streptococcus in 6.1% and 15.6% of women, respectively. Conclusions. Urogenital infections were prevalent in women in preterm labor and full-term labor; however, significant differences between the groups were not observed.

  5. The Prevalence of Urogenital Infections in Pregnant Women Experiencing Preterm and Full-Term Labor

    Science.gov (United States)

    Giraldo, Paulo César; Araújo, Edilson D.; Junior, José Eleutério; do Amaral, Rose Luce Gomes; Passos, Mauro R. L.; Gonçalves, Ana Katherine

    2012-01-01

    Urogenital infections are extremely prevalent during pregnancy and are an important cause of premature labor. However, the prevalence of urogenital infections during childbirth is not well known. Objective. Identify urogenital infections present at the beginning of labor in both full-term and preterm pregnancies. Study Design. Ninety-four women were admitted to the inpatient maternity clinic of the Federal University of Rio Grande do Norte (UFRN). In total, 49 women in preterm labor and 45 women in full-term labor were included in the study, and samples of urinary, vaginal, and perianal material were collected for microbiological analysis. Results. The prevalences of general infections in the preterm labor group and the full-term labor group were 49.0% and 53.3% (P = 0.8300), respectively. Urogenital infections in the preterm and full-term labor groups included urinary tract infection in 36.7% and 22.2% of women, vaginal candidiasis in 20.4% and 28.9% of women, bacterial vaginosis in 34.7% and 28.9% of women, and group B streptococcus in 6.1% and 15.6% of women, respectively. Conclusions. Urogenital infections were prevalent in women in preterm labor and full-term labor; however, significant differences between the groups were not observed. PMID:22505801

  6. Oxytocin receptor blockade: a new principle in the treatment of preterm labor?

    DEFF Research Database (Denmark)

    Andersen, L F; Lyndrup, J; Akerlund, M

    1989-01-01

    a role for oxytocin also in idiopathic preterm labor. A newly synthesized oxytocin analogue, 1-deamino-2-D-Tyr-(OEt)-4-Thr-8-Orn-oxytocin, has been found to be a competitive inhibitor of oxytocin. The present study was conducted to test its efficacy in suppressing uterine contractions during preterm...

  7. Preterm labor in the absence of acute histologic chorioamnionitis is characterized by cellular senescence of the chorioamniotic membranes.

    Science.gov (United States)

    Gomez-Lopez, Nardhy; Romero, Roberto; Plazyo, Olesya; Schwenkel, George; Garcia-Flores, Valeria; Unkel, Ronald; Xu, Yi; Leng, Yaozhu; Hassan, Sonia S; Panaitescu, Bogdan; Cha, Jeeyeon; Dey, Sudhansu K

    2017-11-01

    Decidual senescence has been considered a mechanism of disease for spontaneous preterm labor in the absence of severe acute inflammation. Yet, signs of cellular senescence have also been observed in the chorioamniotic membranes from women who underwent the physiological process of labor at term. We aimed to investigate whether, in the absence of acute histologic chorioamnionitis, the chorioamniotic membranes from women who underwent spontaneous preterm labor or labor at term exhibit signs of cellular senescence. Chorioamniotic membrane samples were collected from women who underwent spontaneous preterm labor or labor at term. Gestational age-matched nonlabor controls were also included. Senescence-associated genes/proteins were determined using reverse transcription quantitative polymerase chain reaction analysis (n = 7-9 each for array; n = 26-28 each for validation), enzyme-linked immunosorbent assays (n = 7-9 each), immunoblotting (n = 6-7 each), and immunohistochemistry (n = 7-8 each). Senescence-associated β-galactosidase activity (n = 7-11 each) and telomere length (n = 15-22 each) were also evaluated. In the chorioamniotic membranes without acute histologic chorioamnionitis: (1) the expression profile of senescence-associated genes was different between the labor groups (term in labor and preterm in labor) and the nonlabor groups (term no labor and preterm no labor), yet there were differences between the term in labor and preterm in labor groups; (2) most of the differentially expressed genes among the groups were closely related to the tumor suppressor protein (TP53) pathway; (3) the expression of TP53 was down-regulated in the term in labor and preterm in labor groups compared to their nonlabor counterparts; (4) the expression of CDKN1A (gene coding for p21) was up-regulated in the term in labor and preterm in labor groups compared to their nonlabor counterparts; (5) the expression of the cyclin kinase CDK2 and cyclins CCNA2, CCNB1, and

  8. Is measurement of cervical length an accurate predictive tool in women with a history of preterm delivery who present with threatened preterm labor?

    Science.gov (United States)

    Melamed, N; Hiersch, L; Meizner, I; Bardin, R; Wiznitzer, A; Yogev, Y

    2014-12-01

    To determine whether sonographically measured cervical length is an effective predictive tool in women with threatened preterm labor and a history of past spontaneous preterm delivery. This was a retrospective cohort study of all women with singleton pregnancies who presented with preterm labor at less than 34 + 0 weeks' gestation and underwent sonographic measurement of cervical length in a tertiary medical center between 2007 and 2012. The accuracy of cervical length in predicting preterm delivery was compared between women with and those without a history of spontaneous preterm delivery. Women with risk factors for preterm delivery other than a history of preterm delivery were excluded from both groups. Overall, 1023 women who presented with preterm labor met the study criteria, of whom 136 (13.3%) had a history of preterm delivery (past-PTD group) and 887 (86.7%) had no risk factors for preterm delivery (low-risk group). The rate of preterm delivery was significantly higher for women with a history of preterm delivery (36.8% vs 22.5%; P delivery interval in low-risk women (r = 0.32, P delivery (r = 0.07, P = 0.4). On multivariable analysis, cervical length was independently associated with the risk of preterm delivery for women in the low-risk group but not for women with a history of previous preterm delivery. For women with previous preterm delivery who presented with threatened preterm labor, cervical length failed to distinguish between those who did and those who did not deliver prematurely (area under the receiver-operating characteristics curve range, 0.475-0.506). When using standardized thresholds, the sensitivity and specificity of cervical length for the prediction of preterm delivery were significantly lower in women with previous preterm delivery than in women with no risk factors for preterm delivery. Cervical length appears to be of limited value in the prediction of preterm delivery among women with threatened preterm labor

  9. Uterine overdistention induces preterm labor mediated by inflammation: observations in pregnant women and nonhuman primates.

    Science.gov (United States)

    Adams Waldorf, Kristina M; Singh, Natasha; Mohan, Aarthi R; Young, Roger C; Ngo, Lisa; Das, Ananya; Tsai, Jesse; Bansal, Aasthaa; Paolella, Louis; Herbert, Bronwen R; Sooranna, Suren R; Gough, G Michael; Astley, Cliff; Vogel, Keith; Baldessari, Audrey E; Bammler, Theodor K; MacDonald, James; Gravett, Michael G; Rajagopal, Lakshmi; Johnson, Mark R

    2015-12-01

    Uterine overdistention is thought to induce preterm labor in women with twin and multiple pregnancies, but the pathophysiology remains unclear. We investigated for the first time the pathogenesis of preterm birth associated with rapid uterine distention in a pregnant nonhuman primate model. A nonhuman primate model of uterine overdistention was created using preterm chronically catheterized pregnant pigtail macaques (Macaca nemestrina) by inflation of intraamniotic balloons (N = 6), which were compared to saline controls (N = 5). Cesarean delivery was performed due to preterm labor or at experimental end. Microarray, quantitative reverse transcriptase polymerase chain reaction, Luminex (Austin, TX), and enzyme-linked immunosorbent assay were used to measure messenger RNA (mRNA) and/or protein levels from monkey (amniotic fluid, myometrium, maternal plasma) and human (amniocytes, amnion, myometrium) tissues. Statistical analysis employed analysis of covariance and Wilcoxon rank sum. Biomechanical forces were calculated using the law of Laplace. Preterm labor occurred in 3 of 6 animals after balloon inflation and correlated with greater balloon volume and uterine wall stress. Significant elevations of inflammatory cytokines and prostaglandins occurred following uterine overdistention in an "inflammatory pulse" that correlated with preterm labor (interleukin [IL]-1β, tumor necrosis factor [TNF]-α, IL-6, IL-8, CCL2, prostaglandin E2, prostaglandin F2α, all P labor (IL6, IL8, CCL2, all P labor. Our results indicate that inflammation is an early event after a mechanical stress on the uterus and leads to preterm labor when the stress is sufficiently great. Further, we find evidence of uterine tissue remodeling and muscle growth as a common, perhaps compensatory, response to uterine distension. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. What Are the Risks Factors for Preterm Labor and Birth?

    Science.gov (United States)

    ... cdc.gov/reproductivehealth/maternalinfanthealth/PretermBirth.htm [top] « What causes it? Is it possible ... research links air pollution and extreme temperature to stillbirth risk All related ...

  11. Comparative analysis of gene expression in maternal peripheral blood and monocytes during spontaneous preterm labor.

    Science.gov (United States)

    Paquette, Alison G; Shynlova, Oksana; Kibschull, Mark; Price, Nathan D; Lye, Stephen J

    2018-03-01

    Preterm birth is the leading cause of newborn death worldwide, and is associated with significant cognitive and physiological challenges in later life. There is a pressing need to define the mechanisms that initiate spontaneous preterm labor, and for development of novel clinical biomarkers to identify high-risk pregnancies. Most preterm birth studies utilize fetal tissues, and there is limited understanding of the transcriptional changes that occur in mothers undergoing spontaneous preterm labor. Earlier work revealed that a specific population of maternal peripheral leukocytes (macrophages/monocytes) play an active role in the initiation of labor. Thus, we hypothesized that there are dynamic gene expression changes in maternal blood leukocytes during preterm labor. Using next-generation sequencing we aim to characterize the transcriptome in whole blood leukocytes and peripheral monocytes of women undergoing spontaneous preterm labor compared to healthy pregnant women who subsequently delivered at full term. RNA sequencing was performed in both whole blood and peripheral monocytes from women who underwent preterm labor (24-34 weeks of gestation, N = 20) matched for gestational age to healthy pregnant controls (N = 30). All participants were a part of the Ontario Birth Study cohort (Toronto, Ontario, Canada). We identified significant differences in expression of 262 genes in peripheral monocytes and 184 genes in whole blood of women who were in active spontaneous preterm labor compared to pregnant women of the same gestational age not undergoing labor, with 43 of these genes differentially expressed in both whole blood and peripheral monocytes. ADAMTS2 expression was significantly increased in women actively undergoing spontaneous preterm labor, which we validated through digital droplet reverse transcriptase polymerase chain reaction. Intriguingly, we have also identified a number of gene sets including signaling by stem cell factor-KIT, nucleotide metabolism

  12. Growth perturbations in a phenotype with rapid fetal growth preceding preterm labor and term birth.

    Science.gov (United States)

    Lampl, Michelle; Kusanovic, Juan Pedro; Erez, Offer; Gotsch, Francesca; Espinoza, Jimmy; Goncalves, Luis; Lee, Wesley; Gomez, Ricardo; Nien, Jyh Kae; Frongillo, Edward A; Romero, Roberto

    2009-01-01

    The variability in fetal growth rates and gestation duration in humans is not well understood. Of interest are women presenting with an episode of preterm labor and subsequently delivering a term neonate, who is small relative to peers of similar gestational age. To further understand these relationships, fetal growth patterns predating an episode of preterm labor were investigated. Retrospective analysis of fetal biometry assessed by serial ultrasound in a prospectively studied sample of pregnancies in Santiago, Chile, tested the hypothesis that fetal growth patterns among uncomplicated pregnancies (n = 3,706) and those with an episode of preterm labor followed by term delivery (n = 184) were identical across the time intervals 16-22 weeks, 22-28 weeks, and 28-34 weeks in a multilevel mixed-effects regression. The hypothesis was not supported. Fetal weight growth rate was faster from 16 weeks among pregnancies with an episode of preterm labor (P term-delivered neonates. Perturbations in abdominal circumference growth and patterns of proportionality suggest an altered growth strategy pre-dating the preterm labor episode.

  13. GROUP B STREPTOCOCCUS CIRCUMVENTS NEUTROPHILS AND NEUTROPHIL EXTRACELLULAR TRAPS DURING AMNIOTIC CAVITY INVASION AND PRETERM LABOR

    Science.gov (United States)

    Boldenow, Erica; Gendrin, Claire; Ngo, Lisa; Bierle, Craig; Vornhagen, Jay; Coleman, Michelle; Merillat, Sean; Armistead, Blair; Whidbey, Christopher; Alishetti, Varchita; Santana-Ufret, Veronica; Ogle, Jason; Gough, Michael; Srinouanprachanh, Sengkeo; MacDonald, James W; Bammler, Theo K; Bansal, Aasthaa; Liggitt, H. Denny; Rajagopal, Lakshmi; Waldorf, Kristina M Adams

    2016-01-01

    Preterm birth is a leading cause of neonatal morbidity and mortality. Although microbial invasion of the amniotic cavity (MIAC) is associated with the majority of early preterm births, the temporal events that occur during MIAC and preterm labor are not known. Group B Streptococci (GBS) are β-hemolytic, gram-positive bacteria, which commonly colonize the vagina but have been recovered from the amniotic fluid in preterm birth cases. To understand temporal events that occur during MIAC, we utilized a unique chronically catheterized nonhuman primate model that closely emulates human pregnancy. This model allows monitoring of uterine contractions, timing of MIAC and immune responses during pregnancy-associated infections. Here, we show that adverse outcomes such as preterm labor, MIAC, and fetal sepsis were observed more frequently during infection with hemolytic GBS when compared to nonhemolytic GBS. Although MIAC was associated with systematic progression in chorioamnionitis beginning with chorionic vasculitis and progressing to neutrophilic infiltration, the ability of the GBS hemolytic pigment toxin to induce neutrophil cell death and subvert killing by neutrophil extracellular traps (NETs) in placental membranes in vivo facilitated MIAC and fetal injury. Furthermore, compared to maternal neutrophils, fetal neutrophils exhibit decreased neutrophil elastase activity and impaired phagocytic functions to GBS. Collectively, our studies demonstrate how a unique bacterial hemolytic lipid toxin enables GBS to circumvent neutrophils and NETs in placental membranes to induce fetal injury and preterm labor. PMID:27819066

  14. Comparison of Crp and Ferritin Levels in Preterm Labor and Premature Membrane Ruptured Cases

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    Yasemin Cekmez

    2014-03-01

    Full Text Available Aim: Premature ruptur of membranes (PROM means the rupture of membranes at least one hour before the active labor begins.It is named as preterm premature rupture of membranes( PretermPROM if the rupture occurs before the 37th weeks of gestation.Although the etiologies,complications and results of the PROM and PretermPROM are similar,it has been showed that the major reason for the PretermPROM is infection in choriodesidual unit. Material and Method: It is important to identify the maternal infection for protection against the negative outcomes of prematurity and preterm labor.To obtain the probable maternal infection we can use serum markers of inflamation like leucocyte count,C-reactive protein,ALP,beta-2 microglobulin,alfa-2 macroglobulin. Results: We observed the serum levels of CRP and ferritin in PROM and PretermPROM diagnosed patients.The aim of this trial was to asses the differences of serum CRP and fibrinogen consantrations in selected PROM and PretermPROM diagnosed cases to emphasize the importance of subclinical infection in these diseases. Discussion: According to the results of our trial we found that CRP levels were in normal range in control group but significantly higher in group with PROM and Preterm PROM.In groups with PROM and Preterm PROM avarege value of ferritin was significantly higher than control group.Present results supports that serum ferritin and CRP levels are useful for follow-up possible infections in pregnant women with PROM and Preterm PROM.

  15. Skipping meals and less walking among African Americans diagnosed with preterm labor.

    Science.gov (United States)

    Hennessy, Mary Dawn; Volpe, Stella L; Sammel, Mary D; Gennaro, Susan

    2010-06-01

    The aim was to compare meal frequency, macronutrient intake, and physical activity between African Americans with preterm labor and those without preterm labor. A descriptive comparative study was used with 80 pregnant African Americans. Three 24-hour diet recalls, the Block 2005 food frequency questionnaire, International Physical Activity Questionnaire, and Perceived Stress Scale were collected at 24 to 34 weeks of gestation. The odds of skipping meals for women in the preterm labor group was 3.57 times the odds of skipped meals for women in the term labor group (95% confidence interval [CI] 1.28-10.16, p=.006). The association was increased to 6.86 (95% CI 2.13-22.12, plabor group (p=.03). Results have implications for prenatal counseling regarding the importance of frequent meal and snack consumption throughout the day. Further research is necessary to establish the mechanisms by which energy consumption contributes to risk for preterm labor. Pregnancy is a time when health professionals monitor women regularly and presents a unique opportunity for practitioners to communicate the importance of frequent meals and snacks throughout pregnancy, as well as the health benefits of walking as a form of physical activity.

  16. Evaluation of prenatal corticosteroid use in spontaneous preterm labor in the Brazilian Multicenter Study on Preterm Birth (EMIP).

    Science.gov (United States)

    Dias, Tabata Z; Passini, Renato; Tedesco, Ricardo P; Lajos, Giuliane J; Rehder, Patricia M; Nomura, Marcelo L; Costa, Maria L; Oliveira, Paulo F; Sousa, Maria H; Cecatti, Jose G

    2017-11-01

    To evaluate prenatal corticosteroid use in women experiencing spontaneous preterm labor and preterm delivery. The present cross-sectional multicenter study analyzed interview data from patients attending 20 hospitals in Brazil owing to preterm delivery between April 1, 2011 and July 30, 2012. Patients were stratified based on preterm delivery occurring before 34 weeks or at 34-36 +6  weeks of pregnancy, and the frequency of prenatal corticosteroid use at admission was compared. Prenatal corticosteroid use, sociodemographic data, obstetric characteristics, and neonatal outcomes were examined. There were 1455 preterm deliveries included in the present study; 527 (36.2%) occurred before 34 weeks of pregnancy and prenatal corticosteroids were used in 285 (54.1%) of these pregnancies. Among neonates delivered at 32-33 +6  weeks, prenatal corticosteroid use was associated with lower pneumonia (P=0.026) and mortality (P=0.029) rates. Among neonates delivered at 34-36 +6  weeks, prenatal corticosteroid use was associated with longer neonatal hospital admission (Pprenatal corticosteroids. This could reflect a sub-optimal interval between administration and delivery. © 2017 International Federation of Gynecology and Obstetrics.

  17. Uterine overdistention induces preterm labor mediated by inflammation: observations in pregnant women and nonhuman primates

    Science.gov (United States)

    Waldorf, Kristina M. Adams; Singh, Natasha; Mohan, Aarthi R.; Young, Roger C.; Ngo, Lisa; Das, Ananya; Tsai, Jesse; Bansal, Aasthaa; Paolella, Louis; Herbert, Bronwen R.; Sooranna, Suren R.; Gough, G. Michael; Astley, Cliff; Vogel, Keith; Baldessari, Audrey E.; Bammler, Theodor K.; MacDonald, James; Gravett, Michael G.; Rajagopal, Lakshmi; Johnson, Mark R.

    2015-01-01

    OBJECTIVE Uterine overdistention is thought to induce preterm labor in women with twin and multiple pregnancies, but the pathophysiology remains unclear. We investigated for the first time the pathogenesis of preterm birth associated with rapid uterine distention in a pregnant nonhuman primate model. STUDY DESIGN A nonhuman primate model of uterine overdistention was created using preterm chronically catheterized pregnant pigtail macaques (Macaca nemestrina) by inflation of intraamniotic balloons (N = 6), which were compared to saline controls (N = 5). Cesarean delivery was performed due to preterm labor or at experimental end. Microarray, quantitative reverse transcriptase polymerase chain reaction, Luminex (Austin, TX), and enzyme-linked immunosorbent assay were used to measure messenger RNA (mRNA) and/or protein levels from monkey (amniotic fluid, myometrium, maternal plasma) and human (amniocytes, amnion, myometrium) tissues. Statistical analysis employed analysis of covariance and Wilcoxon rank sum. Biomechanical forces were calculated using the law of Laplace. RESULTS Preterm labor occurred in 3 of 6 animals after balloon inflation and correlated with greater balloon volume and uterine wall stress. Significant elevations of inflammatory cytokines and prostaglandins occurred following uterine overdistention in an “inflammatory pulse” that correlated with preterm labor (interleukin [IL]-1β, tumor necrosis factor [TNF]-α, IL-6, IL-8, CCL2, prostaglandin E2, prostaglandin F2α, all P < .05). A similar inflammatory response was observed in amniocytes in vitro following mechanical stretch (IL1β, IL6, and IL8 mRNA multiple time points, P < .05), in amnion of women with polyhydramnios (IL6 and TNF mRNA, P < .05) and in amnion (TNF-α) and myometrium of women with twins in early labor (IL6, IL8, CCL2, all P < .05). Genes differentially expressed in the nonhuman primate after balloon inflation and in women with polyhydramnios and twins are involved in tissue

  18. The effect of clindamycin vaginal cream on prevention of preterm labor

    Directory of Open Access Journals (Sweden)

    Farahnaz Changaee

    2016-09-01

    Full Text Available Background: Preterm delivery is one of the most common causes of perinatal mortality around the world. The purpose of this study was to determine the effect of clindamycin vaginal cream in the prevention of preterm labor. Materials and Methods: This study was a control trial carried out on 236 pregnant women, referred to private practice office of a physician,with 13-20 weeks of gestational age. Samples of vaginal smear were gathered, and in the case of abnormal results, subjects were randomly assigned to either a control or case group. Clindamycin group treated with vaginal cream for three nights in the first turn and seven night at the second turn. But the control group received no treatment. Then, all subjects were followed up. Data wero collected using a questionnair and analyzed. Results:The incidence of premature birth in the control group was higher than the group under treatment with clindamycin (12% vs 7%, but this difference was not enough to be statistically significant. It was also shown that the higher incidence of preterm delivery in the control group was lower than the age of pregnancy termination. Mortality in the control group was significantly higher than the control group. Conclusion: Although no significant difference was observed in the rate of preterm labor between the two groups, but in control group gestational age was less and mortality rate was high. It seems that clindamycin in decreasing prenatal mortality is associated with preterm labor effectively.

  19. [Prevalence of urinary tract infection in hospitalized patients with preterm labor].

    Science.gov (United States)

    Acosta-Terriquez, Jorge Emmanuel; Ramos-Martínez, Martín Alberto; Zamora-Aguilar, Liliana María; Murillo-Llanes, Joel

    2014-11-01

    To determine the prevalence of urinary tract infection (UTI) in patients with preterm labor. A prospective, observational, descriptive study, with a sample of 272 patients who were hospitalized in the Hospital de la Mujer at Culiacan, Sinaloa that presented symptoms of preterm labor. Age body mass index (BMI), parity, education, weeks of gestation, mode of delivery, history of preterm delivery and UTI were assessed. Of the 272 patients with threatened preterm delivery, 97 (35.6%) had positive urine culture and of these patients, 32 (32.9%) had preterm labor. Association between urinary tract infection and patients with a hemoglobin (Hb) less than 11 g/dL OR: 2.66 95% CI (1.55-4.55), p 0.0003. Was isolated E. coli in 72 (74.4%) patients, Proteus in 9 (9.2%) patients. It was found that 42% of E. coli strains were resistant to ampicillin and 38.4% to ciprofloxacin. The prevalence of UTI is higher than the national prevalence.

  20. LC/MS/MS data analysis of the human uterine smooth muscle S-nitrosoproteome fingerprint in pregnancy, labor, and preterm labor

    Directory of Open Access Journals (Sweden)

    Craig C. Ulrich

    2015-09-01

    Full Text Available The data described in this article is the subject of an article in the American Journal of Physiology: Cell Physiology, titled “The Human Uterine Smooth Muscle S-nitrosoproteome Fingerprint in Pregnancy, Labor, and Preterm Labor” (doi:10.1152/ajpcell.00198.2013 (Ulrich et al., 2013 [1]. The data described is a large scale mass spectrometry data set that defines the human uterine smooth muscle S-nitrosoproteome differences among laboring, non-laboring, preterm laboring tissue after treatment with S-nitrosoglutathione.

  1. [Atosiban treatment for preterm labor--financial considerations and savings by implementing clinical guidelines].

    Science.gov (United States)

    Hadar, Eran; Mansur, Nariman; Ambar, Irit; Hod, Moshe

    2011-06-01

    Preterm delivery is a significant cause of neonatal morbidity and mortality. Pregnant women, with symptoms and signs consistent with preterm labor, can be treated with various tocolytic drugs. Atosiban is one of many drugs indicated to arrest imminent preterm labor. Various studies show that the efficacy of atosiban is similar to other tocolytic drugs. The main advantage of atosiban is a relativeLy low incidence of adverse maternal reactions. Its considerable shortcoming is the financial cost, compared to other available drugs. In view of its cost, we have decided to implement a strict protocol to direct the use of atosiban, with the intent to reduce costs, without hampering quality of care. The protocol was implemented from July 2009, and it outlines the medical and procedural terms to use atosiban. We compared similar time periods before and after implementation of the protocol. The outcomes compared included: treatment success, rates of preterm deliveries and financial costs. Within the timeframe that the protocol was implemented, we have been able to demonstrate a 40% reduction in atosiban related costs, compared to a parallel period, when the clinical guidelines were not implemented. This translates into savings of about NIS 40,000 (New Israeli Shekel) (approximately $10,000). This was achieved without an increase in the rate of preterm deliveries. Implementing and enforcing a simple protocol of supervision on the use of atosiban enables a considerable reduction of financial costs related to atosiban, without hampering medical care.

  2. Umbilical cord CD71+ erythroid cells are reduced in neonates born to women in spontaneous preterm labor.

    Science.gov (United States)

    Gomez-Lopez, Nardhy; Romero, Roberto; Xu, Yi; Miller, Derek; Unkel, Ronald; C MacKenzie, Tippi; Frascoli, Michela; Hassan, Sonia S

    2016-10-01

    Preterm neonates are highly susceptible to infection. Neonatal host defense against infection seems to be maintained by the temporal presence of immunosuppressive CD71+ erythroid cells. The aim of this study was to investigate whether umbilical cord CD71+ erythroid cells are reduced in neonates born to women who undergo spontaneous preterm labor/birth. Umbilical cord blood samples (n=155) were collected from neonates born to women who delivered preterm with (n=39) and without (n=12) spontaneous labor or at term with (n=82) and without (n=22) spontaneous labor. Time-matched maternal peripheral blood samples were also included (n=111). Mononuclear cells were isolated from these samples, and CD71+ erythroid cells were identified and quantified as CD3-CD235a+CD71+ cells by flow cytometry. (i) The proportion of CD71+ erythroid cells was 50-fold higher in cord blood than in maternal blood; (ii) a reduced number and frequency of umbilical cord CD71+ erythroid cells were found in neonates born to women who underwent spontaneous preterm labor compared to those born to women who delivered preterm without labor; (iii) umbilical cord CD71+ erythroid cells were fewer in neonates born to term pregnancies, regardless of the process of labor, than in those born to women who delivered preterm without labor; and (iv) no differences were seen in umbilical cord CD71+ erythroid cells between neonates born to women who underwent spontaneous preterm labor and those born to women who delivered at term with labor. Umbilical cord CD71+ erythroid cells are reduced in neonates born to women who had undergone spontaneous preterm labor. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  3. Randomized prospective trial comparing ultrasonography and pelvic examination for preterm labor surveillance.

    Science.gov (United States)

    Lorenz, R P; Comstock, C H; Bottoms, S F; Marx, S R

    1990-06-01

    This study was designed to compare the effectiveness of cervical assessment by either ultrasonography or bimanual pelvic examination in a program for preterm labor surveillance. Patients (n = 57) at risk for preterm birth were seen once a week for patient education, review of symptoms, and cervical evaluation. Cervical evaluation was assigned randomly to either ultrasonographic evaluation or pelvic examination. The groups did not differ in demographic or obstetric factors. The overall rate of prematurity was 18%. Preterm labor was more frequent with ultrasonographic evaluation (52%) than with pelvic examination (25%) (p less than 0.05). The group evaluated by ultrasonography received oral tocolytic agents (55%) more than the group that had pelvic examinations (21%) (p less than 0.02). The groups did not differ in infant birth weights, length of gestation, or neonatal mortality or morbidity. In this prospective randomized study of patients at risk for preterm birth, patients under surveillance by ultrasonographic assessment of the cervix did not fare better than those assigned to bimanual examination.

  4. New insights into the role of aminopeptidases in the treatment for both preeclampsia and preterm labor.

    Science.gov (United States)

    Mizutani, Shigehiko; Tsunemi, Taihei; Mizutani, Eita; Hattori, Akira; Tsujimoto, Masafumi; Kobayashi, Hiroshi

    2013-11-01

    Evidence elucidating the pathophysiology and pharmacology of conventional drugs, β-2 stimulants and magnesium sulfate, on safety and effectiveness for preeclampsia and preterm labor are rarely found. Both compounds pass through the placental barrier and could exert their adverse effects on the fetus. Exposure to these agents could be problematic long after the birth, and possibly result in diseases such as autism and cardiomyopathy. Since 1970 the possible roles of placental aminopeptidases, which degrade peptide hormones, in preeclampsia and preterm labor have been studied. Many studies reveal that the fetus secretes peptide hormones, such as angiotensin II, vasopressin, and oxytocin, under hypoxia (stress) during the course of its growth, suggesting the critical effects these hormones have during pregnancy. The roles of placental aminopeptidases, the enzymes which degrade fetal hormones without passing through the placental barrier, were clarified. A first-step production system for recombinant aminopeptidases was established, by which engineered recombinant aminopeptidases were used for further experiments testing expected efficacy on controlling the level of hormones. The authors conclude that both aminopeptidase A and placental leucine aminopeptidase could be potentially safe and effective drugs for patients and their babies in the treatment of preeclampsia and preterm labor.

  5. Efficacy and side effect of ritodrine and magnesium sulfate in threatened preterm labor.

    Science.gov (United States)

    Kim, Min Kyoung; Lee, Seung Mi; Oh, Jung Won; Kim, So Yeon; Jeong, Hye Gyeong; Kim, Sun Min; Park, Chan Wook; Jun, Jong Kwan; Hahn, Seo-Kyung; Park, Joong Shin

    2018-01-01

    In terms of efficacy, several previous studies have shown that the success rate in inhibiting preterm labor was not different between magnesium sulfate and ritodrine. However, there is a paucity of information regarding the efficacy of both medications after consideration of intra-amniotic infection, which is one of the most important prognostic factors in patients of threatened preterm birth. The objective of this study was to compare the efficacy and safety of magnesium sulfate with that of ritodrine in preterm labor. In this retrospective cohort study, we included patients who were admitted and treated with either ritodrine or magnesium sulfate with the diagnosis of preterm labor at 24-33.6 weeks of gestational age between January 2005 to April 2015. Patients were divided into 2 groups according to the first-used tocolytics (ritodrine group and magnesium sulfate group). We compared the efficacy and prevalence of side effect in each group. The efficacy of both tocolytics was evaluated in terms of preterm delivery within 48 hours, 7 days, or 37 weeks of gestation and need for 2nd line therapy. A total number of 201 patients were enrolled including 177 cases in ritodrine group and 24 cases in magnesium sulfate group. The efficacy of both tocolytics (preterm delivery within 48 hours, 7 days, or 37 weeks of gestation and need for 2nd line therapy) was not different between the 2 groups of cases. In multivariate analysis, gestational age at treatment, twin gestation, intra-amniotic infection and maternal C-reactive protein (CRP) was associated with treatment failure (preterm delivery within 48 hours), but the type of tocolytics was not significantly associated with treatment failure. The type of side effect was different in the 2 groups, but the frequency of total adverse effect, need for discontinuation of therapy because of maternal adverse effect, and severe adverse effect were not different between the two groups of cases. The efficacy and safety of magnesium

  6. Comparison of gingival health between mothers with preterm and term labor at Mahdieh Hospital between 2001 and 2002

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    Zadeh Modarres Sh.

    2007-05-01

    Full Text Available Background and Aim: Low birth weight is a significant public health issue. Recent studies have suggested periodontal diseases as risk factor for preterm labor. The aim of this study was to assess the relation between gingival health and preterm labor in a sample of Iranian female population. "nMaterials and Methods: In this cross sectional study, 201 pregnant women without any systemic diseases or other risk factors like psychotic conditions were selected. Ninety-nine of them had term labor (infant≥37 weeks and 102 had preterm labor (infant<37 weeks. Bleeding index, pocket depth and debris index were measured. Data were analyzed by Chi-square and Mann-Whitney tests with p<0.05 as the level of significance."nResults: Bleeding index, probing depth and debris index showed statistically significant differences between preterm and term labor mothers (P<0.001."nConclusion: According to the findings of this study, there is a significant relationship between gingival health and duration of pregnancy. Consequently, periodontal diseases could be risk factor for preterm labor. Oral hygiene is strongly recommended to be included in pregnancy health programs.

  7. TRPC3 Overexpression Promotes the Progression of Inflammation-Induced Preterm Labor and Inhibits T Cell Activation.

    Science.gov (United States)

    Jing, Chen; Dongming, Zheng; Hong, Cui; Quan, Na; Sishi, Liu; Caixia, Liu

    2018-01-01

    To detect the expression of the TRPC3 channel protein in the tissues of women experiencing preterm labor and investigate its interaction with T lymphocytes, providing a theoretical basis for the clinical prevention of threatened preterm labor and the development of drug-targeted therapy. Forty-seven women experiencing preterm labor and 47 women experiencing normal full-term labor were included in this study. All included women underwent delivery via cesarean section; uterine samples were obtained at delivery. The expression of TRPC3 in uterine tissue was detected by immunohistochemistry, real-time quantitative reverse transcription-PCR, and western blot assay. Activation of T lymphocytes in peripheral blood and uterine tissue were detected by flow cytometry. A TRPC3-/- mouse model of inflammation-induced preterm labor was established; expression of TRPC3, Cav3.1, and Cav3.2 were analyzed in mouse uterine tissue. Activation of T lymphocytes in female mouse and human peripheral blood samples was determined using flow cytometry. In women experiencing preterm labor, expression of TRPC3 and the Cav3.1 and Cav3.2 proteins was significantly increased; in addition, the percentage of CD3+, CD4+, and CD8+ T cells in peripheral blood was significantly decreased. TRPC3 knockout significantly delayed the occurrence of preterm labor in mice. The muscle tension of ex vivo uterine strips was lower, Cav3.1 and Cav3.2 protein expression was lower, and the percentage of CD8+ T lymphocytes was significantly increased in wild-type mice subjected to an inflammation-induced preterm labor than in wild-type mice experiencing normal full-term labor. TRPC3 is closely related to the initiation of labor. TRPC3 relies on Cav3.1 and Cav3.2 proteins to inhibit inflammation-induced preterm labor by inhibiting the activation of T cells, in particular CD8+ T lymphocytes. © 2018 The Author(s). Published by S. Karger AG, Basel.

  8. Predictors of Adherence to Relaxation Guided Imagery During Pregnancy in Women with Preterm Labor.

    Science.gov (United States)

    Chuang, Li-Lan; Liu, Shu-Chen; Chen, Yi-Heng; Lin, Li-Chan

    2015-09-01

    To examine adherence to relaxation guided imagery in women experiencing preterm labor as well as predictors influencing adherence. This study used a longitudinal follow-up approach. Each of the 57 participating women received a mini-MP3 player containing a 13-minute relaxation guided imagery audio program that they were instructed to follow daily until giving birth. Follow-up interviews were conducted weekly. A generalized estimating equation was used to predict adherence. The total adherence rate was 58%. Higher adherence was predicted by the presence of at least a college degree (p=0.006), greater perceived stress (p=0.006), a higher risk of preterm delivery (pguided imagery. For women with a lower adherence to relaxation guided imagery, health care professionals may consider individual preferences regarding relaxation techniques.

  9. Labor induction in the patient with preterm premature rupture of membranes.

    Science.gov (United States)

    Packard, Roger Everett; Mackeen, Awathif Dhanya

    2015-10-01

    Preterm premature rupture of membranes (PPROM) affects up to one-third of all preterm births and confers serious maternal risks, including intra-amniotic infection, and an increased risk of neonatal complications, including respiratory distress and intraventricular hemorrhage. Management of PPROM is a highly individualized process that requires an accurate determination of gestational age and causal factors, as well as the balancing of maternal and fetal risks. In this review of the existing literature on induction of labor in PPROM, we examine the differences in appropriate management of patients with early (32 weeks 0 days to 33 weeks 6 days) and near term (34 weeks 0 days to 36 weeks 6 days) PPROM, and compare the safety and efficacy of available treatment options. This review of previous research findings provides general guidelines for clinical decision making and highlights the need for future research on management of PPROM. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Co-infection with vaginal Ureaplasma urealyticum and Mycoplasma hominis increases adverse pregnancy outcomes in patients with preterm labor or preterm premature rupture of membranes.

    Science.gov (United States)

    Kwak, Dong-Wook; Hwang, Han-Sung; Kwon, Ja-Young; Park, Yong-Won; Kim, Young-Han

    2014-03-01

    The purpose of this study was to determine the prevalence of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) in patients with preterm labor or preterm premature rupture of membranes (PPROM) and to determine the effect of these organisms on pregnancy outcomes based on the density of colonization. The study group consisted of 184 women with preterm labor or PPROM. Vaginal cultures for UU and MH were performed for all patients at admission, and the placentas were histologically evaluated after delivery. The prevalence of positive vaginal fluid cultures for genital mycoplasma was 62.5% (112/179). This group included 99 patients carrying only UU and 13 carrying both organisms. No patients were found to carry only MH. Compared to patients only positive for UU, patients with both organisms showed significantly decreased gestational age at birth and birth weight, and significant increases in the incidences of preterm birth, NICU admissions and histologic chorioamnionitis. Vaginal MH tends to be detected with UU, and patients carrying both organisms simultaneously had more severe adverse pregnancy outcomes compared to patients in preterm labor or PPROM who were only positive for UU.

  11. Total and ionized serum magnesium and calcium levels during magnesium sulfate administration for preterm labor

    Science.gov (United States)

    Kim, Won Hee; An, Yuna; Moon, Jong Ho; Noh, Eun Ji; Kim, Jong Woon

    2018-01-01

    Objective This study aimed to estimate the association between total and ionized magnesium, and the changes in serum magnesium and calcium levels in patients with preterm labor during magnesium sulfate (MgSO4) administration. Methods The study population included 64 women who were candidates for intravenous MgSO4 treatment for preterm labor. Serial blood samples were taken and measured total magnesium (T-Mg), ionized magnesium (I-Mg), total calcium (T-Ca), and ionized calcium (I-Ca) levels every one-week interval (1st, 2nd, 3rd). Results There was no significant difference in T-Mg and I-Mg levels during MgSO4 administration (P>0.05). There was no significant difference in T-Ca and I-Ca levels during MgSO4 administration (P>0.05). Compared before and after administration of MgSO4, T-Mg and I-Mg levels and T-Ca levels were changed allow statistically significant (P0.05). There was significant correlation between levels of I-Mg and T-Mg (I-Mg=0.395×T-Mg+0.144, P<0.01). Conclusion There were no significant differences in serum Mg and Ca levels during MgSO4 administration for preterm labor. Compared to the before and after administration of MgSO4, only I-Ca levels were not substantially changed. There are significant correlations between I-Mg and T-Mg levels during administration of MgSO4 and I-Mg level seemed to have more correlation with adverse effect than T-Mg. PMID:29372150

  12. In which preterm labor-patients is intravenous maintenance tocolysis effective?

    Science.gov (United States)

    Yoneda, Satoshi; Yoneda, Noriko; Fukuta, Kaori; Shima, Tomoko; Nakashima, Akitoshi; Shiozaki, Arihiro; Yoshino, Osamu; Kigawa, Mika; Yoshida, Taketoshi; Saito, Shigeru

    2018-03-01

    We evaluated whether maintenance tocolysis (intravenous ritodrine hydrochloride and/or magnesium sulfate) was effective in cases of spontaneous preterm labor with intact membranes. One hundred and thirty preterm labor patients who reached 36 weeks of gestation by maintenance tocolysis were selected. Immediate delivery (ID) after ceasing maintenance tocolysis was defined as an 'effective case'. The correlated factors between ID and no immediate delivery (NID) were statistically analyzed. Thirty-six patients delivered maintenance tocolysis (27.7%) and were defined as effective cases. Multiple logistic regression analysis revealed that amniotic fluid interleukin-8 at admission (≥ 2.3 ng/mL; odds ratio [OR] 5.6, 95% confidence interval [CI] 2.1-17.6; P Maintenance tocolysis may be effective in limited cases with mild intra-amniotic inflammation, in lean women and in cerclage cases. Maintenance tocolysis should be ceased in cases without these clinical factors when clinical symptoms disappear. © 2017 Japan Society of Obstetrics and Gynecology.

  13. Preterm labor

    Science.gov (United States)

    ... fluid leaking from your vagina Sudden increase in vaginal discharge Your provider can do an exam to see ... less than 32 weeks pregnant. This is a vaginal swab that helps ... have a fluid discharge, it will be tested. The test may help ...

  14. 75 FR 70692 - TUV Rheinland PTL, LLC; Application for Recognition

    Science.gov (United States)

    2010-11-18

    ... was current at the time OSHA prepared this notice. UL 1703 Flat-Plate Photovoltaic Modules and Panels... for photovoltaic products, and a leading test organization for photovoltaic technology. Arizona State University (ASU) established the organization in 1992, as the Photovoltaic Testing Laboratory (PTL). The...

  15. Fetal fibronectin testing for prevention of preterm birth in singleton pregnancies with threatened preterm labor: a systematic review and metaanalysis of randomized controlled trials.

    Science.gov (United States)

    Berghella, Vincenzo; Saccone, Gabriele

    2016-10-01

    Fetal fibronectin is an extracellular matrix glycoprotein that is produced by amniocytes and cytotrophoblasts and has been shown to predict spontaneous preterm birth. The aim of this systematic review and metaanalysis of randomized clinical trials was to evaluate the effect of the use of fetal fibronectin in the prevention of preterm birth in singleton pregnancies with threatened preterm labor. The research was conducted with the use of MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID, and Cochrane Library as electronic databases from the inception of each database to February 2016. Selection criteria included randomized clinical trials of singleton gestations with threatened preterm labor that were assigned randomly to management based on fetal fibronectin results (ie, intervention group) or not (ie, comparison group). Types of participants included women with singleton gestations at 23 0/7 to 34 6/7 weeks with threatened preterm labor. Studies that included management that was also based on the use of sonographic cervical length were excluded. The primary outcome was preterm birth at birth at control group. No differences were found in the number of women who delivered within 7 days (12.8% vs 14.5%; relative risk, 0.76; 95% confidence interval, 0.47-1.21), in the mean of gestational age at delivery (mean difference, 0.20 week; 95% confidence interval, -0.26 to 0.67), in the rate of maternal hospitalization (27.4% vs 26.9%; relative risk, 1.07; 95% confidence interval, 0.80-1.44), in the use of tocolysis (25.3% vs 28.2%; relative risk, 0.97; 95% confidence interval, 0.75-1.24), antenatal steroids (29.2% vs 29.2%; relative risk, 1.05; 95% confidence interval, 0.79-1.39), in the mean time in the triage unit (mean difference, 0.60 hour; 95% confidence interval, -0.03 to 1.23) and in neonatal outcomes that included respiratory distress syndrome (1.3% vs 1.5%; relative risk, 0.91; 95% confidence interval, 0.06-14.06), and admission to the neonatal

  16. [Effects of abdominal breathing on state anxiety, stress, and tocolytic dosage for pregnant women in preterm labor].

    Science.gov (United States)

    Yu, Woo-Jeong; Song, Ju-Eun

    2010-06-01

    The purpose of this study was to identify the effects of abdominal breathing on state anxiety, stress and tocolytic dosage for pregnant women in preterm labor. The participants were 60 pregnant women in preterm labor who were hospitalized from April to July, 2009. Thirty participants were assigned to the experimental group and 30 to the control group. None of them had any other complications except preterm labor. The modified Mason's breathing technique was used with the experimental group 3 times a day for 3 days. Data were collected using a self-report questionnaire and chart review, and analyzed with the SPSS 13.0 WIN program. "State anxiety of the experimental group will be lower than that of the control group" was supported. "Stress of the experimental group will be lower than that of the control group" was supported. "The Ritodrine dosage for the experimental group will be lower than that of the control group" was supported. "The Atosiban dosage for the experimental group will be lower than that of the control group" was supported. These results indicate that abdominal breathing is an effective nursing intervention for pregnant women in preterm labor.

  17. Selective versus non-selective culture medium for group B streptococcus detection in pregnancies complicated by preterm labor or preterm-premature rupture of membranes

    Directory of Open Access Journals (Sweden)

    Marcelo Luís Nomura

    Full Text Available The objective of this study was to identify group B streptococcus (GBS colonization rates and compare detection efficiency of selective versus non-selective culture media and anorectal versus vaginal cultures in women with preterm labor and preterm-premature rupture of membranes (PROM. A prospective cohort study of 203 women was performed. Two vaginal and two anorectal samples from each woman were collected using sterile swabs. Two swabs (one anorectal and one vaginal were placed separately in Stuart transport media and cultured in blood-agar plates for 48 hours; the other two swabs were inoculated separately in Todd-Hewitt selective media for 24 hours and then subcultured in blood-agar plates. Final GBS identification was made by the CAMP test. A hundred thrity-two cultures out of 812 were positive. The maternal colonization rate was 27.6%. Colonization rates were 30% for preterm PROM and 25.2% for preterm labor. Todd-Hewitt selective medium detected 87.5% and non-selective medium 60.7% GBS-positive women. Vaginal samples and anorectal samples had the same detection rate of 80.3%. Anorectal selective cultures detected 75% of carriers; 39% of GBS-positive women were detected only in selective medium. A combined vaginal-anorectal selective culture is appropriate for GBS screening in this population, minimizing laboratory costs.

  18. A case of traumatic rupture of a giant omphalocele and liver injury associated with transverse lie and preterm labor

    Directory of Open Access Journals (Sweden)

    Maria E. Linnaus

    2016-11-01

    Full Text Available Perinatal omphalocele rupture is a rare occurrence. We present a case of a baby delivered at 35 weeks with a known giant omphalocele, transverse lie, and the omphalocele downward in the birth canal who suffered rupture of the omphalocele and liver injury around the time of delivery. The pregnancy was complicated by one day of preterm labor, preterm premature rupture of the membranes, and the omphalocele was the presenting part. Despite pulmonary hypertension, rupture of the omphalocele, and a significant liver injury, individualized management with decompression of the liver hematoma allowed successful early closure with mesh followed by delayed reconstruction.

  19. Preserved ex vivo inflammatory status in decidual cells from women with preterm labor and subclinical intrauterine infection.

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    Violeta Castro-Leyva

    Full Text Available OBJECTIVE: To compare the inflammatory response preserved ex vivo by decidual cells isolated from women who experienced preterm labor with and without subclinical intrauterine infection. METHODS: Fetal membranes were obtained after cesarean section from 35 women who delivered before 37 weeks of gestation following spontaneous preterm labor, with no clinical evidence of intrauterine infection. Decidua was microbiologically tested and cultured. Concentrations of anti-inflammatory cytokines (IL-2, IL-4, IL-10, pro-inflammatory cytokines (IL-6, IL-8, IL-1β and TNF-α, and matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9 were measured in the supernatants using Bio-Plex, and prostaglandin E(2 (PGE(2 was measured by enzyme immunoassay. RESULTS: Subclinical infection was confirmed in 10 women (28.5%. Microorganisms isolated were Ureaplasma urealyticum (4, group B streptococci (3, Gardnerella vaginalis (1, and Escherichia coli (2. We found a significant increase of pro-inflammatory cytokines and a significant decrease of anti-inflammatory cytokines in supernatants from decidual cells obtained from women with preterm labor and subclinical intrauterine infection compared to women without infection. Secretion of MMP-1, MMP-8, MMP-9 and PGE(2 was significantly higher in infected women. Secretion of IL-8 by decidual cells from infected women persisted upon repeated in vitro culture passages. CONCLUSIONS: Almost 30% of idiopathic preterm labor cases were associated with subclinical intrauterine infection, and decidual cells isolated from these cases preserved an ex vivo inflammatory status after in vivo bacterial exposure.

  20. Comparison of Risk of Preterm Labor between Vaginal Progesterone and17-Alpha-Hydroxy-Progesterone Caproate in Women with Threatened Abortion: A Randomized Clinical Trial

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    Beigi Abootaleb

    2016-07-01

    Full Text Available Objective Threatened miscarriage is a common complication in pregnancy that leads to adverse pregnancy outcomes such as preterm labor. This study aimed to compare the vaginal progesterone (Cyclogest versus 17-alpha-hydroxyprogesterone caproate (Proluton on preventing preterm labor in pregnant women with threatened abortion at less than 34 weeks’ gestational age. Materials and methods This balanced randomized, double-blind, single-center controlled clinical trial included 190 women with threatened abortion. They were then randomly allocated into Cyclogest (n=95 and 17-alpha-hydroxyprogesterone caproate (Proluton, n=95 groups. Interested outcome was preterm labor less than 34 weeks. The Pearson chi-square and Student’s t test were used to compare two groups. The data were analyzed by Stata software version 13. Results The risks of preterm labor less than 34 weeks in Proluton and Cyclogest groups were 8.6 and 6.52%, respectively. There was no significant difference for risk of preterm labor less than 34 weeks [relative ratio (RR: 1.31, 95% confidence interval (CI: 0.47- 3.66, P=0.59] between two groups. Conclusion Risk of preterm labor in the vaginal progesterone group and 17-alpha-hydroxyprogesterone caproate group in pregnant women with threatened abortion is the same (Registration Number: IRCT2014123120504N1.

  1. Progress in the development of oxytocin antagonists for use in preterm labor.

    Science.gov (United States)

    Williams, P D; Bock, M G; Evans, B E; Freidinger, R M; Pettibone, D J

    1998-01-01

    There is currently a need for new therapeutic agents for treating preterm labor which could offer improved safety and efficacy beyond what has been achieved with the widely employed beta-mimetics. In this regard, the longstanding hypothesis of oxytocin receptor blockade as representing a potentially more selective method of tocolysis has continued to gain support from results obtained in clinical studies with the peptide oxytocin antagonist, atosiban. Our laboratory has focussed on the identification of non-peptide oxytocin antagonists with properties suitable for both oral and intravenous administration. We have previously described the development of potent, camphor-based oxytocin antagonists, including L-368,899 which entered phase I human studies. More recently we have pursued a new structural class of oxytocin antagonists based on the 1-(N-benzoylpiperidin-4-yl)-4H-3,1-benzoxazin-2(1H)-one template. L-372,662 is a new member of this structural class and in our preclinical assays possesses an attractive overall profile from the standpoint of human oxytocin receptor affinity (Ki = 4.9 nM), human oxytocin vs. vasopressin receptor selectivity (> 500-fold), potency as an antagonist of oxytocin-induced uterine contractions in late gestation pregnant rhesus monkeys (AD50 = 36 micrograms/kg), oral bioavailability (F = 90% in dogs), and aqueous solubility (10 mg/mL).

  2. The Maternal-Fetal Medicine Units Cesarean Registry: safety and efficacy of a trial of labor in preterm pregnancy after a prior cesarean delivery.

    Science.gov (United States)

    Durnwald, Celeste P; Rouse, Dwight J; Leveno, Kenneth J; Spong, Catherine Y; MacPherson, Cora; Varner, Michael W; Moawad, Atef H; Caritis, Steve N; Harper, Margaret; Wapner, Ronald J; Sorokin, Yoram; Miodovnik, Menachem; Carpenter, Marshall; Peaceman, Alan M; O'Sullivan, Mary Jo; Sibai, Baha; Langer, Oded; Thorp, John M; Ramin, Susan M; Mercer, Brian M; Gabbe, Steven G

    2006-10-01

    This study was undertaken to compare success rates of vaginal birth after cesarean (VBAC) delivery, and uterine rupture as well as maternal/perinatal outcomes between women with preterm and term pregnancies undergoing trial of labor (TOL), and to compare maternal and neonatal morbidities in those women with preterm pregnancies undergoing a TOL versus repeat cesarean delivery without labor (RCD). Prospective 4-year observational study of women with a singleton gestation and a prior cesarean delivery at 19 academic centers. Clinical characteristics, maternal complications and VBAC delivery success for those with a preterm (24(0)-36(6) weeks) TOL, preterm RCD and term TOL (> or = 37 weeks) were analyzed. Among 3119 preterm pregnancies with prior cesarean delivery, 2338 (75%) underwent a TOL. 15,331 women undergoing TOL at term were also analyzed as a control group. TOL success rates for preterm and term pregnancies were similar (72.8% vs 73.3%, P = .64). Rates of uterine rupture (0.34% vs 0.74%, P = .03) and dehiscence (0.26% vs 0.67%, P = .02) were lower in preterm compared with term TOL. Thromboembolic disease, coagulopathy and transfusion were more common in women undergoing a preterm TOL than those at term. Among women undergoing a preterm TOL, rates of uterine dehiscence, coagulopathy, transfusion, and endometritis were similar to those having a preterm RCD. After controlling for gestational age at delivery and race, neonatal outcomes such as Neonatal Intensive Care Unit (NICU) admission, intraventricular hemorrhage, sepsis, and ventilatory support were similar in both groups except for a higher rate of respiratory distress syndrome in those delivered after a TOL. The likelihood of VBAC success after TOL in preterm pregnancies is comparable to term gestations, with a lower risk of uterine rupture. Perinatal outcomes are similar with preterm TOL and RCD. TOL should be considered as an option for women undergoing preterm delivery with a history of prior cesarean

  3. Severe Acute Dyspnoea of Extra-Thoracic Origin: Experience with Three Primary Thyroid Lymphomas (PTL

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    Adrienne Grueber

    2014-10-01

    Full Text Available Objectives: To recall the common clinical presenting features of and guide the diagnostic procedures of primary thyroid lymphomas (PTL. Materials and methods: We report on three patients developing an acute dyspnoea and fast evolving neck mass in the thyroid caused by a PTL occurring in our regional hospital in Switzerland between 2009 and 2013. Results: PTL causes a neck mass, dyspnoea and dysphonia and responds well to chemotherapy. Mortality is due to relapse or infectious complications. Conclusion: Acute dyspnoea caused by thyroid disease is uncommon. Nevertheless, it is the main symptom in PTL due to rapid growth and compression of the airways. Chemotherapy should be started promptly.

  4. Clinical significance of histologic chorioamnionitis with a negative amniotic fluid culture in patients with preterm labor and premature membrane rupture.

    Science.gov (United States)

    Park, Jeong Woo; Park, Kyo Hoon; Jung, Eun Young

    2017-01-01

    To evaluate the effect of histological chorioamnionitis (HCA) with a negative amniotic fluid (AF) culture on adverse pregnancy and neonatal outcomes and inflammatory status in the AF compartment in women with preterm labor or preterm premature rupture of membranes (PPROM). This is a retrospective cohort study of 153 women diagnosed as having a preterm labor or PPROM (20-34 weeks) who delivered singleton gestations within 48 hours of amniocentesis. AF obtained through amniocentesis was cultured, and interleukin (IL)-6, IL-8, and metalloproteinase-9 (MMP-9) levels were determined. The placentas were examined histologically. The prevalence of HCA with negative AF culture was 23.5% (36/153). The women with HCA but with a negative AF culture (group 2) and those with a positive AF culture (group 3) had a significantly lower mean gestational age at amniocentesis and delivery than those with a negative AF culture and without HCA (group 1). Women in group 3 had the highest levels of AF IL-6, IL-8, and MMP-9, followed by those in group 2, and those in group 1. Composite neonatal morbidity was significantly higher in groups 2 and 3 than in group 1, but this was no longer significant after adjusting for confounders caused mainly by the impact of gestational age. In the women who delivered preterm neonates, HCA with a negative AF culture was associated with increased risks of preterm birth, intense intra-amniotic inflammatory response, and prematurity-associated composite neonatal morbidity, and its risks are similar to the risk posed by positive AF culture.

  5. Clinical significance of histologic chorioamnionitis with a negative amniotic fluid culture in patients with preterm labor and premature membrane rupture.

    Directory of Open Access Journals (Sweden)

    Jeong Woo Park

    Full Text Available To evaluate the effect of histological chorioamnionitis (HCA with a negative amniotic fluid (AF culture on adverse pregnancy and neonatal outcomes and inflammatory status in the AF compartment in women with preterm labor or preterm premature rupture of membranes (PPROM.This is a retrospective cohort study of 153 women diagnosed as having a preterm labor or PPROM (20-34 weeks who delivered singleton gestations within 48 hours of amniocentesis. AF obtained through amniocentesis was cultured, and interleukin (IL-6, IL-8, and metalloproteinase-9 (MMP-9 levels were determined. The placentas were examined histologically.The prevalence of HCA with negative AF culture was 23.5% (36/153. The women with HCA but with a negative AF culture (group 2 and those with a positive AF culture (group 3 had a significantly lower mean gestational age at amniocentesis and delivery than those with a negative AF culture and without HCA (group 1. Women in group 3 had the highest levels of AF IL-6, IL-8, and MMP-9, followed by those in group 2, and those in group 1. Composite neonatal morbidity was significantly higher in groups 2 and 3 than in group 1, but this was no longer significant after adjusting for confounders caused mainly by the impact of gestational age.In the women who delivered preterm neonates, HCA with a negative AF culture was associated with increased risks of preterm birth, intense intra-amniotic inflammatory response, and prematurity-associated composite neonatal morbidity, and its risks are similar to the risk posed by positive AF culture.

  6. Soluble and Endogenous Secretory Receptors for Advanced Glycation End Products in Threatened Preterm Labor and Preterm Premature Rupture of Fetal Membranes

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    Rafał Rzepka

    2015-01-01

    Full Text Available The aim of the study was to compare sRAGE and esRAGE plasma levels in pregnant women with (A threatened premature labor (n=41, (B preterm premature rupture of membranes (n=49, and (C preterm rupture of membranes at term (n=48. The relationship between these and classic intrauterine infection markers and the latent time from symptoms up to delivery depending on RAGE’s concentration were investigated. In groups A and B, a positive correlation was found between plasma sRAGE and latent time (r = 0,422; p = 0,001; r = 0,413, p = 0,004, resp.. High prognostic values were found in both groups for plasma sRAGE concentration and the latent time from symptoms up to delivery. Groups B and C presented higher levels of esRAGE than group A (526,315 ± 129,453 pg/mL and 576,212 ± 136,237 pg/mL versus 485,918 ± 133,127 pg/mL, p< 0,05. The conclusion is that sRAGE concentration can be a favorable prognostic factor in the presence of symptoms of threatened premature labor. Higher esRAGE plasma level in case of the rupture of membranes in mature and premature pregnancy suggests its participation in fetal membranes destruction.

  7. Soluble and Endogenous Secretory Receptors for Advanced Glycation End Products in Threatened Preterm Labor and Preterm Premature Rupture of Fetal Membranes

    Science.gov (United States)

    Dołegowska, Barbara; Kwiatkowski, Sebastian; Sałata, Daria; Budkowska, Marta; Domański, Leszek; Mikołajek-Bedner, Wioletta; Torbé, Andrzej

    2015-01-01

    The aim of the study was to compare sRAGE and esRAGE plasma levels in pregnant women with (A) threatened premature labor (n = 41), (B) preterm premature rupture of membranes (n = 49), and (C) preterm rupture of membranes at term (n = 48). The relationship between these and classic intrauterine infection markers and the latent time from symptoms up to delivery depending on RAGE's concentration were investigated. In groups A and B, a positive correlation was found between plasma sRAGE and latent time (r = 0,422; p = 0,001; r = 0,413, p = 0,004, resp.). High prognostic values were found in both groups for plasma sRAGE concentration and the latent time from symptoms up to delivery. Groups B and C presented higher levels of esRAGE than group A (526,315 ± 129,453 pg/mL and 576,212 ± 136,237 pg/mL versus 485,918 ± 133,127 pg/mL, ppremature labor. Higher esRAGE plasma level in case of the rupture of membranes in mature and premature pregnancy suggests its participation in fetal membranes destruction. PMID:26413536

  8. Triage by cervical length sonographic measurements for targeted therapy in threatened preterm labor: A double blind randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Homeira Vafaei

    2017-11-01

    Full Text Available Background: Preterm labor and birth are associated with several neonatal complications including respiratory distress syndrome and intraventricular hemorrhage. Differentiating true and false labor pain is a dilemma to obstetricians. Objective: To elucidate the role of cervical length measurement in prediction of birth in pregnant women with threatened preterm labor. Materials and Methods: In this double blind randomized clinical trial, 120 women with gestational age <34 wk who presented painful uterine contractions randomly assigned to undergo measurement of cervical length. Patients were registered in the hospital and a unit number was given. Based on the unit numbers, patients were randomly assigned to two groups using a computerized random digit generator. All participants were managed accordingly (n=65 or to receive tocolysis as planned (n=55. Tocolysis was prescribed when cervical length was <15 mm while those with cervical length ≥15 mm were managed expectantly. Delivery within 7 days of the presentation was the primary outcome. Results: This RCT showed in case group, 78.9% of patient with cervical length <15 mm were delivered within 7 days and only 21.1% of them maintained their pregnancy. Of those with cervical length ≥15 mm, only 15.2% were delivered within the study period and the rest (84.8% maintained their pregnancy (p<0.001. Conclusion: “Our results indicate that in women who presented preterm labor symptoms, cervical length measurement will result in decreased unnecessary tocolytic treatment. Women with cervical length ≥15mm should not receive tocolysis, however, withholding corticosteroid therapy in these patients needs further evidence.

  9. Evaluation of the efficacy of atosiban in pregnant women with threatened preterm labor associated with assisted reproductive technology.

    Science.gov (United States)

    Xu, Y-J; Ran, L-M; Zhai, S-S; Luo, X-H; Zhang, Y-Y; Zhou, Z-Y; Liu, Y-H; Ren, L-D; Hong, T; Liu, R

    2016-05-01

    The present study aimed to investigate the effectiveness of atosiban in treating women with threatened preterm labor who had become pregnant through assisted reproductive technology (ART) and the corresponding pregnancy outcomes. Seventy pregnant women with threatened preterm labor after ART were randomly divided into two groups, with 35 cases in the atosiban group and 35 in the ritodrine group. The post-treatment effects and the corresponding pregnancy outcomes were observed. The efficacy of extending gestational age by 48 hours was significantly higher in the atosiban group than in the ritodrine group (p0.05). There was no significant difference between the atosiban and ritodrine groups in the average gestational age at birth (pwomen was higher in the ritodrine group than in the atosiban group (p0.05). Both the perinatal mortality rate and the prevalence of neonatal asphyxia were significantly lower in the atosiban group than in the ritodrine group (p0.05). Administration of atosiban has a comparatively better effect than that of ritodrine on pregnant women who underwent ART and is safe and effective at preventing immediate preterm birth. Atosiban is significantly better than ritodrine at reducing the rates of perinatal mortality and neonatal pneumonia, and the perinatal outcomes for those who began to use atosiban at a gestational age of fewer than 28 weeks were even better.

  10. Effectiveness of Bacterial Vaginosis Screening Program in Routine Prenatal Care and Its Effect on Decrease of Preterm Labor

    Directory of Open Access Journals (Sweden)

    Mehrnaz Mashoufi

    2012-09-01

    Full Text Available Background & Objectives : Bacterial vaginosis is a condition which is determined by changes in microbial ecosystem of vagina and is considered as a preventable risk factor for preterm delivery. This study was conducted to assess the effectiveness of bacterial vaginosis screening program in routine prenatal care and its effect on decreasing preterm labor.   Methods: This clinical trial study was conducted on 474 pregnant women at gestational stage between 2007 and 2008. The participants were randomly divided into 2 groups: intervention group and control group. Screening was performed in intervention group with Amsel's criteria (3 of 4 needed for diagnosis. Positive cases were given clindamycin cream (2% for one week. The outcome of the delivery was assessed in both groups afterward. Data were analyzed by SPSS11 software using descriptive statistics.   Results: There was no significant difference between two groups regarding pregnancy rank, wanted and unwanted pregnancy, insufficient weight gain, mother vaccination and complication of pregnancy. Bacterial vaginosis was observed in 17 out of 216 (8% in the intervention group and then treated. Prevalence of preterm delivery in the intervention and control groups were 3 (1.4% and 12 (4.7%, respectively. The relative risk was protective (RR: 0.3, DR: 0.033, NNT: 30.   Conclusion: Screening and treatment of bacterial vaginosis in pregnant women could significantly decrease the rate of preterm delivery.

  11. Chronic hepatitis B virus infection and preterm labor(birth) in pregnant women-an updated systematic review and meta-analysis.

    Science.gov (United States)

    Ma, Xiaosong; Sun, Dehong; Li, Chuansheng; Ying, Jie; Yan, Youde

    2018-01-01

    We aimed to explore whether maternal chronic hepatitis B virus (HBV) infection certainly affects preterm labor (birth) in pregnant women. Four databases were systematically searched up to May 31, 2017, without language restriction. Any study was included if it clearly defined exposure to chronic HBV infection, reported risk of preterm labor or birth in pregnant women, and reported relative risks (RRs) or odds ratios (ORs) or provided data for estimation. RRs (or ORs) with 95% confidence intervals were pooled using random-effects models. Statistical heterogeneity was assessed with Cochran's Q statistic and I 2 statistic. Twenty-two observational studies involving 6 141 146 pregnant women (three prospective cohort studies, n = 1 116 799; 15 retrospective cohort studies, n = 5 022 513 and four case-control studies, n = 1834) were included. The risk of preterm labor was significantly intensified with chronic HBV infection compared with uninfected women, with substantial heterogeneity. Chronic HBV infection was also significantly associated with a 16% increase in the risk of preterm birth, with substantial heterogeneity. The risk of preterm birth significantly increased by 21% in HBsAg+/HBeAg+ pregnant women compared with uninfected pregnant women. Chronic HBV infection intensifies the risk of preterm labor and birth in pregnant women, but this conclusion should be interpreted with caution given the possibility of residual confounding and be confirmed by well-designed studies in the future. © 2017 Wiley Periodicals, Inc.

  12. Maternal serum advanced glycation end products level as an early marker for predicting preterm labor/PPROM: a prospective preliminary study.

    Science.gov (United States)

    Kansu-Celik, Hatice; Tasci, Yasemin; Karakaya, Burcu Kisa; Cinar, Mehmet; Candar, Tuba; Caglar, Gamze Sinem

    2018-03-05

    To evaluate the value of maternal serum advanced glycation end products (AGEs) level at 11-13 weeks' gestation for the prediction of preterm labor and or preterm premature rupture of membranes (PPROM). This prospective cross-sectional study is performed in a university-affiliated hospital between February and April 2016. The participants of this study are low risk pregnant women. Blood samples for maternal AGEs level were collected in the first trimester of pregnancy and all women completed their antenatal follow-up and delivered in our center. During the follow-up 21 women developed preterm labor/PPROM. The first trimester maternal AGEs levels of preterm labor/PPROM cases were compared with uncomplicated cases (n = 25) matched for age-parity and BMI. The predictive value of AGEs levels for preterm labor/PPROM was also assessed. First-trimester AGEs levels were significantly higher in cases complicated with preterm labor/PPROM (1832 (415-6682) versus 1276 (466-6445) ng/L, p = 0.001 and 1722 (804-6682) versus 1343 (466-6445) ng/L, p = 0.025). According to receiver-operating characteristic curve analysis, the calculated cut off value of AGEs was 1538 ng/L with the sensitivity 91.7%, specificity 73.8%; and the negative and positive predictive values were 91.6 and 29.5%, respectively. For the prediction of preterm labor/PPROM, the relatively high AGEs levels in the first trimester might be an useful marker.

  13. Progesterone Therapy for the Prevention of Preterm Labor in Women with Single Risk-factor: A Systematic Review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Kefayat Chaman-Ara

    2016-04-01

    Full Text Available Background: Preterm labor is a common complication of pregnancy which has become a main health concern around the world due to its negative consequences. Objective: To investigate the efficacy of progesterone therapy in the prevention of preterm labor in women with single risk factor. Search strategy: A PubMed, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Science Direct, Scopus, OVID, EMBASE, SID, Magiran and Google Scholar search (date last searched April 2016 without any time, language and location restriction was done. Inclusion criteria: All randomized clinical trials of singleton pregnancies with single risk factor (prior preterm labor without short cervical length or short cervical length without prior preterm labor which were randomized to progesterone and control groups were included in our meta-analysis. Primary outcome: Our primary outcome was gestational age at delivery. Results: 13 studies (1259 subjects and 2653 control women were included in the meta-analysis. Using random effect model showed that mean gestational age at delivery of progesterone group is 0.74 (0.41-1.06 month longer than that of control group with CI=95% which is significant statically. Conclusions: Progesterone therapy is an effective intervention for the prevention of preterm labor in women with single risk factor. 

  14. Usefulness of maternal serum C-reactive protein with vaginal Ureaplasma urealyticum as a marker for prediction of imminent preterm delivery and chorioamnionitis in patients with preterm labor or preterm premature rupture of membranes.

    Science.gov (United States)

    Kwak, Dong-Wook; Cho, Hee-Young; Kwon, Ja-Young; Park, Yong-Won; Kim, Young-Han

    2015-07-01

    To assess whether maternal serum C-reactive protein (CRP) and genital mycoplasmas measured can help predict imminent preterm delivery or chorioamnionitis in patients with preterm labor (PL) or preterm premature rupture of membranes (PPROM). The study group consisted of 165 women with PL or PPROM. Vaginal cultures for genital mycoplasmas and maternal blood for CRP were obtained when they were admitted for the management of PL or PPROM. An elevated level of serum CRP was defined as ≥0.8 mg/dL. Histologic evaluation of the placenta was performed after delivery. The prevalence of positive vaginal fluid cultures for Ureaplasma urealyticum (UU) was 63.0%, and elevated maternal serum CRP was 32.7%. No outcome variables were associated with vaginal UU infection in patients with lower CRP levels. However, among women with elevated CRP, the mean gestational age at birth was significantly reduced, and low Apgar score, neonatal intensive care unit admission, histologic chorioamnionitis, and delivery within 7 days of admission were significantly more common in patients with vaginal UU. Although vaginal UU in PL or PPROM cannot act as the sole predictor of imminent preterm delivery or chorioamnionitis, it can provide predictive information in patients with elevated maternal serum CRP levels.

  15. Cervical length and gestational age at admission as predictors of intra-amniotic inflammation in preterm labor with intact membranes.

    Science.gov (United States)

    Palacio, M; Cobo, T; Bosch, J; Filella, X; Navarro-Sastre, A; Ribes, A; Gratacós, E

    2009-10-01

    To evaluate cervical length and gestational age as predictors of intra-amniotic inflammation in patients admitted because of preterm labor and intact membranes. Ninety-three pregnant women with preterm labor and intact membranes were included in our study. Cervical length was measured on admission by transvaginal sonography and transabdominal amniocentesis was performed within the first 48 h following admission. Positive amniotic fluid cultures defined intra-amniotic infection. Levels of intra-amniotic interleukin-6 (IL-6) were measured, and a receiver-operating characteristics (ROC) curve was constructed to determine the best cut-off point of IL-6 for predicting intra-amniotic infection. This value was then used as a basis for determining a cut-off of IL-6 for defining intra-amniotic inflammation. Considering inflammatory status, perinatal outcomes were evaluated and compared. Logistic regression was used to investigate associations of different explanatory variables with inflammatory status. A non-invasive approach for detection of intra-amniotic inflammation in women admitted because of preterm labor with intact membranes was evaluated. Intra-amniotic infection and inflammation rates were 14% and 28%, respectively. ROC curve analysis showed that the best cut-off value for IL-6 was 13.4 ng/mL for predicting intra-amniotic infection, which was comparable to the cut-off of 11.3 ng/mL reported previously by other authors (which we used to define inflammation). Regardless of the intra-amniotic microbial status, perinatal outcomes in women who developed intra-amniotic inflammation were worse than in those who did not. Cervical length or= 28 and membranes.

  16. Accuracy of a combined insulin-like growth factor-binding protein-1/interleukin-6 test (Premaquick) in predicting delivery in women with threatened preterm labor.

    Science.gov (United States)

    Eleje, George Uchenna; Ezugwu, Euzebus Chinonye; Eke, Ahizechukwu Chigoziem; Eleje, Lydia Ijeoma; Ikechebelu, Joseph Ifeanyichukwu; Ezebialu, Ifeanyichukwu Uzoma; Obiora, Chukwudi Celestine; Nwosu, Betrand Obi; Ezeama, Chukwuemeka Okwudili; Udigwe, Gerald Okanandu; Okafor, Charles Ikechukwu; Ezugwu, Frank Okechukwu

    2017-11-27

    To determine values of combinations of interleukin-6 (IL-6)/cervical native insulin-like growth factor-binding protein-1 (IGFBP-1)/total IGFBP-1 (Premaquick©) in predicting spontaneous deliveries and spontaneous exclusive preterm deliveries in women with threatened preterm labor. Women with singleton pregnancies between gestation age (GA) of 24 weeks and 36 weeks and 6 days with preterm labor were recruited during a prospective multicenter study. Premaquick© was positive when at least two of three biomarkers were positive. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were estimated for both prediction of spontaneous deliveries and spontaneous exclusive preterm deliveries. Ninety-seven (99.0%) out of 98 women enrolled were analyzed. Based on delivery status 7/14 days post-enrollment of general study population, Premaquick© had a sensitivity of 87.1/85.7%, a specificity of 92.4/96.8%, a PPV of 84.4/93.8% and a NPV of 93.9/92.3% for prediction of spontaneous delivery. Predictive accuracy of Premaquick© test in relation to days of enrollment were: 90.7% (≤7 days) and 92.8% (≤14 days). For women enrolled at GA preterm delivery within 7/14 days of enrollment, respectively. PPV was most significantly different in both groups when outcomes were compared between 2 days and 14 days post-enrollment (Ppreterm deliveries in threatened preterm labor in singleton pregnancies.

  17. Proteomic profiling of amniotic fluid in preterm labor using two-dimensional liquid separation and mass spectrometry.

    Science.gov (United States)

    Bujold, Emmanuel; Romero, Roberto; Kusanovic, Juan Pedro; Erez, Offer; Gotsch, Francesca; Chaiworapongsa, Tinnakorn; Gomez, Ricardo; Espinoza, Jimmy; Vaisbuch, Edi; Mee Kim, Yeon; Edwin, Samuel; Pisano, Mike; Allen, Beth; Podust, Vladimir N; Dalmasso, Enrique A; Rutherford, Jennifer; Rogers, Wade; Moser, Allan; Yoon, Bo Hyun; Barder, Tim

    2008-10-01

    Simultaneous analysis of the protein composition of biological fluids is now possible. Such an approach can be used to identify biological markers of disease and to understand the pathophysiology of disorders that have eluded classification, diagnosis, and treatment. The purpose of this study was to analyze the differences in protein composition of the amniotic fluid of patients in preterm labor. Amniotic fluid was obtained by amniocentesis from three groups of women with preterm labor and intact membranes: (1) women without intra-amniotic infection/inflammation (IAI) who delivered at term, (2) women without IAI who delivered a preterm neonate, and (3) women with IAI. Intra-amniotic infection was defined as a positive amniotic fluid culture for microorganisms. Intra-amniotic inflammation was defined as an elevated amniotic fluid interleukin (IL)-6 (> or =2.3 ng/mL). Two-dimensional (2D) chromatography was used for analysis. The first dimension separated proteins by isoelectric point, while the second, by the degree of hydrophobicity. 2D protein maps were generated using different experimental conditions (reducing agents as well as protein concentration). The maps were used to discern subsets of isoelectric point/hydrophobicity containing differentially expressed proteins. Protein identification of differentially expressed fractions was conducted with mass spectrometry. Enzyme-linked immunosorbent assays (ELISA) as well as surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS)-based on-chip antibody capture immunoassays were also used for confirmation of a specific protein that was differentially expressed. (1) Amniotic fluid protein composition can be analyzed using a combination of 2D liquid chromatography and mass spectrometry for the identification of proteins differentially expressed in patients in preterm labor. (2) While total insulin-like growth factor-binding protein-1 (IGFBP-1) concentration did not change, IGFBP-1

  18. Prevalence and Clinical Significance of Sterile Intra-amniotic Inflammation in Patients with Preterm Labor and Intact Membranes

    Science.gov (United States)

    Romero, Roberto; Miranda, Jezid; Chaiworapongsa, Tinnakorn; Korzeniewski, Steven J.; Chaemsaithong, Piya; Gotsch, Francesca; Dong, Zhong; Ahmed, Ahmed I.; Yoon, Bo Hyun; Hassan, Sonia S.; Kim, Chong J.; Yeo, Lami

    2014-01-01

    Problem Inflammation and infection play a major role in preterm birth. The purpose of this study was to: 1) determine the prevalence and clinical significance of sterile intra-amniotic inflammation; and 2) examine the relationship between amniotic fluid (AF) concentrations of high mobility group box-1 (HMGB1) and the interval from amniocentesis-to-delivery in patients with sterile intra-amniotic inflammation. Method of Study AF samples obtained from 135 women with preterm labor and intact membranes were analyzed using cultivation techniques as well as broad-range PCR and mass spectrometry (PCR/ESI-MS). Sterile intra-amniotic inflammation was defined when patients with negative AF cultures and without evidence of microbial footprints had intra-amniotic inflammation (AF interleukin-6 ≥ 2.6 ng/mL). Results 1) The frequency of sterile intra-amniotic inflammation was significantly greater than that of microbial-associated intra-amniotic inflammation [26% (35/135) vs. 11% (15/135); (p=0.005)]; 2) patients with sterile intra-amniotic inflammation delivered at comparable gestational ages, had similar rates of acute placental inflammation and adverse neonatal outcomes as patients with microbial-associated intra-amniotic inflammation; and 3) patients with sterile intra-amniotic inflammation and high AF concentrations of HMGB1 (≥ 8.55 ng/mL) delivered earlier than those with low AF concentrations of HMGB1 (p=0.02). Conclusions 1) sterile intra-amniotic inflammation is more frequent than microbial-associated intra-amniotic inflammation; and 2) we propose that danger signals participate in sterile intra-amniotic inflammation in the setting of preterm labor. PMID:25078709

  19. [Proteomics and biomarkers for detection of preterm labor: a systematic review].

    Science.gov (United States)

    Musilová, I; Kacerovský, M; Tambor, V; Tosner, J

    2011-02-01

    To review the published articles about identification of biomarkers of spontaneous preterm birth using a proteomic approach and to create a list of potential biomarkers. Systematic review of literature. Department of Obstetrics and Gynecology, Medical Faculty Charles University Hradec Kralove. The following databases were accessed in search of relevant citation: MEDLINE, SCOPUS and PubMed. Totally 101 references were identified and relevant 37 abstracts were screened. As appropriated were pointed 16 studies. Finally, the data were extracted from five articles. The implementation of high-throughput technologies is necessary in the field of spontaneous preterm birth research. A compelling option is the use of proteomics in the area spontaneous preterm birth biomarkers identification in amniotic fluid, maternal serum/plasma, cervical-vaginal fluid and placental tissue. The data was extracted from published articles and a list of 72 proteins was created.

  20. Analysis of Relationship between Tumor Necrosis Factor Alpha Gene (G308A Polymorphism) with Preterm Labor.

    Science.gov (United States)

    Jafarzadeh, Lobat; Danesh, Azar; Sadeghi, Marzieh; Heybati, Fateme; Hashemzadeh, Morteza

    2013-08-01

    Increased concentrations of tumor necrosis factor alpha (TNF-α) in blood and amniotic fluid are observed in women with preterm delivery (PTD) and TNF-α mutations at -308 position are associated with higher expression of this gene. Therefore, we compared the frequency of G308A transition in the promoter region of TNF-α gene of women and neonates delivered preterm with the normal subjects. This cross-sectional study was performed on 135 mothers who were referred for delivery. According to the gestational age, mothers and their neonates were allocated to the case (preterm, 64 subjects) and control (term, 71 subjects) groups. Using the polymerase chain reaction, restrictive fragment length polymorphism (RFLP), genotyping was performed on both maternal peripheral blood and cord blood samples to determine single nucleotide polymorphism in the promoter region of TNF-α gene at -308. Two mothers in the case group, one mother in the control group and one neonate in the case group had genotyping assays (GA) mutation. All other subjects had normal GG genotype. Frequency of GA mutation was not significantly different between two groups (P = 0.47). There is no significant association between PTD and either maternal or fetal TNF-α -308 polymorphism and frequency ofGAmutation is not significantly increased in mothers and neonates delivered preterm. It means that the presence of this mutation by itself does not modify the overall risk of PTD. Investigations on the combination of various polymorphisms indifferent genes are recommended to achieve more accurate results.

  1. Cervical collagen imaging for determining preterm labor risks using a colposcope with full Mueller matrix capability

    Science.gov (United States)

    Stoff, Susan; Chue-Sang, Joseph; Holness, Nola A.; Gandjbakhche, Amir; Chernomordik, Viktor; Ramella-Roman, Jessica

    2016-02-01

    Preterm birth is a worldwide health issue, as the number one cause of infant mortality and neurological disorders. Although affecting nearly 10% of all births, an accurate, reliable diagnostic method for preterm birth has, yet, to be developed. The primary constituent of the cervix, collagen, provides the structural support and mechanical strength to maintain cervical closure, through specific organization, during fetal gestation. As pregnancy progresses, the disorganization of the cervical collagen occurs to allow eventual cervical pliability so the baby can be birthed through the cervical opening. This disorganization of collagen affects the mechanical properties of the cervix and, if the changes occur prematurely, may be a significant factor leading to preterm birth. The organization of collagen can be analyzed through the use of Mueller Matrix Polarimetric imaging of the characteristic birefringence of collagen. In this research, we have built a full Mueller Matrix Polarimetry attachment to a standard colposcope to enable imaging of human cervixes during standard prenatal exams at various stages of fetal gestation. Analysis of the polarimetric images provides information of quantity and organization of cervical collagen at specific gestational stages of pregnancy. This quantitative information may provide an indication of risk of preterm birth.

  2. The effect of barusiban, a selective oxytocin antagonist, in threatened preterm labor at late gestational age: a randomized, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Thornton, Steven; Goodwin, Thomas M; Greisen, Gorm

    2009-01-01

    OBJECTIVE: The objective of the study was to compare barusiban with placebo in threatened preterm labor. STUDY DESIGN: This was a randomized, double-blind, placebo-controlled, multicenter study. One hundred sixty-three women at 34-35 weeks plus 6 days, and with 6 or more contractions of 30 seconds...

  3. Economic analysis comparing induction of labor and expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks (PPROMEXIL trial)

    NARCIS (Netherlands)

    Vijgen, S.M.; Ham, D.P. van der; Bijlenga, D.; Beek, J.J. van; Bloemenkamp, K.W.; Kwee, A.; Groenewout, M.; Kars, M.M.; Kuppens, S.; Mantel, G.; Molkenboer, J.F.; Mulder, A.L.; Nijhuis, J.G.; Pernet, P.J.; Porath, M.; Woiski, M.D.; Weinans, M.J.; Wijngaarden, W.J. van; Wildschut, H.I.J.; Akerboom, B.; Sikkema, J.M.; Willekes, C.; Mol, B.W.; Opmeer, B.C.; et al.,

    2014-01-01

    OBJECTIVE: To compare the costs of induction of labor and expectant management in women with preterm prelabor rupture of membranes (PPROM). DESIGN: Economic analysis based on a randomized clinical trial. SETTING: Obstetric departments of eight academic and 52 non-academic hospitals in the

  4. Economic analysis comparing induction of labor and expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks (PPROMEXIL trial)

    NARCIS (Netherlands)

    Vijgen, Sylvia M. C.; Van der Ham, David P.; Bijlenga, Denise; Van Beek, Johannes J.; Bloemenkamp, Kitty W. M.; Kwee, Anneke; Groenewout, Mariet; Kars, Michael M.; Kuppens, Simone; Mantel, Gerald; Molkenboer, Jan F. M.; Mulder, Antonius L. M.; Nijhuis, Jan G.; Pernet, Paula J. M.; Porath, Martina; Woiski, Mallory D.; Weinans, Martin J. N.; Van Wijngaarden, Wim J.; Wildschut, Hajo I. J.; Akerboom, Bertina; Sikkema, J. Marko; Willekes, Christine; Mol, Ben W. J.; Opmeer, Brent C.

    ObjectiveTo compare the costs of induction of labor and expectant management in women with preterm prelabor rupture of membranes (PPROM). DesignEconomic analysis based on a randomized clinical trial. SettingObstetric departments of eight academic and 52 non-academic hospitals in the Netherlands.

  5. Economic analysis comparing induction of labor and expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks (PPROMEXIL trial)

    NARCIS (Netherlands)

    Vijgen, Sylvia M. C.; van der Ham, David P.; Bijlenga, Denise; van Beek, Johannes J.; Bloemenkamp, Kitty W. M.; Kwee, Anneke; Groenewout, Mariët; Kars, Michael M.; Kuppens, Simone; Mantel, Gerald; Molkenboer, Jan F. M.; Mulder, Antonius L. M.; Nijhuis, Jan G.; Pernet, Paula J. M.; Porath, Martina; Woiski, Mallory D.; Weinans, Martin J. N.; van Wijngaarden, Wim J.; Wildschut, Hajo I. J.; Akerboom, Bertina; Sikkema, J. Marko; Willekes, Christine; Mol, Ben W. J.; Opmeer, Brent C.

    2014-01-01

    To compare the costs of induction of labor and expectant management in women with preterm prelabor rupture of membranes (PPROM). Economic analysis based on a randomized clinical trial. Obstetric departments of eight academic and 52 non-academic hospitals in the Netherlands. Women with PPROM near

  6. High-risk and low-risk human papilloma virus in association to spontaneous preterm labor: a case-control study in a tertiary center, Egypt.

    Science.gov (United States)

    Mosbah, Alaa; Barakat, Rafik; Nabiel, Yasmin; Barakat, Ghada

    2018-03-01

    This study aimed to detect the correlation between human papillomavirus (HPV) and spontaneous preterm labor in Egyptian women and its association to the human papilloma viral load and MPP2 gene expression. We performed an observational comparative case-control study in Department of Obstetric and Gynecology, Mansoura University Hospitals over women presented with spontaneous preterm labor, besides females admitted for giving birth at full term to detect conserved sequence in HPV-L1 gene (GP5/GP6) followed by genotype detection of high- and low-risk HPVs with quantification of the viral load and the MMP2 gene expression using real-time polymerase chain reaction (PCR). The prevalence of HPV was 18.1% in preterm females, but only 4% in full-term women (p value = 0.019*). Twenty percent were PCR positive for HPV 16 and 40% for HPV 18 whereas none of the control was positive for any of the studied high-risk genotypes. Thirty percent were PCR positive for HPV 6 and 10% were positive for HPV 11. MMP2 gene expression was significantly higher in preterm than full term. Human papilloma viral load was found to be positively correlated to the rate of MMP2 expression and the gestational age was significantly related to the viral load and the rate of expression of MMP2 gene. Human pabilloma virus especially high-risk genotypes was correlated to spontaneous preterm labor in Egyptian females through increasing early expression of MMP2 gene. The time of occurrence of preterm labor was affected by the viral load and so the rate of expression of MMP2 gene.

  7. Placental Leucine Aminopeptidase- and Aminopeptidase A- Deficient Mice Offer Insight concerning the Mechanisms Underlying Preterm Labor and Preeclampsia

    Directory of Open Access Journals (Sweden)

    Shigehiko Mizutani

    2011-01-01

    Full Text Available Preeclampsia and preterm delivery are important potential complications in pregnancy and represent the leading causes for maternal and perinatal morbidity and mortality. The mechanisms underlying both diseases remain unknown, thus available treatments (beta2-stimulants and magnesium sulfate are essentially symptomatic. Both molecules have molecular weights less than 5–8 kDa, cross the placental barrier, and thus exert their effects on the fetus. The fetus produces peptides that are highly vasoactive and uterotonic and increase in response to maternal stress and with continued development. Fetal peptides are also small molecules that inevitably leak across into the maternal circulation. Aminopeptidases such as placental leucine aminopeptidase (P-LAP and aminopeptidase A (APA are large molecules that do not cross the placental barrier. We have shown that APA acts as an antihypertensive agent in the pregnant spontaneously hypertensive rat by degrading vasoactive peptides and as a result returns the animal to a normotensive state. P-LAP also acts as an antiuterotonic agent by degrading uterotonic peptides and thus prolongs gestation in the pregnant mouse. Given the ever increasing worldwide incidences of preeclampsia and preterm labor, it is imperative that new agents be developed to safely prolong gestation. We believe that the use of aminopeptidases hold promise in this regard.

  8. Association between CACNA1C gene polymorphisms and ritodrine-induced adverse events in preterm labor patients.

    Science.gov (United States)

    Baek, Min Young; Hwang, Han Sung; Park, Jin Young; Chung, Jee Eun; Lee, Kyung Eun; Lee, Gwan Yung; Seong, Jin Won; Yee, Jeong; Kim, Young Ju; Gwak, Hye Sun

    2017-07-01

    As a tocolytic agent, ritodrine has been used in European and Asian countries but has lost popularity due to safety concerns. This study aimed to investigate the relationship between adverse drug events caused by ritodrine and the CACNA1C polymorphisms in preterm labor patients. Data were collected from medical records including maternal age, gestational age, body mass index, dilation score, effacement score, modified Bishop score, maximum infusion rate, and adverse drug events. Five single-nucleotide polymorphisms of the CACNA1C gene (rs10774053, rs215994, rs215976, rs2239128, and rs2041135) were analyzed. One hundred eighty-six patients were included, 33 of whom had adverse drug events. A allele carriers of rs10774053 showed about 0.293-fold lower adverse drug events than GG genotype carriers (p = 0.012, absolute risk reduction = 16.5%) after adjusting for other confounding variables; the number needed to genotype for preventing one patient with GG genotype from suffering higher incidence of adverse drug events was calculated to be 14.6. Increase in maximum infusion rate of 1 mL/h was associated with a 1.03-fold (95% CI 1.01~1.06, p = 0.005) increased risk of adverse drug events. None of the patients with a CC genotype of rs215994 had adverse drug events, whereas 22.1% of the T allele carriers had adverse drug events. This study showed that CACNA1C gene polymorphisms could alter the probability of adverse drug event risk when ritodrine is used in preterm labor.

  9. The Matrix Metalloproteases and Endothelin-1 in Infection-Associated Preterm Birth

    Directory of Open Access Journals (Sweden)

    Nicole S. Olgun

    2010-01-01

    Full Text Available Preterm birth (PTB is clinically defined as any delivery which occurs before the completion of 37 weeks of gestation, and is currently the most important problem in obstetrics. In the United States, PTB accounts for 12-13% of all live births, and, with the exception of fetuses suffering from anomalies, is the primary cause of perinatal mortality. While the risk factors for PTB are numerous, the single most common cause is intrauterine infection. As there is currently no FDA-approved therapy for infection-associated PTB, understanding the pathogenesis of preterm labor (PTL and delivery should be given high priority. The matrix metalloproteinases (MMPs are a family of enzymes that have been implicated in normal parturition as well as infection-triggered rupture of membranes and preterm birth. Several lines of evidence also suggest a role for endothelin-1 (ET-1 in infection-associated preterm delivery. This paper focuses on the evidence that the MMPs and ET-1 act in the same molecular pathway in preterm birth.

  10. Analysis of relationship between tumor necrosis factor alpha gene (g308a polymorphism with preterm labor

    Directory of Open Access Journals (Sweden)

    Lobat Jafarzadeh

    2013-01-01

    Conclusions: There is no significant association between PTD and either maternal or fetal TNF-α −308 polymorphism and frequency ofGAmutation is not significantly increased in mothers and neonates delivered preterm. It means that the presence of this mutation by itself does not modify the overall risk of PTD. Investigations on the combination of various polymorphisms indifferent genes are recommended to achieve more accurate results.

  11. Effects of antenatal corticosteroids on maternal serum indicators of infection in women at risk for preterm delivery: A randomized trial comparing betamethasone and dexamethasone

    Directory of Open Access Journals (Sweden)

    Azar Danesh

    2012-01-01

    Full Text Available Objective: To compare the effect of betamethasone and dexamethasone on maternal white blood cell (WBC and differential count, erythrocyte sedimentation rate (ESR, Apgar score, maternal and fetal plasma glucose and length of admission to delivery, gestational age at delivery in women at risk of preterm labor (PTL. Study Design: Two hundred and forty pregnant women at risk for PTL with intact membranes or preterm premature rupture of the membranes (PPROM were randomly allocated to receive either two intramuscular injections of 12 mg betamethasone at 24-h intervals or 4 injections of 6 mg dexamethasone at 12-h intervals. Blood tests for WBC and differential count, ESR and fasting plasma glucose were drawn before betamethasone or dexamethasone injection and after injection every 24 h for two days. Pregnancy outcome was assessed as Apgar score, fetal plasma glucose and length of gestation. Result : In the preterm delivery group with intact membranes, no significant differences were found between the two groups in the maternal serum indicators of infection. The mean gestational age at delivery, 1- and 5-min Apgar score were higher in the dexamethasone group than in the betamethasone group. In the PPROM group, a significant rise in WBC count was occurred (12.4 cells/mm 3 vs. 10.5 cells/mm 3 , P < 0.001, none of the other maternal serum indicators of infection and outcome variables showed significant differences between the dexamethasone and betamethasone groups. Conclusions : Dexamethasone compared to betamethasone significantly increased WBC count in women with PPROM, but in women at risk of PTL with intact membranes none of the maternal serum indicators of infection showed significant differences.

  12. Choriodecidual group B streptococcal inoculation induces fetal lung injury without intra-amniotic infection and preterm labor in Macaca nemestrina.

    Directory of Open Access Journals (Sweden)

    Kristina M Adams Waldorf

    Full Text Available BACKGROUND: Early events leading to intrauterine infection and fetal lung injury remain poorly defined, but may hold the key to preventing neonatal and adult chronic lung disease. Our objective was to establish a nonhuman primate model of an early stage of chorioamnionitis in order to determine the time course and mechanisms of fetal lung injury in utero. METHODOLOGY/PRINCIPAL FINDINGS: Ten chronically catheterized pregnant monkeys (Macaca nemestrina at 118-125 days gestation (term=172 days received one of two treatments: 1 choriodecidual and intra-amniotic saline (n=5, or 2 choriodecidual inoculation of Group B Streptococcus (GBS 1×10(6 colony forming units (n=5. Cesarean section was performed regardless of labor 4 days after GBS or 7 days after saline infusion to collect fetal and placental tissues. Only two GBS animals developed early labor with no cervical change in the remaining animals. Despite uterine quiescence in most cases, blinded review found histopathological evidence of fetal lung injury in four GBS animals characterized by intra-alveolar neutrophils and interstitial thickening, which was absent in controls. Significant elevations of cytokines in amniotic fluid (TNF-α, IL-8, IL-1β, IL-6 and fetal plasma (IL-8 were detected in GBS animals and correlated with lung injury (p<0.05. Lung injury was not directly caused by GBS, because GBS was undetectable in amniotic fluid (~10 samples tested/animal, maternal and fetal blood by culture and polymerase chain reaction. In only two cases was GBS cultured from the inoculation site in low numbers. Chorioamnionitis occurred in two GBS animals with lung injury, but two others with lung injury had normal placental histology. CONCLUSIONS/SIGNIFICANCE: A transient choriodecidual infection can induce cytokine production, which is associated with fetal lung injury without overt infection of amniotic fluid, chorioamnionitis or preterm labor. Fetal lung injury may, thus, occur silently without

  13. New insights into the role of sex steroid hormones in pregnancy: possible therapeutic approach by sex steroid hormones for the treatment of both preeclampsia and preterm labor.

    Science.gov (United States)

    Mizutani, S; Mizutani, E

    2015-03-01

    Fetal peptide hormones are essential for the development of fetus, which increase in accordance with pregnancy term. Concentration of these hormones within the feto-placental unit is normally higher than that of maternal circulation. Since these hormones are biologically active, the leakage of these hormones into the maternal circulation is regulated by degradation activity by placental aminopeptidases, in order to maintain the balance between carriage of pregnancy and onset of labor.Because the concentration of these hormones, being regulated by the amount of endogenous production and by physiological degradation by enzymes in the blood and tissue, the balance between production and degradation is a definitive element for maintaining normal gestation and term delivery.The changes of the balance between fetal angiotensin II (A-II) and vasopressin (AVP) andA-II and AVP degrading enzymes, between aminopeptidase A (APA) and placental leucine aminopeptidase( P-LAP) - in the placenta and maternal blood due to fetal stress such as hypoxia - are the provable causes of preeclampsia or preterm labor.Induction of APA and P-LAP by estradiol benzoate (E2) and progesterone (P) from placenta has been demonstrated. They are involved in the regulation of fetal peptide hormones via placental aminopeptidases in homeostasis of pregnancy.Recently it was shown that both APA and P-LAP could be potentially safe and effective drugs for preeclampsia and preterm labor. The authors' proposed sex steroid treatment with dose increasing manner by gestational week (sex steroid treatment) for severe preeclampsia and preterm labor could be candidates replacing conventional treatments. In light of lacking safe and effective medication, the proposed sex steroid treatment is worthwhile for the prospective controlled studies for the treatment of both preeclampsia and preterm labor. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Obstetrical and perinatal pathology in women with risk of preterm labor

    Directory of Open Access Journals (Sweden)

    A. A. Shevchenko

    2017-04-01

    Full Text Available Spontaneous preterm births occurring in 5–13 % of pregnancies are the major cause of perinatal morbidity and mortality, but their frequency has not changed significantly over the past 10 years. Aim. To make the analysis of the clinical features of pregnancy, childbirth, state of the newborn and fetus in pregnant women with premature birth risk in 22–34 weeks’ gestation and feto-placental complex functional state in pregnant women of this cohort. Materials and Methods. The analysis of the clinical, laboratory and functional examination results of 121 women has been done. Women were divided into 3 groups: the main group – 43 patients with singleton pregnancy and risk of premature delivery at term 22–34 weeks who received prevention of RDS (dexamethasone 6 mg i. m. № 4 or betaspan 12 mg i. m. № 2, progestogen therapy (utrozhestan 200 mg 1 time a day vaginally and dalmaksin 200 mg 1 time a day rectally; comparison group – 42 patients also with singleton pregnancy and risk of premature delivery at term 22–34 weeks of gestation who were treated according to the algorithm of the Ukrainian National Guideline № 624 of 03.11.2008; the control group consisted of 36 women with singleton normal pregnancy and delivery which ended with the birth of live full-term newborn. Results. The average age of the examined patients was 27.08 ± 0.79 years. The average assessment of fetuses STV analysis at 22–34 weeks’ gestation with clinical signs of premature birth risk with the main group was – 11.5 ± 0.98 ms, with the comparison group – 9.8 ± 0.97 ms. No significant differences in uterine-placental-fetal circulation of analyzed groups pregnant women were noted. The average gestational age of the main group newborns was 37.9 ± 2.38 weeks and it was higher than in the comparison group (36.9 ± 4.2 weeks. 23.81 % of comparison group pregnancies ended with a preterm birth, which was significantly higher than in the main group (p < 0

  15. Antibiotic Therapy for Premature Rupture of Membranes and Preterm Labor and Effect on Fetal Outcome

    Science.gov (United States)

    Seelbach-Goebel, B.

    2013-01-01

    In Germany almost 10 % of children are born before the end of 37th week of gestation. In at least one quarter of these cases, ascending infection of the vagina plays a causative role, particularly during the early weeks of gestation. If, in addition to the decidua, the amniotic membrane, amniotic fluid and the umbilical cord are also affected, infection not only triggers uterine contractions and premature rupture of membranes but also initiates a systemic inflammatory reaction on the part of the fetus, which can increase neonatal morbidity. Numerous studies and meta-analyses have found that antibiotic therapy prolongs pregnancy and reduces neonatal morbidity. No general benefit of antibiotic treatment was found for premature uterine contractions. But it is conceivable that a subgroup of pregnant women would benefit from antibiotic treatment. It is important to identify this subgroup of women and offer them targeted treatment. This overview summarizes the current body of evidence on antibiotic treatment for impending preterm birth and the effect on neonatal outcomes. PMID:24771902

  16. Omega-3 polyunsaturated fatty acids enhance cytokine production and oxidative stress in a mouse model of preterm labor.

    Science.gov (United States)

    Boulis, Tharwat Stewart; Rochelson, Burton; Novick, Olivia; Xue, Xiangying; Chatterjee, Prodyot K; Gupta, Madhu; Solanki, Malvika H; Akerman, Meredith; Metz, Christine N

    2014-11-01

    Omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation during pregnancy remains controversial. We sought to examine the effects of ω-3 PUFA on inflammation and oxidative stress in vitro and in vivo using a model of preterm labor. In vivo. Female Swiss Webster mice were fed a normal diet or a 5% fish oil (FO) diet for 3 weeks then mated with normal-fed males. On gestational day 15, dams were injected with either saline (n=10 per group) or lipopolysaccharide (LPS, intrauterine) (n=10 per group). Maternal plasma, amniotic fluid, placentas, and uteri were collected 4 h later and assessed for cytokines; maternal plasma and amniotic fluids were analyzed for oxidative stress. In vitro. RAW264.7 mouse macrophage-like cells were treated with either: vehicle, H2O2, docosahexaenoic acid (DHA), or eicosapentaenoic acid (EPA) (0, 0.1-100 μM) and analyzed for oxidative stress. In vivo. Administration of the 5% FO diet enhanced LPS-induced cytokines in the placenta (Pstress than control-fed animals (Pstress were observed in the amniotic fluid. In vitro. Treatment of macrophage-like cells with ω-3 PUFA significantly and dose-dependently increased oxidative stress (Pstress in vivo. Likewise, DHA and EPA induced oxidative stress in macrophage-like cells in vitro.

  17. Bacteria localization and chorion thinning among preterm premature rupture of membranes.

    Directory of Open Access Journals (Sweden)

    Kimberly B Fortner

    Full Text Available OBJECTIVE: Bacterial colonization of the fetal membranes and its role in pathogenesis of membrane rupture is poorly understood. Prior retrospective work revealed chorion layer thinning in preterm premature rupture of membranes (PPROM subjects. Our objective was to prospectively examine fetal membrane chorion thinning and to correlate to bacterial presence in PPROM, preterm, and term subjects. STUDY DESIGN: Paired membrane samples (membrane rupture and membrane distant were prospectively collected from: PPROM = 14, preterm labor (PTL = 8, preterm no labor (PTNL = 8, term labor (TL = 10, and term no labor (TNL = 8, subjects. Sections were probed with cytokeratin to identify fetal trophoblast layer of the chorion using immunohistochemistry. Fluorescence in situ hybridization was performed using broad range 16 s ribosomal RNA probe. Images were evaluated, chorion and choriodecidua were measured, and bacterial fluorescence scored. Chorion thinning and bacterial presence were compared among and between groups using Student's t-test, linear mixed effect model, and Poisson regression model (SAS Cary, NC. RESULTS: In all groups, the fetal chorion cellular layer was thinner at rupture compared to distant site (147.2 vs. 253.7 µm, p<0.0001. Further, chorion thinning was greatest among PPROM subjects compared to all other groups combined, regardless of site sampled [PPROM(114.9 vs. PTL(246.0 vs. PTNL(200.8 vs. TL(217.9 vs. TNL(246.5]. Bacteria counts were highest among PPROM subjects compared to all other groups regardless of site sampled or histologic infection [PPROM(31 vs. PTL(9 vs. PTNL(7 vs. TL(7 vs. TNL(6]. Among all subjects at both sites, bacterial counts were inversely correlated with chorion thinning, even excluding histologic chorioamnionitis (p<0.0001 and p = 0.05. CONCLUSIONS: Fetal chorion was uniformly thinner at rupture site compared to distant sites. In PPROM fetal chorion, we demonstrated pronounced global thinning

  18. Crystal Structure of the Non-heme Iron Dixoygenase PtlH in Pentalenolactone Biosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    You,Z.; Omura, S.; Ikeda, H.; Cane, D.; Jogl, G.

    2007-01-01

    The non-heme iron dioxygenase PtlH from the soil organism Streptomyces avermitilis is a member of the iron(II)/{alpha}-ketoglutarate-dependent dioxygenase superfamily and catalyzes an essential reaction in the biosynthesis of the sesquiterpenoid antibiotic pentalenolactone. To investigate the structural basis for substrate recognition and catalysis, we have determined the x-ray crystal structure of PtlH in several complexes with the cofactors iron, a-ketoglutarate, and the non-reactive enantiomer of the substrate, ent-1-deoxypentalenic acid, in four different crystal forms to up to 1.31 Angstroms resolution. The overall structure of PtlH forms a double-stranded barrel helix fold, and the cofactor-binding site for iron and a-ketoglutarate is similar to other double-stranded barrel helix fold enzymes. Additional secondary structure elements that contribute to the substrate-binding site in PtlH are not conserved in other double-stranded barrel helix fold enzymes. Binding of the substrate enantiomer induces a reorganization of the monoclinic crystal lattice leading to a disorder-order transition of a C-terminal {alpha}-helix. The newly formed helix blocks the major access to the active site and effectively traps the bound substrate. Kinetic analysis of wild type and site-directed mutant proteins confirms a critical function of two arginine residues in substrate binding, while simulated docking of the enzymatic reaction product reveals the likely orientation of bound substrate.

  19. Labor.

    Science.gov (United States)

    Martz, Carlton

    2001-01-01

    This theme issue of the "Bill of Rights in Action" looks at labor issues. The first article examines the unionization efforts of the Wobblies in the United States at the beginning of the 20th century. The second article explores the protests of the Luddites during Britain's Industrial Revolution. The final article looks at whether…

  20. Human papillomavirus infects placental trophoblast and Hofbauer cells, but appears not to play a causal role in miscarriage and preterm labor.

    Science.gov (United States)

    Ambühl, Lea M M; Leonhard, Anne K; Widen Zakhary, Carina; Jørgensen, Annemette; Blaakaer, Jan; Dybkaer, Karen; Baandrup, Ulrik; Uldbjerg, Niels; Sørensen, Suzette

    2017-10-01

    Recently, an association between human papillomavirus infection and both spontaneous abortion and spontaneous preterm delivery was suggested. However, the reported human papillomavirus prevalence in pregnant women varies considerably and reliable conclusions are difficult. We aimed to investigate human papillomavirus infection in placental tissue of a Danish study cohort. Furthermore, we studied the cellular localization of human papillomavirus. In this prospective case-control study, placental tissue was analyzed for human papillomavirus infection by nested PCR in the following four study groups: full-term delivery (n = 103), spontaneous preterm delivery (n = 69), elective abortion (n = 54), and spontaneous abortion (n = 44). Moreover, human papillomavirus cellular target was identified using in situ hybridization. Human papillomavirus prevalence in placental tissue was 8.7% in full-term deliveries, 8.8% in spontaneous preterm deliveries, 10.9% in spontaneous abortions, and 20.4% in elective abortions. Twelve different human papillomavirus types were detected, and placental human papillomavirus infection was associated to a disease history of cervical cancer. Human papillomavirus DNA was identified in trophoblast cells, cells of the placental villi mesenchyme including Hofbauer cells, and in parts of the encasing endometrium. Placental human papillomavirus infections are not likely to constitute a risk factor for spontaneous preterm labor or spontaneous abortions in the Danish population, although an effect of human papillomavirus DNA in placental cells cannot be excluded. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  1. Aspartate aminotransferase and free thyroid hormones in vaginal washing fluid as markers for preterm pre-labor rupture of membranes.

    Science.gov (United States)

    Farag, Amr H; Elghetany, Sherif S; Elkashif, Mohamed S

    2015-09-01

    To evaluate the diagnostic value of vaginal fluid aspartate aminotransferase (AST), free triiodothyronine (T3) and free thyroxine (T4 ) in women with preterm pre-labor rupture of membranes (PPROM). A case-control study was carried out of 100 women: 50 with PPROM (study group) and 50 age-, gestational age- and weight-matched women with intact membranes (control group). All women underwent sterile speculum vaginal examination. The vaginal posterior fornix was irrigated and the retrieved fluid was sent for AST, free T3 and free T4 assays. Median vaginal fluid free T3, free T4 and AST were significantly higher in the PPROM group compared with the control group, with vaginal fluid free T4 having the largest area under the curve on receiver operating characteristic curve analysis (P<0.001). Sensitivity, specificity, positive and negative predictive values for free T3 (cut-off, 1.06 pg/mL) were 88%, 70%, 74.6% and 85.4%, respectively, while those for free T4 (cut-off 0.063 ng/dL) were 86%, 72%, 75.4% and 83.7%, and those for AST (4.5 IU/L) were 56%, 70%, 65.1% and 61.4%, respectively. Vaginal fluid AST had less diagnostic accuracy when compared with either free T3 or free T4. Vaginal fluid AST, free T3 and free T4 seem to be useful and simple markers in diagnosis of PPROM. © 2015 Japan Society of Obstetrics and Gynecology.

  2. Terbutaline impairs the development of peripheral noradrenergic projections: potential implications for autism spectrum disorders and pharmacotherapy of preterm labor.

    Science.gov (United States)

    Slotkin, Theodore A; Seidler, Frederic J

    2013-01-01

    Terbutaline, a β2-adrenoceptor agonist, is used off-label for long-term management of preterm labor; such use is associated with increased risk of neurodevelopmental disorders, including autism spectrum disorders. We explored the mechanisms underlying terbutaline's effects on development of peripheral sympathetic projections in developing rats. Terbutaline administration on postnatal days 2-5 led to immediate and persistent deficiencies in cardiac norepinephrine levels, with greater effects in males than in females. The liver showed a lesser effect; we reasoned that the tissue differences could represent participation of retrograde trophic signaling from the postsynaptic site to the developing neuronal projection, since hepatic β2-adrenoceptors decline in the perinatal period. Accordingly, when we gave terbutaline earlier, on gestational days 17-20, we saw the same deficiencies in hepatic norepinephrine that had been seen in the heart with the later administration paradigm. Administration of isoproterenol, which stimulates both β1- and β2-subtypes, also had trophic effects that differed in direction and critical period from those elicited by terbutaline; methoxamine, which stimulates α1-adrenoceptors, was without effect. Thus, terbutaline, operating through trophic interactions with β2-adrenoceptors, impairs development of noradrenergic projections in a manner similar to that previously reported for its effects on the same neurotransmitter systems in the immature cerebellum. Our results point to the likelihood of autonomic dysfunction in individuals exposed prenatally to terbutaline; in light of the connection between terbutaline and autism, these results could also contribute to autonomic dysregulation seen in children with this disorder. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Prediction of preterm delivery

    NARCIS (Netherlands)

    Wilms, F.F.

    2014-01-01

    Preterm delivery is in quantity and in severity an important issue in the obstetric care in the Western world. There is considerable knowledge on maternal and obstetric risk factors of preterm delivery. Of the women presenting with preterm labor, the majority is pregnant with a male fetus and in

  4. Patient satisfaction and psychological well-being after internet-based cognitive behavioral stress management (IB-CBSM) for women with preterm labor: A randomized controlled trial.

    Science.gov (United States)

    Scherer, S; Alder, J; Gaab, J; Berger, T; Ihde, K; Urech, C

    2016-01-01

    Despite its value for the management of psychological burden, little is known about the efficacy of and patient satisfaction with internet-based cognitive behavioral stress management (IB-CBSM) for women with preterm labor. The present study sets out to analyze stress/anxiety reduction, patient satisfaction and patient's working alliance in a group of 58 women with preterm labor participating in an online psychological stress management project. As part of the project, women were randomly assigned to online stress management or a control condition. Levels of stress and anxiety decreased significantly in both conditions from pre- to post-treatment measure. Participants in IB-CBSM reported significant higher working alliance inventory (WAI) scores in the task and goal subscale (pstress/anxiety outcome. Regarding patient satisfaction, women in the IB-CBSM reported significantly higher satisfaction scores (pstress/anxiety reduction outcome. Based on these findings, it can be presumed that measures of agreement with working alliance parameters, especially task and goal components, are substantially important for more effective and satisfactory therapeutic interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Does pharmacotherapy for preterm labor sensitize the developing brain to environmental neurotoxicants? Cellular and synaptic effects of sequential exposure to terbutaline and chlorpyrifos in neonatal rats

    International Nuclear Information System (INIS)

    Rhodes, Melissa C.; Seidler, Frederic J.; Qiao, Dan; Tate, Charlotte A.; Cousins, Mandy M.; Slotkin, Theodore A.

    2004-01-01

    It is increasingly clear that environmental toxicants target specific human subpopulations. In the current study, we examined the effects of prior developmental exposure to a β 2 -adrenoceptor agonist used to arrest preterm labor, terbutaline, on the subsequent effects of exposure to the organophosphate insecticide, chlorpyrifos (CPF). Neonatal rats were given terbutaline on postnatal day (PN) 2-5, followed by CPF on PN11-14. Although neither treatment affected growth or viability, each elicited alterations in indices of brain cell differentiation and cholinergic innervation in the immediate posttreatment period (PN15), persisting into adulthood (PN60). Biomarkers of brain cell number (DNA concentration and content), cell size (protein/DNA ratio) and neuritic projections (membrane/total protein) were affected by either agent alone, with patterns consistent with neuronal and neuritic damage accompanied by reactive gliosis. The combined exposure augmented these effects by both additive and synergistic mechanisms. Similarly, choline acetyltransferase (ChAT), a constitutive marker for cholinergic nerve terminals, was affected only by combined exposure to both terbutaline and CPF. Indices of cholinergic synaptic activity [hemicholinium-3 and m 2 -muscarinic acetylcholine receptor binding] showed impairment after exposure to either terbutaline or CPF but the effects were more severe when the treatments were combined. These findings suggest that terbutaline, like CPF, is a developmental neurotoxicant, and that its use in the therapy of preterm labor may create a subpopulation that is sensitized to the adverse neural effects of a subsequent exposure to organophosphate insecticides

  6. Treatments for Preterm Labor

    Science.gov (United States)

    ... Moms Need Blog News & Media News Videos Mission stories Ambassadors Spotlights Tools & Resources Frequently asked media questions ... may recommend a cerclage if you have a short cervix . Talk to your provider to see if ...

  7. Comparison of rapid MMP-8 and interleukin-6 point-of-care tests to identify intra-amniotic inflammation/infection and impending preterm delivery in patients with preterm labor and intact membranes.

    Science.gov (United States)

    Chaemsaithong, Piya; Romero, Roberto; Docheva, Nikolina; Chaiyasit, Noppadol; Bhatti, Gaurav; Pacora, Percy; Hassan, Sonia S; Yeo, Lami; Erez, Offer

    2018-01-01

    Among patients presenting with preterm labor and intact membranes, those with intra-amniotic inflammation have adverse obstetrical and neonatal outcomes. The diagnosis of intra-amniotic inflammation can easily be made by detecting an elevated concentration of the cytokine interleukin (IL)-6 or the enzyme neutrophil collagenase, also known as matrix metalloproteinase (MMP)-8. The diagnostic performances of MMP-8 and IL-6 enzyme-linked immunosorbent assay tests are similar. Recently, a rapid test has become available for point-of-care determination of either MMP-8 or IL-6. The objectives of this study were to compare the diagnostic indices and predictive values between the rapid MMP-8 and IL-6 tests for the identification of intra-amniotic inflammation in patients with preterm labor and intact membranes. We performed a retrospective cohort study including 124 women with singleton pregnancies who presented with symptoms of preterm labor and underwent transabdominal amniocentesis for the evaluation of microbial invasion of the amniotic cavity (MIAC). MIAC was defined according to amniotic fluid culture results (aerobic and anaerobic bacteria as well as genital Mycoplasmas). Amniotic fluid white blood cell (WBC) counts were determined using a hemocytometer chamber. An elevated amniotic fluid MMP-8 concentration was assessed using Yoon's MMP-8 Check ® (cutoff: 10 ng/mL). An elevated amniotic fluid IL-6 concentration was scored when there was a positive result for the lateral flow-based immunoassay (cutoff: ≥745 pg/mL and ≥1000 pg/mL). In order to objectively compare rapid MMP-8 and rapid IL-6 tests to identify intra-amniotic inflammation, an amniotic fluid WBC count of ≥50 cells/mm 3 was used to define intra-amniotic inflammation. (1) The rapid tests had the same sensitivity for the detection of intra-amniotic inflammation [85.7% (18/21) for all]; (2) the specificity of the rapid MMP-8 test was higher than that of the rapid IL-6 test (cutoff: 745

  8. Detection of microbial invasion of the amniotic cavity by analysis of cervicovaginal proteins in women with preterm labor and intact membranes.

    Science.gov (United States)

    Combs, C Andrew; Garite, Thomas J; Lapidus, Jodi A; Lapointe, Jerome P; Gravett, Michael; Rael, Julie; Amon, Erol; Baxter, Jason K; Brady, Kim; Clewell, William; Eddleman, Keith A; Fortunato, Stephen; Franco, Albert; Haas, David M; Heyborne, Kent; Hickok, Durlin E; How, Helen Y; Luthy, David; Miller, Hugh; Nageotte, Michael; Pereira, Leonardo; Porreco, Richard; Robilio, Peter A; Simhan, Hyagriv; Sullivan, Scott A; Trofatter, Kenneth; Westover, Thomas

    2015-04-01

    Microbial invasion of the amniotic cavity (MIAC) is common in early preterm labor and is associated with maternal and neonatal infectious morbidity. MIAC is usually occult and is reliably detected only with amniocentesis. We sought to develop a noninvasive test to predict MIAC based on protein biomarkers in cervicovaginal fluid (CVF) in a cohort of women with preterm labor (phase 1) and to validate the test in an independent cohort (phase 2). This was a prospective study of women with preterm labor who had amniocentesis to screen for MIAC. MIAC was defined by positive culture and/or 16S ribosomal DNA results. Nine candidate CVF proteins were analyzed by enzyme-linked immunosorbent assay. Logistic regression was used to identify combinations of up to 3 proteins that could accurately classify the phase 1 cohort (N = 108) into those with or without MIAC. The best models, selected by area under the curve (AUC) of the receiver operating characteristic curve in phase 1, included various combinations of interleukin (IL)-6, chemokine (C-X-C motif) ligand 1 (CXCL1), alpha fetoprotein, and insulin-like growth factor binding protein-1. Model performance was then tested in the phase 2 cohort (N = 306). MIAC was present in 15% of cases in phase 1 and 9% in phase 2. A 3-marker CVF model using IL-6 plus CXCL1 plus insulin-like growth factor binding protein-1 had AUC 0.87 in phase 1 and 0.78 in phase 2. Two-marker models using IL-6 plus CXCL1 or alpha fetoprotein plus CXCL1 performed similarly in phase 2 (AUC 0.78 and 0.75, respectively), but were not superior to CVF IL-6 alone (AUC 0.80). A cutoff value of CVF IL-6 ≥463 pg/mL (which had 81% sensitivity in phase 1) predicted MIAC in phase 2 with sensitivity 79%, specificity 78%, positive predictive value 38%, and negative predictive value 97%. High levels of IL-6 in CVF are strongly associated with MIAC. If developed into a bedside test or rapid laboratory assay, cervicovaginal IL-6 might be useful in selecting patients in

  9. High-speed test of SFQ-shift register files using PTL wiring

    International Nuclear Information System (INIS)

    Fujiwara, K.; Yamashiro, Y.; Yoshikawa, N.; Hashimoto, Y.; Yorozu, S.; Terai, H.; Fujimaki, A.

    2004-01-01

    We have been developing an SFQ shift register memory, which is one candidate to realize high-throughput and high-density superconductive memories. We have modified our memory architecture in order to adapt it to our SFQ microprocessor, CORE1. The new version of the shift register memory is composed of shift registers with non-destructive readout operation, which have an internal feedback. We have also studied the availability of passive transmission line (PTL) wiring in the memory system at high speed. The tested circuit is a 4-byte shift register file, where four kinds of wiring circuits are used between a decoder and shift registers. We have measured the dependences of the DC bias margin on the operating frequency for all wiring methods, and obtained almost the same dependences, which shows the availability of the PTL wiring in the memory system. We have used the NEC 2.5 kA/cm 2 Nb standard process and the CONNECT cell library

  10. Economic analysis comparing induction of labor and expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks (PPROMEXIL trial).

    Science.gov (United States)

    Vijgen, Sylvia M C; van der Ham, David P; Bijlenga, Denise; van Beek, Johannes J; Bloemenkamp, Kitty W M; Kwee, Anneke; Groenewout, Mariët; Kars, Michael M; Kuppens, Simone; Mantel, Gerald; Molkenboer, Jan F M; Mulder, Antonius L M; Nijhuis, Jan G; Pernet, Paula J M; Porath, Martina; Woiski, Mallory D; Weinans, Martin J N; van Wijngaarden, Wim J; Wildschut, Hajo I J; Akerboom, Bertina; Sikkema, J Marko; Willekes, Christine; Mol, Ben W J; Opmeer, Brent C

    2014-04-01

    To compare the costs of induction of labor and expectant management in women with preterm prelabor rupture of membranes (PPROM). Economic analysis based on a randomized clinical trial. Obstetric departments of eight academic and 52 non-academic hospitals in the Netherlands. Women with PPROM near term who were not in labor 24 h after PPROM. A cost-minimization analysis was done from a health care provider perspective, using a bottom-up approach to estimate resource utilization, valued with unit-costs reflecting actual costs. Primary health outcome was the incidence of neonatal sepsis. Direct medical costs were estimated from start of randomization to hospital discharge of mother and child. Induction of labor did not significantly reduce the probability of neonatal sepsis [2.6% vs. 4.1%, relative risk 0.64 (95% confidence interval 0.25-1.6)]. Mean costs per woman were €8094 for induction and €7340 for expectant management (difference €754; 95% confidence interval -335 to 1802). This difference predominantly originated in the postpartum period, where the mean costs were €5669 for induction vs. €4801 for expectant management. Delivery costs were higher in women allocated to induction than in women allocated to expectant management (€1777 vs. €1153 per woman). Antepartum costs in the expectant management group were higher because of longer antepartum maternal stays in hospital. In women with pregnancies complicated by PPROM near term, induction of labor does not reduce neonatal sepsis, whereas costs associated with this strategy are probably higher. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. The role of ultrasound in the prediction of preterm labour | Doshani ...

    African Journals Online (AJOL)

    Preterm labour (PTL) before 34 weeks gestation which complicates 3-4% of pregnancies is one of the most challenging problems in modern maternity are. It is the single most important cause of neonatal morbidity and mortality and disability in children and adults. About 75% of neonatal deaths occur in infants born ...

  12. Impact of Azithromycin on Pregnancy Prolongation in Women at Risk of Preterm Labor: A Time-to-Event Analysis.

    Science.gov (United States)

    Goyer, Isabelle; Ferland, Gabrielle; Ruo, Ni; Morin, Caroline; Brochet, Marie-Sophie; Morin, Lucie; Ferreira, Ema

    2016-09-13

    Since 2006, the empiric use of azithromycin in women at risk of premature birth has become prevalent in our institution without any evidence of its efficacy. Although antibiotics can prolong pregnancy in preterm prolonged rupture of membranes, no published data are available for women with intact membranes. To describe the purpose of adding azithromycin to the usual treatments (cerclage, tocolysis, rest, etc.) to prolong pregnancy in women with intact membranes who are at risk of or already in preterm labour. A retrospective observational cohort study was done at a Mother-Child University Hospital Centre. Patients admitted to obstetric ward who received azithromycin between January 1 st , 2006 and August 1 st , 2010 were included. A total of 127 exposed women were matched to 127 controls through medical records and pharmacy software. A time-to-event analysis was done to compare gestational age at the time of the recorded composite event (delivery, or rupture of membranes, or second intervention to prolong pregnancy). To compare proportions of composite event at different time points, χ 2 tests were used. Patients who received azithromycin had a more severe condition at presentation. Once adjusted for confounding factors, prolongation of pregnancy (HR =1.049; CI 95%: 0.774-1.421 [p=0.758]) and gestational age at the event (HR=1.200; CI 95%: 0.894-1.609 [p=0.225]) did not differ between the groups. The proportions of women with an event ≥7 days post-diagnosis or ≥37 gestational weeks were similar. Azithromycin was added to medical therapy in a more at-risk population and no clear benefit was measured.

  13. Internet-based stress management for women with preterm labour--a case-based experience report.

    Science.gov (United States)

    Scherer, Sandra; Urech, Corinne; Hösli, Irene; Tschudin, Sibil; Gaab, Jens; Berger, Thomas; Alder, Judith

    2014-12-01

    Pregnant women with preterm labour (PTL) in pregnancy often experience increased distress and anxieties regarding both the pregnancy and the child's health. The pathogenesis of PTL is, among other causes, related to the stress-associated activation of the maternal-foetal stress system. In spite of these psychobiological associations, only a few research studies have investigated the potential of psychological stress-reducing interventions. The following paper will present an online anxiety and stress management self-help program for pregnant women with PTL. Structure and content of the program will be illustrated by a case-based experience report. L.B., 32 years (G3, P1), was recruited at gestational week 27 while hospitalized for PTL for 3 weeks. She worked independently through the program for 6 weeks and had regular written contact with a therapist. Processing the program had a positive impact on L.B.'s anxiety and stress levels, as well as on her experienced depressive symptoms and bonding to the foetus. As PTL and the risk of PTB are associated with distress, psychological stress-reducing interventions might be beneficial. This study examines the applicability of an online intervention for pregnant women with PTL. The case report illustrates how adequate low-threshold psychological support could be provided to these women.

  14. Diagnóstico do parto pré-termo pela medida ultrassonográfica do comprimento do colo uterino Preterm labor diagnosis by sonographic measurement of the uterine cervical length

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Ferreira Novaes

    2009-10-01

    Full Text Available OBJETIVO: Medir o comprimento do colo uterino, utilizando a ultrassonografia transvaginal, em pacientes com quadro clínico compatível com ameaça de parto pré-termo, e correlacionar a medida do colo uterino, em cada caso, com a interrupção espontânea da gravidez dentro de sete dias. MATERIAIS E MÉTODOS: Foram realizados exames ultrassonográficos em 72 pacientes com quadro clínico compatível com ameaça de parto pré-termo. RESULTADOS: A sensibilidade do exame foi de 90,5%, a especificidade, de 98%, o valor preditivo positivo, de 95%, e o valor preditivo negativo, de 96%. A análise foi realizada utilizando-se a medida de 15 mm de comprimento do colo uterino como valor preditivo do parto pré-termo. CONCLUSÃO: Parece ser possível prever o parto pré-termo em pacientes com colo uterino menor que 15 mm. Tal observação poderá trazer contribuição para a administração mais oportuna de corticoides, com o intuito de acelerar a maturidade pulmonar fetal.OBJECTIVE: To measure the uterine cervical length by using transvaginal ultrasonography in patients with clinical signs compatible with preterm labor threat, and correlating each individual measurement with spontaneous pregnancy interruption within seven days. MATERIALS AND METHODS: Sonographic examinations were performed in 72 patients with clinical signs compatible with preterm labor threat. RESULTS: Sensitivity was 90.5%, specificity, 98%, positive predictive value, 95%, and negative predictive value, 96%. A standard uterine cervix length of 15 mm was considered as a predictive value for preterm labor. CONCLUSION: It seems to be possible to foresee preterm delivery in patients whose cervical length is < 15 mm. Such observation could contribute to a timely corticosteroid administration to accelerate fetal lung maturity.

  15. Preterm Birth

    Science.gov (United States)

    ... After hours (404) 639-2888 Contact Media Preterm Birth Recommend on Facebook Tweet Share Compartir Preterm birth ... Can anything be done to prevent a preterm birth? Preventing preterm birth remains a challenge because there ...

  16. Developmental exposure to terbutaline and chlorpyrifos: pharmacotherapy of preterm labor and an environmental neurotoxicant converge on serotonergic systems in neonatal rat brain regions

    International Nuclear Information System (INIS)

    Aldridge, Justin E.; Meyer, Armando; Seidler, Frederic J.; Slotkin, Theodore A.

    2005-01-01

    Developmental exposure to unrelated neurotoxicants can nevertheless produce similar neurobehavioral outcomes. We examined the effects of developmental exposure to terbutaline, a tocolytic β 2 -adrenoceptor agonist used to arrest preterm labor, and chlorpyrifos (CPF), a widely used organophosphate pesticide, on serotonin (5HT) systems. Treatments were chosen to parallel periods typical of human developmental exposures, terbutaline (10 mg/kg) on postnatal days (PN) 2-5 and CPF (5 mg/kg) on PN11-14, with assessments conducted on PN45, comparing each agent alone as well as sequential administration of both. Although neither treatment affected growth or viability, each elicited similar alterations in factors that are critical to the function of the 5HT synapse: 5HT 1A receptors, 5HT 2 receptors, and the presynaptic 5HT transporter (5HTT). Either agent elicited global increases in 5HT receptors and the 5HTT in brain regions possessing 5HT cell bodies (midbrain, brainstem) as well as in the hippocampus, which contains 5HT projections. For both terbutaline and CPF, males were affected more than females, although there were some regional disparities in the sex selectivity between the two agents. Both altered 5HT receptor-mediated cell signaling, suppressing stimulatory effects on adenylyl cyclase and enhancing inhibitory effects. When animals were exposed sequentially to both agents, the outcomes were no more than additive and, for many effects, less than additive, suggesting convergence of the two agents on a common set of developmental mechanisms. Our results indicate that 5HT systems represent a target for otherwise unrelated neuroteratogens

  17. Immune cell and transcriptomic analysis of the human decidua in term and preterm parturition.

    Science.gov (United States)

    Rinaldi, S F; Makieva, S; Saunders, P T; Rossi, A G; Norman, J E

    2017-10-01

    Is labour, both at term and preterm, associated with alterations in decidual lymphocyte densities and widespread changes to the decidual transcriptome? The onset of parturition, both at term and preterm, is associated with widespread gene expression changes in the decidua, many of which are related to inflammatory signalling, but is not associated with changes in the number of any of the decidual lymphocyte populations examined. Given its location, directly at the maternal-foetal interface, the decidua is likely to play a pivotal role in the onset of parturition, however, the molecular events occurring in the decidua in association with the onset of labour, both at term and preterm, remain relatively poorly defined. Using flow cytometry and microarray analysis, the present study aimed to investigate changes to the immune cell milieu of the decidua in association with the onset of parturition and define the decidual gene signature associated with term and preterm labour (PTL). This study used decidual samples collected from 36 women across four clinical groups: term (38-42 weeks of gestation) not in labour, TNL; term in labour, TL; preterm (preterm in labour, PTL. Decidual lymphocytes were isolated from fresh decidual tissue collected from women in each of our four patient groups and stained with a panel of antibodies (CD45, CD3, CD19, CD56, CD4, CD8 and TCRVα24-Jα18) to investigate lymphocyte populations present in the decidua (TNL, n = 8; TL, n = 7; PTNL, n = 5; PTL, n = 5). RNA was extracted from decidual tissue and subjected to Illumina HT-12v4.0 BeadChip expression microarrays (TNL, n = 11; TL, n = 8; PTNL, n = 7; PTL, n = 10). Quantitative real-time PCR (qRT-PCR) was used to validate the microarray results. The relative proportions of decidual lymphocytes (T cells, NK cells, B cells and invariant natural killer (iNKT) cells) were unaffected by either gestation or labour status. However, we found elevated expression of the non-classical MHC-protein, CD1D, in

  18. Preterm (Premature) Labor and Birth

    Science.gov (United States)

    ... these signs or symptoms: • Change in type of vaginal discharge (watery, mucus, or bloody) • Increase in amount of ... of a protein called fetal fibronectin in the vaginal discharge may be measured. The presence of this protein ...

  19. Extremely Preterm Birth

    Science.gov (United States)

    ... Search FAQs Extremely Preterm Birth Page Navigation ▼ ACOG Pregnancy Book Patient Education FAQs Patient Education Pamphlets - Spanish FAQ173, June 2016 ... Labor and Birth (FAQ087) Tobacco, Alcohol, Drugs, and Pregnancy (FAQ170) Patient Education ... Committee Opinions Practice Bulletins Patient ...

  20. Prevention of preterm birth.

    LENUS (Irish Health Repository)

    Flood, Karen

    2012-02-01

    Preterm birth (delivery before 37 completed weeks of gestation) is common and rates are increasing. In the past, medical efforts focused on ameliorating the consequences of prematurity rather than preventing its occurrence. This approach resulted in improved neonatal outcomes, but it remains costly in terms of both the suffering of infants and their families and the economic burden on society. Increased understanding of the pathophysiology of preterm labor has altered the approach to this problem, with increased focus on preventive strategies. Primary prevention is a limited strategy which involves public education, smoking cessation, improved nutritional status and avoidance of late preterm births. Secondary prevention focuses on recurrent preterm birth which is the most recognisable risk factor. Widely accepted strategies include cervical cerclage, progesterone and dedicated clinics. However, more research is needed to explore the role of antibiotics and anti-inflammatory treatments in the prevention of this complex problem.

  1. Prevalência e fatores associados à prematuridade entre gestantes submetidas à inibição de trabalho de parto prematuro Prevalence and risk factors associated to preterm delivery among pregnant women submitted to preterm labor inhibition treatment

    Directory of Open Access Journals (Sweden)

    Lucila Coca Bezerra

    2006-06-01

    Full Text Available OBJETIVOS: identificar a prevalência de parto prematuro em gestantes submetidas ao tratamento de inibição de trabalho de parto prematuro e analisar os fatores associados. MÉTODOS: estudo transversal, com dados coletados de 163 prontuários de gestantes submetidas a tratamento de inibição de trabalho de parto prematuro atendidas em 1995-2000, no Hospital Universitário da Universidade de São Paulo, Brasil. A variável dependente constituiu-se na ocorrência de parto prematuro e as independentes foram: idade, escolaridade, ocupação, paridade, companheiro, tabagismo, infecção urinária prévia, número de consultas pré-natal e intervalo interpartal. A análise foi feita pelo teste de associação pelo Qui-quadrado e modelos de regressão logística univariado e múltiplo. RESULTADOS: 66,3% das gestantes tiveram filhos prematuros e, em 22,7% dos casos, o parto ocorreu antes de 34 semanas. Houve associação estatística significativa entre parto prematuro e ser nulípara e apresentar número baixo de consultas pré-natal. CONCLUSÕES: atenção especial deve ser dada às gestantes nulíparas e com número reduzido de consulta pré-natal submetidas ao tratamento de inibição de trabalho de parto prematuro, com a finalidade de prevenir esse evento.OBJECTIVES: to identify preterm delivery prevalence in pregnant women submitted to preterm delivery inhibition treatment and to analyze associated factors. METHODS: cross sectional study with data collected from 163 pregnant women medical files seen from 1995-2000 at the University Hospital of the University of São Paulo, Brazil. The dependent variable was preterm delivery and the independent ones were: age, education, job, parity, companion, smoking, prior urinary infection, number of prenatal medical visits and birth interval. Analysis was performed through association by the Chi-square test and univariate and multiple logistic regression models. RESULTS: 66.3% of the women had preterm

  2. [Impact of threatened preterm labor and lower genital tract biocenosis on the concentrations of selected proinflammatory cytokines in cervicovaginal fluid of pregnant women].

    Science.gov (United States)

    Kalinka, Jarosław; Wasiela, Małgorzata; Brzezińska-Błaszczyk, Ewa

    2003-10-01

    Recent studies have suggested that proinflammatory cytokines might play a crucial role in the mechanism of preterm labour and delivery. Lower genital tract infection could also influence the cytokines levels. The main aim of this study was to compare the concentrations of interleukin (IL)-1 alpha, IL-1 beta, IL-6 and IL-8 in cervicovaginal fluid of pregnant women with threatened preterm labour (TPL) with group of women with normal course of pregnancy (reference group) and to determine impact of lower genital tract microflora on cytokines concentration. Cervicovaginal fluids were obtained by lavage from 40 pregnant women at 22 to 34 weeks' gestation. Those samples were analyzed for the concentrations of selected cytokines using standard enzyme-linked immunosorbent assay technique. Lower genital tract microbiology was diagnosed using Gram stain method according to Spiegel's criteria. TPL was defined as uterine contractions treated by tocolysis. Threatened preterm labour (TPL) was diagnosed in 22 (55.0%) cases. Mean gestational age at the time of cytokines measurement was 28.6 weeks. Mean concentrations of IL-1 alpha, IL-1 beta and IL-8 measured in cervicovaginal fluid of pregnant women with TPL and in reference group were similar (89.43 vs. 91.17 pg/ml; 42.05 vs. 41.01 pg/ml and 621.8 vs. 697.8 pg/ml, respectively). Vaginal levels of IL-6 was higher among women with preterm labour (21.1 pg/ml vs. 13.9 pg/ml) as compared to reference group. Bacterial vaginosis (BV) was diagnosed in 11 women (27.5%) while grade I microflora in 19 (47.5%). There was a positive correlation between BV and IL-1 alpha and IL-1 beta concentration but no with IL-6 and IL-8. Vaginal levels of IL-6 were found to be significantly elevated among women with threatened preterm labour while IL-1 alpha and IL-1 beta among women with BV. The usefulness of cytokines measurement in cervicovaginal fluid of pregnant women for prediction of preterm delivery should be clarified in further after excluding

  3. Electrohysterographic Characterization of Labor Contractions

    DEFF Research Database (Denmark)

    Mikkelsen, Eva; Fuglsang-Frederiksen, Anders; Petersen, Olav Bjørn

    2012-01-01

    Background: Better methods are needed for preterm labor diagnostication. We hypothesize 1) that depolarization of the myometrium propagates from fundus to isthmus, 2) that the propagation velocity (PV) is faster in labor than in non-labor, and 3) that PV can be determined by electromyography (EMG......). PV may be the best EMG-predictor of preterm labor. Knowledge on how to determine PV is insufficient though. Objective: To investigate EMG-signals from laboring myometrium and to develop a method for determining PV. Method: We included 10 women in active labor. EMG-signals were obtained via three...... of the vertical electrode order. Conclusion: Depolarization of the laboring myometrium may therefore not occur in the direction from fundus to isthmus. Further investigation is needed for PV determination....

  4. Colonização bacteriana do canal cervical em gestantes com trabalho de parto prematuro ou ruptura prematura de membranas Cervical bacterial colonization in women with preterm labor or premature rupture of membranes

    Directory of Open Access Journals (Sweden)

    Giuliane Jesus Lajos

    2008-08-01

    Full Text Available OBJETIVO: estudar a colonização bacteriana do canal cervical em gestantes com trabalho de parto prematuro ou com ruptura prematura de membranas. MÉTODOS: foram avaliadas 212 gestantes com trabalho de parto prematuro ou ruptura prematura de membranas. Na admissão hospitalar foram coletadas duas amostras do conteúdo endocervical e realizadas bacterioscopia e cultura em meios ágar sangue e ágar chocolate. Foram analisadas associações da colonização endocervical com infecção do trato urinário materno, corioamnionite, utilização de antibióticos, sofrimento fetal, prematuridade e infecção e óbito neonatais. RESULTADOS: a prevalência de colonização endocervical foi 14,2% (IC95%=9,5-18,9%, com resultados similares entre os casos com trabalho de parto prematuro ou ruptura prematura de membranas. O microorganismo mais prevalente na população estudada foi o estreptococo do grupo B (9,4%, sendo também isolados Candida sp, Streptococcus sp, Streptococcus pneumoniae, Escherichia coli e Enterococcus sp. Das bacterioscopias analisadas, os achados mais freqüentes foram baixa prevalência de bacilos de Döderlein e elevado número de leucócitos. Em mulheres colonizadas, houve maior prevalência de infecção do trato urinário (23,8 versus 5,4%; pPURPOSE: to study cervical colonization in women with preterm labor or premature rupture of membranes. METHODS: two hundred and twelve pregnant women with preterm labor or premature rupture of membranes were studied. Two cervical samples from each woman were collected and bacterioscopy and culture were performed. Association of cervical microorganisms and urinary tract infection, chorioamnionitis, fetal stress, antibiotic use, prematurity, neonatal infection, and neonatal death were evaluated. RESULTS: the prevalence of endocervical colonization was 14.2% (CI95%=9.5-18.9%, with similar results in preterm labor or premature rupture of membranes. Group B streptococcus was the most prevalent

  5. Misoprostol for pre-term labor induction in the second trimester: Role of medical history and clinical parameters for prediction of time to delivery.

    Science.gov (United States)

    di Liberto, Alexander; Endrikat, Jan; Frohn, Sandra; Solomayer, Erich; Ertan, Kubilay

    2014-01-01

    Serious fetal malformations and/or chromosome aberrations detected by modern diagnostic tools in early pregnancy require discussions on induced abortion with pregnant women. Competent counseling includes prediction of the time needed for the whole abortion process. In an attempt to refine our predictions, we evaluated the impact of 11 medical history and clinical variables on time to delivery. We performed a retrospective chart analysis on 79 women submitted for pre-term abortion because of fetal anomalies. Abortion was induced by vaginal application of misoprostol (prostaglandine E1, Cytotec™, Pfizer, New York, USA). We investigated 11 medical history and clinical variables for their impact on the percentage of women delivering within 24 hours (primary endpoint) and on the mean induction-delivery time interval (secondary endpoint). Fifty-three percent (42/79) of women delivered within 24 hours; 83.6% (66/79) delivered within 48 hours. A total of 83.3% of women with a history of late abortion delivered within 24 hours, whereas 50.7% without this history did. Mean induction-delivery time interval was 12.3 hours versus 35.5 hours, respectively. For history of early abortion, the figures were 65.2% versus 48.2% for delivery within 24 hours and 15.6 hours versus 32.5 hours for mean induction-delivery time interval. Current weight of fetus >500 g, weight of last previous newborn of ≤3500 g, previous pregnancies, premature rupture of membranes, and an elevated CRP of >0.5 mg/dL also cut time to delivery. Surprisingly, maternal and gestational age had no remarkable or consistent impact on the mean induction-delivery time interval. None of the differences reached statistical significance. Eighty-three percent of women needed 1000 μg or less for successful delivery. Neither variables of medical history nor specific clinical variables allow for precise prediction of time to delivery in the second trimester. Certain parameters, however, show a trend to reduce the

  6. Labor Induction

    Science.gov (United States)

    f AQ FREQUENTLY ASKED QUESTIONS FAQ154 LABOR, DELIVERY, AND POSTPARTUM CARE Labor Induction • What is labor induction? • Why is labor induced? • What is the Bishop score? • What is “ripening ...

  7. Predicting preterm birth: Cervical length and fetal fibronectin.

    Science.gov (United States)

    Son, Moeun; Miller, Emily S

    2017-12-01

    Spontaneous preterm birth remains the leading cause of neonatal morbidity and mortality worldwide, and accounts for a significant global health burden. Several obstetric strategies to screen for spontaneous preterm delivery, such as cervical length and fetal fibronectin measurement, have emerged. However, the effectiveness of these strategies relies on their ability to accurately predict those pregnancies at increased risk for spontaneous preterm birth (SPTB). Transvaginal cervical shortening is predictive of preterm birth and when coupled with appropriate preterm birth prevention strategies, has been associated with reductions in SPTB in asymptomatic women with a singleton gestation. The use of qualitative fetal fibronectin may be useful in conjunction with cervical length assessment in women with acute preterm labor symptoms, but data supporting its clinical utility remain limited. As both cervical length and qualitative fetal fibronectin have limited capacity to predict preterm birth, further studies are needed to investigate other potential screening modalities. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. What Is Preterm Labor and Birth?

    Science.gov (United States)

    ... Research Information Find a Study Resources and Publications Reading and Reading Disorders Condition Information NICHD Research Information Find a ... 5 American College of Obstetricians and Gynecologists. (2013). Definition of term pregnancy. Committee Opinion No. 579. Obstetrics ...

  9. Prevalence and correlates of preterm labor among young parturient women attending public hospitals in Brazil Prevalencia y factores correlativos del parto prematuro en las jóvenes parturientas que acuden a los hospitales públicos del Brasil

    Directory of Open Access Journals (Sweden)

    Angélica E. Miranda

    2012-11-01

    Full Text Available OBJECTIVE: To determine the prevalence of and risk factors for preterm labor (OBJETIVO: Determinar la prevalencia y los factores de riesgo de parto prematuro (menos de 37 semanas de gestación en las jóvenes embarazadas del Brasil. MÉTODOS: Se llevó a cabo un estudio transversal a escala nacional en jóvenes parturientas de 15 a 24 años de edad que acudieron a las maternidades públicas brasileñas en el 2009. Los entrevistadores administraron cuestionarios al ingresar la parturienta en la maternidad (o poco después de parto, si las mujeres participantes tenían demasiado dolor como para responder durante el trabajo del parto. Las participantes respondieron a un cuestionario que recopilaba datos demográficos, conductuales y clínicos. RESULTADOS: Se incluyeron en el estudio un total de 2 071 (86,3% parturientas de las 2 400 invitadas a participar. La media de edad fue de 20,2 años (desviación estándar [SD]: 2,7 y el promedio de años de enseñanza escolar fue de 8 (SD: 2,4. Se produjo un parto prematuro en 450 mujeres (21,7%. La proporción más alta de parto prematuro (36,1% se observó en la región del Norte y la proporción más baja (6,9% en la región del Sur. En el modelo final de regresión logística con variables múltiples, el vivir en la región del Norte (razón de posibilidades [OR]: 1,43; intervalo de confianza [IC] de 95%: 1,28-1,59; el tener ingresos mensuales inferiores a dos veces el salario mínimo brasileño (OR: 1,27, IC de 95%: 1,01-1,60; el haber sido víctima de violencia doméstica (OR: 2,27, IC de 95%: 1,23-4,18; y el haber recibido una atención prenatal inadecuada (OR: 3,17, IC de 95%: 2,54-3,97 seguían siendo factores correlativos significativos de parto prematuro en esta población. CONCLUSIONES: Los resultados muestran una alta prevalencia del parto prematuro en las mujeres jóvenes del Brasil. El parto prematuro presenta una etiología multifactorial. Se deben destinar más recursos de salud p

  10. Labor Force

    Science.gov (United States)

    Occupational Outlook Quarterly, 2012

    2012-01-01

    The labor force is the number of people ages 16 or older who are either working or looking for work. It does not include active-duty military personnel or the institutionalized population, such as prison inmates. Determining the size of the labor force is a way of determining how big the economy can get. The size of the labor force depends on two…

  11. Maternal Plasma Metabolomic Profiles in Spontaneous Preterm Birth: Preliminary Results

    Directory of Open Access Journals (Sweden)

    Barbara Lizewska

    2018-01-01

    Full Text Available Objective. To profile maternal plasma metabolome in spontaneous preterm birth. Method. In this retrospective case-control study, we have examined plasma of patient with preterm birth (between 22 and 36 weeks of pregnancy (n=57, with threatened preterm labor (between 23 and 36 weeks of pregnancy (n=49, and with term delivery (n=25. Plasma samples were analysed using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q-TOF-MS in positive and negative polarity modes. Results. We found 168 differentially expressed metabolites that were significantly distinct between study groups. We determined 51 metabolites using publicly available databases that could be subdivided into one of the five groups: amino acids, fatty acids, lipids, hormones, and bile acids. PLS-DA models, verified by SVM classification accuracy, differentiated preterm birth and term delivery groups. Conclusions. Maternal plasma metabolites are different between term and preterm parturitions. Part of them may be related with preterm labor, while others may be affected by gestational age or the beginning of labor. Metabolite profile can classify preterm or term delivery groups raising the potential of metabolome as a biomarker to identify high-risk pregnancies. Metabolomic studies are also a tool to detect individual compounds that may be further tested in targeted researches.

  12. A blueprint for the prevention of preterm birth: vaginal progesterone in women with a short cervix

    Science.gov (United States)

    Romero, Roberto; Yeo, Lami; Miranda, Jezid; Hassan, Sonia; Conde-Agudelo, Agustin; Chaiworapongsa, Tinnakorn

    2014-01-01

    Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, and is the most important challenge to modern obstetrics. A major obstacle has been that preterm birth is treated (implicitly or explicitly) as a single condition. Two-thirds of preterm births occur after the spontaneous onset of labor, and the remaining one-third after “indicated” preterm birth; however, the causes of spontaneous preterm labor and “indicated” preterm birth are different. Spontaneous preterm birth is a syndrome caused by multiple etiologies, one of which is a decline in progesterone action, which induces cervical ripening. A sonographic short cervix (identified in the midtrimester) is a powerful predictor of spontaneous preterm delivery. Randomized clinical trials and individual patient meta-analyses have shown that vaginal progesterone reduces the rate of preterm delivery at cervix, and therefore, the compound of choice is natural progesterone (not the synthetic progestin). Routine assessment of the risk of preterm birth with cervical ultrasound coupled with vaginal progesterone for women with a short cervix is cost-effective, and implementation of such a policy is urgently needed. Vaginal progesterone is as effective as cervical cerclage in reducing the rate of preterm delivery in women with a singleton gestation, history of preterm birth, and a short cervix (<25mm). PMID:23314512

  13. Preterm birth and periodontal disease: A medical perspective

    Directory of Open Access Journals (Sweden)

    Neeta Dhabhai

    2016-01-01

    Full Text Available Births occurring before 37 weeks resulting in prematurity poses serious hazards to the baby from delayed growth, neurodevelopmental anomalies to death and unfortunately India is in the top four countries with maximum preterm births and leads globally in deaths by prematurity. Infection is a very important component of the etiopathogenesis of preterm labor and periodontal disease is a rather unexplored aspect of infection very often overlooked by the general gynecologist and the dental practitioner equally. Periodontal disease is a potential foci of infectious pathogens which may disseminate hematogenously and effect the fetus. In this article, an effort has been made to find an evidence-based link between periodontal disease and preterm labor to drive home the conclusion that an early screening and diagnosis in pregnancy followed up with effective treatment of periodontal disease may significantly reduce the burden of preterm births.

  14. Bacterial Hyaluronidase Promotes Ascending GBS Infection and Preterm Birth

    Directory of Open Access Journals (Sweden)

    Jay Vornhagen

    2016-06-01

    Full Text Available Preterm birth increases the risk of adverse birth outcomes and is the leading cause of neonatal mortality. A significant cause of preterm birth is in utero infection with vaginal microorganisms. These vaginal microorganisms are often recovered from the amniotic fluid of preterm birth cases. A vaginal microorganism frequently associated with preterm birth is group B streptococcus (GBS, or Streptococcus agalactiae. However, the molecular mechanisms underlying GBS ascension are poorly understood. Here, we describe the role of the GBS hyaluronidase in ascending infection and preterm birth. We show that clinical GBS strains associated with preterm labor or neonatal infections have increased hyaluronidase activity compared to commensal strains obtained from rectovaginal swabs of healthy women. Using a murine model of ascending infection, we show that hyaluronidase activity was associated with increased ascending GBS infection, preterm birth, and fetal demise. Interestingly, hyaluronidase activity reduced uterine inflammation but did not impact placental or fetal inflammation. Our study shows that hyaluronidase activity enables GBS to subvert uterine immune responses, leading to increased rates of ascending infection and preterm birth. These findings have important implications for the development of therapies to prevent in utero infection and preterm birth.

  15. Labor unions

    OpenAIRE

    Streeck, Wolfgang

    2001-01-01

    "Labor unions are interest associations of workers in waged employment. They are formed to improve the market situation and the life chances of their members, by representing them in the labor market, at the workplace, and in the polity, and in particular by collectively regulating their members' terms of employment. Unions emerged in the transition to industrial society in the nineteenth century, together with the de-fedualization of work, the rise of free labor markets, and the commodificat...

  16. Preterm dietary study

    DEFF Research Database (Denmark)

    Zachariassen, G; Fenger-Gron, J

    2014-01-01

    To describe eating habits and possible feeding intolerance among preterm infants based on type of nutrition.......To describe eating habits and possible feeding intolerance among preterm infants based on type of nutrition....

  17. Electrohysterographic evaluation of preterm contractions in a patient with a unicornuate uterus

    NARCIS (Netherlands)

    van 't Hooft, Janneke; Rabotti, Chiara; Oei, S. Guid

    2013-01-01

    Women with Müllerian anomalies are at increased risk of preterm labor. The analysis of parameters derived by the electrohysterogram such as its conduction velocity are promising for preterm delivery prediction. However, an electrohysterogram has never been measured in Müllerian anomalies. A

  18. Alternative splicing: an important mechanism for myometrial gene regulation that can be manipulated to target specific genes associated with preterm labour

    Directory of Open Access Journals (Sweden)

    Tyson-Capper Alison

    2007-06-01

    Full Text Available Abstract Considerable effort has been expended in attempting to distinguish genes that contribute to initiating the onset of term and preterm labour (PTL from those that change in expression as a consequence of the progression of labour. The ability to define more clearly the genes involved in triggering labour contractions should lead to the development of new effective and safer strategies to prevent preterm birth. There is ample evidence to suggest that specific genes are co-ordinately regulated within the upper and lower regions of the myometrium prior to and during parturition and many of these genes are regulated by alternative pre-mRNA splicing. This mini-review highlights that expression of a range of different splicing factors, with defined roles in pre-mRNA splicing, is both temporally and spatially regulated within the uterine smooth muscle during pregnancy and labour. Moreover, several of these splicing factors play key roles in controlling the differential expression of specific regulatory proteins involved in uterine signalling and uterine quiescence. In addition, antisense morpholino oligonucleotide manipulation of pre-mRNA splicing may have potential in defining and targeting uterine pro-labour genes and thus contribute to the development of new therapeutic approaches to prevent PTL.

  19. Epidemiology of preterm birth.

    Science.gov (United States)

    Purisch, Stephanie E; Gyamfi-Bannerman, Cynthia

    2017-11-01

    Preterm birth is a worldwide epidemic with a global incidence of 15 million per year. Though rates of preterm birth in the United States have declined over the last decade, nearly 1 in 10 babies is still born preterm. The incidence, gestational age, and underlying etiology of preterm birth is highly variable across different racial and ethnic groups and geographic boundaries. In this article, we review the epidemiology of preterm birth in the United States and globally, with a focus on temporal trends and racial, ethnic, and geographic disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. The role of progesterone in prevention of preterm birth

    Directory of Open Access Journals (Sweden)

    Jodie M Dodd

    2009-07-01

    Full Text Available Jodie M Dodd, Caroline A CrowtherDiscipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, AustraliaAbstract: Preterm birth continues to provide an enormous challenge in the delivery of perinatal health care, and is associated with considerable short and long-term health consequences for surviving infants. Progesterone has a role in maintaining pregnancy, by suppression of the calcium–calmodulin–myosin light chain kinase system. Additionally, progesterone has recognized anti-inflammatory properties, raising a possible link between inflammatory processes, alterations in progesterone receptor expression and the onset of preterm labor. Systematic reviews of randomized controlled trials evaluating the use of intramuscular and vaginal progesterone in women considered to be at increased risk of preterm birth have been published, with primary outcomes of perinatal death, preterm birth <34 weeks, and neurodevelopmental handicap in childhood. Eleven randomized controlled trials were included in the systematic review, involving 2714 women and 3452 infants, with results presented according to the reason women were considered to be at increased risk of preterm birth. While there is a potential beneficial effect in the use of progesterone for some women considered to be at increased risk of preterm birth, primarily in the reduction in the risk of preterm birth before 34 weeks gestation, it remains unclear if the observed prolongation of pregnancy translates into improved health outcomes for the infant.Keywords: progesterone, preterm birth, systematic review, randomized trial

  1. Sleep duration, vital exhaustion, and odds of spontaneous preterm birth: a case-control study.

    Science.gov (United States)

    Kajeepeta, Sandhya; Sanchez, Sixto E; Gelaye, Bizu; Qiu, Chunfang; Barrios, Yasmin V; Enquobahrie, Daniel A; Williams, Michelle A

    2014-09-27

    Preterm birth is a leading cause of perinatal morbidity and mortality worldwide, resulting in a pressing need to identify risk factors leading to effective interventions. Limited evidence suggests potential relationships between maternal sleep or vital exhaustion and preterm birth, yet the literature is generally inconclusive. We examined the relationship between maternal sleep duration and vital exhaustion in the first six months of pregnancy and spontaneous (non-medically indicated) preterm birth among 479 Peruvian women who delivered a preterm singleton infant (exhaustion were ascertained through in-person interviews. Spontaneous preterm birth cases were further categorized as those following either spontaneous preterm labor or preterm premature rupture of membranes. In addition, cases were categorized as very (exhaustion was also associated with increased odds of preterm birth (aOR = 2.41; 95% CI 1.79-3.23) compared to no exhaustion (Ptrend exhaustion on the odds of spontaneous preterm birth. The results of this case-control study suggest maternal sleep duration, particularly short sleep duration, and vital exhaustion may be risk factors for spontaneous preterm birth. These findings call for increased clinical attention to maternal sleep and the study of potential intervention strategies to improve sleep in early pregnancy with the aim of decreasing risk of preterm birth.

  2. Cesarean Delivery for a Life‑threatening Preterm Placental Abruption

    African Journals Online (AJOL)

    Following a failed induction of labor with a deteriorating maternal condition despite resuscitation, emergency cesarean delivery was offered with good maternal outcome. Cesarean delivery could avert further disease progression and possible maternal death in cases of severe preterm placental abruption where vaginal ...

  3. Evaluation of Maternal Serum 25-Hydroxyvitamin D, Paraoxonase 1 Levels, and Neutrophil-to-Lymphocyte Ratio in Spontaneous Preterm Birth.

    Science.gov (United States)

    Bozoklu Akkar, Ozlem; Sancakdar, Enver; Karakus, Savas; Yildiz, Caglar; Akkar, Ismail; Arslan, Murat; Sahin, Irfan Oguz; Imir Yenicesu, Ayse Gonca; Cetin, Ali

    2016-04-13

    BACKGROUND The aim of this study was to evaluate the association of maternal serum 25-hydroxyvitamin D, paraoxonase 1, and neutrophil-to-lymphocyte ratio in women having early spontaneous preterm birth without clinical chorioamnionitis. MATERIAL AND METHODS This study was prospectively administered in women referred to our obstetrics service with preterm labor that resulted in preterm birth (n=35) and term labor that ended in term birth (n=44). The maternal serum levels of 25-hydroxyvitamin D and paraoxonase 1 were measured and neutrophil-to-lymphocyte ratio was calculated. RESULTS The 25-hydroxyvitamin D and paraoxonase 1 levels of the preterm group were significantly lower than those of the term group (pparaoxonase 1 in the preterm group (r=0.35; p=0.021). CONCLUSIONS Decreased maternal serum 25-hydroxyvitamin D and paraoxonase 1 levels and increased neutrophil-to-lymphocyte ratio may have a role in the etiology of spontaneous preterm birth.

  4. Effects of antenatal dexamethasone administration on fetal and uteroplacental Doppler waveforms in women at risk for spontaneous preterm birth

    Directory of Open Access Journals (Sweden)

    Elwani Elsnosy

    2017-03-01

    Conclusion: Maternal dexamethasone administration to pregnant women at risk of preterm labor improves the blood flow of the maternal uterine artery, fetal MCA, descending aorta and umbilical artery 24 h after its administration.

  5. Prediction of Delivery in Women with Threatening Preterm Labour using Phosphorylated Insulin-Like Growth Factor Binding Protein-1 and Cervical Length using Transvaginal Ultrasound.

    Science.gov (United States)

    Kumari, Amrita; Saini, Vandana; Jain, P K; Gupta, Mamta

    2017-09-01

    Preterm delivery remains a challenge in Obstetrics as it is responsible for significant cause of perinatal morbidity and mortality. At present there is no standard test for prediction of preterm labour for timely referral to a center with NICU facilities. To evaluate the effectiveness of the cervical phosphorylated insulin like growth factor binding protein-1(phIGFBP-1), cervical length measurement and combination of phIGFBP-1 with cervical length for Predicting Preterm Labour (PTL). It was a observational prospective study done from January 2014 to April 2015 in Department of Obstetrics and Gynaecology, NDMC Medical College and Hindu Rao Hospital, Delhi, India. A total of 100 women with singleton pregnancy, between 24 and 36 weeks of gestation with complaint of uterine contractions were randomly selected. These women were subjected to detect phIGFBP-1 in cervical secretions and cervical length measurement by Transvaginal Sonography (TVS). Result of the test, cervical length and time lapse between test and delivery was noted and the results were analysed. The cervical length less than 25 mm was used as a cut off point for predicting pre-term delivery. Data was analysed using SPSS software version 20.0. The Negative Predictive Value (NPV) of phIGFBP-1 and cervical length was similar (95.2% vs 94.05%) respectively for prediction of preterm labour within one week of admission and 93.92% vs 94.80% at 37 weeks of gestational age. Combined test had higher NPV of 96.38% at 34 weeks of gestation and 94% within two days of admission. Positive Predictive Value (PPV) was low for both the test and combining the two-test did not have any advantage as far as PPV was concerned. Receiver Operating Characteristic (ROC) curve showed that the combined test had a superior result in predicting PTL compared to either phIGFBP-1 or cervical length. The combined test had steepest ROC curve at preterm delivery independently. The combined use of phIGFBP-1 and TVS for cervical length shows an

  6. The preterm cervix reveals a transcriptomic signature in the presence of premature prelabor rupture of membranes.

    Science.gov (United States)

    Makieva, Sofia; Dubicke, Aurelija; Rinaldi, Sara F; Fransson, Emma; Ekman-Ordeberg, Gunvor; Norman, Jane E

    2017-06-01

    Premature prelabor rupture of fetal membranes accounts for 30% of all premature births and is associated with detrimental long-term infant outcomes. Premature cervical remodeling, facilitated by matrix metalloproteinases, may trigger rupture at the zone of the fetal membranes overlying the cervix. The similarities and differences underlying cervical remodeling in premature prelabor rupture of fetal membranes and spontaneous preterm labor with intact membranes are unexplored. We aimed to perform the first transcriptomic assessment of the preterm human cervix to identify differences between premature prelabor rupture of fetal membranes and preterm labor with intact membranes and to compare the enzymatic activities of matrix metalloproteinases-2 and -9 between premature prelabor rupture of fetal membranes and preterm labor with intact membranes. Cervical biopsies were collected following preterm labor with intact membranes (n = 6) and premature prelabor rupture of fetal membranes (n = 5). Biopsies were also collected from reference groups at term labor (n = 12) or term not labor (n = 5). The Illumina HT-12 version 4.0 BeadChips microarray was utilized, and a novel network graph approach determined the specificity of changes between premature prelabor rupture of fetal membranes and preterm labor with intact membranes. Quantitative reverse transcription-polymerase chain reaction and Western blotting confirmed the microarray findings. Immunofluorescence was used for localization studies and gelatin zymography to assess matrix metalloproteinase activity. PML-RARA-regulated adapter molecule 1, FYVE-RhoGEF and PH domain-containing protein 3 and carcinoembryonic antigen-ralated cell adhesion molecule 3 were significantly higher, whereas N-myc downstream regulated gene 2 was lower in the premature prelabor rupture of fetal membranes cervix when compared with the cervix in preterm labor with intact membranes, term labor, and term not labor. PRAM1 and CEACAM3 were localized

  7. Density of Stromal Cells and Macrophages Associated With Collagen Remodeling in the Human Cervix in Preterm and Term Birth.

    Science.gov (United States)

    Dubicke, Aurelija; Ekman-Ordeberg, Gunvor; Mazurek, Patricia; Miller, Lindsay; Yellon, Steven M

    2016-05-01

    Remodeling of the cervix occurs in advance of labor both at term and at preterm birth. Morphological characteristics associated with remodeling in rodents were assessed in cervix biopsies from women at term (39 weeks' gestation) and preterm (cervix biopsies from women in labor at term and preterm compared to that in the cervix from nonlaboring women. Extracellular collagen was more degraded in sections of cervix from women at term, based on optical density of picrosirius red stain, versus that in biopsies from nonpregnant women. However, collagen structure was unchanged in the cervix from women at preterm labor versus the nonpregnant group. As an indication of inflammation, cell nuclei density was decreased in cervix biopsies from pregnant women irrespective of labor compared to the nonpregnant group. Moreover, CD68-stained macrophages increased to an equivalent extent in cervix subepithelium and stroma from groups in labor, both at term and preterm, as well as in women not in labor at term. Evidence for a similar inflammatory process in the remodeled cervix of women at term and preterm birth parallels results in rodent models. Thus, a conserved final common mechanism involving macrophages and inflammation may characterize the transition to a ripe cervix before birth at term and in advance of premature birth. © The Author(s) 2015.

  8. Child Labor

    OpenAIRE

    Christopher Udry

    2003-01-01

    In recent years, there has been an astonishing proliferation of empirical work on child labor. An Econlit search of keywords "child lab*r" reveals a total of 6 peer reviewed journal articles between 1980 and 1990, 65 between 1990 and 2000, and 143 in the first five years of the present decade. The purpose of this essay is to provide a detailed overview of the state of the recent empirical literature on why and how children work as well as the consequences of that work. Section 1 defines terms...

  9. Endocrine, paracrine, and autocrine placental mediators in labor.

    Science.gov (United States)

    Iliodromiti, Zoe; Antonakopoulos, Nikolaos; Sifakis, Stavros; Tsikouras, Panagiotis; Daniilidis, Angelos; Dafopoulos, Kostantinos; Botsis, Dimitrios; Vrachnis, Nikolaos

    2012-01-01

    Considering that preterm birth accounts for about 6-10% of all births in Western countries and of more than 65% of all perinatal deaths, elucidation of the particularly complicated mechanisms of labor is essential for determination of appropriate and effective therapeutic interventions. Labor in humans results from a complex interplay of fetal and maternal factors, which act upon the uterus to trigger pathways leading gradually to a coordinated cervical ripening and myometrial contractility. Although the exact mechanism of labor still remains uncertain, several components have been identified and described in detail. Based on the major role played by the human placenta in pregnancy and the cascade of labor processes activated via placental mediators exerting endocrine, paracrine, and autocrine actions, this review article has aimed at presenting the role of these mediators in term and preterm labor and the molecular pathways of their actions. Some of the aforementioned mediators are involved in myometrial activation and preparation and others in myometrial stimulation leading to delivery. In the early stages of pregnancy, myometrial molecules, like progesterone, nitric oxide, and relaxin, contribute to the retention of pregnancy. At late stages of gestation, fetal hypothalamus maturation signals act on the placenta causing the production of hormones, including CRH, in an endocrine manner; the signals then enhance paracrinically the production of more hormones, such as estrogens and neuropeptides, that contribute to cervical ripening and uterine contractility. These molecules act directly on the myometrium through specific receptors, while cytokines and multiple growth factors are also produced, additionally contributing to labor. In situations leading to preterm labor, as in maternal stress and fetal infection, cytokines trigger placental signaling sooner, thus leading to preterm birth.

  10. Fatiga laboral

    Directory of Open Access Journals (Sweden)

    Useche Mora Luz Graciela

    1992-06-01

    Full Text Available

    La fatiga laboral es un fenómeno complejo y muy común en los ambientes de trabajo especialmente en aquellos que requieren de una alta carga física y en los que son utilizadas complicadas tecnologías que presentan al hombre máximas exigencias, obligándolo a trabajar más allá de sus posibilidades psicofisiológicas y en condiciones muchas veces nocivas. En este sentido, el presente artículo se propone presentar el análisis de aspectos fundamentales de la fatiga que requieren ser conocidos por todo trabajador, con el fin de evitar situaciones de morbilidad y, por qué no decirlo, hasta de muerte.

     

  11. Low levels of anti-secretory factor in placenta are associated with preterm birth and inflammation.

    Science.gov (United States)

    Gustafsson, Anna M; Fransson, Emma; Dubicke, Aurelija; Hjelmstedt, Anna K; Ekman-Ordeberg, Gunvor; Silfverdal, Sven-Arne; Lange, Stefan; Jennische, Eva; Bohlin, Kajsa

    2018-03-01

    Anti-secretory factor is a protein that regulates secretory and inflammatory processes and preterm birth is associated with inflammation. Therefore, our hypothesis was that anti-secretory factor might play a role in immune reactivity and homeostasis during pregnancy. Following spontaneous onset of labor and preterm or term delivery, placenta biopsies were collected. The levels of anti-secretory factor and markers of inflammation (CD68, CD163) and vascularization (CD34, smooth muscle actin) were analyzed by immunohistochemistry. The 61 placental biopsies included 31 preterm (preterm placentas exhibited lower levels of anti-secretory factor (p = 0.008) and larger numbers of CD68-positive cells (p Preterm placentas had blood vessel of smaller diameter (p = 0.036) indicative of immaturity. The level of interleukin-6 in cord blood was higher after very preterm than term birth, suggesting a fetal inflammatory response. The placenta level of anti-secretory factor was positively correlated to the length of gestation (p = 0.025) and negatively correlated to the levels of the inflammatory markers CD68 (p = 0.015) and CD163 (p = 0.028). Preterm delivery is associated with low levels of anti-secretory factor in placenta. Inflammation, a potential trigger of preterm birth, is more pronounced in the preterm placenta and inversely related to the placental level of anti-secretory factor, suggesting both a link and a potential target for intervention. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. [Relationship between periodontal diseases and ascending bacterial infection with preterm delivery].

    Science.gov (United States)

    Ovalle, Alfredo; Gamonal, Jorge; Martínez, M Angélica; Silva, Nora; Kakarieka, Elena; Fuentes, Ariel; Chaparro, Alejandra; Gajardo, Marta; León, Rubén; Ahumada, Alexis; Cisternas, Carlos

    2009-04-01

    There is an association between periodontal diseases and preterm delivery. To assess the relationship between periodontal diseases, ascending bacterial infection and placental pathology with preterm delivery. A periodontal examination and collection of amniotic fluid and subgingival plaque samples were performed in women with preterm labor with intact membranes, without an evident clinical cause or preterm premature rupture of membranes, without clinical chorioamnionitis or labor and a gestational age between 24 and 34 weeks. Microbial invasion of the amniotic cavity was defined as the presence of a positive amniotic fluid culture. Cervicovaginal infection was defined as a bacterial vaginosis or positive culture of cervix or vagina with a high neutrophil count. Ascending bacterial infection was diagnosed as the microbial invasion of the amniotic cavity by ascending bacteria or cervicovaginal infection. Corioamnionitis, funisitis or vellositis were diagnosed. Fifty-nine women were included: forty-two with preterm labor with intact membranes and seventeen with preterm premature rupture of membranes. The prevalence of periodontal diseases was 93.2%. Microbial invasion of the amniotic fluid was detected in 27.1% of patients. periodontal pathogenic bacteria were isolated in 18.6% of amniotic fluid samples and 71.2% of subgingival plaque samples. The prevalence of ascending bacterial infection was 83.1% and in 72.9% of women it was associated with periodontal disease. Preterm delivery (<37 weeks) occurred in 64.4% of patients and was significantly associated with generalized periodontal disease and with the association of ascending bacterial infection and periodontal diseases. Patients with preterm delivery and generalized periodontal disease had a higher frequency of chorioamnionitis and funisitis. Generalized periodontal disease and its association with ascending bacterial infection are related to preterm delivery and placental markers of bacterial ascending infection.

  13. Does alcohol increase the risk of preterm delivery?

    DEFF Research Database (Denmark)

    Kesmodel, Ulrik; Olsen, Sjúrður Fróði; Secher, Niels Jørgen

    2000-01-01

    We evaluated the association between alcohol intake during pregnancy and preterm delivery. Women attending routine antenatal care at Aarhus University Hospital, Denmark, from 1989–1991 and 1992–1996 were eligible. We included 18,228 singleton pregnancies in the analyses. We obtained prospective...... information on alcohol intake at 16 and 30 weeks of gestation, other lifestyle factors, maternal characteristics, and obstetrical risk factors from self-administered questionnaires and hospital files. For women with alcohol intake of 1–2, 3–4, 5–9, and >=10 drinks/week the risk ratio (RR) of preterm delivery.......78–7.13) at 30 weeks. Adjustment for smoking habits, caffeine intake, age, height, pre-pregnant weight, marital status, occupational status, education, parity, chronic diseases, previous preterm delivery, mode of initiation of labor, and sex of the child did not change the conclusions, nor did restriction...

  14. The relationship of the subtypes of preterm birth with retinopathy of prematurity.

    Science.gov (United States)

    Lynch, Anne M; Wagner, Brandie D; Hodges, Jennifer K; Thevarajah, Tamara S; McCourt, Emily A; Cerda, Ashlee M; Mandava, Naresh; Gibbs, Ronald S; Palestine, Alan G

    2017-09-01

    Retinopathy of prematurity is an adverse outcome of preterm birth and is a leading cause of childhood blindness. The relationship between the subtypes of preterm birth with retinopathy of prematurity is understudied. To investigate whether there is a difference in the incidence of type 1 or type 2 retinopathy of prematurity in infants with preterm birth resulting from spontaneous preterm labor, a medical indication of preterm birth, or preterm premature rupture of the membranes. A retrospective cohort study was conducted of 827 infants screened for retinopathy of prematurity who were delivered at a single tertiary care center in Colorado. All infants fulfilled the American Academy of Pediatrics 2013 screening criteria for retinopathy of prematurity defined as "infants with a birth weight of ≤1500 g or gestational age of 30 weeks or less (as defined by the attending neonatologist) and selected infants with a birth weight between 1500 and 2000 g or gestational age of >30 weeks with an unstable clinical course, including those requiring cardiorespiratory support and who are believed by their attending pediatrician or neonatologist to be at high risk for retinopathy of prematurity." Two independent reviewers masked to retinopathy of prematurity outcomes determined whether preterm birth resulted from spontaneous preterm labor, medical indication of preterm birth, or preterm premature rupture of the membranes. Discrepancies were resolved by a third reviewer. Data were analyzed with univariate and multivariable logistic regression. In our cohort, the frequency of preterm birth resulting from spontaneous preterm labor, medical indication of preterm birth, or preterm premature rupture of the membranes was 34%, 40%, and 26%, respectively. The mean gestational age (weeks, days) ± SD (range) in the cohort and across the preterm birth subtypes was as follows: entire cohort, 28 weeks, 6 days ± 2 weeks, 3 days (23 weeks, 3 days - 36 weeks, 4 days); spontaneous preterm labor

  15. Breastfeeding the preterm infant

    Directory of Open Access Journals (Sweden)

    Luigi Corvaglia

    2013-06-01

    Full Text Available Due to its peculiar nutritional and non-nutritional contents, which include long-chain polyunsatured fatty acids (LC-PUFA, prebiotics, immunological factors, hormones and growth factors, breast milk shows significant advantages over infant formulas in nourishing preterm infants. Better neurocognitive outcomes, which are reported to persist far beyond the early childhood, have been largely observed in breastfed preterm infants; a role of LC-PUFA in promoting neural and retinal development is assumed. As far as the gastrointestinal tract is concerned, several evidences have reported a dose-related reduction in NEC incidence among preterm infants fed on human milk. Moreover, the higher amount of immunological factors as secretory IgA within preterm breast milk might play a remarkable role in reducing the overall infections. Despite breastfeeding in preterm infants is generally linked with lowered growth rates which might potentially affect neurocognitive outcomes, the beneficial effects of human milk on neurodevelopment prevail. Fortified human milk might better fulfill the particular nutritional needs of preterm infants. However, as breast milk fortification is difficult to carry out after the achievement of full oral feeding, some concerns on the nutritional adequacy of exclusive breastfeeding during hospitalization as well as after discharge have been raised. Finally, breastfeeding also entails maternal psychological beneficial effects, as promoting the motherhood process and the mother-child relationship, which could be undermined in those women experiencing preterm delivery. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  16. Screening for spontaneous preterm birth

    NARCIS (Netherlands)

    van Os, M.A.; van Dam, A.J.E.M.

    2015-01-01

    Preterm birth is the most important cause of perinatal morbidity and mortality worldwide. In this thesis studies on spontaneous preterm birth are presented. The main objective was to investigate the predictive capacity of mid-trimester cervical length measurement for spontaneous preterm birth in a

  17. Colonização materna e neonatal por estreptococo do grupo B em situações de ruptura pré-termo de membranas e no trabalho de parto prematuro Group B streptococcus maternal and neonatal colonization in preterm rupture of membranes and preterm labor

    Directory of Open Access Journals (Sweden)

    Marcelo Luís Nomura

    2009-08-01

    dois casos de sepse precoce por EGB nesta amostra, com prevalência de 10,8 casos por mil nascidos vivos e mortalidade de 50%. CONCLUSÕES: a amostra avaliada apresenta altas taxas de colonização materna por Streptococcus agalactiae. São necessários o uso de meio de cultura seletivo e a associação de culturas ano-retais e vaginais para aumentar a taxa de detecção do EGB. A incidência de sepse neonatal precoce foi elevada nesta população.PURPOSE: to indentify the prevalence and risk factors of maternal colonization by group B streptococcus (GBS in pregnant women with premature labor (PL and/or premature membrane rupture (PMR. METHODS: two anal and two vaginal swabs were collected from 203 pregnant women with diagnosis of PL or PMR assisted at the practice along one year. Pregnant women with imminent labor at admission were excluded. One swab of each source was placed in a transfer milieu and sent for culture in blood-agar plates; the two remaining swabs were incubated for 24 hours in Todd-Hewitt milieu for further sowing in blood-agar plates. Risk factors were analyzed by the chi-square test, Student's t-test (p-value set at 0.05 and 95% confidence interval and logistic regression. The following variables were analyzed: age, race, parity and mother schooling; culture results by source and type of culture; admission diagnosis; gestational age at admission; asymptomatic bacteriuria; gestational age at delivery; type of delivery; neonatal GBS colonization rate and immediate neonatal condition. RESULTS: prevalence of maternal GBS colonization was 27.6% (56 cases. The colonization rates according to gestational complications were 30% for PMR, 25.2% for PL and 17.8% for PL + PMR. Univariate analysis has shown that the variables Caucasian race, low level of schooling and bacteriuria were associated with higher colonization rates. Multivariate analysis showed that the presence of urinary infection was the only variable associated with maternal colonization. The GBS

  18. Fetal adrenal gland biometry and cervical elastography as predictors of preterm birth: A comparative study.

    Science.gov (United States)

    Agarwal, Shubhra; Agarwal, Arjit; Joon, Pawan; Saraswat, Shalini; Chandak, Shruti

    2018-02-01

    Preterm birth is a major health problem in developing and developed countries leading to rising health care costs and long-term neurodevelopmental disability. The study aims to evaluate the role of new quantitative markers, like the elastography of cervix (shear wave speed estimation), fetal adrenal zone enlargement, and corrected fetal adrenal gland volume; in preterm birth prediction and analyze their relative importance. Thus, these markers may be beneficial in early preterm birth detection and prevent the related morbidities. Thirty pregnant females (from 28 to 37 weeks of gestational age), showing clinical signs and delivery outcome of preterm birth were included in the study with an equal number of not-in-labor antenatal females at ≥37 weeks as controls. These patients were categorized as preterm and term groups. Both the groups were subjected to trans-abdominal ultrasonography where cervical length, cervical shear wave speed (dynamic elastography) and fetal adrenal gland parameters were measured. Shear wave speed estimation of the antenatal cervix showed the highest sensitivity and specificity (96.7% and 87% respectively) in the prediction of preterm birth and also showed a strong correlation with fetal adrenal gland enlargement. Fetal adrenal zone enlargement was also shown to be a reliable marker of preterm birth, however, with reduced sensitivity and specificity than shear wave speed. The elastographic advancement and fetal adrenal biometry derived quantitative markers can be used as an objective and standard criterion for accurate prediction of preterm birth.

  19. Effect of maintenance tocolysis with nifedipine in established preterm labour on pregnancy prolongation and neonatal outcome.

    Science.gov (United States)

    Aggarwal, Ajay; Bagga, Rashmi; Girish, Bhavana; Kalra, Jaswinder; Kumar, Praveen

    2018-02-01

    Fifty women with singleton pregnancies between 26 +0/7 and 33 +6/7  weeks of gestation and arrested preterm labour (PTL) after acute tocolysis were randomised by a computer generated randomisation table into an intervention group (n = 25) who received maintenance tocolysis with tablet nifedipine for 12 days or up to 34 weeks of gestation, whichever was later and a control group (n = 25). The primary outcome was achievement of term gestation and the secondary outcomes were the number of days gained till delivery and neonatal mortality and morbidity. The mean gestation at admission, cervical dilatation and effacement were similar in the two groups (30 + weeks, 2.5 cm, 60%). In the intervention group, 7/25 (28%) and in the control group, 2/25 (8%) delivered at term (p = .066) and pregnancy prolongation of 20 days (IQR 2.5-51) and 14 days (IQR 1-27.5) were achieved, respectively (p = .269). Maintenance tocolysis was given for a median of 14 days (range 3-25.5). Kaplan-Meier analysis showed no statistically significant difference in prolongation of pregnancy between the control and the intervention groups (p = .077). The median number of days of neonatal hospital stay were reduced with maintenance tocolysis, but the difference was not significant (4.0 vs 5.5; p = .608). The mean birth weight was significantly higher in the intervention group (2266 vs 1880 g, p = .044). Among women at a high risk for preterm birth (PTB) due to established PTL as evidenced by a mean cervical dilatation of 2.5 cm and a PTB rate of 92% in the control group, maintenance tocolysis did not prolong the pregnancy or reduce the neonatal hospital stay significantly. Impact statement What is already known on this subject: In women with preterm labour (PTL) the role of maintenance tocolysis following acute tocolysis to reduce recurrent PTL is uncertain. Of the six studies using nifedipine, one reported pregnancy prolongation (26.65 vs 16.14 days, p

  20. Role of acoustic radiation force impulse and shear wave velocity in prediction of preterm birth: a prospective study.

    Science.gov (United States)

    Agarwal, Arjit; Agarwal, Shubhra; Chandak, Shruti

    2017-01-01

    Background Preterm birth is one of the important causes of neonatal morbidity where we rely on subjective criteria such as modified Bishop's scoring and contemporary sonographic measurement of cervical length. Acoustic radiation force impulse (ARFI) is a technological advancement in elastography that can be employed in prediction of cervical softening and preterm labor. Purpose To evaluate the role of ARFI technique and shear wave velocity (SWV) estimates as a predictor of preterm birth and its comparison with other clinical and sono-elastographic measures. Material and Methods Thirty-four pregnant women (gestation age = 28-37 weeks age) showing features suggestive of preterm labor were included and evaluated with modified Bishop's score, cervical length by ultrasound (US), ARFI to derive Elastography index (EI), and SWV of the cervix. The patients were later divided into two groups, using the clinical outcome of preterm or term delivery. Results Twenty patients delivered at term (gestational age > 37 weeks) and 14 were preterm. Receiver operating characteristics (ROC) curves showed SWV with highest sensitivity and specificity (93% and 90%, respectively) for the prediction of preterm birth at a cutoff value of 2.83 m/s. EI and modified Bishop's score were comparable to each other, but were less sensitive techniques. Conclusion Elastographic assessment of antenatal cervix is a novel technique of virtual palpation of internal os and can be utilized as an objective criterion for preterm birth prediction.

  1. Preterm labor and premature birth: Are you at risk?

    Science.gov (United States)

    ... premature birth The newborn intensive care unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Calculating your due date Ovulation calendar Order bereavement materials News Moms Need Blog Stories & Media ...

  2. Neonatology oxidative status in preterm infants with premature preterm rupture of membranes and fetal inflammatuar response syndrome.

    Science.gov (United States)

    Özalkaya, Elif; Karatekin, Güner; Topçuoğlu, Sevilay; Karatepe, Hande Özgün; Hafızoğlu, Taner; Baran, Pervin; Ovalı, Fahri

    2017-10-01

    The aim of this study, to determine an index of oxidative stress index in preterm infants less than 34 weeks gestational age with premature preterm rupture of membrane (PPROM) and fetal inflammatory response syndrome (FIRS). This study was designed as a prospective study. Fifty-one premature infants less than 35 weeks of gestational age were included in the study. The umbilical cord blood concentrations of IL-6, TAC (total antioxidant capacity) and PON-1 (paraoxonase-1) levels and TOS (total oxidative stress) were studied. The oxidative stress index (OSI = TAC/TOS) was calculated in all of prematüre infants. PPROM was defined as rupture of membranes at least 24 hours before the onset of labor. FIRS was defined by an umbilical cord IL-6 level greater than 11 pg/mL. Premature infants included in the study were divided into 4 groups. Group 1 included preterm infants without FIRS and with PPROM (n = 16), while Group 2 included preterm infants without PPROM and with FIRS (n = 9), Group 3 consisted of premature infants with PPROM and FIRS (n = 21) and Group 4 included premature infants without PPROM or FIRS (n = 5). Umbilical cord TOS level was found to be higher in the preterm infants without FIRS and with PPROM (36.1 μmol H 2 O 2 Equiv./L) compared to the preterm infants without PPROM or FIRS (11.9 μmol H 2 O 2 Equiv./L) (p = 0.03). Umbilical cord PON-1 level was found to be lower in the preterms without FIRS and with PPROM (32 U/L), preterms without PPROM and with FIRS (30. 3 U/L) and the preterm infants with both PPROM and FIRS (48.6 U/L) compared to the preterm infants having no PPROM or FIRS (85.6 U/L) (p = 0.001). High pro-oxidant capacity was found in PPROM and low antioxidant capacity in PPROM and FIRS. Copyright © 2017. Published by Elsevier B.V.

  3. Spontaneous preterm birth: advances toward the discovery of genetic predisposition.

    Science.gov (United States)

    Strauss, Jerome F; Romero, Roberto; Gomez-Lopez, Nardhy; Haymond-Thornburg, Hannah; Modi, Bhavi P; Teves, Maria E; Pearson, Laurel N; York, Timothy P; Schenkein, Harvey A

    2018-03-01

    innate immune response (eg, CARD6, CARD8, NLRP10, NLRP12, NOD2, TLR10) and antimicrobial peptide/proteins (eg, DEFB1, MBL2). These findings support the concept that preterm labor, at least in part, has an inflammatory etiology, which can be induced by pathogens (ie, intraamniotic infection) or "danger signals" (alarmins) released during cellular stress or necrosis (ie, sterile intraamniotic inflammation). These findings support the notion that preterm birth has a polygenic basis that involves rare mutations or damaging variants in multiple genes involved in innate immunity and host defense mechanisms against microbes and their noxious products. An overlap among the whole exome sequencing-identified genes and other inflammatory conditions associated with preterm birth, such as periodontal disease and inflammatory bowel disease, was observed, which suggests a shared genetic substrate for these conditions. We propose that whole exome sequencing, as well as whole genome sequencing, is the most promising approach for the identification of functionally significant genetic variants responsible for spontaneous preterm birth, at least in the context of pathologic inflammation. The identification of genes that contribute to preterm birth by whole exome sequencing, or whole genome sequencing, promises to yield valuable population-specific biomarkers to identify the risk for spontaneous preterm birth and potential strategies to mitigate such a risk. Published by Elsevier Inc.

  4. Spontaneous and indicated preterm delivery risk is increased among overweight and obese women without prepregnancy chronic disease.

    Science.gov (United States)

    Kim, S S; Mendola, P; Zhu, Y; Hwang, B S; Grantz, K L

    2017-10-01

    To investigate the independent impact of prepregnancy obesity on preterm delivery among women without chronic diseases by gestational age, preterm category and parity. A retrospective cohort study. Data from the Consortium on Safe Labor (CSL) in the USA (2002-08). Singleton deliveries at ≥23 weeks of gestation in the CSL (43 200 nulliparas and 63 129 multiparas) with a prepregnancy body mass index (BMI) ≥18.5 kg/m 2 and without chronic diseases. Association of prepregnancy BMI and the risk of preterm delivery was examined using Poisson regression with normal weight as reference. Preterm deliveries were categorised by gestational age (extremely, very, moderate to late) and category (spontaneous, indicated, no recorded indication). Relative risk of spontaneous preterm delivery was increased for extremely preterm among obese nulliparas (1.26, 95% CI: 0.94-1.70 for overweight; 1.88, 95% CI: 1.30-2.71 for obese class I; 1.99, 95% CI: 1.32-3.01 for obese class II/III) and decreased for moderate to late preterm delivery among overweight and obese multiparas (0.90, 95% CI: 0.83-0.97 for overweight; 0.87, 95% CI: 0.78-0.97 for obese class I; 0.79, 95% CI: 0.69-0.90 for obese class II/III). Indicated preterm delivery risk was increased with prepregnancy BMI in a dose-response manner for extremely preterm and moderate to late preterm among nulliparas, as it was for moderate to late preterm delivery among multiparas. Prepregnancy BMI was associated with increased risk of preterm delivery even in the absence of chronic diseases, but the association was heterogeneous by preterm categories, gestational age and parity. Obese nulliparas without chronic disease had higher risk for spontaneous delivery <28 weeks of gestation. © 2017 Royal College of Obstetricians and Gynaecologists.

  5. Factors associated with preterm, early preterm and late preterm birth in Malawi.

    Directory of Open Access Journals (Sweden)

    Nynke R van den Broek

    Full Text Available Assessment of risk factors for preterm birth in a population with high incidence of preterm birth and HIV infection.Secondary analysis of data for 2,149 women included in a community based randomized placebo controlled trial for the prevention of preterm birth (APPLe trial (ISRCTN84023116 with gestational age at birth determined through ultrasound measurement in early pregnancy. Multivariate Logistic Regression analyses to obtain models for three outcome variables: all preterm, early preterm, and late preterm birth.No statistical differences were noted for the prevalence of HIV infection (p = 0.30 or syphilis (p = 0.12 between women who delivered preterm versus term. BMI (Adjusted OR 0.91 (0.85-0.97; p = 0.005 and weight gain (Adjusted OR 0.89 (0.82-0.97; p = 0.006 had an independent, protective effect. Previous preterm birth doubled the odds of preterm birth (Adjusted OR 2.13 (1.198-3.80; p = 0.01. Persistent malaria (despite malaria prophylaxis increased the risk of late preterm birth (Adjusted OR 1.99 (1.05-3.79; p = 0.04. Age <20 (Adjusted OR 1.73 (1.03-2.90; p = 0.04 and anemia (Adjusted OR 1.95 (1.08-3.52; p = 0.03 were associated with early preterm birth (<34 weeks.Despite claims that HIV infection is an important cause of preterm birth in Africa, we found no evidence of an association in this population (unexposed to anti-retroviral treatment. Persistent malaria was associated with late preterm birth. Maternal undernourishment and anemia were independently associated with early preterm birth. The study did not assess whether the link was direct or whether a common precursor such as chronic infection was responsible for both maternal effects and early labour.

  6. Umbilical Cord Prostaglandins in Term and Preterm Parturition

    Science.gov (United States)

    Hong, J.-S.; Romero, R.; Lee, D.-C.; Than, N. G.; Yeo, L.; Chaemsaithong, P.; Ahn, S.; Kim, J.-S.; Kim, C. J.; Kim, Y.M.

    2017-01-01

    Objective Prostaglandins (PGs) are considered the universal mediators of parturition. Amniotic fluid PGE2 and PGF2α concentrations increase before the onset of spontaneous labor at term, as well as during labor. This study was conducted to determine if the concentrations of umbilical cord PGE2 and PGF2α change with advancing gestational age, spontaneous labor at term, and preterm labor (with and without funisitis). Methods Umbilical cord (UC) tissue samples were obtained from women (N=158) with singleton pregnancies in the following groups: 1) term deliveries without labor (TNL; n=20); 2) term deliveries with labor (TIL; n= 20); 3) spontaneous preterm deliveries (sPTD) with (n=20) and without acute funisitis (n=20); and 4) preeclampsia without labor (n=78). The concentrations of PGs were determined in different locations of the UC. PGE2 and PGF22α were measured by specific immunoassays. Non-parametric statistics were used for analysis. Results 1) In spontaneous preterm deliveries, the median UC PGE2 concentration was higher in cases with funisitis than in those without funisitis (233.7 pg/μg vs. 87.4 pg/μg of total protein, p=0.001); 2) the median UC PGE2 concentration in sPTD with funisitis was also higher than that obtained from samples who had undergone labor at term (233.7 pg/μg vs. 116.1 pg/μg of total protein, p=0.03); 3) the UC PGE2 and PGF2α concentration increased as a function of advancing gestational age before 36 weeks (PGE2: rho = 0.59, pumbilical cord are higher in the presence of acute funisitis than in the absence of this lesion; 2) spontaneous labor at term was not associated with a change in the UC concentration of PGE2 and PGF2α; and 3) the UC concentrations of PGE2 and PGF2α increased as a function of gestational age. We propose that UC PGs act as inflammatory mediators generated in the context of fetal systemic inflammation. PMID:25758616

  7. Leading causes of preterm delivery as risk factors for intraventricular hemorrhage in very preterm infants: results of the EPIPAGE 2 cohort study.

    Science.gov (United States)

    Chevallier, Marie; Debillon, Thierry; Pierrat, Veronique; Delorme, Pierre; Kayem, Gilles; Durox, Mélanie; Goffinet, François; Marret, Stephane; Ancel, Pierre Yves

    2017-05-01

    Intraventricular hemorrhage is a major risk factor for neurodevelopmental disabilities in preterm infants. However, few studies have investigated how pregnancy complications responsible for preterm delivery are related to intraventricular hemorrhage. We sought to investigate the association between the main causes of preterm delivery and intraventricular hemorrhage in very preterm infants born in France during 2011 between 22-31 weeks of gestation. The study included 3495 preterm infants from the national EPIPAGE 2 cohort study who were admitted to neonatal intensive care units and had at least 1 cranial ultrasound assessment. The primary outcome was grade I-IV intraventricular hemorrhage according to the Papile classification. Multinomial logistic regression models were used to study the relationship between risk of intraventricular hemorrhage and the leading causes of preterm delivery: vascular placental diseases, isolated intrauterine growth retardation, placental abruption, preterm labor, and premature rupture of membranes, with or without associated maternal inflammatory syndrome. The overall frequency of grade IV, III, II, and I intraventricular hemorrhage was 3.8% (95% confidence interval, 3.2-4.5), 3.3% (95% confidence interval, 2.7-3.9), 12.1% (95% confidence interval, 11.0-13.3), and 17.0% (95% confidence interval, 15.7-18.4), respectively. After adjustment for gestational age, antenatal magnesium sulfate therapy, level of care in the maternity unit, antenatal corticosteroids, and chest compressions, infants born after placental abruption had a higher risk of grade IV and III intraventricular hemorrhage compared to those born under placental vascular disease conditions, with adjusted odds ratios of 4.3 (95% confidence interval, 1.1-17.0) and 4.4 (95% confidence interval, 1.1-17.6), respectively. Similarly, preterm labor with concurrent inflammatory syndrome was associated with an increased risk of grade IV intraventricular hemorrhage (adjusted odds ratio

  8. Prevalence and perinatal mortality associated with preterm births in a tertiary medical center in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2014-10-01

    perinatal mortality rate for preterm babies in the study center was 46.1% (236/512. The stillbirth rate for preterm babies was 22.0% (149/678 and the adjusted early neonatal death rate was 24.0% (87/363.Conclusion: The prevalence of preterm births and associated perinatal mortality were high which may be a reflection of suboptimal prenatal and newborn care. An urgent improvement in prenatal and newborn care is therefore needed in the study center in order to improve the capacity to prevent or abate preterm labor, and preterm premature rupture of membranes; and to reduce avoidable stillbirths. Further upgrading of personnel and facilities in the newborn special care unit is also required to minimize early neonatal deaths.Keywords: preterm birth, prevalence, mortality, pattern, Nigeria

  9. Management of late-preterm premature rupture of membranes: the PPROMEXIL-2 trial

    NARCIS (Netherlands)

    van der Ham, David P.; van der Heyden, Jantien L.; Opmeer, Brent C.; Mulder, Antonius L. M.; Moonen, Rob M. J.; van Beek, J. Hans J.; Franssen, Maureen T. M.; Bloemenkamp, Kitty W. M.; Sikkema, J. Marko M.; de Groot, Christianne J. M.; Porath, Martina; Kwee, Anneke; Woiski, Mallory D.; Duvekot, J. Hans J.; Akerboom, Bettina M. C.; van Loon, Aren J.; de Leeuw, Jan W.; Willekes, Christine; Mol, Ben W. J.; Nijhuis, Jan G.

    2012-01-01

    OBJECTIVE: The evidence for the management of near term prelabor rupture of membranes is poor. From January 2007 until September 2009, we performed the PPROM Expectant Management versus Induction of Labor (PPROMEXIL) trial. In this trial, we showed that in women with preterm prelabor rupture of

  10. Management of late-preterm premature rupture of membranes : the PPROMEXIL-2 trial

    NARCIS (Netherlands)

    van der Ham, David P.; van der Heyden, Jantien L.; Opmeer, Brent C.; Mulder, Antonius L. M.; Moonen, Rob M. J.; van Beek, J. (Hans) J.; Franssen, Maureen T. M.; Bloemenkamp, Kitty W. M.; Sikkema, J. (Marko) M.; de Groot, Christianne J. M.; Porath, Martina; Kwee, Anneke; Woiski, Mallory D.; Duvekot, J. (Hans) J.; Akerboom, Bettina M. C.; van Loon, Aren J.; de Leeuw, Jan W.; Willekes, Christine; Mol, Ben W. J.; Nijhuis, Jan G.

    2012-01-01

    OBJECTIVE: The evidence for the management of near term prelabor rupture of membranes is poor. From January 2007 until September 2009, we performed the PPROM Expectant Management versus Induction of Labor (PPROMEXIL) trial. In this trial, we showed that in women with preterm prelabor rupture of

  11. Bacteria Localization and Chorion Thinning among Preterm Premature Rupture of Membranes

    Science.gov (United States)

    Fortner, Kimberly B.; Grotegut, Chad A.; Ransom, Carla E.; Bentley, Rex C.; Feng, Liping; Lan, Lan; Heine, R. Phillips; Seed, Patrick C.; Murtha, Amy P.

    2014-01-01

    Objective Bacterial colonization of the fetal membranes and its role in pathogenesis of membrane rupture is poorly understood. Prior retrospective work revealed chorion layer thinning in preterm premature rupture of membranes (PPROM) subjects. Our objective was to prospectively examine fetal membrane chorion thinning and to correlate to bacterial presence in PPROM, preterm, and term subjects. Study Design Paired membrane samples (membrane rupture and membrane distant) were prospectively collected from: PPROM = 14, preterm labor (PTL = 8), preterm no labor (PTNL = 8), term labor (TL = 10), and term no labor (TNL = 8), subjects. Sections were probed with cytokeratin to identify fetal trophoblast layer of the chorion using immunohistochemistry. Fluorescence in situ hybridization was performed using broad range 16 s ribosomal RNA probe. Images were evaluated, chorion and choriodecidua were measured, and bacterial fluorescence scored. Chorion thinning and bacterial presence were compared among and between groups using Student's t-test, linear mixed effect model, and Poisson regression model (SAS Cary, NC). Results In all groups, the fetal chorion cellular layer was thinner at rupture compared to distant site (147.2 vs. 253.7 µm, prupture site compared to distant sites. In PPROM fetal chorion, we demonstrated pronounced global thinning. Although cause or consequence is uncertain, bacterial presence is greatest and inversely correlated with chorion thinning among PPROM subjects. PMID:24421883

  12. Racial/ethnic differences in preterm perinatal outcomes.

    Science.gov (United States)

    Wallace, Maeve E; Mendola, Pauline; Kim, Sung Soo; Epps, Nikira; Chen, Zhen; Smarr, Melissa; Hinkle, Stefanie N; Zhu, Yeyi; Grantz, Katherine L

    2017-03-01

    Racial disparities in preterm birth and infant death have been well documented. Less is known about racial disparities in neonatal morbidities among infants who are born at death among infants who are born preterm differs by maternal race. A retrospective cohort design included medical records from preterm deliveries of 19,325 black, Hispanic, and white women in the Consortium on Safe Labor. Sequentially adjusted Poisson models with generalized estimating equations estimated racial differences in the risk for neonatal morbidities and death, controlling for maternal demographics, health behaviors, and medical history. Sex differences between and within race were examined. Black preterm infants had an elevated risk for perinatal death, but there was no difference in risk for neonatal death across racial groups. Relative to white infants, black infants were significantly more likely to experience sepsis (9.1% vs 13.6%), peri- or intraventricular hemorrhage (2.6% vs 3.3%), intracranial hemorrhage (0.6% vs 1.8%), and retinopathy of prematurity (1.0% vs 2.6%). Hispanic and white preterm neonates had similar risk profiles. In general, female infants had lower risk relative to male infants, with white female infants having the lowest prevalence of a composite indicator of perinatal death or any morbidity across all races (30.9%). Differences in maternal demographics, health behaviors, and medical history did little to influence these associations, which were robust to sensitivity analyses of pregnancy complications as potential underlying mechanisms. Preterm infants were at similar risk for neonatal death, regardless of race; however, there were notable racial disparities and sex differences in rare, but serious, adverse neonatal morbidities. Published by Elsevier Inc.

  13. Effect of aspirin treatment on TNFalpha production by women with a history of preterm birth.

    Science.gov (United States)

    Peltier, Morgan R; Faux, David S; Hamblin, Steven D; Cooper, Corrina; Silver, Robert M; Esplin, M Sean

    2009-06-01

    Lipopolysaccharide (LPS)-stimulated TNFalpha production is reported to be greater for whole blood (WB) cultures prepared from patients with a history of preterm birth than cultures obtained from women with a history of term birth. The objectives of this study were (1) to determine if there is a similar differential responsiveness for peripheral blood mononuclear leukocytes (PBML) and (2) to determine if treatment with aspirin influences LPS-stimulated TNFalpha production in these patients. WB and PBML were obtained from women with a history of preterm delivery before 32 weeks (cases; n=5) and age- and race-matched controls (n=5) with a history of uncomplicated term delivery. WB and PBML were cultured and stimulated with LPS. All participants then took aspirin daily for 1 week and responsiveness of PBML and WB cultures to LPS was retested. The history of preterm labor was found to have no effect on LPS-stimulated TNFalpha production in cultures of WB or PBML. Aspirin treatment enhanced LPS-stimulated TNFalpha production by PBML from controls but not cases. We conclude that endotoxin responsiveness of women with a history of preterm birth is similar to that of women with a history of term birth in terms of in vitro TNFalpha production. Aspirin increases TNFalpha production by PBML in control women but not in women with a history of preterm birth. The divergent responses to aspirin treatment in patients with and without prior preterm labor may reflect differential regulation of cytokine production by prostaglandins in women with preterm labor associated with infection or inflammation.

  14. Cerebral oxygenation in preterm infants.

    Science.gov (United States)

    Fyfe, Karinna L; Yiallourou, Stephanie R; Wong, Flora Y; Odoi, Alexsandria; Walker, Adrian M; Horne, Rosemary S C

    2014-09-01

    Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P preterm compared with term infants at 2 to 4 weeks, in both positions (P preterm infants in the prone position at 2 to 3 months (P position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk. Copyright © 2014 by the American Academy of Pediatrics.

  15. Comparison of Hair Cortisol Levels and Perceived Stress in Mothers Who Deliver at Preterm and Term.

    Science.gov (United States)

    Duffy, Allyson R; Schminkey, Donna L; Groer, Maureen W; Shelton, Melissa; Dutra, Samia

    2018-01-01

    To evaluate relationships between hair cortisol levels and perceived stress in mothers who deliver preterm and term. We hypothesized that the rate of change in cortisol levels would be greater in the preterm delivery group. This preliminary study compared hair cortisol levels and Perceived Stress Scale (PSS) scores in predominately Caucasian mothers who delivered preterm ( n = 22) and term ( n = 30). We collected PSS and hair samples of ≥10 cm in length from mothers after delivery. Hair was segmented into three sections, and cortisol was measured using enzyme-linked immunosorbent assay. The mean gestational age was 31.45 ( SD = 4.2) weeks for preterm deliveries and 39.45 ( SD = 1.1) for term. Cortisol differed significantly in the third trimester between mothers delivering term and preterm ( t = 2.16, df = 48, p = .04) and trended toward significance in the second trimester ( t = 1.88, df = 48, p = .06). PSS differed significantly between the two groups ( t = -2.96, df = 50, p = .05). Our data did not provide support for our hypothesis. There appeared to be a blunted, flattened pattern of change in cortisol levels across gestation in the women who delivered preterm, suggesting diminished hypothalamic-pituitary-adrenal axis responsiveness in mechanisms that promote preterm labor. Future studies are needed to further evaluate best strategies for measuring the mechanisms of allostatic load during pregnancy along with the psychoneuroendocrine and immune triggers and placental responses that lead to premature birth.

  16. Annexin A2 in amniotic fluid: correlation with histological chorioamnionitis, preterm premature rupture of membranes, and subsequent preterm delivery.

    Science.gov (United States)

    Namba, Fumihiko; Ina, Shihomi; Kitajima, Hiroyuki; Yoshio, Hiroyuki; Mimura, Kazuya; Saito, Shigeru; Yanagihara, Itaru

    2012-01-01

    The aim of this study was to determine whether amniotic fluid levels of annexin A2, a phospholipid-binding protein that is abundant in amnion and regulates fibrin homeostasis, are associated with histological chorioamnionitis, preterm premature rupture of the membranes, and subsequent preterm delivery. Amniotic fluid was obtained from 55 pregnant women with preterm labor and/or preterm premature rupture of the membranes before 32weeks of gestation, and amniotic fluid levels of annexin A2 were measured with a sandwich enzyme-linked immunosorbent assay. Amniotic fluid levels of annexin A2 in patients with histological chorioamnionitis was higher than that in the remainder (P=0.053), whereas amniotic fluid levels of annexin A2 in patients with preterm premature rupture of the membranes was significantly higher than that in the remainder (P=0.002). Amniotic levels of annexin A2 was a fair test (area under receiver-operator characteristic curve=0.679), and amniotic fluid levels of annexin A2>878.2ng/mL had a sensitivity of 68.8%, a specificity of 65.2%, a positive predictive value of 73.3%, and a negative predictive value of 60.0% for predicting delivery within 2weeks after amniotic fluid sampling. Furthermore, the combined use of amniotic fluid cut-off levels of 878.2ng/mL for annexin A2 and 13.3ng/mL for interleukin-8 improved the specificity (91.3%) and the positive predictive value (89.5%). We identified amniotic fluid levels of annexin A2, especially in combination with amniotic fluid levels of interleukin-8, as a novel predictive marker for preterm delivery. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

  17. Preterm labour: tsunami waves?

    Science.gov (United States)

    Douglas, Alison J

    2010-09-01

    Preterm labour and birth can be delayed but are generally unstoppable, threatening the health of the mother-baby duo. This may be a result of peripheral signals prematurely recruiting the oxytocin neurones that co-ordinate the timing of birth and, via specialised activity and secretion patterns, drive uterine contractions. Once sensitised, these neurones respond with waves of activity, even to weak stimuli, resulting in a positive-feedback loop that escalates towards inevitable birth.

  18. Introducing Labor History.

    Science.gov (United States)

    Whitmer, John Dale

    1997-01-01

    Provides a brief overview for including labor history in the social studies curriculum. Notes the broad range of subjects (geography, history, economics, music, and art) and approaches (women's history, social history, oral history) that encompass labor history. (MJP)

  19. Labor Force Participation Rate

    Data.gov (United States)

    City and County of Durham, North Carolina — This thematic map presents the labor force participation rate of working-age people in the United States in 2010. The 2010 Labor Force Participation Rate shows the...

  20. Department of Labor

    Science.gov (United States)

    ... Agricultural Employment Child Labor Statistics Door-to-Door Sales Employment by Parents Entertainment Industry Employment Exemptions to the FLSA Hazardous Jobs International Child Labor DOL Kids' Pages Newspaper Delivery Nonagricultural ...

  1. Characteristics of childbearing women, obstetrical interventions and preterm delivery: a comparison of the US and France.

    Science.gov (United States)

    Zeitlin, Jennifer; Blondel, Béatrice; Ananth, Cande V

    2015-05-01

    Preterm delivery rates have remained consistently higher in the US than France, but the reasons for this excess remain poorly understood. We examined if differences in socio-demographic risk factors or more liberal use of obstetrical interventions contributed to higher rates in the US. Data on singleton live births in 1995, 1998 and 2003 from US birth certificates and the French National Perinatal Survey were used to analyze preterm delivery rate by maternal characteristics (age, parity, marital status, education, race (US)/nationality (France), prenatal care and smoking). We distinguished between preterm deliveries with a cesarean or a labor induction and those without these interventions. Unadjusted and adjusted risk ratios (RR) for the US compared to France were estimated using log-binomial regression. Preterm delivery rates were 7.9 % in the US and 4.7 % in France (risk ratio [RR] = 1.7, 95 % confidence interval [CI] 1.6-1.8). The US had more teen mothers and late entry to prenatal care, but fewer women smoked, although adjustment for these and other confounders did not reduce RR (1.8, 95 % CI 1.7-1.9). Preterm delivery rates associated with labor induction or cesarean were 3.3 % in the US and 2.1 % in France (RR 1.6, 95 % CI 1.5-1.7); the corresponding rates for preterm delivery without these interventions were 4.5 and 2.5 % (RR 1.8, 95 % CI 1.7-1.9), respectively. Key socio-demographic risk factors and more obstetric intervention do not explain higher US preterm delivery rates. Avenues for future research include the impact of universal access to health services (universal health insurance?) on health care quality and the association between more generous social policies, stress and the risks of preterm delivery.

  2. The Role of Body, Mind, and Environment in Preterm Birth: Mind the Gap.

    Science.gov (United States)

    Yamamoto, Shelby; Premji, Shahirose

    2017-11-01

    Preterm birth continues to be a problem affecting low-, middle-, and high-income countries, with rates increasing in some areas despite ongoing efforts to reduce the incidence. This emphasizes the need for more effective interventions, particularly if we aim to achieve the broad health targets of the Sustainable Development Goals (SDGs) by 2030. The current focus on medically-oriented interventions such as reducing nonmedically-indicated induction of labor, cesarean birth, and multiple embryo transfers associated with assisted reproductive technologies, as well as the application of cervical cerclage and use of progesterone therapy, though important, are likely only partial solutions to the complex phenomenon of preterm birth. Preterm birth has multiple etiologies. The biologic mechanisms involved in preterm labor and how it may be triggered are not well understood. There is growing evidence to suggest some of these triggers may also be related to stress and environmental conditions. In this review, we focus on evidence concerning psychosocial (mind) and environmental factors (environment) as well as briefly review the evidence related to maternal and fetal factors (body) associated with the risk of preterm birth, with reference to some of the SDGs. We also assess emerging evidence regarding the interaction of the body, mind, and environment in relation to preterm birth, currently a gap in our knowledge, and how these interactions could impact clinical practice. Findings suggest that multidisciplinary expertise and approaches will be needed to develop effective interventions to address the complex etiologies of preterm birth, as opposed to single-risk-factor mitigation. Clinicians and researchers will play key roles in identifying many of these risk factors and shaping interventions that address this complex issue. Addressing the interlinkages between body, mind, and environment through the integration of research and clinical practice is critical to reducing the

  3. The prevalence of very preterm deliveries, risk factors, and neonatal complications in Arash women hospital: a brief report

    Directory of Open Access Journals (Sweden)

    Abootaleb Beigi

    2013-06-01

    Full Text Available Background: Very preterm birth (26-32 weeks has an important effect on infant morta-lity and disability of infancy. The aim of this study was to investigate the prevalence of very preterm delivery and early neonatal morbidity (the first 28 days after birth.Methods: In this cross-sectional retrospective study, among 4393 delivery in Arash Women's Hospital in Tehran, 59 deliveries were very preterm that resulted in 79 very preterm neonate births. We assessed maternal risk factors and neonatal complications in women who were admitted for delivery from March 2009 to March 2010.Results: Among 59 pregnant women, 17 (12/27% had multiple pregnancies and 17 (12/27% had premature rupture of fetal membranes. Caesarean section method was more common than normal vaginal delivery (46 cases- 97/77%. Women aged 18 to 35 had the highest rate of preterm delivery (45/86%. Among 79 very preterm neonates about half of them were very low birth weight, 74 neonates (93/67% suffered from respiratory distress syndrome and 13 deaths were reported.Conclusion: Premature birth is a multi-factorial phenomenon. Identifying maternal risk factors and increasing knowledge about it can decrease the rate of preterm labor. The prevention of premature labor is better than cure. Further prospective studies with large number of patients and long-term follow-up are recommended for better understanding of the phenomenon.

  4. ARIZONA FARM LABOR REPORT.

    Science.gov (United States)

    SALTER, RICHARD H.

    THE ORGANIZATION OF THE FARM PLACEMENT PROGRAM IS DESCRIBED. INCLUDED ARE THE ADMINISTRATIVE ORGANIZATIONS, THE LOCAL LEVELS, THE STATE FARM LABOR ADVISORY COMMITTEE, AND THE PLANNING AND OPERATING METHODS USED BY FARM PLACEMENT PERSONNEL IN MEETING FARM LABOR NEEDS. MAJOR CROP ACTIVITIES ARE RELATED TO COTTON AND VEGETABLES. THE LABOR FORCE IS…

  5. The value of acute phase reactants in predicting preterm delivery.

    Science.gov (United States)

    Cetinkaya, Salih; Ozaksit, Gulnur; Biberoglu, Ebru Hacer; Oskovi, Asli; Kirbas, Ayse

    2017-12-01

    We aimed to determine the potential value of maternal serum levels of acute phase reactants in the prediction of preterm delivery in women with threatened preterm labor (TPL). Ninety-one pregnant women diagnosed with TPL and 83 healthy pregnant women as a control group were included in this prospective controlled study. All the pregnant women were followed until delivery and obstetric data and the serum levels of acute phase reactants were recorded for each participant. The study group was further divided into two groups according to the gestational age at delivery, which include women delivering prematurely and the ones who gave birth at term. Serum albumin levels were significantly lower and mean serum ferritin levels were significantly higher in the study groups when compared the control group. Although an association between decreased serum albumin level and TPL, also between increased serum ferritin levels and preterm birth and low birth weight were demonstrated, more extensive studies are needed to clarify the potential use of the acute phase reactants in the prediction of preterm birth.

  6. Labor migration in Asia.

    Science.gov (United States)

    Martin, P L

    1991-01-01

    "A recent conference sponsored by the United Nations Center for Regional Development (UNCRD) in Nagoya, Japan examined the growing importance of labor migration for four major Asian labor importers (Japan, Hong Kong, Malaysia, and Singapore) and five major labor exporters (Bangladesh, Korea, Pakistan, Philippines, and Thailand).... The conference concluded that international labor migration would increase within Asia because the tight labor markets and rising wages which have stimulated Japanese investment in other Asian nations, for example, have not been sufficient to eliminate migration push and pull forces...." excerpt

  7. Neurodevelopmental outcome in preterm infants

    NARCIS (Netherlands)

    Bos, Arend F.; Roze, Elise

    AIM To determine the distribution of cognitive and motor scores in preterm children, and to establish the influence of brain lesions and decreasing gestational age thereon. METHOD One hundred and six very preterm children (63 males, 43 females; gestational age 24.0-31.6wk; birthweight 480-2275g)

  8. Prediction of Spontaneous Preterm Birth

    NARCIS (Netherlands)

    Dijkstra, Karolien

    2002-01-01

    Preterm birth is a leading cause of neonatal morbidity and mortality. It is a major goal in obstetrics to lower the incidence of spontaneous preterm birth (SPB) and related neonatal morbidity and mortality. One of the principal objectives is to discover early markers that would allow us to identify

  9. Cerebral oximetry in preterm infants

    DEFF Research Database (Denmark)

    Greisen, Gorm; Andresen, Bjørn; Plomgaard, Anne Mette

    2016-01-01

    Preterm birth constitutes a major cause of death before 5 years of age and it is a major cause of neurodevelopmental impairment across the world. Preterm infants are most unstable during the transition between fetal and newborn life during the first days of life and most brain damage occurs...

  10. Preterm Birth: Transition to Adulthood

    Science.gov (United States)

    Allen, Marilee C.; Cristofalo, Elizabeth; Kim, Christina

    2010-01-01

    Preterm birth is associated with greater difficulty with transitions from childhood to adolescence to adulthood. Adolescents and young adults born preterm have higher rates of cerebral palsy, intellectual disability, cognitive impairment, learning disability, executive dysfunction, attention deficit disorder, and social-emotional difficulties than…

  11. Cesarean delivery in the second stage of labor and the risk of subsequent premature birth.

    Science.gov (United States)

    Wood, Stephen L; Tang, Selphee; Crawford, Susan

    2017-07-01

    Cesarean delivery is being increasingly used by obstetricians for indicated deliveries in the second stage of labor. Unplanned extension of the uterine incision involving the cervix often occurs with these surgeries. Therefore, we hypothesized that cesarean delivery in the second stage of labor may increase the rate of subsequent spontaneous premature birth. We sought to determine if cesarean delivery in the late first stage of labor or in the second stage of labor increases the risk of a subsequent spontaneous preterm birth. We conducted a retrospective cohort study of matched first and second births from a large Canadian perinatal database. The primary outcomes were spontaneous premature birth cesarean delivery. The protocol and analysis plan was registered prior to obtaining data at Open Science Foundation. In total, 189,021 paired first and second births were identified. The risk of spontaneous preterm delivery cesarean delivery in the second stage of labor (relative risk, 1.57; 95% confidence interval, 1.43-1.73 and relative risk, 2.12; 95% confidence interval, 1.67-2.68, respectively). The risk of perinatal death in the second birth, excluding congenital anomalies, was also correspondingly increased (relative risk, 1.44; 95% confidence interval, 1.05-1.96). Cesarean delivery in second stage of labor was associated with a 2-fold increase in the risk of spontaneous preterm birth <32 weeks of gestation in a subsequent birth. This information may inform management of operative delivery in the second stage. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Short-term tocolytics for preterm delivery – current perspectives

    Directory of Open Access Journals (Sweden)

    Haas DM

    2014-03-01

    Full Text Available David M Haas, Tara Benjamin, Renata Sawyer, Sara K QuinneyDepartment of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USAAbstract: Administration of short-term tocolytic agents can prolong pregnancy for women in preterm labor. Prolonging pregnancy has many benefits because it allows for other proven interventions, such as antenatal corticosteroid administration, to be accomplished. This review provides an overview of currently utilized tocolytic agents and the evidence demonstrating their efficacy for prolonging pregnancy by at least 48 hours. General pharmacological principles for the clinician regarding drugs in pregnancy are also briefly discussed. In general, while the choice of the best first-line short-term tocolytic drug is not clear, it is evident that use of these agents has a clear place in current obstetric therapeutics.Keywords: tocolytics, short-term, preterm delivery

  13. What does entailment for PTL mean?

    CSIR Research Space (South Africa)

    Booth, R

    2015-03-01

    Full Text Available ranked interpretation such thatR , K. Then R˚pKq IJLM R. We will denote by CnLMp¨q the consequence operator de- fined viaR˚pKq, i.e., CnLMpKq “ tα P L‚ | R˚pKq , αu. The next result outlines which properties from the previous section are satisfied by Cn... (or deemed more normal or typical) than those higher up. We can write a ranked interpretation R “ xV,ăy alternatively as a partition R “ pL0, . . . , Lnq of V , where v ă v1 iff v P Li, v1 P Lj and i ă j. That is, Li is the set of all valuations...

  14. Detection and risk stratification of women at high risk of preterm birth in rural communities near Nagpur, India.

    Science.gov (United States)

    Patel, Archana; Prakash, Amber Abhijeet; Pusdekar, Yamini V; Kulkarni, Hemant; Hibberd, Patricia

    2017-09-19

    Presently, preterm birth is globally the leading cause of neonatal mortality. Prompt community based identification of women at high risk for preterm births (HRPB) can either help to avert preterm births or avail effective interventions to reduce neonatal mortality due to preterm births. We evaluated the performance of a package to train community workers to detect the presence of signs or symptoms of HRPB. Pregnant women enrolled in the intervention arm of a cluster randomized trial of Antenatal Corticosteroids (ACT Trial) conducted at Nagpur, India were informed about 4 directly observable signs and symptoms of preterm labor. Community health workers actively monitored these women from 24 to 36 weeks of gestation for these signs or symptoms. If they were present (HRPB positive) the identified women were brought to government health facilities for assessment and management. HRPB positive could also be determined by the provider if the woman presented directly to the facility. Risk stratification was based on the number of signs or symptoms present. The outcome of preterm birth was based on the clinical assessment of gestational age birth weight of birth in the HRPB positives was 8.14 (95% confidence interval 7.16-9.26). The LR of a preterm birth increased in women who had more signs or symptoms of HRBP (p birth weight and higher rates of stillbirths, neonatal deaths and postnatal complications. Addition of risk stratification improved the prediction of preterm delivery (Integrated Discrimination Improvement 17% (95% CI 15-19%)). The package for detection of signs and symptoms of HRPB is feasible, promising and likely to improve management of preterm labor. NCT01073475 on February 21, 2010 and NCT01084096 on March 9, 2010.

  15. La Justicia Laboral

    Directory of Open Access Journals (Sweden)

    Montoya Melgar, Alfredo

    2003-07-01

    Full Text Available Iniciada en el último cuarto del siglo XIX nuestra legislación laboral, pronto se plantea la exigencia de que las reglas sustantivas del nuevo Derecho vayan acompañadas de normas jurisdiccionales y procesales específicas, atentas a las exigencias de la justicia laboral. Tras una etapa de justicia social paritaria, obrero-patronal, la jurisdicción laboral pasa a ser desempeñada por jueces profesionales centrándose en la Magistratura de Trabajo y consolidándose el diseño procesal en sucesivas Leyes de Procedimiento Laboral.
    En la actualidad, y aunque la nueva Ley de Enjuiciamiento Civil ha incidido de modo relevante sobre el proceso laboral, es obvia la influencia que el modelo del proceso laboral ha ejercido con carácter previo sobre el nuevo proceso civil.

  16. Expression of selected genes in preterm premature rupture of fetal membranes.

    Science.gov (United States)

    Kuć, Paweł; Laudański, Piotr; Kowalczuk, Oksana; Chyczewski, Lech; Laudański, Tadeusz

    2012-08-01

    To analyse the expression of 15 genes encoding receptors and enzymes associated with the molecular mechanism of the tocolytic drugs atosiban (oxytocin receptor antagonist), nifedipine (calcium channel blocker) and celecoxib (selective cyclo-oxygenase-2 inhibitor) in preterm labor patients with premature rupture of fetal membranes in relation to symptoms of intrauterine infection and preterm labor risk factors. Experimental molecular study. Tertiary obstetric care center. Myometrial samples were obtained during cesarean sections from 35 patients who delivered preterm with unverified symptoms of intrauterine infection, 35 patients who delivered preterm without symptoms of intrauterine infection and 90 women who delivered at term. The Micro Fluidic Profiling Card analytic system was used to evaluate mRNA expression of the genes of interest. The relative quantification values for mRNA expression. The median oxytocin receptor and cyclo-oxygenase-2 mRNA expression in preterm patients with clinical symptoms of intrauterine infection was significantly higher than in preterm patients without symptoms. The median mRNA expression of β(1) , β(3) and β(4) subunits of the L-type calcium channel and prostaglandin E(2) receptor was significantly higher in preterm patients compared with term patients. The mRNA expression of hormones, enzymes and their receptors associated with tocolytic actions can differ in various clinical conditions. The expression of these genes is regulated at different levels and can be modified by inflammatory factors, which affect their functions. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Elderly Labor and Unemployment

    OpenAIRE

    Watanabe, Minoru; Yasuoka, Masaya

    2017-01-01

    Economically developed countries are confronting the aging of society. Especially, their respective shares of elderly people among the total population in Japan are highest in the world. Moreover, the labor participation rates of older people in Japan are higher than in other OECD countries. Several reasons underlie the increased labor participation of older people in Japan. One reason is the subsidy for the labor supply of elderly people. This paper presents an examination of how this subsid...

  18. Industrial labor relations manual

    Science.gov (United States)

    1992-01-01

    The NASA Industrial Labor Relations Manual provides internal guidelines and procedures to assist NASA Field Installations in dealing with contractor labor management disputes, Service Contract Act variance hearings, and to provide access of Labor Union Representatives to NASA for the purpose of maintaining schedules and goals in connection with vital NASA programs. This manual will be revised by page changes as revisions become necessary. Initial distribution of this manual has been made to NASA Headquarters and Field Installations.

  19. Adult outcomes of preterm children.

    Science.gov (United States)

    Hack, Maureen

    2009-10-01

    The survivors of the initial years of neonatal intensive care of preterm infants reached adulthood during the last decade. Reports of their adult outcomes examined have included neurodevelopmental, behavioral and health outcomes as well as social functioning and reproduction. Despite statistically significant differences between preterm young adults and controls in most outcomes studied, the majority of preterm survivors do well and live fairly normal lives. The two major predictors of adult outcomes are lower gestational age that reflect perinatal injury and family sociodemographic status which reflects both genetic and environmental effects.

  20. Nonpharmacologic labor analgesia.

    Science.gov (United States)

    Arendt, Katherine W; Tessmer-Tuck, Jennifer A

    2013-09-01

    A supportive medical team should be well informed on the various pharmacologic and nonpharmacologic modalities of coping with or mitigating labor pain to appropriately support and respectfully care for parturients. Using the methodical rigor of previously published Cochrane systematic reviews, this summary evaluates and discusses the efficacy of nonpharmacologic labor analgesic interventions. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Transit labor relations guide

    Science.gov (United States)

    2001-09-01

    This report is designed as a guide for those involved in labor relations in the transit industry. It begins with a history of transit labor relations. The economic, political, and legal environment of transit relations is then discussed. A section fo...

  2. Multidimensional proteomics analysis of amniotic fluid to provide insight into the mechanisms of idiopathic preterm birth.

    Directory of Open Access Journals (Sweden)

    Irina A Buhimschi

    2008-04-01

    Full Text Available Though recent advancement in proteomics has provided a novel perspective on several distinct pathogenetic mechanisms leading to preterm birth (inflammation, bleeding, the etiology of most preterm births still remains elusive. We conducted a multidimensional proteomic analysis of the amniotic fluid to identify pathways related to preterm birth in the absence of inflammation or bleeding.A proteomic fingerprint was generated from fresh amniotic fluid using surface-enhanced laser desorbtion ionization time of flight (SELDI-TOF mass spectrometry in a total of 286 consecutive samples retrieved from women who presented with signs or symptoms of preterm labor or preterm premature rupture of the membranes. Inflammation and/or bleeding proteomic patterns were detected in 32% (92/286 of the SELDI tracings. In the remaining tracings, a hierarchical algorithm was applied based on descriptors quantifying similarity/dissimilarity among proteomic fingerprints. This allowed identification of a novel profile (Q-profile based on the presence of 5 SELDI peaks in the 10-12.5 kDa mass area. Women displaying the Q-profile (mean+/-SD, gestational age: 25+/-4 weeks, n = 40 were more likely to deliver preterm despite expectant management in the context of intact membranes and normal amniotic fluid clinical results. Utilizing identification-centered proteomics techniques (fluorescence two-dimensional differential gel electrophoresis, robotic tryptic digestion and mass spectrometry coupled with Protein ANalysis THrough Evolutionary Relationships (PANTHER ontological classifications, we determined that in amniotic fluids with Q-profile the differentially expressed proteins are primarily involved in non-inflammatory biological processes such as protein metabolism, signal transduction and transport.Proteomic profiling of amniotic fluid coupled with non-hierarchical bioinformatics algorithms identified a subgroup of patients at risk for preterm birth in the absence of intra

  3. Genomics of Preterm Birth

    Science.gov (United States)

    Swaggart, Kayleigh A.; Pavlicev, Mihaela; Muglia, Louis J.

    2015-01-01

    The molecular mechanisms controlling human birth timing at term, or resulting in preterm birth, have been the focus of considerable investigation, but limited insights have been gained over the past 50 years. In part, these processes have remained elusive because of divergence in reproductive strategies and physiology shown by model organisms, making extrapolation to humans uncertain. Here, we summarize the evolution of progesterone signaling and variation in pregnancy maintenance and termination. We use this comparative physiology to support the hypothesis that selective pressure on genomic loci involved in the timing of parturition have shaped human birth timing, and that these loci can be identified with comparative genomic strategies. Previous limitations imposed by divergence of mechanisms provide an important new opportunity to elucidate fundamental pathways of parturition control through increasing availability of sequenced genomes and associated reproductive physiology characteristics across diverse organisms. PMID:25646385

  4. Optimizing Nutrition in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Bai-Horng Su

    2014-02-01

    Full Text Available Extrauterine growth restriction is common in very preterm infants. The incidence in very-low-birth-weight infants ranges between 43% and 97% in various centers, with a wide variability due to the use of different reference growth charts and nonstandard nutritional strategies. Extrauterine growth restriction is associated with an increased risk of poor neurodevelopmental outcome. Inadequate postnatal nutrition is an important factor contributing to growth failure, as most very preterm infants experience major protein and energy deficits during neonatal intensive care unit hospitalization. First-week protein and energy intake are associated with 18-month developmental outcomes in very preterm infants. Early aggressive nutrition, including parenteral and enteral, is well tolerated in the very preterm infant and is effective in improving growth. Continued provision of appropriate nutrition (fortified human milk or premature formula is important throughout the growing care during the hospitalization. After discharge, exclusively breast-fed infants require additional supplementation. If formula-fed, nutrient-enriched postdischarge formula should be continued for approximately 9 months corrected age. Supplementation of the preterm formulas with protein would increase the protein/energy ratio (3 g/100 kcal, leading to increased lean mass with relatively decreased fat deposition. Further research is required to optimize the nutritional needs of preterm infants and to evaluate the effects of nutritional interventions on long-term growth, neurodevelopment, and other health outcomes.

  5. Why are We Waiting to Start Large Scale Clinical Testing of Human Chorionic Gonadotropin for the Treatment of Preterm Births?

    Science.gov (United States)

    Rao, C V

    2016-07-01

    Preterm births are an expensive global health problem. Despite the basic science and clinical research advances to better understand and prevent preterm births, the rates are increasing. There are several therapeutic options. While some options such as progestins work for selected women, others such as magnesium sulfate can only be used for delaying births for 24 to 48 hours so that the patients can be treated with corticosteroids to promote fetal lung maturity. Based on the scientific and clinical evidence, we recommend testing human chorionic gonadotropin in a large multicenter, randomized, double-blind, and placebo-controlled clinical trials in women with active preterm labor and those with a previous history of preterm births. Human chorionic gonadotropin is not only inexpensive but also has not shown any side effects so far in the infants or in the mothers. © The Author(s) 2015.

  6. The changes of circulating lymphocyte sub-populations in women with preterm labour: a case-controlled study.

    Science.gov (United States)

    Sendag, Fatih; Itil, Ismail Mete; Terek, Mustafa Cosan; Yilmaz, Huseyin

    2002-10-01

    The aim of this study was to determine the changes in circulating T-cell subpopulations, B cells and natural killer cells in patients with imminent preterm labour. Thirty-five pregnant patients with imminent preterm labour and 35 women with uncomplicated pregnancies were included in the study. The gestational ages of the patients ranged from 28 to 36 weeks in both groups. The specific lymphocyte antigens were detected using direct staining with monoclonal antibodies, and analysed by flow cytometry. We observed no significant difference in the mean percentage of T cell subpopulations, natural killer cells and active T cells in the group of patients with preterm labor when compared to controls. The mean percentage of T CD3+ lymphocytes was significantly lower and that of B CD19+ cells higher in the study group when compared to controls. The alterations in maternal circulating lymphocyte subpopulations could be associated with the mechanisms mediating preterm labour.

  7. Preterm Parturient with Polyhydramnios and Pancreatitis: Primary Presentation of Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Esther S. Han

    2018-01-01

    Full Text Available Objective. To report a case of severe hypercalcemia secondary to primary hyperparathyroidism in a late-preterm pregnant patient and review medical and surgical treatments as well as obstetric and neonatal outcomes. Background. Diagnosis of parathyroid disease during pregnancy can be difficult due to nonspecific presentation. Management decisions are complex and require multidisciplinary collaboration. Case. A 29-year-old G2P1001 woman at 35 weeks and 3 days’ gestation presented with preterm contractions, polyhydramnios, pancreatitis, and severe hypercalcemia. Work-up revealed primary hyperparathyroidism with multiple thyroid nodules. Patient history, presentation, and biopsy were suspicious for parathyroid carcinoma. Despite severe hypercalcemia, both patient and fetus remained stable and medical management was pursued in an attempt to optimize mother and fetus prior to delivery. Due to recalcitrant hypercalcemia, surgical resection was ultimately required. She was subsequently delivered in the setting of preterm labor. Final pathology revealed parathyroid adenoma with atypia and occult papillary thyroid carcinoma. Conclusion. Symptoms of hypercalcemia can mimic those of a normal third trimester pregnancy and can have serious maternal and fetal effects if left untreated. A coordinated, multidisciplinary approach to these patients is necessary.

  8. Use of metabolomics for the identification and validation of clinical biomarkers for preterm birth: Preterm SAMBA

    OpenAIRE

    Cecatti, Jose G.; Souza, Renato T.; Sulek, Karolina; Costa, Maria L.; Kenny, Louise C.; McCowan, Lesley M. E.; Pacagnella, Rodolfo C.; Villas-Boas, Silas G.; Mayrink, Jussara; Passini, Renato; Franchini, Kleber G.; Baker, Philip N.

    2016-01-01

    Background: Spontaneous preterm birth is a complex syndrome with multiple pathways interactions determining its occurrence, including genetic, immunological, physiologic, biochemical and environmental factors. Despite great worldwide efforts in preterm birth prevention, there are no recent effective therapeutic strategies able to decrease spontaneous preterm birth rates or their consequent neonatal morbidity/mortality. The Preterm SAMBA study will associate metabolomics technologies to identi...

  9. Labor Education and Organizational Participation

    Science.gov (United States)

    Roberts, Higdon C., Jr.

    1976-01-01

    Most of the leadership throughout the labor movement have been concerned about the lack of rank and file participation in labor unions. An evaluation of the relationship of labor education and union participation is explored. (WL)

  10. CHILD LABOR IN PALEMBANG

    Directory of Open Access Journals (Sweden)

    Indri Ariyanti

    2016-07-01

    Full Text Available This research explains the effects of gender, parents’ education, parent’s income, the number of siblings, childbirth order, the presence of parents and patriarchal kinship system on the probability of child labor in Palembang. This study, especially, investigates the probability of children age 7-15 years old to be a worker. It is found that factors that significantly affect child labor are gender, the number of siblings, childbirth order, the presence of parents and patriarchal system. However, parents’ education and income are found to be insignificant in affecting the probability of child labor in Palembang.

  11. Maternal race and intergenerational preterm birth recurrence.

    Science.gov (United States)

    Smid, Marcela C; Lee, Jong Hyung; Grant, Jacqueline H; Miles, Gandarvaka; Stoddard, Gregory J; Chapman, Derek A; Manuck, Tracy A

    2017-10-01

    Preterm birth is a complex disorder with a heritable genetic component. Studies of primarily White women born preterm show that they have an increased risk of subsequently delivering preterm. This risk of intergenerational preterm birth is poorly defined among Black women. Our objective was to evaluate and compare intergenerational preterm birth risk among non-Hispanic Black and non-Hispanic White mothers. This was a population-based retrospective cohort study, using the Virginia Intergenerational Linked Birth File. All non-Hispanic Black and non-Hispanic White mothers born in Virginia 1960 through 1996 who delivered their first live-born, nonanomalous, singleton infant ≥20 weeks from 2005 through 2009 were included. We assessed the overall gestational age distribution between non-Hispanic Black and White mothers born term and preterm (preterm (preterm birth, 34-36 weeks; and early preterm birth, preterm birth among all eligible births; and (2) suspected spontaneous preterm birth among births to women with medical complications (eg, diabetes, hypertension, preeclampsia and thus higher risk for a medically indicated preterm birth). Multivariable logistic regression was used to estimate odds of preterm birth and spontaneous preterm birth by maternal race and maternal gestational age after adjusting for confounders including maternal education, maternal age, smoking, drug/alcohol use, and infant gender. Of 173,822 deliveries captured in the intergenerational birth cohort, 71,676 (41.2%) women met inclusion criteria for this study. Of the entire cohort, 30.0% (n = 21,467) were non-Hispanic Black and 70.0% were non-Hispanic White mothers. Compared to non-Hispanic White mothers, non-Hispanic Black mothers were more likely to have been born late preterm (6.8% vs 3.7%) or early preterm (2.8 vs 1.0%), P preterm were not at an increased risk of early or late preterm delivery compared to non-Hispanic White mothers born term. The risk of early preterm birth was most

  12. Labor Agreement Information System (LAIRS)

    Data.gov (United States)

    Office of Personnel Management — The Labor Agreement Information Retrieval System (LAIRS) is a database containing historical information on labor-management relations in the Federal Government. It...

  13. Preterm Delivery in the Setting of Left Calyceal Rupture

    Directory of Open Access Journals (Sweden)

    Brent Hanson

    2015-01-01

    Full Text Available Spontaneous rupture of the renal collecting system is a rare but serious complication of pregnancy. We report a case of nontraumatic left renal calyceal rupture in a pregnancy which ultimately progressed to preterm delivery. A 29-year-old primigravida with a remote history of urolithiasis presented with left flank pain, suprapubic pain, and signs of preterm labor at 33 weeks of gestation. The patient was believed to have urolithiasis, although initial renal ultrasound failed to demonstrate definitive calculi. After a temporary improvement in flank pain with medication, the patient experienced acute worsening of her left flank pain. Urology was consulted and further imaging was obtained. Magnetic resonance imaging (MRI was consistent with bilateral hydronephrosis and rupture of the left renal calyx. Given the patient’s worsening pain in the setting of left calyceal rupture, the urology team planned for placement of a left ureteral stent. However, before the patient could receive her stent, she progressed to active labor and delivered a viable female infant vaginally. Following delivery, the patient’s flank pain resolved rapidly and spontaneously, so no surgical intervention was performed. A summary of the literature and the details of this specific clinical situation are provided.

  14. Maximizing Labor Market Mobility

    Directory of Open Access Journals (Sweden)

    Andrei Mihai Cristea

    2013-12-01

    Full Text Available Employment policies are a set of measures developed by the state to intervene in the labor market in order to stimulate job creation, improvement of human resources to adapt to the needs of the economy, to ensure fluid and efficient labor market flexibility, decreasing the imbalances and dysfunctions.This article attempts to link the maintenance and increase of employment rate through direct or indirect actions to ensure jobs for young people entering the labor market, for the unemployed and others who want to hire as employees. Goal of ensuring full employment of labor on the one hand seeks a decent living, and on the other hand a high level of product supply

  15. Cell-free DNA, inflammation, and the initiation of spontaneous term labor.

    Science.gov (United States)

    Herrera, Christina A; Stoerker, Jay; Carlquist, John; Stoddard, Gregory J; Jackson, Marc; Esplin, Sean; Rose, Nancy C

    2017-11-01

    Hypomethylated cell-free DNA from senescent placental trophoblasts may be involved in the activation of the inflammatory cascade to initiate labor. To determine the changes in cell-free DNA concentrations, the methylation ratio, and inflammatory markers between women in labor at term vs women without labor. In this prospective cohort study, eligible participants carried a nonanomalous singleton fetus. Women with major medical comorbidity, preterm labor, progesterone use, aneuploidy, infectious disease, vaginal bleeding, abdominal trauma, or invasive procedures during the pregnancy were excluded. Maternal blood samples were collected at 28 weeks, 36 weeks, and at admission for delivery. Total cell-free DNA concentration, methylation ratio, and interleukin-6 were analyzed. The primary outcome was the difference in methylation ratio in women with labor vs without labor. Secondary outcomes included the longitudinal changes in these biomarkers corresponding to labor status. A total of 55 women were included; 20 presented in labor on admission and 35 presented without labor. Women in labor had significantly greater methylation ratio (P = .001) and interleukin-6 (P labor. After we controlled for body mass index and maternal age, methylation ratio (adjusted relative risk, 1.38; 95% confidence interval, 1.13 to 1.68) and interleukin-6 (adjusted relative risk, 1.12, 95% confidence interval, 1.07 to 1.17) remained greater in women presenting in labor. Total cell-free DNA was not significantly different in women with labor compared with women without. Longitudinally, total cell-free DNA (P labor, P = .002 without labor) and interleukin-6 (P labor, P = .01 without labor) increased significantly across gestation in both groups. The methylation ratio increased significantly in women with labor from 36 weeks to delivery (P = .02). Spontaneous labor at term is associated with a greater cell-free DNA methylation ratio and interleukin-6 compared with nonlabored controls. As

  16. Cerebral oxygenation in the preterm neonate

    NARCIS (Netherlands)

    Dix, L.M.L.

    2017-01-01

    Although survival rates of preterm infants are improving, preterm birth is still associated with significant morbidity.The brain is one of the most vulnerable organs in preterm infants. Neonatal brain injury can have a large impact on the quality of life. Monitoring the immature brain is therefore

  17. Spontaneous preterm birth : prevention, management and outcome

    NARCIS (Netherlands)

    Vermeulen, Gustaaf Michiel

    1999-01-01

    Preterm birth (birth before 37 completed weeks of pregnancy) is a major cause of perinatal morbidity and mortality. Strategies to prevent and adequately treat preterm labour, in order to postpone birth and to identify risk factors for neonatal damage due to preterm birth, have to be developed by

  18. Potential Peripartum Markers of Infectious-Inflammatory Complications in Spontaneous Preterm Birth

    Directory of Open Access Journals (Sweden)

    Vojtech Tambor

    2015-01-01

    Full Text Available Spontaneous preterm birth significantly contributes to the overall neonatal morbidity associated with preterm deliveries. Nearly 50% of cases are associated with microbial invasion of the amniotic cavity followed by an inflammatory response. Robust diagnostic tools for neonates jeopardized by infection and inflammation may thus decrease the overall neonatal morbidity substantially. Amniotic fluid retrieved during labor retains fetal and pregnancy-related protein fingerprint and its sampling does not place any unwanted stress on women. Using exploratory and targeted methods we analyzed proteomes of amniotic fluid sampled at the end of spontaneous preterm labor prior to delivery from women with and without infection and inflammation. Exploratory data indicated several amniotic fluid proteins to be associated with infectious-inflammatory complications in spontaneous preterm birth. LC-SRM analysis subsequently verified statistically significant changes in lipocalin-1 (P=0.047 and AUC = 0.67, P=0.046, glycodelin (P=0.013 and AUC = 0.73, P=0.013, and nicotinamide phosphoribosyltransferase (P=0.018 and AUC = 0.71, P=0.01.

  19. Potential Peripartum Markers of Infectious-Inflammatory Complications in Spontaneous Preterm Birth.

    Science.gov (United States)

    Tambor, Vojtech; Vajrychova, Marie; Kacerovsky, Marian; Link, Marek; Domasinska, Petra; Menon, Ramkumar; Lenco, Juraj

    2015-01-01

    Spontaneous preterm birth significantly contributes to the overall neonatal morbidity associated with preterm deliveries. Nearly 50% of cases are associated with microbial invasion of the amniotic cavity followed by an inflammatory response. Robust diagnostic tools for neonates jeopardized by infection and inflammation may thus decrease the overall neonatal morbidity substantially. Amniotic fluid retrieved during labor retains fetal and pregnancy-related protein fingerprint and its sampling does not place any unwanted stress on women. Using exploratory and targeted methods we analyzed proteomes of amniotic fluid sampled at the end of spontaneous preterm labor prior to delivery from women with and without infection and inflammation. Exploratory data indicated several amniotic fluid proteins to be associated with infectious-inflammatory complications in spontaneous preterm birth. LC-SRM analysis subsequently verified statistically significant changes in lipocalin-1 (P = 0.047 and AUC = 0.67, P = 0.046), glycodelin (P = 0.013 and AUC = 0.73, P = 0.013), and nicotinamide phosphoribosyltransferase (P = 0.018 and AUC = 0.71, P = 0.01).

  20. Endocrine disruptors and spontaneous premature labor: a case control study

    Directory of Open Access Journals (Sweden)

    Swaby Cheryl

    2007-11-01

    Full Text Available Abstract Background Premature labor is a poorly understood condition. Estrogen is thought to play a key role and therefore the labor process may be affected by endocrine disruptors. We sought to determine whether or not an environmental toxicant, DDE, or dietary derived endocrine disruptors, daidzein and genistein, are associated with spontaneous preterm labor. Methods Cases were defined as primiparous patients having a preterm delivery at or before 35 weeks following the spontaneous onset of labor. Controls were defined as primiparous women who delivered on the same day as the cases but at term gestation. Over approximately 1 year, 26 cases and 52 controls were recruited. Subjects agreed to have blood tests on day one postpartum for DDE and for the phytoestrogens genistein and daidzein. Results The mean concentration of DDE was similar in the case and control groups: 4.29 vs 4.32 ng/g lipid p = .85. In the case group, 13/26 had detectable levels of daidzein (range 0.20 – 1.56 ng/ml compared to 25/52 controls (range 0.21 – 3.26 ng/ml. The mean concentration of daidzein was similar in cases compared to controls: 0.30 vs .34 ng/ml p = 0.91. Of the case group,14/26 had detectable levels of genistein (range 0.20 – 2.19 ng/ml compared to 32/52 controls (range 0.21 – 2.55 ng/ml. The mean concentration of genistein was similar in cases compared to controls: 0.39 vs 0.31 ng/ml, p = 0.61. Conclusion The serum levels of DDE in this population were found to be low. There appears to be no relationship between serum concentrations of DDE, daidzein, and genistein and spontaneous preterm labor in our population. The inability to identify an effect may be related to the comparatively low concentrations of DDE in our population and the rapid and variable reduction of phytoestrogens from women in labor.

  1. Investigating the Prevalence of Preterm Birth in Iranian Population: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Sharifi, Nasibeh; Khazaeian, Somayyeh; Pakzad, Reza; Fathnezhad Kazemi, Azita; Chehreh, Hashemmieh

    2017-12-01

    Introduction: Despite medical advances, preterm delivery remains a global problem in developed and developing countries. The present study was aimed at conducting a systematic review and meta-analysis of studies on the prevalence of preterm delivery in Iran. Methods: This study was carried out on studies conducted in Iran by searching databases of SID, Magiran, Irandoc, MEDLIB, Iranmedex, PubMed, Web of science, Google Scholar and Scopus. The search was conducted using advanced search and keywords of preterm delivery and equivalents of it in Mesh and their Farsi's Synonymous in all articles from 2000-2016.After extracting the data, the data were combined using a random model. Heterogeneity of the studies was assessed using Q test I2 index and the data were analyzed using STATA Ver.11 software. Results: The total number of samples in this study was 41773. In 19 reviewed articles, the overall prevalence of preterm delivery, based on the random effects model, was estimated to be a total of 10% (95% CI, 9-12). The lowest prevalence of preterm labor was 5.4% in Bam and the highest prevalence was 19.85% in Tehran. There was no significant difference between the prevalence of preterm delivery compared to year of study and sample size. Conclusion: This study reviewed the findings of previous studies and showed that preterm delivery is a relatively prevalent problem in Iran. Therefore, adopting appropriate interventions in many cases including life skills training, self-care and increasing pregnancy care to reduce these consequences and their following complications in high risk patients seem necessary.

  2. Risk Factors for Cesarean Delivery following Labor Induction in Multiparous Women

    Directory of Open Access Journals (Sweden)

    Corine J. Verhoeven

    2013-01-01

    Full Text Available Objective. To identify potential risk factors for cesarean delivery following labor induction in multiparous women at term. Methods. We conducted a retrospective case-control study. Cases were parous women in whom the induction of labor had resulted in a cesarean delivery. For each case, we used the data of two successful inductions as controls. Successful induction was defined as a vaginal delivery after the induction of labor. The study was limited to term singleton pregnancies with a child in cephalic position. Results. Between 1995 and 2010, labor was induced in 2548 parous women, of whom 80 had a cesarean delivery (3%. These 80 cases were compared to the data of 160 parous women with a successful induction of labor. In the multivariate analysis history of preterm delivery (odds ratio (OR 5.3 (95% CI 1.1 to 25, maternal height (OR 0.87 (95% CI 0.80 to 0.95 and dilatation at the start of induction (OR 0.43 (95% CI 0.19 to 0.98 were associated with failed induction. Conclusion. In multiparous women, the risk of cesarean delivery following labor induction increases with previous preterm delivery, short maternal height, and limited dilatation at the start of induction.

  3. Cerebral NIRS patterns in late preterm and very preterm infants becoming late preterm.

    Science.gov (United States)

    Grometto, Alice; Pizzo, Benedetta; Strozzi, Maria Chiara; Gazzolo, Francesca; Gazzolo, Diego

    2017-11-20

    Near Infrared Spectroscopy (NIRS) has been proposed as a useful, noninvasive monitoring technique providing reliable information about central nervous system (CNS) oximetry and function. Recently, brain damage has been reconsidered as a dynamic process evolving over the weeks of gestation. We therefore investigated NIRS cerebral pattern differences between healthy late preterm infants (LPTo) and very preterm infants becoming late preterm (LPT). We conducted an observational study in 40 healthy late preterm infants, matched for gestational age at monitoring, of whom 20 where LPTo and 20 LPT. Clinical, diagnostic and laboratory monitoring procedures and cerebral oximetry (crSO 2 ) and function (cFTOE) were recorded on admission into the study. No significant differences (p > .05, for all) were found between groups regarding clinical, diagnostic or laboratory parameters. Higher crSO 2 and lower cFTOE (p preterm infants becoming LPT. Future studies correlating NIRS variables and long-term neurological outcome in LPT are needed to elucidate the concept of dynamic brain damage pathogenesis.

  4. The heritability of preterm delivery.

    Science.gov (United States)

    Ward, Kenneth; Argyle, VeeAnn; Meade, Mary; Nelson, Lesa

    2005-12-01

    To study the heritability of preterm delivery. Women who delivered a singleton infant at less than 36 weeks of gestation were asked about their family history. Twenty-eight families were identified in which the proband had at least five first- or second-degree relatives with preterm delivery. An extensive genealogy database (GenDB) was constructed using more than 9,000 genealogy sources in the public domain (records before 1929). GenDB documents the relationships between more than 17.5 million ancestors and 3.5 million descendants of approximately 10,000 individuals who moved to Utah in the mid 1800s. This database was searched for the names, birth dates, and birthplaces of the four grandparents for each of the 28 probands. Pairwise coefficients of kinship were determined for the 93 preterm delivery grandparents identified, and for sets of 100 individuals born in the 1920s who were randomly selected from the population database. Probands had a mean of 3.3 grandparents included in this database. The average coefficient of kinship for controls was 1.5 x 10(6) (standard deviation = 0.6 x 10(6)). This measure agrees with previous calculations for the Utah population. The coefficient of kinship for familial preterm delivery grandparents was more than 50 standard deviations higher (3.4 x 10(5) [P < .001]). This study confirms the familial nature of preterm delivery. On average, gravidae randomly selected from our population are 23rd degree relatives, while these preterm delivery probands are eighth-degree relatives. A genome-wide scan using these affected families is underway.

  5. Caffeine therapy in preterm infants

    Science.gov (United States)

    Abdel-Hady, Hesham; Nasef, Nehad; Shabaan, Abd Elazeez; Nour, Islam

    2015-01-01

    Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies exist among various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring. In the current review, we will summarize the available evidence for the best practice in using caffeine therapy in preterm infants. PMID:26566480

  6. TODAY THE GLOBAL LABOR MARKET

    Directory of Open Access Journals (Sweden)

    D. G. Shchipanova

    2013-01-01

    Full Text Available The international movement of labor, including temporary impacts on the socio-economic development of the donor and recipient countries the labor force. In this regard, it is relevant and legitimate problems of the evolution of the global labor market, the need to examine the issues of labor mobility, the problems of international labor migration and its impact on the national markets of skilled labor in the context of globalization. Distribution and use of human resources becomes cross-border nature, and so an international study of the labor market.

  7. Fetal fibronectin as a predictor of labor in Mexican women

    Directory of Open Access Journals (Sweden)

    Mario I. Ortiz

    2012-05-01

    Full Text Available Background: The presence of fetal fibronectin in vaginal secretions has been regarded as a predictor of labor in pregnant term and preterm. Objective: For this reason the purpose of this study was to evaluate the predictive validity of fibronectin in pregnant women who attended the General Hospital SSH Pachuca, Hidalgo, Mexico. Methodology: We included pregnant patients admitted to hospital for pregnancy control. Fetal fibronectin was determined in all participants and then followed until the onset of labor. Results: A total of 148 patients participated. One group with 53 patients less than 37 weeks gestation, and another group of 95 patients with 37 or more weeks gestation. In general, the test showed an average sensitivity of 72.5% and specificity 82.9% average for both groups. Conclusion: Based on these results, we recommend using fibronectin test in pregnant women after 32 weeks of gestation, both in emergency departments and outpatient clinics.

  8. Is induced abortion with misoprostol a risk factor for late abortion or preterm delivery in subsequent pregnancies?

    Science.gov (United States)

    Winer, Norbert; Resche-Rigon, Mathieu; Morin, Christine; Ville, Yves; Rozenberg, Patrick

    2009-07-01

    To examine whether a first or second trimester induced abortion with misoprostol influences the risk of late abortion or preterm delivery in subsequent pregnancies. Case-control study in a teaching hospital from January 2005 to June 2006. The cases had singleton pregnancies delivered at 16-36 weeks of gestation after spontaneous late abortions, preterm labor or preterm premature rupture of membrane, or induction of labor for preterm premature rupture of membrane before 37 weeks. The control group was composed of the two consecutive spontaneous singleton deliveries at >or=37 weeks of gestation after each new case (ratio 2/1). The principal outcome measure was late abortion or preterm delivery. The association between late abortion or preterm delivery and a previous induced abortion with misoprostol was first assessed with the Cochran-Mantel-Haenszel chi-square test. Conditional logistic regression models adapted for clustered data were then further used to quantify the effect size, measured by estimated odds ratios (ORs) with their 95% confidence intervals (95% CI). The study included 245 cases and 490 controls. There was no significant difference in mean maternal age, number of pregnancies, parity, smoking, or history of first trimester miscarriage between cases and controls. However, a history of late abortion or previous preterm delivery was significantly more frequent among cases than controls. Forty (16.3%) cases and 56 (11.5%) controls had a history of cervical ripening with misoprostol before vacuum curettage or evacuation, or of medical abortion by misoprostol alone or with mifepristone (OR 1.51, 95% CI: 0.95-2.39; p=0.08). After adjustment for maternal age and number of pregnancies with a multivariable conditional regression model, the adjusted OR was estimated at 1.33 (95% CI: 0.81-2.17; p=0.25). Despite the need for prudence, these results provide some reassurance that induced abortion with misoprostol during the first or second trimester of pregnancy is

  9. Prophylactic Probiotics for Preterm Infants

    DEFF Research Database (Denmark)

    Olsen, Rie; Greisen, Gorm; Schrøder, Morten

    2016-01-01

    BACKGROUND: Necrotizing enterocolitis (NEC) is a major morbidity and cause of mortality in preterm neonates. Probiotics seem to have a beneficial role in preventing NEC, which is confirmed in meta-analyses of randomized controlled trials (RCTs). We therefore aimed to review and confirm the effica...

  10. Allostatic Load and Preterm Birth

    Directory of Open Access Journals (Sweden)

    David M. Olson

    2015-12-01

    Full Text Available Preterm birth is a universal health problem that is one of the largest unmet medical needs contributing to the global burden of disease. Adding to its complexity is that there are no means to predict who is at risk when pregnancy begins or when women will actually deliver. Until these problems are addressed, there will be no interventions to reduce the risk because those who should be treated will not be known. Considerable evidence now exists that chronic life, generational or accumulated stress is a risk factor for preterm delivery in animal models and in women. This wear and tear on the body and mind is called allostatic load. This review explores the evidence that chronic stress contributes to preterm birth and other adverse pregnancy outcomes in animal and human studies. It explores how allostatic load can be used to, firstly, model stress and preterm birth in animal models and, secondly, how it can be used to develop a predictive model to assess relative risk among women in early pregnancy. Once care providers know who is in the highest risk group, interventions can be developed and applied to mitigate their risk.

  11. Particulate matter and preterm birth

    Science.gov (United States)

    Particulate matter (PM) has been variably associated with preterm birth (PTB) (gestation <37 weeks), but the role played by specific chemical components of PM has been little studied. We examined the association between ambient PM <2.5 micrometers in aerodynamic diameter (PM2.S) ...

  12. Loss of cannabinoid receptor CB1 induces preterm birth.

    Directory of Open Access Journals (Sweden)

    Haibin Wang

    2008-10-01

    Full Text Available Preterm birth accounting approximate 10% of pregnancies in women is a tremendous social, clinical and economic burden. However, its underlying causes remain largely unknown. Emerging evidence suggests that endocannabinoid signaling via cannabinoid receptor CB1 play critical roles in multiple early pregnancy events in both animals and humans. Since our previous studies demonstrated that loss of CB1 defers the normal implantation window in mice, we surmised that CB1 deficiency would influence parturition events.Exploiting mouse models with targeted deletion of Cnr1, Cnr2 and Ptgs1 encoding CB1, CB2 and cyclooxygenase-1, respectively, we examined consequences of CB1 or CB2 silencing on the onset of parturition. We observed that genetic or pharmacological inactivation of CB1, but not CB2, induced preterm labor in mice. Radioimmunoassay analysis of circulating levels of ovarian steroid hormones revealed that premature birth resulting from CB1 inactivation is correlated with altered progesterone/estrogen ratios prior to parturition. More strikingly, the phenotypic defects of prolonged pregnancy length and parturition failure in mice missing Ptgs1 were corrected by introducing CB1 deficiency into Ptgs1 null mice. In addition, loss of CB1 resulted in aberrant secretions of corticotrophin-releasing hormone and corticosterone during late gestation. The pathophysiological significance of this altered corticotrophin-releasing hormone-driven endocrine activity in the absence of CB1 was evident from our subsequent findings that a selective corticotrophin-releasing hormone antagonist was able to restore the normal parturition timing in Cnr1 deficient mice. In contrast, wild-type females receiving excessive levels of corticosterone induced preterm birth.CB1 deficiency altering normal progesterone and estrogen levels induces preterm birth in mice. This defect is independent of prostaglandins produced by cyclooxygenase-1. Moreover, CB1 inactivation resulted in

  13. [The use of progestatives for the prevention of spontaneous preterm birth].

    Science.gov (United States)

    Azria, E

    2016-12-01

    To identify clinical situations in which progestatives used to reduce the risk of spontaneous preterm delivery and/or reduced adverse neonatal outcomes have been evaluated and identify situations in which 17OHPC or vaginal progesterone might be recommended. Bibliographic searches were performed in the Medline and Cochrane databases with the use of a combination of keywords and text words related to "progesterone", "tocolysis", and "preterm labor" from 1956 through July 2016. 17OHPC administrated after 16 weeks gestational age is not associated with an increased risk of birth defect (LE3). Because of discrepancies on the risk associated with first trimester utilization, it is recommended not to use it before 16 weeks (grade C). Utilization of 17OHPC and vaginal progesterone during both second and third trimester is not associated with an increased risk of congenital abnormalities and developmental adverse outcomes (LE3). Utilization of progestatives is not associated with an increased risk of intrahepatic cholestasis of pregnancy (LE3) and gestational diabetes (LE3). 17OHPC is not recommended as a primary prevention of preterm delivery in a population of women with monofetal pregnancy without history of preterm delivery (grade C). Although systematic screening of short cervix is not recommended (Professional consensus), the discovery of a short cervix (<20mm) between 16 and 24 weeks in an asymptomatic woman with monofetal pregnancy without history of preterm delivery indicates the daily administration of vaginal progesterone until 36 weeks gestational age (grade B). In a randomized controlled trial, 17OHPC is associated with a decreased risk of preterm delivery before 34 weeks gestationnal age (LE2) and with a reduction of neonatal morbidity (LE3) in women with at least one previous preterm delivery before 34 weeks gestationnal age. It is not possible to recommend the systematic use of 17OHPC on the basis of this sole trial with limited external validity

  14. Labor Market Progeria.

    Science.gov (United States)

    Rodeheaver, Dean

    1990-01-01

    Social ambivalence toward women's roles, sexuality, appearance, and aging combine with social standards of attractiveness to create both age and sex discrimination in the workplace. The life expectancy of presentability is shorter among women than men, thus creating an accelerated aging process termed labor market progeria. (SK)

  15. Cultivating Labor Management Collaboration

    Science.gov (United States)

    Spector, Stacy

    2013-01-01

    In many districts, the notion of labor groups and district administration working together conjures descriptions of war and battle rather than cooperation and collaboration. However, in San Juan Unified School District, the headline, "Union and District Exhibit Positive Partnership" exemplifies the changing relationship between teacher…

  16. Cognitive impairment at age 5 years in very preterm infants born following premature rupture of membranes.

    Science.gov (United States)

    Mura, Thibault; Picaud, Jean-Charles; Larroque, Béatrice; Galtier, Florence; Marret, Stephane; Roze, Jean-Christophe; Truffert, Patrick; Kuhn, Pierre; Fresson, Jeanne; Thiriez, Gérard; Arnaud, Catherine; Mercier, Gregoire; Picot, Marie-Christine; Ancel, Pierre-Yves; Ledesert, Bernard

    2013-08-01

    To evaluate the relationship between preterm premature rupture of membranes (PPROM) and cognitive impairment in 5-year-old children born very preterm. The Etude Epidémiologique sur les Petits Ages Gestationnels Study is a population-based cohort of children followed up from birth to age 5 years recruited in 9 French regions in 1997. We analyzed data from singletons born between 24 and 32 weeks gestation categorized into 4 groups according to etiology of prematurity: infants born after PPROM, after idiopathic preterm labor, in a vascular context (Vasc), and to women with other complications (Other). Cognitive development at age 5 years was assessed using the Mental Processing Composite score of the Kaufman-Assessment Battery for Children. Among the 1051 children followed up to age 5 years, the mean Mental Processing Composite score was 93.6 ± 19.7, and 13.3% of the children (140 of 1051) had cognitive impairment. After adjustment for potential confounders, the risk of cognitive impairment among infants in the PPROM group was not significantly different than that in the idiopathic preterm labor group (OR, 1.09; 95% CI, 0.62-1.92) and the Other group (OR, 1.36; 95% CI, 0.75-2.47), but was lower than that in the Vasc group (OR, 1.86; 95% CI, 1.16-2.97). In the PPROM group, the risk of cognitive impairment was greater when the latency period (ie, time from rupture to delivery) was <3 days (OR, 2.32; 95% CI, 1.07-5.02). Preterm infants born after PPROM are not at increased risk for cognitive impairment in childhood, but the time between PPROM and birth may influence that risk. Copyright © 2013 Mosby, Inc. All rights reserved.

  17. Prevalence and determinants of pre-term deliveries in the University of Ilorin Teaching Hospital, Ilorin, Nigeria

    Directory of Open Access Journals (Sweden)

    O. A. Mokuolu

    2010-03-01

    Full Text Available In Nigeria, over 900,000 children under the age of five years die every year. Early neonatal death is responsible for a little over 20% of these deaths. Prematurity remains a significant cause of these early neonatal deaths. In some series, it is reported to be responsible for 60-70% of these deaths. This study aimed to determine the prevalence and determinants of pre-term deliveries at the University of Ilorin Teaching Hospital, Ilorin. This was a prospective cohort study conducted over a 9-month period at the University of Ilorin Teaching Hospital. Records of deliveries and data on maternal socio-biological and antenatal variables were collected during this period in order to determine the prevalence and determinants of pre-term deliveries. Out of the 2,489 deliveries that took place over a 9-month period, there were 293 pre-terms, giving a pre-term delivery rate of 120 per 1,000 deliveries. Of the total deliveries, 1,522 singleton deliveries that satisfied inclusion criteria were recruited; 185 of them were pre-term deliveries giving a case:control ratio of 1:7. Significant determinants of pre-term delivery identified were previous pre-term delivery (P=0.001; OR=3.55; 95% CI=1.71-7.30, antepartum hemorrhage (P=0.000; OR=8.95; 95%CI=4.06-19.78, premature rupture of the membranes (P=0.000; OR=6.48; 95%CI=4.33-9.67, maternal urinary tract infection (P=0.006; OR=5.89; 95%CI=1.16-27.57, pregnancy induced hypertension (P=0.007; OR=3.23; 95%CI=2.09-4.99, type of labor (P=0.000; OR=6.44; 95%CI=4.42-9.38 and booking status (P=0.000; OR=4.67; 95%CI=3.33-6.56. The prevalence of pre-term delivery was 120 per 1,000 live births. Factors significantly associated with pre-term delivery were low socio-economic class, previous pre-term delivery, antepartum hemorrhage, premature rupture of fetal membranes, urinary tract infection, pregnancy induced hypertension, induced labor, and booking elsewhere outside the teaching hospital.

  18. Child labor, agricultural shocks and labor sharing in rural Ethiopia

    NARCIS (Netherlands)

    Z.Y. Debebe (Zelalem)

    2010-01-01

    textabstractThe author studies the effect of an agricultural shock and a labor sharing arrangement (informal social network) on child labor. Albeit bad parental preference to child labor (as the strand of literature claims), poor households face compelling situations to send their child to work.

  19. Labor on Campus: Academic Library Service to Labor Groups.

    Science.gov (United States)

    Schmidle, Deborah Joseph

    2002-01-01

    Examines academic library service to labor groups, particularly in the area of Internet training. Results of an informal survey of 53 academic libraries in schools with labor study programs in the United States and Canada indicate that few provide direct services to labor unions, and provides an example of one that does at Cornell University.…

  20. Parturients' need of continuous labor support in labor wards

    African Journals Online (AJOL)

    Administrator

    continuous non-medical care of a laboring woman. It includes physical ... having shorter labors, reduced need for oxytocin, anesthesia ..... social differences. In our culture, women especially mothers play vital role in labor and delivery while men are put aside. Since father/partners lack experience and objectivity due to their ...

  1. Preterm delivery predicted by soluble CD163 and CRP in women with symptoms of preterm delivery

    DEFF Research Database (Denmark)

    Vogel, Ida; Grove, Jakob; Thorsen, Poul

    2005-01-01

    : High levels of sCD163 or CRP are associated with an increased risk of preterm delivery in women with symptoms of delivery. Good prediction of preterm delivery before 34 weeks of gestation was obtained by a combination of preterm prelabour rupture of membranes (PPROM), overweight, relaxin, CRP and s...

  2. Early vs delayed clamping of the umbilical cord in full term, preterm and very preterm infants

    DEFF Research Database (Denmark)

    Moller, N.K.; Weber, T.

    2008-01-01

    Randomized studies from 2006 and two meta-analyses published in 2007 agree that clamping of the umbilical cord can be delayed. For the preterm and very preterm infant benefits include less need for blood transfusion and less morbidity, especially for the very preterm male infant. For the term...

  3. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery

    NARCIS (Netherlands)

    Schaaf, J. M.; Hof, M. H. P.; Mol, B. W. J.; Abu-Hanna, A.; Ravelli, A. C. J.

    2012-01-01

    Please cite this paper as: Schaaf J, Hof M, Mol B, Abu-Hanna A, Ravelli A. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery.BJOG 2012;119:16241629. Objective To determine the risk of preterm birth in a subsequent twin pregnancy after previous singleton

  4. Comparison of Perinatal Outcome of Preterm Births Starting in Primary Care versus Secondary Care in Netherlands: A Retrospective Analysis of Nationwide Collected Data

    NARCIS (Netherlands)

    van der Ven, A. J.; Schaaf, J. M.; van Os, M. A.; de Groot, C. J. M.; Haak, M. C.; Pajkrt, E.; Mol, B. W. J.

    2014-01-01

    Introduction. In Netherlands, the obstetric care system is divided into primary and secondary care by risk level of the pregnancy. We assessed the incidence of preterm birth according to level of care and the association between level of care at time of labor onset and delivery and adverse perinatal

  5. Late preterm birth is associated with short-term morbidity but not with adverse neurodevelopmental and physical outcomes at 1 year

    DEFF Research Database (Denmark)

    Hughes, Alice; Greisen, Gorm; Arce, Joan-Carles

    2014-01-01

    We compared the neonatal and infant outcomes at one year (Bayley mental and psychomotor development index, and physical growth) of babies who were (n = 63) or were not (n = 100) delivered prior to 37 weeks in women admitted in threatened late preterm labor (34-35(+6) weeks) with a cervix ≤15 mm...

  6. Does fish oil prevent preterm birth?

    DEFF Research Database (Denmark)

    Secher, Niels Jørgen

    2007-01-01

    A literature review was performed on the effect of fish oil on preterm birth in observational and randomized studies. The only weak effect on preterm birth found in meta-analyses could be caused by the low compliance, and the fact that many women stop supplementation before term together with a f......A literature review was performed on the effect of fish oil on preterm birth in observational and randomized studies. The only weak effect on preterm birth found in meta-analyses could be caused by the low compliance, and the fact that many women stop supplementation before term together...... with a fast acting effect on fish oil....

  7. Socio-economic inequality in preterm birth

    DEFF Research Database (Denmark)

    Petersen, Christina Bjørk; Mortensen, Laust Hvas; Morgen, Camilla Schmidt

    2009-01-01

    by maternal educational attainment and analysed in 5-year intervals from 1981 to 2000. Compared with mothers with >12 years of education, mothers with years of education had similarly increased risks of very, and to a lesser extent moderately, preterm birth in all four countries. The educational gradient...... increased slightly over time in very preterm births in Denmark, while there was a slight narrowing of the gap in Sweden. In moderately preterm births, the educational inequality gap was constant over the study period in Denmark, Norway and Sweden, but narrowed in Finland. The educational gradient in preterm...

  8. Progesterone to prevent spontaneous preterm birth

    Science.gov (United States)

    Romero, Roberto; Yeo, Lami; Chaemsaithong, Piya; Chaiworapongsa, Tinnakorn; Hassan, Sonia

    2014-01-01

    Summary Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, and its prevention is an important healthcare priority. Preterm parturition is one of the ‘great obstetrical syndromes’ and is caused by multiple etiologies. One of the mechanisms of disease is the untimely decline in progesterone action, which can be manifested by a sonographic short cervix in the midtrimester. The detection of a short cervix in the midtrimester is a powerful risk factor for preterm delivery. Vaginal progesterone can reduce the rate of preterm delivery by 45%, and the rate of neonatal morbidity (admission to neonatal intensive care unit, respiratory distress syndrome, need for mechanical ventilation, etc.). To prevent one case of spontaneous preterm birth birth in women with a short cervix both with and without a prior history of preterm birth. In patients with a prior history of preterm birth, vaginal progesterone is as effective as cervical cerclage to prevent preterm delivery. 17α-Hydroxyprogesterone caproate has not been shown to be effective in reducing the rate of spontaneous preterm birth in women with a short cervix. PMID:24315687

  9. LABOR DISCRIMINATION IN BULGARIA

    Directory of Open Access Journals (Sweden)

    Vyara Slavyanska

    2017-03-01

    Full Text Available Labor discrimination is a phenomenon with very serious social and economic consequences, which has increased actuality and importance in Bulgaria nowadays. Because of the high price of discrimination, building effective anti-discrimination legislation occupies a special place in the policy of the European Union. Despite the European directives, the presence of anti-discrimination legislation and the broadly declared anti-discrimination inclinations in our country, these are absolutely not enough for providing environment of equality, with a climate of respect and tolerance to the differences. It turns out that certain groups are definitely victims of labor discrimination. In this connection the present article consecutively identifies these groups, as well as the reasons for their discrimination, underlining the necessity and benefits of the integration of the different.

  10. Labor Informality: General Causes

    Directory of Open Access Journals (Sweden)

    Gustavo Sandoval Betancour

    2016-04-01

    Full Text Available The article examines the main causes of labor informality in order to verify the validity of classical theories that explain unemployment in market economies and its relationship to informality. Methodologically, the project was based, in the empirical part, on international statistics, comparing the evolution of labor market structure in a combined sample of highly industrialized countries and other less industrialized ones. Empirical evidence supports the conclusion that the classical economic theory of Marxist origin is inefficient to explain the causes of unemployment in contemporary market economies, as well as it fails to satisfactorily explain informality. On the contrary, we conclude that the theory in question is more relevant to explain informality in centrally planned economies where this phenomenon has been present even more significantly than in free market economies.

  11. Division of Labor

    KAUST Repository

    Oke, Muse

    2014-09-12

    The first assignment of DNA polymerases at the eukaryotic replication fork was possible after the in vitro reconstitution of the simian virus 40 (SV40) replication system. In this system, DNA polymerase α (Pol α) provides both leading and lagging strands with RNA-DNA primers that are extended by DNA polymerase δ (Pol δ). Extrapolating the architecture of the replication fork from the SV40 model system to an actual eukaryotic cell has been challenged by the discovery of a third DNA polymerase in Saccharomyces cerevisiae, DNA polymerase ε (Pol ε). A division of labor has been proposed for the eukaryotic replication fork whereby Pol ε replicates the leading strand and Pol δ replicates the lagging strand. However, an alternative model of unequal division of labor in which Pol δ can still participate in leading-strand synthesis is plausible.

  12. Labor Arbitration and Dispute Resolution.

    Science.gov (United States)

    Getman, Julius G.

    1979-01-01

    Discusses the nature of labor arbitration; then explores the transferability of the labor arbitration model. Argues that the establishment and legitimation of unions and collective bargaining are responsible for the success of labor arbitration, not vice versa. Available from The Yale Law Journal, 401A Yale Station, New Haven, Connecticut 06520;…

  13. Strategies to Prevent Preterm Birth

    Science.gov (United States)

    Newnham, John P.; Dickinson, Jan E.; Hart, Roger J.; Pennell, Craig E.; Arrese, Catherine A.; Keelan, Jeffrey A.

    2014-01-01

    After several decades of research, we now have evidence that at least six interventions are suitable for immediate use in contemporary clinical practice within high-resource settings and can be expected to safely reduce the rate of preterm birth. These interventions involve strategies to prevent non-medically indicated late preterm birth; use of maternal progesterone supplementation; surgical closure of the cervix with cerclage; prevention of exposure of pregnant women to cigarette smoke; judicious use of fertility treatments; and dedicated preterm birth prevention clinics. Quantification of the extent of success is difficult to predict and will be dependent on other clinical, cultural, societal, and economic factors operating in each environment. Further success can be anticipated in the coming years as other research discoveries are translated into clinical practice, including new approaches to treating intra-uterine infection, improvements in maternal nutrition, and lifestyle modifications to ameliorate maternal stress. The widespread use of human papillomavirus vaccination in girls and young women will decrease the need for surgical interventions on the cervix and can be expected to further reduce the risk of early birth. Together, this array of clinical interventions, each based on a substantial body of evidence, is likely to reduce rates of preterm birth and prevent death and disability in large numbers of children. The process begins with an acceptance that early birth is not an inevitable and natural feature of human reproduction. Preventative strategies are now available and need to be applied. The best outcomes may come from developing integrated strategies designed specifically for each health-care environment. PMID:25477878

  14. Cerebral palsy in preterm infants

    Directory of Open Access Journals (Sweden)

    Demeši-Drljan Čila

    2016-01-01

    Full Text Available Background/Aim. Cerebral palsy (CP is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS. Results. More than half of the children with CP were born prematurely (54.4%. Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001. In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049, children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0% affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032. Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy. [Projekat Ministarstva nauke Republike

  15. Amniotic fluid "sludge"; prevalence and clinical significance of it in asymptomatic patients at high risk for spontaneous preterm delivery.

    Science.gov (United States)

    Adanir, Ilknur; Ozyuncu, Ozgur; Gokmen Karasu, Ayse Filiz; Onderoglu, Lutfu S

    2018-01-01

    The aim of our study is to determine prevalence and clinical significance of the presence of amniotic fluid "sludge" among asymptomatic patients at high-risk for spontaneous preterm delivery, prospectively. In our study, 99 patients at high risk for spontaneous preterm delivery were evaluated for the presence of amniotic fluid sludge with transvaginal ultrasonography at 20-22, 26-28, and 32-34 gestational weeks, prospectively; between August 2009 and October 2010 in Hacettepe University Hospital. And, these patients were followed up for their delivery weeks and pregnancy outcomes. We defined the high-risk group as the patients possessing one or more of the followings; a history of spontaneous preterm delivery, recent urinary tract infections, polyhydramnios, uterine leiomyomas, müllerian duct anomalies, and history of cone biyopsy or LEEP. Patients with multiple gestations, placenta previa, fetal anomalies, or symptoms of preterm labor at first examination were excluded. We have obtained ethical board approval from Hacettepe University (16.07.2009-HEK/No:09-141-59). The prevalence of amniotic fluid sludge in the study population was 19,6% (18/92). The rates of spontaneous preterm delivery at preterm delivery (p = 0.002). A higher proportion of neonates born to patients with amniotic fluid sludge had a neonatal morbidity (50% (9/18) vs. 24,3% (18/74), p = 0.044) and died in the perinatal period, (p = 0,013) than those born to patients without sludge. When we combined sludge and cervical lenght (CL) (preterm delivery; it catched more women with preterm delivery, (p = 0.000). While sensitivity of sludge was 37,5%, and sensitivity of CL was 34%, sensitivity of "sludge positive or CL ≤25 mm" was 56% for preterm birth (PTB) in high-risk group. The prevalence of amniotic fluid sludge is 19,6% and "sludge" is an independent risk factor for spontaneous preterm delivery among asymptomatic patients at high-risk for spontaneous preterm delivery. PTB is

  16. Onset of human preterm and term birth is related to unique inflammatory transcriptome profiles at the maternal fetal interface

    Directory of Open Access Journals (Sweden)

    Radek Bukowski

    2017-09-01

    Full Text Available Background Preterm birth is a main determinant of neonatal mortality and morbidity and a major contributor to the overall mortality and burden of disease. However, research of the preterm birth is hindered by the imprecise definition of the clinical phenotype and complexity of the molecular phenotype due to multiple pregnancy tissue types and molecular processes that may contribute to the preterm birth. Here we comprehensively evaluate the mRNA transcriptome that characterizes preterm and term labor in tissues comprising the pregnancy using precisely phenotyped samples. The four complementary phenotypes together provide comprehensive insight into preterm and term parturition. Methods Samples of maternal blood, chorion, amnion, placenta, decidua, fetal blood, and myometrium from the uterine fundus and lower segment (n = 183 were obtained during cesarean delivery from women with four complementary phenotypes: delivering preterm with (PL and without labor (PNL, term with (TL and without labor (TNL. Enrolled were 35 pregnant women with four precisely and prospectively defined phenotypes: PL (n = 8, PNL (n = 10, TL (n = 7 and TNL (n = 10. Gene expression data were analyzed using shrunken centroid analysis to identify a minimal set of genes that uniquely characterizes each of the four phenotypes. Expression profiles of 73 genes and non-coding RNA sequences uniquely identified each of the four phenotypes. The shrunken centroid analysis and 10 times 10-fold cross-validation was also used to minimize false positive finings and overfitting. Identified were the pathways and molecular processes associated with and the cis-regulatory elements in gene’s 5′ promoter or 3′-UTR regions of the set of genes which expression uniquely characterized the four phenotypes. Results The largest differences in gene expression among the four groups occurred at maternal fetal interface in decidua, chorion and amnion. The gene expression profiles showed

  17. Neurologic and metabolic issues in moderately preterm, late preterm, and early term infants.

    Science.gov (United States)

    Laptook, Abbot R

    2013-12-01

    Common neurologic morbidities encountered in very preterm and extremely preterm infants (intracranial hemorrhage, white matter injury and periventricular leukomalacia, and apnea of prematurity) are much less common in moderately preterm and late preterm infants. The frequency of germinal matrix hemorrhage-intraventricular hemorrhage and white matter injury are reported to be low, but selection bias in neuroimaging surveillance prevents ascertainment of precise frequencies. The major neurologic morbidity of moderately and late preterm infants is feeding difficulty reflecting developmental integration of suck, swallow, and breathing. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Preterm premature rupture of the fetal membranes: association with sociodemographic factors and maternal genitourinary infections ,

    Directory of Open Access Journals (Sweden)

    Arnildo A. Hackenhaar

    2014-04-01

    Full Text Available OBJECTIVE:tthis study aimed to investigate the incidence of premature rupture of fetal membranes in preterm singleton pregnancies and its association with sociodemographic factors and maternal self-reported genitourinary infections.METHODS:this was a population-based cross-sectional study, which included all mothers of newborns of singleton deliveries that occurred in 2010, with birth weight > 500 grams, who resided in the city of Rio Grande. Women were interviewed in the two maternity hospitals. Cases were women who had lost amniotic fluid before hospitalization and whose gestational age was less than 37 weeks. Statistical analysis was performed by levels to control for confounding factors using Poisson regression.RESULTS:of the 2,244 women eligible for the study, 3.1% had preterm premature rupture of fetal membranes, which was more frequent, after adjustment, in women of lower socioeconomic status, (prevalence ratio [PR] = 1.94, with lower level of schooling (PR = 2.43, age > 29 years (PR = 2.49, and smokers (PR = 2.04. It was also associated with threatened miscarriage (PR = 1.68 and preterm labor, (PR = 3.40. There was no association with maternal urinary tract infection or presence of genital discharge.CONCLUSIONS:the outcome was more common in puerperal women with lower level of schooling, lower socioeconomic status, older, and smokers, as well as those with a history of threatened miscarriage and premature labor. These factors should be considered in the prevention, diagnosis, and therapy approach.

  19. 75 FR 8402 - Child Labor, Forced Labor, and Forced or Indentured Child Labor in the Production of Goods in...

    Science.gov (United States)

    2010-02-24

    ... submission to the Office of Child Labor, Forced Labor and Human Trafficking at the e-mail or physical address... addressed to Ms. McCarter or Ms. Strotkamp at the Office of Child Labor, Forced Labor and Human Trafficking... Office of Child Labor, Forced Labor and Human Trafficking (OCFT). SUPPLEMENTARY INFORMATION: Section 105...

  20. Description and search labor for information retrieval

    OpenAIRE

    Warner, Julian

    2007-01-01

    Selection power is taken as the fundamental value for information retrieval systems. Selection power is regarded as produced by selection labor, which itself separates historically into description and search labor. As forms of mental labor, description and search labor participate in the conditions for labor and for mental labor. Concepts and distinctions applicable to physical and mental labor are indicated, introducing the necessity of labor for survival, the idea of technology as a human ...

  1. Incapacidad laboral total

    Directory of Open Access Journals (Sweden)

    Orlando Díaz Tabares

    1997-04-01

    Full Text Available Se realizó un estudio longitudinal, descriptivo y retrospectivo con el objetivo de conocer el comportamiento de la incapacidad permanente para el trabajo en el municipio "San Cristóbal" durante el decenio 1982-1991, y se aplicó el método de encuesta por el que se recogieron datos que fueron extraídos del modelo oficial de peritaje médico laboral y de la entrevista con el peritado. Los resultados fueron plasmados en tablas de contingencias donde se relacionan las variables por cada año estudiado, y se aplicó la prueba estadística de chi cuadrado. El número de individuos dictaminados con incapacidad laboral total fue de 693; predominó en reportes el año 1988 con 114 casos y muy discretamente el sexo femenino sobre el masculino, el grupo etáreo de 45 a 54 años con 360 casos y la artrosis como entidad valorada por ortopedia, con análisis estadísticos significativos. No resultó estadísticamente significativo, el predominio de la hipertensión arterial sistémica entre las entidades valoradas por la especialidad de medicina interna como causas de incapacidad laboral. Fue muy significativa la variación del número de dictaminados por la comisión en cada uno de los años estudiados y que el porcentaje de ellos que se encontraban realizando trabajos que demandan esfuerzo físico de moderado a intenso al momento de aplicar la encuesta, ascendió al 64,9.A longitudinal, descriptive and retrospective study was conducted in order to know the behavior of permanent labor disability at the municipality of San Cristóbal during 1982-1991. A survey was done to collect data taken from the official model of medical inspections and from the interview with the disabled worker. The results were shown in contingency tables where the variables are related by every year studied. The chi square statistical test was applied. The number of individuals with labor disability was 693. As for reports, the year 1988 predominated with 114. There was a discreet

  2. Hypothyroxinaemia and thyroid function after preterm birth

    NARCIS (Netherlands)

    van Wassenaer, Aleid G.; Kok, Joke H.

    2004-01-01

    The concentration of thyroid hormone in preterm infants is lower than that in term infants. This phenomenon is referred to as transient hypothyroxinaemia of prematurity. Low thyroid hormone levels after very preterm birth are associated with worse developmental outcome in childhood, but only one

  3. Does fish oil prevent preterm birth?

    DEFF Research Database (Denmark)

    Secher, Niels Jørgen

    2007-01-01

    A literature review was performed on the effect of fish oil on preterm birth in observational and randomized studies. The only weak effect on preterm birth found in meta-analyses could be caused by the low compliance, and the fact that many women stop supplementation before term together...

  4. Literacy Skills of Children Born Preterm

    Science.gov (United States)

    Holm, Alison; Crosbie, Sharon

    2010-01-01

    Most children born preterm are considered neurologically normal and free of disability. However in follow-up studies at school age, preterm children, born without major impairment, have been shown to have lower cognitive abilities and associated academic, social and behavioural difficulties. This study investigated the literacy, phonological…

  5. Global report on preterm birth and stillbirth (3 of 7: evidence for effectiveness of interventions

    Directory of Open Access Journals (Sweden)

    Rubens Craig E

    2010-02-01

    Full Text Available Abstract Introduction Interventions directed toward mothers before and during pregnancy and childbirth may help reduce preterm births and stillbirths. Survival of preterm newborns may also be improved with interventions given during these times or soon after birth. This comprehensive review assesses existing interventions for low- and middle-income countries (LMICs. Methods Approximately 2,000 intervention studies were systematically evaluated through December 31, 2008. They addressed preterm birth or low birth weight; stillbirth or perinatal mortality; and management of preterm newborns. Out of 82 identified interventions, 49 were relevant to LMICs and had reasonable amounts of evidence, and therefore selected for in-depth reviews. Each was classified and assessed by the quality of available evidence and its potential to treat or prevent preterm birth and stillbirth. Impacts on other maternal, fetal, newborn or child health outcomes were also considered. Assessments were based on an adaptation of the Grades of Recommendation Assessment, Development and Evaluation criteria. Results Most interventions require additional research to improve the quality of evidence. Others had little evidence of benefit and should be discontinued. The following are supported by moderate- to high-quality evidence and strongly recommended for LMICs: • Two interventions prevent preterm births—smoking cessation and progesterone • Eight interventions prevent stillbirths—balanced protein energy supplementation, screening and treatment of syphilis, intermittant presumptive treatment for malaria during pregnancy, insecticide-treated mosquito nets, birth preparedness, emergency obstetric care, cesarean section for breech presentation, and elective induction for post-term delivery • Eleven interventions improve survival of preterm newborns—prophylactic steroids in preterm labor, antibiotics for PROM, vitamin K supplementation at delivery, case management of

  6. Essays on labor economics.

    OpenAIRE

    Centeno, Mário José Gomes de Freitas

    2000-01-01

    Doctor of Philosophy in subject of Economics This thesis studies three different aspects of the labor market functioning. In the first chapter I investigate how the unemployment insurance (UI) system affects match quality. The argument is that UI enables workers to sort themselves into bet­ ter jobs. I present a model of job-search that predicts procyclical match quality and that higher UI reduces mismatch over the cycle. Using data from the NLSY I find that a higher level of UI increases ...

  7. Flexibilidad laboral y empleo

    OpenAIRE

    Joseph Ramos Quiñones

    2007-01-01

    Entre las reformas “neo-liberales” más conflictivas es la que se refiere a la flexibilidad laboral. Para muchos es la gran reforma faltante; para otros, es una forma solapada de eliminar las conquistas de la clase trabajadora. El artículo pretende analizar de la forma más objetiva y desapasionada los argumentos teóricos y empíricos en torno a este tema, con énfasis en la economía “estrella” de la región, Chile.El trabajo consta de 3 partes. Primero, se presentan los argumentos teóricos a favo...

  8. Preterm Infants and Parents’ self-esteem

    DEFF Research Database (Denmark)

    Aagaard, Hanne; Madsen, Mette Kold

    Background: Little is known about parents to preterm infants and their self-esteem. The care of preterm infants in the neonatal intensive care unit (NICU) is in accordance with the principles of Family Centered Care. Previously, focus has mainly been on the mother-infant-dyad. Current research has...... shown that involving the father at an early stage improves the psychological dynamic of fatherhood and encourages bonding with the infant. The self-esteem of parents appears to be negatively affected after preterm birth. Objective: To get more knowledge and a deeper understanding of the preterm parents......’ experiences of their self-esteem during admission to the NICU and later eight months after discharge. Method and data collection: A qualitative semi-structured interview was conducted in two phases: 1) Three weeks after giving birth to a preterm infant and eight months after discharge. Parents were...

  9. preterm births in a resource constrained setting: soci

    African Journals Online (AJOL)

    2015-12-01

    Dec 1, 2015 ... cerebral palsy, visual and hearing impairment are also more common in preterm infants. Preterm birth in it- ... vious history of induced abortion, previous history of pre-term delivery, history of antenatal ..... cioeconomic status with stress which has been found to be a trigger for preterm labour and delivery.6 ...

  10. Preterm Birth: An Overview of Risk Factors and Obstetrical Management

    Science.gov (United States)

    Stewart, Amanda; Graham, Ernest

    2010-01-01

    Preterm birth is the leading cause of neonatal mortality and a major public health concern. Risk factors for preterm birth include a history of preterm birth, short cervix, infection, short interpregnancy interval, smoking, and African-American race. The use of progesterone therapy to treat mothers at risk for preterm delivery is becoming more…

  11. Labor Market Reforms in Europe: Towards More Flexicure Labor Markets?

    OpenAIRE

    Eichhorst, Werner; Marx, Paul; Wehner, Caroline

    2016-01-01

    Labor market segmentation refers to a salient divide between secure and insecure jobs and is related to problems in important areas, including macro‐economic efficiency, workers' wellbeing and repercussions for social cohesion. European countries have started a new wave of labor market reforms in the aftermath of the 2008/09 crisis to tackle a number of issues, including labor market segmentation. This particularly concerns reforms in: (1) employment protection, i.e. dismissal protection and ...

  12. Congenital tuberculosis in an extremely preterm infant conceived after in vitro fertilization: case report

    Directory of Open Access Journals (Sweden)

    Veronica Samedi

    2017-02-01

    Full Text Available Abstract Background Congenital tuberculosis is a rare manifestation of tuberculosis. The diagnosis is often delayed, especially in preterm neonates because of the non-specific clinical presentation and the lack of awareness of maternal disease prior to pregnancy. Case Presentation We report a case of congenital tuberculosis in an infant born at 24 weeks of gestation to a mother who presented with uncontrolled seizures during preterm labor. Maternal diagnosis was initially made by placental pathology, and later confirmed by isolation of Mycobacterium tuberculosis in urine, gastric aspirates and sputum. Full screening was performed on the newborn infant, and both mother and infant were successfully treated for tuberculosis with a four drug regimen. Conclusion Pregnancy can exacerbate latent tuberculosis and women originating from endemic areas are especially susceptible. The best way to prevent congenital tuberculosis is to have a high index of suspicion and identify and treat tuberculosis in pregnant women.

  13. Distribution of invariant natural killer T cells and dendritic cells in late pre-term birth without acute chorioamnionitis.

    Science.gov (United States)

    Negishi, Yasuyuki; Shima, Yoshio; Takeshita, Toshiyuki; Takahashi, Hidemi

    2017-06-01

    Acute chorioamnionitis (aCAM) is an important cause of pre-term birth. However, little is known about the pathogenesis of late pre-term birth without aCAM that was the most common category of pre-term birth. Here we analyze the kinetics of immune cells obtained from the decidua of women with late pre-term births with and without aCAM. Deciduas were obtained from women who underwent labor with late pre-term birth without aCAM (PB-n/aCAM) or with aCAM (PB-w/aCAM). The population of DEC-205 + dendritic cells (DCs), macrophages, invariant natural killer T (iNKT) cells, NK cells, CD8 + T cells, and CD4 + T cells were analyzed by flow cytometry. The number of iNKT cells was higher in the decidua obtained from women with PB-n/aCAM than PB-w/aCAM. DEC-205 + DCs obtained from women with PB-n/aCAM preferentially induced iNKT cell proliferation. iNKT cell accumulation with DEC-205 + DCs in PB-n/aCAM suggests that iNKT cells contribute to the onset of PB-n/aCAM. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Primate-specific evolution of noncoding element insertion into PLA2G4C and human preterm birth

    Directory of Open Access Journals (Sweden)

    Fellman Vineta

    2010-12-01

    Full Text Available Abstract Background The onset of birth in humans, like other apes, differs from non-primate mammals in its endocrine physiology. We hypothesize that higher primate-specific gene evolution may lead to these differences and target genes involved in human preterm birth, an area of global health significance. Methods We performed a comparative genomics screen of highly conserved noncoding elements and identified PLA2G4C, a phospholipase A isoform involved in prostaglandin biosynthesis as human accelerated. To examine whether this gene demonstrating primate-specific evolution was associated with birth timing, we genotyped and analyzed 8 common single nucleotide polymorphisms (SNPs in PLA2G4C in US Hispanic (n = 73 preterm, 292 control, US White (n = 147 preterm, 157 control and US Black (n = 79 preterm, 166 control mothers. Results Detailed structural and phylogenic analysis of PLA2G4C suggested a short genomic element within the gene duplicated from a paralogous highly conserved element on chromosome 1 specifically in primates. SNPs rs8110925 and rs2307276 in US Hispanics and rs11564620 in US Whites were significant after correcting for multiple tests (p PLA2G4C activity. Conclusions Our findings suggest that variation in PLA2G4C may influence preterm birth risk by increasing levels of prostaglandins, which are known to regulate labor.

  15. Preterm birth among women living within 600 meters of high voltage overhead Power Lines: a case-control study.

    Science.gov (United States)

    Sadeghi, Taktom; Ahmadi, Amirmasoud; Javadian, Maryam; Gholamian, Sayyed Asghar; Delavar, Mouloud Agajani; Esmailzadeh, Sedigheh; Ahmadi, Bahare; Hadighi, Mozhgan Sadat Hassanpour

    2017-09-26

    The issue of preterm birth due to exposure to magnetic fields from power lines is unclear. Exposure to electromagnetic field in uterus has been hypothesized as possible preterm birth. The aim of the present study was to determine whether living closer to high voltage power lines increased the risk of preterm labor. In a nested case-control study, 135 cases of singleton live spontaneous preterm birth in Rohani hospital, Babol, Iran, during the period between 2013 and 2014 were studied. The 150 control subjects were singleton term live birth in the same year of birth and city of residence using randomized-digit dialing. The shortest distance to any of the high voltage power lines to the maternal residence during pregnancy was measured using ArcGIS software for every case and control. To test the association between the preterm births and the residential proximity to power lines, stepwise multiple logistic regression was used. There were 28 households, 20 cases (14.8%) and 8 controls (5.3%) situated within 600 meters of high voltage power lines. The adjusted OR for spontaneous preterm birth and birth defect in women who were living in less than 600 meters from high voltage power lines was higher compared to those living at farther distance (OR = 3.28, CI: 1.37 to 7.85) and (OR = 5.05, CI: 1.52 to 16.78), respectively. Therefore, installing overhead power lines and stations within 600 meters or making overhead underground would be useful in the prevention of both preterm birth and birth defect.

  16. Total matrix metalloproteinase-8 serum levels in patients labouring preterm and patients with threatened preterm delivery.

    Directory of Open Access Journals (Sweden)

    Piotr Laudański

    2010-11-01

    Full Text Available Preterm labour and prematurity are still a main cause of perinatal morbidity nowadays. The aim of our study was to assess the role of MMP-8 as a predictive marker of preterm delivery. Four groups of patients were involved to the study: I - pregnant women at 24-34 weeks of gestation with any symptoms of threatened preterm labour; II - threatened preterm labour patients between 24-34 weeks of gestation; III - preterm vaginal delivery patients; IV - healthy term vaginal delivery patients. Serum concentration of total MMP-8 was measured using two enzyme-linked immunosorbent assays. There were no significant differences in the median concentrations of total MMP-8 between physiological pregnancy and threatened preterm labour patients with existing uterine contractility. No significant differences of total MMP-8 were either found between healthy term and preterm labouring patients. The studies on a larger population are needed to reject the hypothesis that preterm labour is connected with increased MMP-8 plasma concentrations of women in preterm labour and threatened preterm delivery.

  17. Use of metabolomics for the identification and validation of clinical biomarkers for preterm birth: Preterm SAMBA.

    Science.gov (United States)

    Cecatti, Jose G; Souza, Renato T; Sulek, Karolina; Costa, Maria L; Kenny, Louise C; McCowan, Lesley M; Pacagnella, Rodolfo C; Villas-Boas, Silas G; Mayrink, Jussara; Passini, Renato; Franchini, Kleber G; Baker, Philip N

    2016-08-08

    Spontaneous preterm birth is a complex syndrome with multiple pathways interactions determining its occurrence, including genetic, immunological, physiologic, biochemical and environmental factors. Despite great worldwide efforts in preterm birth prevention, there are no recent effective therapeutic strategies able to decrease spontaneous preterm birth rates or their consequent neonatal morbidity/mortality. The Preterm SAMBA study will associate metabolomics technologies to identify clinical and metabolite predictors for preterm birth. These innovative and unbiased techniques might be a strategic key to advance spontaneous preterm birth prediction. Preterm SAMBA study consists of a discovery phase to identify biophysical and untargeted metabolomics from blood and hair samples associated with preterm birth, plus a validation phase to evaluate the performance of the predictive modelling. The first phase, a case-control study, will randomly select 100 women who had a spontaneous preterm birth (before 37 weeks) and 100 women who had term birth in the Cork Ireland and Auckland New Zealand cohorts within the SCOPE study, an international consortium aimed to identify potential metabolomic predictors using biophysical data and blood samples collected at 20 weeks of gestation. The validation phase will recruit 1150 Brazilian pregnant women from five participant centres and will collect blood and hair samples at 20 weeks of gestation to evaluate the performance of the algorithm model (sensitivity, specificity, predictive values and likelihood ratios) in predicting spontaneous preterm birth (before 34 weeks, with a secondary analysis of delivery before 37 weeks). The Preterm SAMBA study intends to step forward on preterm birth prediction using metabolomics techniques, and accurate protocols for sample collection among multi-ethnic populations. The use of metabolomics in medical science research is innovative and promises to provide solutions for disorders with multiple

  18. Lactate produced during labor modulates uterine inflammation via GPR81 (HCA1).

    Science.gov (United States)

    Madaan, Ankush; Nadeau-Vallée, Mathieu; Rivera, Jose Carlos; Obari, Dima; Hou, Xin; Sierra, Estefania Marin; Girard, Sylvie; Olson, David M; Chemtob, Sylvain

    2017-01-01

    -induced uterine inflammation, preterm birth, and associated neonatal mortality. Collectively, our data uncover a novel link between the anaerobic glycolysis and the control of uterine inflammation wherein the high levels of lactate produced during labor act on uterine GPR81 to down-regulate key proinflammatory genes. This discovery may represent a novel feedback mechanism to regulate inflammation during labor, and conveys a potential rationale for the use of GPR81 agonists to attenuate inflammation and resulting preterm birth. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [International trends in laboral risk legislation].

    Science.gov (United States)

    García-Vigil, José Luis

    2010-01-01

    It had been established that labor damage are: laboral injuries, professional diseases and others diseases related with laboral conditions. All of them are referred to as diseases or damages suffered as a consequence of a laboral relations. It is implicated that the damage occurs in the place or during a laboral scheduled time with a causal direct relation. There is a trend in the Spanish laboral legislation, which is controversial in laboral medicine, because it includes a Law for the Prevention of Laboral Risks that consider also to the chronic diseases as a cause no traumatic of a laboral risk to conditioned a damage during the laboral journey.

  20. Amniotic Fluid Glucose Concentration: A Marker for Infection in Preterm Labor and Preterm Premature Rupture of Membranes

    Directory of Open Access Journals (Sweden)

    Gary A. Dildy

    1994-01-01

    Full Text Available Amniotic fluid Gram stain and culture have been utilized as laboratory tests of microbial invasion of the amniotic cavity. The Gram stain of amniotic fluid has a low sensitivity in the detection of clinical infection or microbial invasion of the amniotic cavity, and amniotic fluid culture results are not immediately available for management decisions. Glucose concentration is used to diagnose infection in other sites such as cerebrospinal fluid.

  1. Labor Quality Growth in Germany

    OpenAIRE

    Guido Schwerdt; Jarkko Turunen

    2009-01-01

    Extending the common baseline model in various dimensions does not fundamentally change the low contribution of labor quality to productivity growth in Germany. Labor quality growth is low owing to a small increase in the share of workers with higher education, a negative contribution from a higher share of females and declines in relative returns. The contribution of actual labor market experience is lower than suggested by an age proxy.

  2. Labor Supply and Optimization Frictions

    DEFF Research Database (Denmark)

    Søgaard, Jakob Egholt

    In this paper I investigate the nature of optimization frictions by studying the labor market of Danish students. This particular labor market is an interesting case study as it features a range of special institutional settings that affect students’ incentive to earn income and comparing outcomes...... across these setting effectively allow you to distinguish between different types of frictions. I find that the considered labor market is significantly affected by optimizations frictions, which masks the bunching at kink points normally associated with a positive labor supply elasticity under standard...

  3. Modulation of amniotic fluid activin-a and inhibin-a in women with preterm premature rupture of the membranes and infection-induced preterm birth.

    Science.gov (United States)

    Rosenberg, Victor A; Buhimschi, Irina A; Dulay, Antonette T; Abdel-Razeq, Sonya S; Oliver, Emily A; Duzyj, Christina M; Lipkind, Heather; Pettker, Christian M; Buhimschi, Catalin S

    2012-02-01

    Activins and inhibins are important modulators of inflammatory processes. We explored activation of amniotic fluid (AF) activin-A and inhibin-A system in women with intra-amniotic infection and preterm premature rupture of the membranes (PPROM). We analyzed 78 AF samples: '2nd trimester-control' (n=12), '3rd trimester-control' (n=14), preterm labor with intact membranes [positive-AF-cultures (n=13), negative-AF-cultures (n=13)], and PPROM [positive-AF-cultures (n=13), negative-AF-cultures (n=13)]. Activin-A levels were evaluated ex-vivo following incubation of amniochorion and placental villous explants with Gram-negative lipopolysaccharide (LPS) or Gram-positive (Pam3Cys) bacterial mimics. Ability of recombinant activin-A and inhibin-A to modulate inflammatory reactions in fetal membranes was explored through explants' IL-8 release. Activin-A and inhibin-A were present in human AF and were gestational age-regulated. Activin-A was significantly upregulated by infection. Lower inhibin-A levels were seen in PPROM. LPS elicited release of activin-A from amniochorion, but not from villous explants. Recombinant activin-A stimulated IL-8 release from amniochorion, an effect that was not reversed by inhibin-A. Human AF activin-A and inhibin-A are involved in biological processes linked to intra-amniotic infection/inflammation-induced preterm birth. © 2011 John Wiley & Sons A/S.

  4. Frequency and clinical significance of short cervix in patients with preterm premature rupture of membranes.

    Directory of Open Access Journals (Sweden)

    Seung Mi Lee

    Full Text Available Cervical length measurement has been uggested as a useful tool for predicting intra-amniotic infection/inflammation in preterm labor, but little information is available in the setting of preterm premature rupture of membranes (pPROM. We aimed to determine whether a short cervical length is independently associated with an increased risk of intra-amniotic infection or inflammation and impending preterm delivery in women with pPROM.This was a retrospective cohort study involving 171 consecutive singleton pregnant women with pPROM (21+0-33+6 weeks' gestation, who underwent amniocentesis. Amniotic fluid (AF was cultured, and assayed for interleukin (IL-6 and IL-8. Cervical length was measured at the time of amniocentesis by transvaginal ultrasonography with an aseptic technique. Short cervical length was defined as a cervical length of ≤15 mm. Intra-amniotic infection was defined as a positive AF culture for microorganisms and intra-amniotic inflammation was defined as elevated AF concentrations of IL-6 or IL-8 (IL-6 ≥1.5 ng/mL and/or IL-8 ≥1.3 ng/mL.Fifty (29.2% women had a sonographic cervical length of ≤15mm. On univariate analysis, short cervical length was associated with an increased risk for intra-amniotic infection and/or inflammation; no other parameters studied showed a significant association. Multivariable analyses indicated that short cervical length was significantly associated with a higher risk of impending preterm delivery (within 2 days of measurement, within 7 days of measurement, and before 34 weeks, and remained significant after adjustment for potential confounders.In women with pPROM, short cervical length is associated with an increased risk for intra-amniotic infection/inflammation and associated with impending preterm delivery, independent of the presence of intra-amniotic infection/inflammation.

  5. Challenges and Consequences of Preterm Birth

    Directory of Open Access Journals (Sweden)

    Sribas Goswami

    2014-11-01

    Full Text Available Preterm births have been a challenge to obstetricians and paediatricians. Preterm births affect all population irrespective of age, race and economic status due to lack of seriousness and awareness among the pregnant women. Preterm birth is one of the leading causes of infant morbidity and mortality, amounting to billions of dollars each year, thus increasing the cost for health care. Proper awareness programs about preterm birth may help the women population to know and understand better the signs and symptoms of preterm labour. Preterm birth is a complex cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, neighborhood characteristics, environmental exposures, medical conditions, infertility treatments, biological factors and genetics. Many of these factors occur in combination, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. The empirical investigation was carried out to draw correlation between preterm birth and eventuality through this study.

  6. Delayed development of systemic immunity in preterm pigs as a model for preterm infants

    DEFF Research Database (Denmark)

    Nguyen, Duc Ninh; Jiang, Pingping; Frøkiær, Hanne

    2016-01-01

    Preterm neonates are highly sensitive to systemic infections in early life but little is known about systemic immune development following preterm birth. We hypothesized that preterm neonates have immature systemic immunity with distinct developmental trajectory for the first several weeks of life......-mediated IL-6 and TNF-α production. These immune parameters remained different between preterm and near-term pigs at 2-3 weeks, even when adjusted for post-conceptional age. Our data suggest that systemic immunity follows a distinct developmental trajectory following preterm birth that may be influenced......, poor neutrophil phagocytic rate, and limited cytokine responses to TLR1/2/5/7/9 and NOD1/2 agonists. The preterm systemic responses remained immature during the first postnatal week, but thereafter showed increased blood leukocyte numbers, NK cell proportion, neutrophil phagocytic rate and TLR2...

  7. Born too soon: preterm birth matters.

    Science.gov (United States)

    Howson, Christopher P; Kinney, Mary V; McDougall, Lori; Lawn, Joy E

    2013-01-01

    Urgent action is needed to address preterm birth given that the fi rst country-level estimates show that globally 15 million babies are born too soon and rates are increasing in most countries with reliable time trend data. As the fi rst in a supplement entitled “Born Too Soon”, this paper focuses on the global policy context. Preterm birth is critical for progress on Millennium Development Goal 4 (MDG) for child survival by 2015 and beyond, and gives added value to maternal health (MDG 5) investments also linking to non-communicable diseases. For preterm babies who survive, the additional burden of prematurity-related disability may aff ect families and health systems. Prematurity is an explicit priority in many high-income settings; however, more attention is needed especially in low- and middle-income countries where the invisibility of preterm birth as well as its myths and misconceptions have slowed action on prevention and care. Recent global attention to preterm birth hit a tipping point in 2012, with the May 2 publication of Born Too Soon: The Global Action Report on Preterm Birth and with the 2nd annual World Prematurity Day on November 17 which mobilised the actions of partners in many countries to address preterm birth and newborn health. Interventions to strengthen preterm birth prevention and care span the continuum of care for reproductive, maternal, newborn and child health. Both prevention of preterm birth and implementation of care of premature babies require more research, as well as more policy attention and programmatic investment.

  8. Effects of Labor Taxes and Unemployment Compensation on Labor Supply in a Search Model with an Endogenous Labor Force

    OpenAIRE

    Been-Lon Chen; Chih-Fang Lai

    2014-01-01

    Labor taxes and unemployment compensation were blamed for causing relative declines in labor supply in the EU to the US in the past decades. We propose a model with an endogenous labor force and compare with the model with an exogenous labor force. Because of discouraging the labor force, labor taxes decrease employment in our model less than the model with an exogenous labor force, have ambiguous effects on hours, and decrease less labor supply in our model. Due to boosting the labor force, ...

  9. LABOR MARKET POLICIES AND EFFECTIVENESS

    Directory of Open Access Journals (Sweden)

    DRITAN SHORAJ

    2012-05-01

    Full Text Available In this paper will be examined some important issues of the labor market policies in Albania. As well, the analysis of labor market institutions such as the Social Insurances or the Syndicates on the efficiency of employing active labor forces. Which are the policies on the protection of the labor forces and the criteria of definition of the minimum salary? Furthermore, it continues with the importance of reforms in the labor market policies, to be examined in the labor market aspect as a production factor and as a regulator of the internal market. Fast globalization is causing continuous risk and movement for the active labor forces. The increase and development of technology puts out of the market many employees, decreasing the number of unqualified employees and increases the demand for the qualified ones. Does the globalization really affect the labor market, efficiency and as a consequence increase production, or the latter are benefits only for the developed economic countries? At the same time, we shall examine the movement of the labor forces from one country to another and the fluctuation of the relevant salaries. In general, the analysis of this paper faces two key issues: the first being raised on discussion of the kinds of programs on the active labor forces, such as programs of direct employment or consideration of employment in public sector, and the second regarding the methodology of evaluating these programs. How effective are them on the domestic market? The paper ends with conclusions and recommendations on the efficiency of policies for the labor market forces.

  10. Survival and neurodevelopmental outcomes of preterm infants.

    Science.gov (United States)

    Hack, Maureen

    2007-12-01

    Survival of preterm infants, which increased dramatically during the years after the introduction of neonatal intensive care, reached a plateau in the mid- to late 1990s. Neonatal morbidity, which increased initially, has decreased since 2000 and resulted in a decrease in the rates of cerebral palsy. Follow-up of preterm infants to early childhood and school age reveals higher rates of asthma, cerebral palsy, subnormal cognitive function, poorer academic achievement, and behavioral problems. Although many of the problems persist into adulthood, preterm survivors regard their overall health and quality of life similar to that of normal birth weight controls.

  11. Delayed development of systemic immunity in preterm pigs as a model for preterm infants

    Science.gov (United States)

    Nguyen, Duc Ninh; Jiang, Pingping; Frøkiær, Hanne; Heegaard, Peter M. H.; Thymann, Thomas; Sangild, Per T.

    2016-01-01

    Preterm neonates are highly sensitive to systemic infections in early life but little is known about systemic immune development following preterm birth. We hypothesized that preterm neonates have immature systemic immunity with distinct developmental trajectory for the first several weeks of life, relative to those born at near-term or term. Using pigs as a model, we characterized blood leukocyte subsets, antimicrobial activities and TLR-mediated cytokine production during the first weeks after preterm birth. Relative to near-term and term pigs, newborn preterm pigs had low blood leukocyte counts, poor neutrophil phagocytic rate, and limited cytokine responses to TLR1/2/5/7/9 and NOD1/2 agonists. The preterm systemic responses remained immature during the first postnatal week, but thereafter showed increased blood leukocyte numbers, NK cell proportion, neutrophil phagocytic rate and TLR2-mediated IL-6 and TNF-α production. These immune parameters remained different between preterm and near-term pigs at 2–3 weeks, even when adjusted for post-conceptional age. Our data suggest that systemic immunity follows a distinct developmental trajectory following preterm birth that may be influenced by postnatal age, complications of prematurity and environmental factors. Consequently, the immediate postnatal period may represent a window of opportunity to improve innate immunity in preterm neonates by medical, antimicrobial or dietary interventions. PMID:27830761

  12. Murphy's Moral Economy of Labor.

    Science.gov (United States)

    Masters, Roger D.

    1996-01-01

    Praises and summarizes James Bernard Murphy's "The Moral Economy of Labor: Aristotelian Themes in Economic Theory." Linking economic theories from Adam Smith to Karl Marx, Murphy criticizes traditional economic and social thinking regarding the division of labor. He proposes an integration of conceptualization and execution to humanize…

  13. Labor Unions and Asset Prices

    DEFF Research Database (Denmark)

    Busato, Francesco; Addessi, William

    The paper investigates the nexus between labor and financial markets, focusing on the interaction between labor union behavior in setting wages, firms' investment strategy and asset prices. The way unions set wage claims after observing firm's financial performance increases the volatility of firms...

  14. Legal Intervention in Labor Arbitration

    Science.gov (United States)

    Gullett, C. Ray

    1978-01-01

    From a private process between unions and management, labor arbitration has become a matter for federal arbitrators to decide. The article traces this development through various federal court cases and legislation, particularly unfair labor practice charges under Title VII of the Civil Rights Act. (MF)

  15. Economic implications of labor induction.

    Science.gov (United States)

    Garcia-Simon, Raquel; Montañes, Antonio; Clemente, Jesús; Del Pino, María D; Romero, Manuel A; Fabre, Ernesto; Oros, Daniel

    2016-04-01

    To assess health service costs associated with labor induction according to different clinical situations in a tertiary-level hospital. In a prospective study, individual patient cost data were assessed for women admitted for induction of labor at a tertiary hospital in Spain between November 1, 2012, and August 31, 2013. The costs of labor induction were estimated according to maternal and neonatal outcomes, method of delivery, cervical condition at admission, and obstetric indication. Direct costs including professional fees, epidural, maternal stay, consumables, and drugs were calculated. Overall, 412 women were included in the final cost analysis. The mean total cost of labor induction was €3589.87 (95% confidence interval [CI] 3475.13-3704.61). Cesarean delivery after labor induction (€4830.45, 95% CI 4623.13-5037.58) was significantly more expensive than spontaneous delivery (€3037.45, 95% CI 2966.91-3179.99) and instrumental vaginal delivery (€3344.31, 95%CI 3151.69-3536.93). The total cost for patients with a very unfavorable cervix (Bishop score Labor induction for hypertensive disorders of pregnancy was the most expensive obstetric indication for induction of labor (€4347.32, 95% CI 3890.45-4804.18). Following the induction of labor, a number of patient- and treatment-related factors influence costs associated with delivery. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Precariedad laboral : una realidad comparada

    OpenAIRE

    García del Campo, Alberto

    2012-01-01

    El trabajo “Precariedad Laboral: una realidad comparada”, es un estudio sincrónico y diasincrónico de la última Reforma Laboral acometida por el actual Gobierno español, que esta levantando muchas protestas entre los ciudadanos Grado en Relaciones laborales y Recursos Humanos

  17. Nuevas Formas de Precariedad Laboral

    OpenAIRE

    Zubiri-Rey, Jon Bernat

    2008-01-01

    En este artículo trataremos de recoger brevemente algunas conceptualizaciones sobre la precariedad laboral que son necesarias para aproximarse a estos fenómenos complejos. Seguidamente trataremos de presentar esquemáticamente algunas herramientas que pueden ser utlizadas para medir las Nuevas Formas de Precariedad Laboral, tarea ineludible para que una critica social y sindical trasformadora sea posible.

  18. [Demography and labor shortage. Future challenges of labor market policy].

    Science.gov (United States)

    Fuchs, J

    2013-03-01

    For demographic reasons, the German labor force will decrease dramatically and it will be much older on average. However, labor demand, especially for qualified workers, is expected to remain high. This paper focuses on the possibilities of expanding the labor force by increasing the participation rates of women and older persons. Herein, the change in the labor force is decomposed with respect to population and labor participation and, moreover, the effects of higher participation rates are simulated. The decomposition and simulation scenarios are based on data published by the Institute for Employment Research. The analysis clearly reveals that the effect of a considerably higher labor participation of women and older workers will disappear over time when the working-age population shrinks more and more. In addition, individuals who are currently unemployed or out of the labor force are not skilled enough. Since it seems difficult to get more qualified workers in the short and even in the medium term, improving the conditions for women and older people to take up jobs should be tackled soon. This includes investments in education and health care.

  19. Antimicrobials for Preterm Birth Prevention: An Overview

    Directory of Open Access Journals (Sweden)

    Akila Subramaniam

    2012-01-01

    Full Text Available Objective. Preterm birth (PTB remains a major cause of neonatal morbidity and mortality. The association between PTB and infection is clear. The purpose of this report is to present a focused review of information on the use of antibiotics to prevent PTB. Methods. We performed a search of the PubMed database restricted to clinical trials or meta-analyses published in English from 1990 through May 2011 using keywords “antibiotics or antimicrobials” and “preterm.” Results. The search yielded 67 abstracts for review. We selected 31 clinical trials (n=26 or meta-analysis (n=5 for further full-text review. Discussion of each eligible clinical trial, its specific inclusion criteria, antibiotic regimen used, and study results are presented. Overall, trials evaluating antibiotic treatment to prevent preterm birth have yielded mixed results regarding any benefit. Conclusion. Routine antibiotic prophylaxis is not recommended for prevention of preterm birth.

  20. Preterm twin gestation and cystic periventricular leucomalacia

    NARCIS (Netherlands)

    Resch, B; Jammernegg, A; Vollaard, E; Maurer, U; Mueller, WD; Pertl, B

    Objective: To identify risk factors for the development of cystic periventricular leucomalacia (PVL) in twin gestation. Design: Retrospective case-control study. Setting: Tertiary care university hospital, Department of Paediatrics, Division of Neonatology, Graz, Austria. Patients: Preterm twin

  1. SOCIODEMOGRAPHIC DOAMINS OF DEPRIVATION AND PRETERM BIRTH

    Science.gov (United States)

    Background. Neighborhood-level deprivation has long been associated with adverse outcomes, including preterm birth (PTB), as observed in the authors' previous work using a composite deprivation index. Area disadvantage is multifaceted comprising income, employment, education and...

  2. INCOME INCONGRUITY, RACE AND PRETERM BIRTH

    Science.gov (United States)

    Previous research with vital records finds income incongruity associated with adverse birth outcomes. We examined the effects of negative income incongruity (reporting lower household income than the census tract median household income) on preterm birth (PTB <37 weeks completed ...

  3. A Select Bibliography of Books on Labor Issues.

    Science.gov (United States)

    American Federation of Labor and Congress of Industrial Organizations, Washington, DC.

    This annotated bibliography of 90 books on labor issues presents selections in the following areas: labor history, biographies, contemporary issues, labor economics and labor relations, labor law, labor unions, women and work, and reference books. (DB)

  4. 76 FR 38110 - Notice of Intent To Resume the Agricultural Labor Survey and Farm Labor Reports.

    Science.gov (United States)

    2011-06-29

    ... Agricultural Labor Survey and Farm Labor Reports. AGENCY: National Agricultural Statistics Service, USDA... approved information collection, the Agricultural Labor Survey, and its associated publication. FOR FURTHER.... Department of Agriculture, (202) 720-4333. SUPPLEMENTARY INFORMATION: Title: Agricultural Labor Survey. OMB...

  5. Maintenance therapy with oxytocin antagonists for inhibiting preterm birth after threatened preterm labour.

    Science.gov (United States)

    Papatsonis, Dimitri N M; Flenady, Vicki; Liley, Helen G

    2013-10-13

    In some women, an episode of preterm labour settles and does not result in immediate preterm birth. Subsequent treatment with tocolytic agents such as oxytocin receptor antagonists may then have the potential to prevent the recurrence of preterm labour, prolonging gestation, and preventing the adverse consequences of prematurity for the infant. To assess the effects of maintenance therapy with oxytocin antagonists administered by any route after an episode of preterm labour in order to delay or prevent preterm birth. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2013), sought ongoing and unpublished trials by contacting experts in the field and searched the reference lists of relevant articles. Randomised controlled trials comparing oxytocin antagonists with any alternative tocolytic agent, placebo or no treatment, used for maintenance therapy after an episode of preterm labour. We used the standard methods of The Cochrane Collaboration and the Cochrane Pregnancy and Childbirth Group. Two review authors independently undertook evaluation of methodological quality and extracted trial data. This review includes one trial of 513 women. When compared with placebo, atosiban did not reduce preterm birth before 37 weeks (risk ratio (RR) 0.89; 95% confidence intervals (CI) 0.71 to 1.12), 32 weeks (RR 0.85; 95% CI 0.47 to 1.55), or 28 weeks (RR 0.75; 95% CI 0.28 to 2.01). No difference was shown in neonatal morbidity, or perinatal mortality. There is insufficient evidence to support the use of oxytocin receptor antagonists to inhibit preterm birth after a period of threatened or actual preterm labour. Any future trials using oxytocin antagonists or other drugs as maintenance therapy for preventing preterm birth should examine a variety of important infant outcome measures, including reduction of neonatal morbidity and mortality, and long-term infant follow-up. Future research should also focus on the pathophysiological pathways that

  6. Child labor in Bombay.

    Science.gov (United States)

    Mehta, M N; Prabhu, S V; Mistry, H N

    1985-01-01

    Of the world's largest child labor force in India, Bombay has over 30,000 working children, most of them migrants. In a prospective study of 73 working children from a part of Dharavi, the biggest slum in Asia, 68% were working as hotel boys; 22% had started working before their 10th birthday, a large number doing so to increase the family income, but earning less than Rs. 100 ($11) per month. Forty percent worked more than 12 hours a day and only 16% continued schooling. Two-thirds depended entirely on their employers for food which was adequate and no child in the study was malnourished. Overall incidence of anemia and vitamin deficiency was 10% each. Only 7% had ailments related to their occupation. Because this was a cross-sectional study no conclusions can be drawn regarding long term and residual effects. Preventing children from working is likely to make worse their own as well as their families' problems unless substitute sources of income or welfare are available. Legal protection and other services near their working places are essential for those who have to work.

  7. Biomarkers of spontaneous preterm birth

    DEFF Research Database (Denmark)

    Polettini, Jossimara; Cobo, Teresa; Kacerovsky, Marian

    2017-01-01

    predictors of pregnancy outcome. This systematic review was conducted to synthesize the knowledge on PTB biomarkers identified using multiplex analysis. Three electronic databases (PubMed, EMBASE and Web of Science) were searched for studies in any language reporting the use of multiplex assays for maternal......Despite decades of research on risk indicators of spontaneous preterm birth (PTB), reliable biomarkers are still not available to screen or diagnose high-risk pregnancies. Several biomarkers in maternal and fetal compartments have been mechanistically linked to PTB, but none of them are reliable......) followed by MIP-1β, GM-CSF, Eotaxin, and TNF-RI (two studies) were reported more than once in maternal serum. However, results could not be combined due to heterogeneity in type of sample, study population, assay, and analysis methods. By this systematic review, we conclude that multiplex assays...

  8. Pathomorphological findings in preterm infants

    International Nuclear Information System (INIS)

    Amann, G.

    2000-01-01

    Pathomorphology in the preterm infant represents an interaction of morphological organ immaturity and neonatal management with their respective sequelae. Pathomorphological examples include the modification in the morphology of hyaline membrane disease and bronchopulmonary dysplasia as a consequence of modern neonatal therapy. Hemorrhagic and ischemic/hypoxic lesions of the central nervous system may occur in age- and agent-related distributional patterns, with subependymal hemorrhage and periventricular leukomalacia representing the most important examples. The most common intestinal finding, namely, necrotizing enterocolitis, typically shows segmental alterations, the morphology of which largely depends on the dominating causative agent. Hepatic cholestasis and fatty change are mostly consequences of parenteral nutrition or hypoxic/ischemic stress. Hepatic necrosis can be associated with the latter, but may also indicate disseminated intravascular coagulation. Vascular pathomorphology is represented by thromembolic lesions, in most instances corresponding to sequelae of neonatal management. (orig.) [de

  9. Behavioral influences on preterm birth: a review.

    Science.gov (United States)

    Savitz, David A; Murnane, Pamela

    2010-05-01

    Epidemiologic studies of potential behavioral influences on preterm birth have proliferated and yet, with the exception of tobacco smoking, none can be considered an established cause. We conducted a comprehensive summary of the epidemiologic evidence on tobacco, alcohol, and illicit drug use, and physical, sexual, and occupational activity, to identify promising research directions, as well as research topics that are at an impasse based on currently available methods. Tobacco use is weakly but consistently associated with preterm birth-stronger for heavier smoking, and for spontaneous preterm birth and earlier preterm births. Weaker evidence suggests an adverse effect of environmental tobacco smoke, heavy alcohol or cocaine use, and physically strenuous work. Low levels of alcohol use, caffeine, sexual activity, and employment have generally not been found to be associated with preterm birth, and leisure-time physical activity has generated mixed results. Progress will require more detailed consideration of antecedents, new technologies for assessing exposure, and examination of biologic consequences of the behaviors of interest, focusing on pathways thought to mediate preterm delivery. New strategies-rather than more applications of the same approaches used in past studies-will move the research toward identifying causal relationships and, ultimately, may suggest preventive measures.

  10. [Prevention of preterm birth complications by antenatal corticosteroid administration].

    Science.gov (United States)

    Schmitz, T

    2016-12-01

    NEC (LE3). Repeated antenatal corticosteroid administration is associated in the neonatal period with respiratory benefits (LE1) but decreased birth weight (LE1) and, in childhood, with possible neurological impairment (LE2). Therefore, this strategy is not recommended (grade A). Rescue courses are only associated with neonatal respiratory benefits (LE2). Because of the possible adverse effects associated with this strategy when delivery occurs during the 24hours following the first injection and because of the doubts raised by repeated courses, rescue courses are not recommended (Professional consensus). It is not possible to recommend one corticosteroid (betamethasone or dexamethasone) over another (Professional consensus). In case of contraindication for the intramuscular (IM) route, the intravenous route might be proposed (Professional consensus). The oral route is not recommended (grade A) because of increased rates of IVH and neonatal sepsis in comparison with the IM route (LE1). Either betamethasone as 2 injections of 12mg 24hours apart or dexamethasone as 4 injections of 6mg 12hours apart is recommended (grade A). Antenatal corticosteroid-induced alterations of fetal heart rate and movements should be recognized by the care providers of women at risk of preterm birth to avoid unjustified decision of labor induction or cesarean (Professional consensus). Gestational diabetes and pre-existing diabetes are not contraindication to antenatal corticosteroid therapy (Professional consensus). However, caution should be exercised in women with poorly controlled type 1 diabetes (Professional consensus). The apprehension to provoke maternal or neonatal infection should not delay antenatal corticosteroid administration even in case of preterm premature rupture of membranes (grade A). Antenatal corticosteroid administration is recommended to every woman at risk of preterm delivery before 34 weeks of gestation (grade A). Repeated courses of antenatal corticosteroids are

  11. Retrospective evaluation of risk factors and perinatal outcome of umbilical cord prolapse during labor.

    Science.gov (United States)

    Kaymak, O; Iskender, C; Ibanoglu, M; Cavkaytar, S; Uygur, D; Danisman, N

    2015-07-01

    Umbilical cord prolapse has a reported prevalence of 0.1-0.6%. In previous studies, risk factors for umbilical prolapse have been identified as multiparity, preterm delivery, non-vertex presentation, and obstetric manipulation for labor induction. In the present study, we aimed to investigate the risk factors for umbilical cord prolapse and to determine the factors that may relate to neonatal morbidity in these patients. This study consisted of recorded cases of umbilical cord prolapse at Dr Zekai Tahir Burak Research and Training Hospital between January 2008 and May 2013. Clinical and demographic data were obtained by reviewing the patients' medical records. Student's t test was performed for parametric variables between groups, and a Chi-square test was performed for nonparametric variables between groups. A logistic regression was performed to investigate the effects of clinical parameters such as gestational age, diagnosis to delivery interval, and fetal presentation on neonatal morbidity. The patients with umbilical cord prolapse during labor had higher rates of preterm deliveries, low-birth-weight infants, and non-vertex presentations than the control group did. Preterm delivery, non-vertex presentation, presence of polyhydramnios, and spontaneous membrane rupture increased the risk of umbilical cord prolapse significantly. In the regression analysis, gestational age and diagnosis to delivery interval greater than 10 minutes predicted adverse neonatal outcomes independently. Umbilical cord prolapse is more common in cases of preterm delivery, non-vertex fetal presentation, and spontaneous rupture of membranes. A diagnosis to delivery interval greater than ten minutes is independently associated with an adverse neonatal outcome.

  12. Does labor market history matter?

    DEFF Research Database (Denmark)

    Lesner, Rune Vammen

    2014-01-01

    This paper finds that labor market history plays an important role in the Danish labor market both by directly affecting the transitions between labor market states and indirectly through the wage. When comparing the relative importance of different types of state dependence, it is found...... that occurrence dependence from non-employment states seems to have the strongest effect on the employment rate, while employment history is the main driver of state dependence in the wage. Predictions based on the estimated model reveal potential negative long-term effects from external employment shocks...

  13. Recurrence risk of preterm birth in subsequent singleton pregnancy after preterm twin delivery

    NARCIS (Netherlands)

    Schaaf, Jelle M.; Hof, Michel H. P.; Mol, Ben Willem J.; Abu-Hanna, Ameen; Ravelli, Anita C. J.

    2012-01-01

    OBJECTIVE: The purpose of this study was to investigate the recurrence risk of preterm birth ( <37 weeks' gestation) in a subsequent singleton pregnancy after a previous nulliparous preterm twin delivery. STUDY DESIGN: We included 1957 women who delivered a twin gestation and a subsequent singleton

  14. Brazilian multicentre study on preterm birth (EMIP: prevalence and factors associated with spontaneous preterm birth.

    Directory of Open Access Journals (Sweden)

    Renato Passini

    Full Text Available BACKGROUND: Preterm birth rate is increasing and is currently a worldwide concern. The purpose of this study was to estimate the prevalence of preterm birth in a sample of health facilities in Brazil and to identify the main risk factors associated with spontaneous preterm births. METHODS AND FINDINGS: This was a multicentre cross sectional study on preterm births in 20 referral obstetric hospitals with a case-control component to identify factors associated with spontaneous preterm birth. Surveillance was implemented at all centres to identify preterm births. For eligible consenting women, data were collected through a post-delivery questionnaire completed with information from all mother-newborn medical records until death or discharge or at a maximum of 60 days post-delivery, whichever came first. The risk of spontaneous preterm birth was estimated with OR and 95%CI for several predictors. A non-conditional logistic regression analysis was then performed to identify independently associated factors. The overall prevalence of preterm birth was 12.3%. Among them, 64.6% were spontaneous and 35.4% therapeutic. In the case-control component, 2,682 spontaneous preterm births were compared to a sample of 1,146 term births. Multivariate analyses identified the following as risk factors for spontaneous preterm birth among women with at least one previous birth: a previous preterm birth (ORadj = 3.19, 2.30-4.43, multiple pregnancy (ORadj = 29.06, 8.43-100.2, cervical insufficiency (ORadj = 2.93, 1.07-8.05, foetal malformation (ORadj = 2.63, 1.43-4.85, polyhydramnios (ORadj = 2.30, 1.17-4.54, vaginal bleeding (ORadj = 2.16, 1.50-3.11, and previous abortion (ORadj = 1.39, 1.08-1.78. High BMI (ORadj = 0.94, 0.91-0.97 and weight gain during gestation (ORadj = 0.92, 0.89-0.95 were found to be protective factors. CONCLUSIONS: The preterm birth rate in these health facilities in Brazil is high and spontaneous preterm births

  15. Cell-associated interleukin-8 in cord blood of term and preterm infants.

    Science.gov (United States)

    Dembinski, J; Behrendt, D; Heep, A; Dorn, C; Reinsberg, J; Bartmann, P

    2002-03-01

    To assess the effect of gestational age and labor on the interleukin-8 (IL-8) concentration in whole cord blood and serum, IL-8 levels were determined simultaneously in cord blood serum and lysate in 134 infants. Following the elimination of some of the samples due to exclusion criteria, the data for 99 uninfected infants (71 term and 28 preterm) and 9 infants with neonatal bacterial infection delivered either vaginally or by elective or emergency cesarean section were analyzed. The effects of labor and gestational age were tested by analysis of variance. IL-8 was not detectable in the serum of 25 infants, whereas IL-8 levels in whole blood were measurable in all of the samples. The median IL-8 conncentrations in whole cord blood lysate were 106 pg/ml (range, 20 to 415 pg/ml) in preterm infants and 176 pg/ml (range, 34 to 1,667 pg/ml) in term infants. In contrast to the IL-8 levels in serum, IL-8 levels in whole blood were reduced after ECS. Gestational age had no independent effect on the IL-8 concentrations in either serum or whole blood; these concentrations increased in infected infants after labor. We conclude that the neonatal proinflammatory response to labor stress was more evident in the concentrations of IL-8 in whole blood than in serum. The levels of IL-8 in whole-blood lysate reflect proinflammatory stimulation in neonates and may be a useful diagnostic tool for the early diagnosis of neonatal infection.

  16. Smoking, Labor, & Delivery: It's Complicated

    Science.gov (United States)

    You probably have mixed feelings about going into labor. On one hand, bringing a new life into the world is really exciting. On the other, it can be really scary to have a baby, especially if this is your first child. Unfortunately, it can be even scarier if you smoke. Research shows that smoking during pregnancy can lead to serious complications for you and your baby during labor and delivery.

  17. [Prevention of spontaneous preterm birth in asymptomatic twin pregnancies].

    Science.gov (United States)

    Sentilhes, L; Bouhours, A-C; Bouet, P-E; Boussion, F; Biquard, F; Gillard, P; Descamps, P

    2009-12-01

    To determine prenatal methods to predict and prevent spontaneous preterm birth in asymptomatic twin pregnancies. Articles were searched using PubMed, Embase and Cochrane library. Uterine activity monitoring and bacterial vaginosis screening are not useful to predict preterm birth (EL2 and EL3 respectively). Current literature data are contradictory and insufficient to determine whether fetal fibronectin and digital cervical assessment are predictors of preterm birth. History of preterm birth (EL4), and cervical length measurement by transvaginal ultrasonography (EL2) predict preterm birth. Nevertheless, there are no intervention studies that have evaluated cervical length measurement in the prevention of preterm birth. Hospital bedrest, prophylactic tocolytic and progesterone therapy, and prophylactic cervical cerclage in patients with or without short cervix have not been shown to be effective in preventing preterm birth. Prenatal methods to prevent spontaneous preterm birth in asymptomatic twin pregnancies are currently very limited. Copyright © 2009 Elsevier Masson SAS. All rights reserved.

  18. The immune consequences of preterm birth

    Directory of Open Access Journals (Sweden)

    Jacqueline M Melville

    2013-05-01

    Full Text Available Preterm birth occurs in 11% of live births globally and accounts for 35% of all newborn deaths. Preterm newborns have immature immune systems, with reduced innate and adaptive immunity; their immune systems may be further compromised by various factors associated with preterm birth.The immune systems of preterm infants have a smaller pool of monocytes and neutrophils, impaired ability of these cells to kill pathogens, and lower production of cytokines which limits T cell activation and reduces the ability to fight bacteria and detect viruses in cells, compared to term infants.Intrauterine inflammation is a major contributor to preterm birth, and causes premature immune activation and cytokine production. This can induce immune tolerance leading to reduced newborn immune function. Intrauterine inflammation is associated with an increased risk of early-onset sepsis and likely has long-term adverse immune consequences.Requisite medical interventions further impact on immune development and function. Antenatal corticosteroid treatment to prevent newborn respiratory disease is routine but may be immunosuppressive, and has been associated with febrile responses, reductions in lymphocyte proliferation and cytokine production, and increased risk of infection. Invasive medical procedures result in an increased risk of late-onset sepsis. Respiratory support can cause chronic inflammatory lung disease associated with increased risk of long-term morbidity.Colonisation of the infant by microorganisms at birth is a significant contributor to the establishment of the microbiome. Caesarean section affects infant colonisation, potentially contributing to lifelong immune function and wellbeing.Several factors associated with preterm birth alter immune function. A better understanding of perinatal modification of the preterm immune system will allow for the refinement of care to minimise lifelong adverse immune consequences.

  19. Group B Streptococcus Positive Culture’s Results in Pregnants with Preterm Premature Rupture of Membranes

    Directory of Open Access Journals (Sweden)

    Farzaneh Broomand

    2008-09-01

    Full Text Available Objective: Preterm premature rupture of membranes (PPROM occurs in 2% of all pregnancies. The aim of this study was to compare positive cultures of GBS in two groups of pregnant women.Materials and methods: This case control research was conducted on 242 pregnant women: first group was consisted of 117 pregnant with PPROM and gestational ages between 26-37 weeks; second group was consisted of 125 term pregnant women with intact membranes and before onset of labor. Rectovaginal and urine samples were studied using specific culture medium of GBS, "Todd Hewitt Broth". The percentage of positive results was calculated using odds ratio and chi-square test.Results: GBS cultures were positive in 20 cases (17% in PPROM group and 5 cases in group of term pregnant (4% (Odds ratio=4.95 CI= 1.79-13.67, p=0.001. Past history of preterm labor and neonate hospitalization were more common in PPROM group but without any significant relationship to positive cultures.Conclusion: Our study showed significant difference of GBS colonization rate between two groups (p=0.001. According to CDC and ACOG guidelines routine screening and treatment of positive cases are indicated.

  20. Fetal adrenal gland volume and preterm birth: a prospective third-trimester screening evaluation.

    Science.gov (United States)

    Hoffman Sage, Yael; Lee, Lydia; Thomas, Ann M; Benson, Carol B; Shipp, Thomas D

    2016-01-01

    Given the importance of the fetal adrenal gland in producing hormones critical to labor, we sought to evaluate whether sonographic three-dimensional measurements of the adrenal gland are a useful screening tool for spontaneous preterm birth (SPTB). We prospectively screened 128 non-anomalous singletons from 24 to 36 weeks' gestation with volumetric measurements of the fetal adrenal gland at their indicated antenatal sonogram. Labor and delivery outcomes were assessed and compared with respect to adrenal volume. When corrected for estimated fetal weight, the 11 women (9%) who delivered following SPTB had smaller adrenals than those who did not, 0.33 cm(3)/kg compared with 0.57 cm(3)/kg, respectively (p = 0.006). There was no difference in volumes between those who delivered by SPTB within 7 days or greater than 14 days from measurement (0.34 cm(3)/kg versus 0.33 cm(3)/kg, p = 0.79). Among women at increased risk of SPTB, those with SPTB had smaller adrenals than those who did not: 0.32 cm(3)/kg versus 0.53 cm(3)/kg, p = 0.06. We found fetal adrenal glands significantly smaller for those delivering preterm. Given the prior literature and our asymptomatic population, our data support multiple pathways leading to SPTB.

  1. Why Should We Care about Child Labor? The Education, Labor Market, and Health Consequences of Child Labor

    Science.gov (United States)

    Beegle, Kathleen; Dehejia, Rajeev; Gatti, Roberta

    2009-01-01

    Despite the extensive literature on the determinants of child labor, the evidence on the consequences of child labor on outcomes such as education, labor, and health is limited. We evaluate the causal effect of child labor participation among children in school on these outcomes using panel data from Vietnam and an instrumental variables strategy.…

  2. Effect of sitting position on respiratory status in preterm infants.

    Science.gov (United States)

    Shiraishi, Mika; Hirasawa, Kyoko; Shimizu, Satoru; Nishida, Hiroshi; Osawa, Makiko

    2009-01-01

    To evaluate whether using a sitting-type car safety seats for preterm infants is advisable. A total of 65 preterm infants underwent polysomnography in the supine and sitting positions. The infants with position were suspected to cause DS in infants. Sitting-type car safety seats should be used with caution for preterm infants, and all preterm infants need to be screened by polysomnographic examination in the sitting position.

  3. Thymic size in preterm neonates: a sonographic study

    DEFF Research Database (Denmark)

    Jeppesen, Dorthe Lisbeth; Hasselbalch, H; Poulsen, Susanne Dam

    2003-01-01

    AIM: To assess the variation in size of the thymus in vivo in preterm neonates and to identify relations between thymic size and gestational age (GA), birthweight, occurrence of postnatal infections and maternal alcohol and tobacco intake during pregnancy. METHODS: Eighty preterm neonates with a GA...... neonates. A normal range for Ti in preterm neonates has been established. The sonographic method is a safe and effective technique for measuring the size of the thymus in preterm infants....

  4. Occupational lifting of heavy loads and preterm birth:

    DEFF Research Database (Denmark)

    Runge, Stine Bjerrum; Pedersen, Jacob Krabbe; Svendsen, Susanne Wulff

    2013-01-01

    To examine the association between occupational lifting during pregnancy and preterm birth. The risk of preterm birth was estimated for total burden lifted per day and number of medium and heavy loads lifted per day.......To examine the association between occupational lifting during pregnancy and preterm birth. The risk of preterm birth was estimated for total burden lifted per day and number of medium and heavy loads lifted per day....

  5. Maternal and fetal factors observed with late preterm births

    OpenAIRE

    Madhusudan Dey; Raju Agarwal; Devkalyan Maji; Uttara A. Kohli

    2015-01-01

    Backround: Although neonatal morbidity and mortality rates are fallen in recent decades, the prevalence of preterm deliveries has increased especially late preterm births. Late preterm deliveries are at increased risk of various neonatal complications compared to term deliveries. This study was carried out to identify the maternal characteristics and co-morbidites found with late preterm births and feto-maternal outcome in terms of indication of delivery, route of delivery, Apgar score and...

  6. Systematic identification of spontaneous preterm birth-associated RNA transcripts in maternal plasma.

    Directory of Open Access Journals (Sweden)

    Stephen S C Chim

    Full Text Available BACKGROUND: Spontaneous preterm birth (SPB, before 37 gestational weeks is a major cause of perinatal mortality and morbidity, but its pathogenesis remains unclear. Studies on SPB have been hampered by the limited availability of markers for SPB in predelivery clinical samples that can be easily compared with gestational age-matched normal controls. We hypothesize that SPB involves aberrant placental RNA expression, and that such RNA transcripts can be detected in predelivery maternal plasma samples, which can be compared with gestational age-matched controls. PRINCIPAL FINDINGS: Using gene expression microarray to profile essentially all human genes, we observed that 426 probe signals were changed by >2.9-fold in the SPB placentas, compared with the spontaneous term birth (STB placentas. Among the genes represented by those probes, we observed an over-representation of functions in RNA stabilization, extracellular matrix binding, and acute inflammatory response. Using RT-quantitative PCR, we observed differences in the RNA concentrations of certain genes only between the SPB and STB placentas, but not between the STB and term elective cesarean delivery placentas. Notably, 36 RNA transcripts were observed at placental microarray signals higher than a threshold, which indicated the possibility of their detection in maternal plasma. Among them, the IL1RL1 mRNA was tested in plasma samples taken from 37 women. It was detected in 6 of 10 (60% plasma samples collected during the presentation of preterm labor (≤32.9 weeks in women eventually giving SPB, but was detected in only 1 of 27 (4% samples collected during matched gestational weeks from women with no preterm labor (Fisher exact test, p = 0.00056. CONCLUSION: We have identified 36 SPB-associated RNA transcripts, which are possibly detectable in maternal plasma. We have illustrated that the IL1RL1 mRNA was more frequently detected in predelivery maternal plasma samples collected from women

  7. Preterm premature rupture of the fetal membranes: association with sociodemographic factors and maternal genitourinary infections.

    Science.gov (United States)

    Hackenhaar, Arnildo A; Albernaz, Elaine P; da Fonseca, Tânia M V

    2014-01-01

    this study aimed to investigate the incidence of premature rupture of fetal membranes in preterm singleton pregnancies and its association with sociodemographic factors and maternal self-reported genitourinary infections. this was a population-based cross-sectional study, which included all mothers of newborns of singleton deliveries that occurred in 2010, with birth weight ≥ 500 grams, who resided in the city of Rio Grande. Women were interviewed in the two maternity hospitals. Cases were women who had lost amniotic fluid before hospitalization and whose gestational age was less than 37 weeks. Statistical analysis was performed by levels to control for confounding factors using Poisson regression. of the 2,244 women eligible for the study, 3.1% had preterm premature rupture of fetal membranes, which was more frequent, after adjustment, in women of lower socioeconomic status, (prevalence ratio [PR]=1.94), with lower level of schooling (PR=2.43), age > 29 years (PR=2.49), and smokers (PR=2.04). It was also associated with threatened miscarriage (PR=1.68) and preterm labor, (PR=3.40). There was no association with maternal urinary tract infection or presence of genital discharge. the outcome was more common in puerperal women with lower level of schooling, lower socioeconomic status, older, and smokers, as well as those with a history of threatened miscarriage and premature labor. These factors should be considered in the prevention, diagnosis, and therapy approach. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  8. Singleton preterm births in Korle bu teaching hospital, Accra, Ghana ...

    African Journals Online (AJOL)

    Objective: To determine the singleton preterm birth rate, the relative proportions of the clinical categories of preterm births and to compare the outcomes in these categories. Setting: Department of Obstetrics & Gynaecol-ogy, Korle Bu Teaching Hospital. Participants: Preterm births from 1st July to 31st December 2003.

  9. Risk assessment and management to prevent preterm birth

    NARCIS (Netherlands)

    Koullali, B.; Oudijk, M. A.; Nijman, T. A. J.; Mol, B. W. J.; Pajkrt, E.

    2016-01-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history

  10. Antibiotics after preterm premature rupture of the membranes.

    Science.gov (United States)

    Singh, Katherine; Mercer, Brian

    2011-06-01

    Preterm premature rupture of the membranes remains a common cause of preterm deliveries and neonatal morbidities. The goal of this study is to review the evidence with regard to the antibiotic treatment after preterm premature rupture of the membranes, long-term outcomes related to antibiotic treatment, and possible complications with treatment. Future research goals are also discussed.

  11. Early postnatal calcium and phosphorus metabolism in preterm infants

    NARCIS (Netherlands)

    Christmann, Viola; de Grauw, Anne M.; Visser, Reina; Matthijsse, René P.; van Goudoever, Johannes B.; van Heijst, Arno F. J.

    2014-01-01

    Bone mineralisation in preterm infants is related to the supply of calcium (Ca) and phosphorus (P). We increased the amount of minerals in parenteral nutrition (PN) for preterm infants and evaluated postnatal Ca and P metabolism in relation to mineral and vitamin D (vitD) intake. Preterm infants,

  12. Vaginal progesterone combined with cervical pessary: A chance for pregnancies at risk for preterm birth?

    Science.gov (United States)

    Stricker, Nathanael; Timmesfeld, Nina; Kyvernitakis, Ioannis; Goerges, Janina; Arabin, Birgit

    2016-06-01

    Precocious cervical ripening, as defined by cervical shortening on transvaginal sonography, has prompted a broad evaluation of secondary strategies (such as cerclage, vaginal progesterone, or a cervical pessary) to prevent preterm delivery. However, there is still a lack of direct comparisons between individual treatments or their combinations. We sought to compare at-risk patients and screening patients who had been treated with cervical pessary alone with patients who had been treated with pessary plus vaginal progesterone. This is a pre- and postintervention cohort study from a preterm labor clinic where placement of a cervical pessary has been the standard treatment since 2008 for at-risk women defined by (1) a history of spontaneous preterm birth at suppositories) was prescribed in addition to the pessary. Both at-risk patients (n = 55) and screening patients (n = 51) were treated at the time of diagnosis. The primary outcome was the rate of preterm deliveries at <34 weeks of gestation. Secondary outcomes included deliveries at <28, <32, and <37 weeks of gestation, the days from start of therapy until delivery, a composite index of neonatal outcome, and the number of days in the neonatal intensive care unit. Primary and secondary outcomes were compared between groups with the use of multivariable models to adjust for possible confounders. Delivery at <34 weeks of gestation occurred in 17 of 53 patients (32.1%) who were treated with pessary plus progesterone, compared with 13 of 53 patients (24.5%) who were treated with pessary alone (P = .57). Similarly, there was no difference in the rate of preterm delivery at <28, <32, or <37 weeks of gestation. The composite poor neonatal outcome was 15.1% in the pessary group vs 18.9% in the combined group (P = .96). The mean duration of stay in the neonatal intensive care unit was 46.5 days (range, 9-130 days) in the combined vs 52.0 days (range, 3-151 days) in the pessary group (P < .001). In this cohort study

  13. [Prevention of spontaneous preterm birth (excluding preterm premature rupture of membranes): Guidelines for clinical practice - Text of the Guidelines (short text)].

    Science.gov (United States)

    Sentilhes, L; Sénat, M-V; Ancel, P-Y; Azria, E; Benoist, G; Blanc, J; Brabant, G; Bretelle, F; Brun, S; Doret, M; Ducroux-Schouwey, C; Evrard, A; Kayem, G; Maisonneuve, E; Marcellin, L; Marret, S; Mottet, N; Paysant, S; Riethmuller, D; Rozenberg, P; Schmitz, T; Torchin, H; Langer, B

    2016-12-01

    To determine the measures to prevent spontaneous preterm birth (excluding preterm premature rupture of membranes)and its consequences. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. In France, premature birth concerns 60,000 neonates every year (7.4 %), half of them are delivered after spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated to a decrease of prematurity (level of evidence [LE] 1). This is therefore recommended (grade A). Routine screening and treatment of vaginal bacteriosis in general population is not recommended (grade A). Asymptomatic women with single pregnancy without history of preterm delivery and a short cervix between 16 and 24 weeks is the only population in which vaginal progesterone is recommended (grade B). A history-indicated cerclage is not recommended in case of only past history of conisation (grade C), uterine malformation (Professional consensus), isolated history of pretem delivery (grade B) or twin pregnancies in primary (grade B) or secondary (grade C) prevention of preterm birth. A history-indicated cerclage is recommended for single pregnancy with a history of at least 3 late miscarriages or preterm deliveries (grade A).). In case of past history of a single pregnancy delivery before 34 weeks gestation (WG), ultrasound cervical length screening is recommended between 16 and 22 WG in order to propose a cerclage in case of lengthpremature rupture of membranes. Maintenance tocolysis is not recomended (grade B). Antenatal corticosteroid administration is recommended to every woman at risk of preterm delivery before 34 weeks of gestation (grade A). After 34 weeks, evidences are not consistent enough to recommend systematic antenatal corticosteroid treatment (grade B), however, a course might be indicated in the clinical situations associated with the

  14. Optimising preterm nutrition: present and future

    LENUS (Irish Health Repository)

    Brennan, Ann-Marie

    2016-04-01

    The goal of preterm nutrition in achieving growth and body composition approximating that of the fetus of the same postmenstrual age is difficult to achieve. Current nutrition recommendations depend largely on expert opinion, due to lack of evidence, and are primarily birth weight based, with no consideration given to gestational age and\\/or need for catch-up growth. Assessment of growth is based predominately on anthropometry, which gives insufficient attention to the quality of growth. The present paper provides a review of the current literature on the nutritional management and assessment of growth in preterm infants. It explores several approaches that may be required to optimise nutrient intakes in preterm infants, such as personalising nutritional support, collection of nutrient intake data in real-time, and measurement of body composition. In clinical practice, the response to inappropriate nutrient intakes is delayed as the effects of under- or overnutrition are not immediate, and there is limited nutritional feedback at the cot-side. The accurate and non-invasive measurement of infant body composition, assessed by means of air displacement plethysmography, has been shown to be useful in assessing quality of growth. The development and implementation of personalised, responsive nutritional management of preterm infants, utilising real-time nutrient intake data collection, with ongoing nutritional assessments that include measurement of body composition is required to help meet the individual needs of preterm infants.

  15. Palivizumab use in preterm neonates.

    LENUS (Irish Health Repository)

    Kingston, S

    2012-01-31

    Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis in infants. Palivizumab is an immunoprophylactic agent for RSV prevention in preterm infants and those with neonatal chronic lung disease. This study examines its use across neonatal units in Ireland. A questionnaire was administered to one Consultant Neonatologist or Paediatrician in each of the 20 maternity centres in Ireland about their guidelines for Palivizumab administration. There is variation in administration of Palivizumab with little consistency found between protocols reported in terms of age and presence of chronic lung disease. Ten centres have in house protocols, 3 centres use the American Academy of Paediatrics (AAP) guidelines, 2 centres prefer the UK Joint Committee on Vaccination and Immunisation (JCVI) guidelines and 3 centres do not have a set protocol. Four participants felt its use has impacted on hospital admissions and 61% believe its use is cost effective. The budgetary implication for immunoprophylaxis with Palivizumab in Ireland is estimated at 1.5 to 2 million euros annually. Given current pharmacoeconomic constraints there is a need to implement a national protocol on RSV immunoprophylaxis.

  16. Palivizumab use in preterm neonates.

    LENUS (Irish Health Repository)

    Kingston, S

    2010-05-01

    Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis in infants. Palivizumab is an immunoprophylactic agent for RSV prevention in preterm infants and those with neonatal chronic lung disease. This study examines its use across neonatal units in Ireland. A questionnaire was administered to one Consultant Neonatologist or Paediatrician in each of the 20 maternity centres in Ireland about their guidelines for Palivizumab administration. There is variation in administration of Palivizumab with little consistency found between protocols reported in terms of age and presence of chronic lung disease. Ten centres have in house protocols, 3 centres use the American Academy of Paediatrics (AAP) guidelines, 2 centres prefer the UK Joint Committee on Vaccination and Immunisation (JCVI) guidelines and 3 centres do not have a set protocol. Four participants felt its use has impacted on hospital admissions and 61% believe its use is cost effective. The budgetary implication for immunoprophylaxis with Palivizumab in Ireland is estimated at 1.5 to 2 million euros annually. Given current pharmacoeconomic constraints there is a need to implement a national protocol on RSV immunoprophylaxis.

  17. [Trends in labor medicine in Mexico].

    Science.gov (United States)

    Nava-Hernández, Rodolfo

    2010-01-01

    Labor medicine is the natural field for searching the relation between society, work and disease. It is also the field for preventing labor diseases, and for the application resulting from search as protection measures in the laboral services. At present, tendencies in laboral medicine services are multidisciplinary where the specialists need to development competences in epidemiology, clinics, investigation, toxicology, dermatology and many other fields.

  18. Child Labor, Learning Problems, and Poverty

    Science.gov (United States)

    Taylor, Mark

    2017-01-01

    In Africa, approximately 80 million children are working. Africa's 41% child labor rate is nearly twice as high as that in Asia. This study examined whether child labor is a direct result of poverty or of reading and math problems in school. The study analyzed reading and math scores of 62 child laborers and 62 non-child laborers from a farming…

  19. 10 CFR 440.19 - Labor.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Labor. 440.19 Section 440.19 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION WEATHERIZATION ASSISTANCE FOR LOW-INCOME PERSONS § 440.19 Labor. Payments for labor costs under § 440.18(c)(2) must consist of: (a) Payments permitted by the Department of Labor to...

  20. Prone position and reduced thoracoabdominal asynchrony in preterm newborns.

    Science.gov (United States)

    Oliveira, Trícia G; Rego, Maria A S; Pereira, Nadja C; Vaz, Lorena O; França, Danielle C; Vieira, Danielle S R; Parreira, Verônica F

    2009-01-01

    To assess the effect of prone and supine positions on breathing pattern variables, thoracoabdominal motion and peripheral oxygen saturation of hemoglobin of premature newborn infants recovering from respiratory distress syndrome, while breathing spontaneously and in rapid eye movement sleep. This was a quasi-experimental study. Twelve preterms weighing > 1,000 g at enrollment were studied in both positions, in random order. Respiratory inductive plethysmography was used to analyze breathing pattern (tidal volume, respiratory rate, minute ventilation, mean inspiratory flow) and thoracoabdominal motion (labored breathing index, phase relation in inspiration, phase relation in expiration, phase relation in total breath and phase angle). Pulse oximetry was used to evaluate peripheral oxygen saturation. Student's t test for paired samples or the Wilcoxon test were used for statistical analysis. Significance was set at p position was associated with significant reductions in labored breathing index (-0.84+/-0.69; p = 0.001; 95%CI -1.29 to -0.40), phase relation in inspiration (-27.36+/-17.55; p = 0.000; 95%CI -38.51 to -16.20), phase relation in expiration (-32.36+/-16.20; p = 0.000; 95%CI -42.65 to -22.06) and phase relation in total breath (-30.20+/-14.76; p = 0.000; 95%CI -39.59 to -20.82). There were no significant differences between the two positions in any of the other variables analyzed. The prone position resulted in a significant reduction in thoracoabdominal asynchrony, without affecting breathing pattern or peripheral oxygen saturation.

  1. Changes in perinatal care and survival in very preterm and extremely preterm infants in the Netherlands between 1983 and 1995

    NARCIS (Netherlands)

    Anthony, S.; Ouden, L.D.; Brand, R.; Verloove-Vanhorick, P.; Gravenhorst, J.B.

    2004-01-01

    Objective: To evaluate changes in obstetrical and neonatal care for very preterm and extremely preterm infants between 1983 and 1995 in The Netherlands and to evaluate the effect of those changes. Study design: Data on all very preterm or VLBW infants from the linked national obstetrical and

  2. Stability of Developmental Problems after School Entry of Moderately-Late Preterm and Early Preterm-Born Children

    NARCIS (Netherlands)

    Hornman, Jorijn; de Winter, Andrea F; Kerstjens, Jorien M; Bos, Arend F; Reijneveld, Sijmen A

    OBJECTIVE: To assess the stability of developmental problems in moderately-late preterm-born children compared with early preterm and full term-born children before school entry at age 4 years and 1 year after school entry at age 5 years. STUDY DESIGN: We included 376 early preterm, 688 born

  3. Maternal obesity is associated with chorioamnionitis and earlier indicated preterm delivery among expectantly managed women with preterm premature rupture of membranes.

    Science.gov (United States)

    Hadley, Emily E; Discacciati, Andrea; Costantine, Maged M; Munn, Mary B; Pacheco, Luis D; Saade, George R; Chiossi, Giuseppe

    2017-09-22

    To determine the association between maternal obesity and delivery due to chorioamnionitis prior to labor onset, among expectantly managed women with preterm premature rupture of membranes (pPROM). This was a secondary analysis of a multicenter randomized trial of magnesium sulfate versus placebo to prevent cerebral palsy or death among offspring of women with anticipated delivery at 24-31-week gestation. After univariable analysis, Cox proportional hazard evaluated the association between maternal obesity and chorioamnionitis, while Laplace regression investigated how obesity affects the gestational age at delivery of the first 20% of women developing the outcome of interest. A total of 164 of the 1942 women with pPROM developed chorioamnionitis prior to labor onset. Obese women had a 60% increased hazard of developing such complication (adjusted HR 1.6, 95%CI 1.1-2.1, p = .008), prompting delivery 1.5 weeks earlier, as the 20th survival percentile was 27.2-week gestation (95%CI 26-28.6) among obese as opposed to 28.8 weeks (95%CI 27.4-30.1) (p = .002) among nonobese women. Maternal obesity is a risk factor for chorioamnionitis prior to labor onset. Future studies will determine if obesity is important enough to change the management of latency after pPROM according to maternal BMI.

  4. Early vs delayed clamping of the umbilical cord in full term, preterm and very preterm infants

    DEFF Research Database (Denmark)

    Moller, N.K.; Weber, T.

    2008-01-01

    Randomized studies from 2006 and two meta-analyses published in 2007 agree that clamping of the umbilical cord can be delayed. For the preterm and very preterm infant benefits include less need for blood transfusion and less morbidity, especially for the very preterm male infant. For the term inf...... infant benefits include improved hematologic status measured as hematocrit and iron status and less risk of anaemia during the first months of life. No harmful effects were seen, even though significant polycythaemia could be demonstrated Udgivelsesdato: 2008/5/26...

  5. Atosiban in the Management of Preterm Labour

    Directory of Open Access Journals (Sweden)

    Gail M Fullerton

    2011-01-01

    Full Text Available The purpose of this review was to look at the evidence available for the use of atosiban as a tocolytic in cases of threatened preterm labour. A Royal College of Obstetricians and Gynaecologists Green Top Guideline concluded that there was no clear evidence to show a benefit to tocolysis in reducing perinatal and neonatal morbidity and mortality. Using a systematic literature search, we summarise the evidence available on the use of atosiban for the prevention of preterm birth and compare it with other commonly used tocolytic agents in terms of efficacy, patient preference and drug safety. We conclude that although atosiban appears to be the tocolytic of choice, a clear benefit of using tocolysis in all cases of threatened preterm labour remains to be justified and clinical management should be tailored according to individual needs.

  6. Prognostic accuracy of electroencephalograms in preterm infants

    DEFF Research Database (Denmark)

    Fogtmann, Emilie Pi; Plomgaard, Anne Mette; Greisen, Gorm

    2017-01-01

    CONTEXT: Brain injury is common in preterm infants, and predictors of neurodevelopmental outcome are relevant. OBJECTIVE: To assess the prognostic test accuracy of the background activity of the EEG recorded as amplitude-integrated EEG (aEEG) or conventional EEG early in life in preterm infants...... for predicting neurodevelopmental outcome. DATA SOURCES: The Cochrane Library, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: We included observational studies that had obtained an aEEG or EEG within 7 days of life in preterm infants and reported...... neurodevelopmental outcomes 1 to 10 years later. DATA EXTRACTION: Two reviewers independently performed data extraction with regard to participants, prognostic testing, and outcomes. RESULTS: Thirteen observational studies with a total of 1181 infants were included. A metaanalysis was performed based on 3 studies...

  7. Survival pattern among extreme preterm infants.

    Science.gov (United States)

    Manzar, S

    2000-02-01

    To look at the survival pattern of extreme preterm Omani infants (23-26 weeks gestation) and compare it with the western countries. All extreme preterm Omani infants (gestational age of 23 to 26 weeks) admitted from November 1991 to February 1998 at the Neonatal Intensive Care Unit of Sultan Qaboos University Hospital were reviewed. The detailed records of the infants, including name of mother, age, gravidity, parity, route of delivery, Apgar score, time of birth, inborn or outborn, birth weight, gestational age, sex, need for resuscitation, course in the Neonatal Intensive Care Unit, admission and discharge diagnosis, and outcome were collected from the register. The infants were stratified according to the gestational age and then analyzed for the survival rate among the different gestational ages. A total of 32 extreme preterm infants were admitted to the Neonatal Intensive Care Unit of Sultan Qaboos University Hospital from November 1991 to February 1998. The mean birth weight of the cohort was noted to be 798+123 gram (Range 480-1015 grams). The mean gestational age was noted to be 25.5+0.95 weeks (Range 23-26 weeks). An equal number of males and females were noted in the cohort, with male to female ratio of 1:1. A total of 13 infants survived out of 32 infants. The overall survival rate for the cohort was noted to be 41%. For the present study, the western statistics are averaged and than compared with the Omani statistics. The survival rate for western 26 week preterm infants was (on average) 61% as compared to 44% among Omani preterm infants. The same trend of low survival was noted for 23 and 24 week Omani infants, except for only one 25 week infant. The significant lower survival rate suggests the need for more attention and improvement in the management and care provided to the extreme preterm Omani infants.

  8. Emotional labor in nursing praxis

    Directory of Open Access Journals (Sweden)

    José Manuel da Silva Vilelas

    Full Text Available Healthcare work is, by nature, an activity full of intense emotions and therefore, is opportune ground for exploring emotions in the workplace in different contexts of nursing care. It is a very fertile terrain if care is focused on the emotions of the client, nurses, healthcare teams, and on the interaction of all actors involved. This article presents a theoretical reflection exploring the concept of emotional labor in the context of nursing care. Theoretical references from several fields of knowledge, namely sociology and nursing, have been adopted to conceptualize the theme. Studies on emotional labor have contributed toward the understanding of the key issue of emotional management in healthcare institutions and both its positive and negative impact on clients and professionals. The development of the theme of emotional labor in nursing has given rise to numerous theoretical approaches and perspectives explaining this concept.

  9. Magnesium Sulfate and Betamethasone Reduce NUR77 Expression in a Preterm Labor Mouse Model

    Science.gov (United States)

    2016-06-29

    of Obstetrics & Gynecology , Division of Maternal Fetal Medicine 2. Department of Clinical Investigation Madigan Army Medical Center, Tacoma W A, USA...3. Department of Obstetrics & Gynecology , Division ofMaternal Fetal Medicine Naval Medical Center San Diego, CA, USA ABSTRACT Objective: Women in...with LPS injury (19) (Figure 2. * denote pɘ.05). Although all genes examined showed increases, only Plpl , Ill b, and Tlr4 were significantly

  10. Hypnotherapy for labor and birth.

    Science.gov (United States)

    Beebe, Kathleen R

    2014-01-01

    Hypnotherapy is an integrative mind-body technique with therapeutic potential in various health care applications, including labor and birth. Evaluating the efficacy of this modality in controlled studies can be difficult, because of methodologic challenges, such as obtaining adequate sample sizes and standardizing experimental conditions. Women using hypnosis techniques for childbirth in hospital settings may face barriers related to caregiver resistance or institutional policies. The potential anxiolytic and analgesic effects of clinical hypnosis for childbirth merit further study. Nurses caring for women during labor and birth can increase their knowledge and skills with strategies for supporting hypnotherapeutic techniques. © 2014 AWHONN.

  11. The Efficiency of Sensory Integration Interventions in Preterm Infants.

    Science.gov (United States)

    Pekçetin, Serkan; Akı, Esra; Üstünyurt, Zeynep; Kayıhan, Hülya

    2016-10-01

    This study aimed to explore the effects of individualized sensory integration interventions on the sensory processing functions of preterm infants. Thirty-four preterm infants (intervention group) at a corrected age of seven months and 34 term infants (control group) were included. The preterm infants underwent an eight-week sensory integration intervention. Before and after the intervention, the preterm infants' sensory processing functions were evaluated using the Test of Sensory Functions in Infants and compared with those of term infants. Preterm infants had significantly poorer sensory processing function preintervention when compared with term infants. There was a significant improvement in preterm infants' sensory processing functions after the sensory integration intervention. In conclusion, preterm infants should be evaluated for sensory processing disorders and individualized sensory integration interventions should be implemented. © The Author(s) 2016.

  12. Endoplasmic reticulum stress is increased after spontaneous labor in human fetal membranes and myometrium where it regulates the expression of prolabor mediators.

    Science.gov (United States)

    Liong, Stella; Lappas, Martha

    2014-09-01

    Increasing evidence indicates that endoplasmic reticulum (ER) stress is involved in various diseases. In nongestational tissues, several markers of the unfolded protein response (UPR) have been shown to regulate the inflammatory response. Thus, the aim of this study was to determine the effect of human labor on markers of ER stress in fetal membranes and myometrium. In addition, the effect of ER stress inhibition on the expression and secretion of proinflammatory and prolabor mediators was also assessed. The markers of ER stress, GRP78, IRE1, and spliced XBP1 (XBP1s), were significantly increased in fetal membranes and myometrium after term and preterm labor compared to nonlaboring samples. Given that inflammation is considered to be one of the leading causes of spontaneous preterm birth, here we used bacterial endotoxin lipopolysaccharide (LPS) as a model for infection-induced preterm birth. In term nonlabored fetal membranes and myometrium, LPS induced UPR activation as evidenced by a significant increase in the expression of GRP78, IRE1, and XBP1s in fetal membranes and myometrium. The use of the chemical chaperones 4-phenylbutyric acid (4-PBA) and tauroursodeoxycholic acid (TUDCA) alleviated ER stress induced by LPS. 4-PBA and TUDCA also ameliorated the increase in LPS-induced prolabor mediators. Our data suggest that the UPR may regulate the inflammatory responses associated with labor or infection in fetal membranes and myometrium of pregnant term and preterm women. Thus, the use of ER stress inhibitors, in particular 4-PBA or TUDCA, may be a potential therapeutic strategy for the prevention of infection-mediated spontaneous preterm birth. © 2014 by the Society for the Study of Reproduction, Inc.

  13. Predicting preeclampsia from a history of preterm birth.

    Science.gov (United States)

    Rasmussen, Svein; Ebbing, Cathrine; Irgens, Lorentz M

    2017-01-01

    To assess whether women with a history of preterm birth, independent on the presence of prelabour rupture of the membranes (PROM) and growth deviation of the newborn, are more likely to develop preeclampsia with preterm or preterm birth in a subsequent pregnancy. We conducted a population-based cohort study, based on Medical Birth Registry of Norway between 1967 and 2012, including 742,980 women with singleton pregnancies who were followed up from their 1st to 2nd pregnancy. In the analyses we included 712,511 women after excluding 30,469 women with preeclampsia in the first pregnancy. After preterm birth without preeclampsia in the first pregnancy, the risk of preterm preeclampsia in the second pregnancy was 4-7 fold higher than after term birth (odds ratios 3.5; 95% confidence interval (CI) 3.0-4.0 to 6.5; 95% CI 5.1-8.2). The risk of term preeclampsia in the pregnancy following a preterm birth was 2-3 times higher than after term birth (odds ratios 1.6; 95% CI 1.5-1.8 to 2.6; 95% CI 2.0-3.4). After spontaneous non-PROM preterm birth and preterm PROM, the risk of preterm preeclampsia was 3.3-3.6 fold higher than after spontaneous term birth. Corresponding risks of term preeclampsia was 1.6-1.8 fold higher. No significant time trends were found in the effect of spontaneous preterm birth in the first pregnancy on preterm or term preeclampsia in the second pregnancy. The results suggest that preterm birth, regardless of the presence of PROM, and preeclampsia share pathophysiologic mechanisms. These mechanisms may cause preterm birth in one pregnancy and preeclampsia in a subsequent pregnancy in the same woman. The association was particularly evident with preterm preeclampsia.

  14. Neuroimaging biomarkers of preterm brain injury: toward developing the preterm connectome

    International Nuclear Information System (INIS)

    Panigrahy, Ashok; Wisnowski, Jessica L.; Furtado, Andre; Lepore, Natasha; Paquette, Lisa; Bluml, Stefan

    2012-01-01

    For typically developing infants, the last trimester of fetal development extending into the first post-natal months is a period of rapid brain development. Infants who are born premature face significant risk of brain injury (e.g., intraventricular or germinal matrix hemorrhage and periventricular leukomalacia) from complications in the perinatal period and also potential long-term neurodevelopmental disabilities because these early injuries can interrupt normal brain maturation. Neuroimaging has played an important role in the diagnosis and management of the preterm infant. Both cranial US and conventional MRI techniques are useful in diagnostic and prognostic evaluation of preterm brain development and injury. Cranial US is highly sensitive for intraventricular hemorrhage (IVH) and provides prognostic information regarding cerebral palsy. Data are limited regarding the utility of MRI as a routine screening instrument for brain injury for all preterm infants. However, MRI might provide diagnostic or prognostic information regarding PVL and other types of preterm brain injury in the setting of specific clinical indications and risk factors. Further development of advanced MR techniques like volumetric MR imaging, diffusion tensor imaging, metabolic imaging (MR spectroscopy) and functional connectivity are necessary to provide additional insight into the molecular, cellular and systems processes that underlie brain development and outcome in the preterm infant. The adult concept of the ''connectome'' is also relevant in understanding brain networks that underlie the preterm brain. Knowledge of the preterm connectome will provide a framework for understanding preterm brain function and dysfunction, and potentially even a roadmap for brain plasticity. By combining conventional imaging techniques with more advanced techniques, neuroimaging findings will likely be used not only as diagnostic and prognostic tools, but also as biomarkers for long-term neurodevelopmental

  15. Neuroimaging biomarkers of preterm brain injury: toward developing the preterm connectome

    Energy Technology Data Exchange (ETDEWEB)

    Panigrahy, Ashok [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Children' s Hospital of Pittsburgh of UPMC, Department of Pediatric Radiology, Pittsburgh, PA (United States); Wisnowski, Jessica L. [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); University of Southern California, Brain and Creativity Institute, Los Angeles, CA (United States); Furtado, Andre [Children' s Hospital of Pittsburgh of UPMC, Department of Pediatric Radiology, Pittsburgh, PA (United States); Lepore, Natasha [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Paquette, Lisa [Children' s Hospital Los Angeles, Center for Fetal and Neonatal Medicine, Los Angeles, CA (United States); Bluml, Stefan [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); University of Southern California, Department of Biomedical Engineering, Los Angeles, CA (United States)

    2012-01-15

    For typically developing infants, the last trimester of fetal development extending into the first post-natal months is a period of rapid brain development. Infants who are born premature face significant risk of brain injury (e.g., intraventricular or germinal matrix hemorrhage and periventricular leukomalacia) from complications in the perinatal period and also potential long-term neurodevelopmental disabilities because these early injuries can interrupt normal brain maturation. Neuroimaging has played an important role in the diagnosis and management of the preterm infant. Both cranial US and conventional MRI techniques are useful in diagnostic and prognostic evaluation of preterm brain development and injury. Cranial US is highly sensitive for intraventricular hemorrhage (IVH) and provides prognostic information regarding cerebral palsy. Data are limited regarding the utility of MRI as a routine screening instrument for brain injury for all preterm infants. However, MRI might provide diagnostic or prognostic information regarding PVL and other types of preterm brain injury in the setting of specific clinical indications and risk factors. Further development of advanced MR techniques like volumetric MR imaging, diffusion tensor imaging, metabolic imaging (MR spectroscopy) and functional connectivity are necessary to provide additional insight into the molecular, cellular and systems processes that underlie brain development and outcome in the preterm infant. The adult concept of the ''connectome'' is also relevant in understanding brain networks that underlie the preterm brain. Knowledge of the preterm connectome will provide a framework for understanding preterm brain function and dysfunction, and potentially even a roadmap for brain plasticity. By combining conventional imaging techniques with more advanced techniques, neuroimaging findings will likely be used not only as diagnostic and prognostic tools, but also as biomarkers for long

  16. Neuroimaging biomarkers of preterm brain injury: toward developing the preterm connectome

    Science.gov (United States)

    Panigrahy, Ashok; Wisnowski, Jessica L.; Furtado, Andre; Lepore, Natasha; Paquette, Lisa; Bluml, Stefan

    2013-01-01

    For typically developing infants, the last trimester of fetal development extending into the first post-natal months is a period of rapid brain development. Infants who are born premature face significant risk of brain injury (e.g., intraventricular or germinal matrix hemorrhage and periventricular leukomalacia) from complications in the perinatal period and also potential long-term neurodevelopmental disabilities because these early injuries can interrupt normal brain maturation. Neuroimaging has played an important role in the diagnosis and management of the preterm infant. Both cranial US and conventional MRI techniques are useful in diagnostic and prognostic evaluation of preterm brain development and injury. Cranial US is highly sensitive for intraventricular hemorrhage IVH and provides prognostic information regarding cerebral palsy. Data are limited regarding the utility of MRI as a routine screening instrument for brain injury for all preterm infants. However, MRI might provide diagnostic or prognostic information regarding PVL and other types of preterm brain injury in the setting of specific clinical indications and risk factors. Further development of advanced MR techniques like volumetric MR imaging, diffusion tensor imaging, metabolic imaging (MR spectroscopy) and functional connectivity are necessary to provide additional insight into the molecular, cellular and systems processes that underlie brain development and outcome in the preterm infant. The adult concept of the “connectome” is also relevant in understanding brain networks that underlie the preterm brain. Knowledge of the preterm connectome will provide a framework for understanding preterm brain function and dysfunction, and potentially even a roadmap for brain plasticity. By combining conventional imaging techniques with more advanced techniques, neuroimaging findings will likely be used not only as diagnostic and prognostic tools, but also as biomarkers for long-term neurodevelopmental

  17. Loss of Progesterone Receptor-Mediated Actions Induce Preterm Cellular and Structural Remodeling of the Cervix and Premature Birth

    Science.gov (United States)

    Yellon, Steven M.; Dobyns, Abigail E.; Beck, Hailey L.; Kurtzman, James T.; Garfield, Robert E.; Kirby, Michael A.

    2013-01-01

    A decline in serum progesterone or antagonism of progesterone receptor function results in preterm labor and birth. Whether characteristics of premature remodeling of the cervix after antiprogestins or ovariectomy are similar to that at term was the focus of the present study. Groups of pregnant rats were treated with vehicle, a progesterone receptor antagonist (onapristone or mifepristone), or ovariectomized on day 17 postbreeding. As expected, controls given vehicle delivered at term while rats delivered preterm after progesterone receptor antagonist treatment or ovariectomy. Similar to the cervix before term, the preterm cervix of progesterone receptor antagonist-treated rats was characterized by reduced cell nuclei density, decreased collagen content and structure, as well as a greater presence of macrophages per unit area. Thus, loss of nuclear progesterone receptor-mediated actions promoted structural remodeling of the cervix, increased census of resident macrophages, and preterm birth much like that found in the cervix at term. In contrast to the progesterone receptor antagonist-induced advance in characteristics associated with remodeling, ovariectomy-induced loss of systemic progesterone did not affect hypertrophy, extracellular collagen, or macrophage numbers in the cervix. Thus, the structure and macrophage census in the cervix appear sufficient for premature ripening and birth to occur well before term. With progesterone receptors predominantly localized on cells other than macrophages, the findings suggest that interactions between cells may facilitate the loss of progesterone receptor-mediated actions as part of a final common mechanism that remodels the cervix in certain etiologies of preterm and with parturition at term. PMID:24339918

  18. Early preterm delivery due to placenta previa is an independent risk factor for a subsequent spontaneous preterm birth

    Science.gov (United States)

    2012-01-01

    Background To determine whether patients with placenta previa who delivered preterm have an increased risk for recurrent spontaneous preterm birth. Methods This retrospective population based cohort study included patients who delivered after a primary cesarean section (n = 9983). The rate of placenta previa, its recurrence, and the risk for recurrent preterm birth were determined. Results Patients who had a placenta previa at the primary CS pregnancy had an increased risk for its recurrence [crude OR of 2.65 (95% CI 1.3-5.5)]. The rate of preterm birth in patients with placenta previa in the primary CS pregnancy was 55.9%; and these patients had a higher rate of recurrent preterm delivery than the rest of the study population (p placenta previa in the primary CS pregnancy, those who delivered preterm had a higher rate of recurrent spontaneous preterm birth regardless of the location of their placenta in the subsequent delivery [OR 3.09 (95% CI 2.1-4.6)]. In comparison to all patients with who had a primary cesarean section, patients who had placenta previa and delivered preterm had an independent increased risk for recurrent preterm birth [OR of 3.6 (95% CI 1.5-8.5)]. Conclusions Women with placenta previa, who deliver preterm, especially before 34 weeks of gestation, are at increased risk for recurrent spontaneous preterm birth regardless to the site of placental implantation in the subsequent pregnancy. Thus, strict follow up by high risk pregnancies specialist is recommended. PMID:22876799

  19. Indeterminacy and labor augmenting externalities

    DEFF Research Database (Denmark)

    Poulsen, Odile; Goenka, Aditya

    2002-01-01

    In this two-sector discrete time model of endogenous economic growth intersectoral effects are assumed to be "labor augmenting" We derive necessary and sufficient conditions for local indeterminacy and multiplicity of the balanced growth path in terms of factor intensities in both sectors...

  20. Misguided guidelines for managing labor.

    Science.gov (United States)

    Cohen, Wayne R; Friedman, Emanuel A

    2015-06-01

    In a recent review we expressed concerns about new guidelines for the assessment and management of labor recommended jointly by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM). These guidelines are based heavily on a new concept of how cervical dilatation and fetal descent progress, derived from the work of Zhang et al. In their Viewpoint article they have addressed, but not allayed, the concerns we described in our review. We assert that the dilatation curve promulgated by Zhang et al cannot be reconciled with direct clinical observation. Even if they were correct, however, it still does not follow that the ACOG/SMFM guidelines should recommend replacing the coherent system of identifying and managing labor aberrations described by Friedman. That system is grounded in well-established clinical principles based on decades of use and the objectively documented association of some labor abnormalities with poor fetal and maternal outcomes. Recommendations for new clinical management protocols should require the demonstration of superior outcomes through extensive, preferably prospective, assessment. Using untested guidelines for the management of labor may adversely affect women and children. Even if those guidelines were to reduce the currently excessive cesarean delivery rate, the price of that benefit is likely to be a trade-off in harm to parturients and their offspring. The nature and degree of that harm needs to be documented before considering adoption of the guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. A global strategy for labor.

    Science.gov (United States)

    Faux, Jeff

    2002-01-01

    The rules of the global market were established to protect the interests of investors at the expense of workers and they shift benefits to investors, costs to workers. Globalization is measured by the interests of investors. But 20 years of investor protectionism show that growth has slowed and equality has gotten worse. The purpose of neo-liberal policies has been to discipline labor to free capital from having to bargain with workers over gains from rising productivity. But such bargaining is the essence of a democratic market. Uncontrolled globalization puts government's domestic policies on the side of capital. In an economy whose growth depends on foreign markets, rising domestic wages make it harder to compete internationally. There has been a general deterioration of labor's position relative to capital's. A global marketplace implies a global politics, and the real work happens when representatives of multi-national business privately negotiate the rules. Labor must change the framework in which the investor class pursues its interest across borders, while workers are constricted by borders. Labor unions are critical; they can deny the human resource necessary for profits. The strike is the ultimate threat to investors. One solution: a "grand bargain" linking development with broadly increased living standards connected to planning for sustainable development to create a global social contract. Workers have advantages: they are the majority and they are indispensable.

  2. Monitoring your baby before labor

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000485.htm Monitoring your baby before labor To use the sharing features on ... what the results mean for you and your baby. Alternative Names Prenatal care - monitoring; Pregnancy care - monitoring; Non-stress test - monitoring; NST- ...

  3. laboral en México

    Directory of Open Access Journals (Sweden)

    Orlandina de Oliveira

    2006-01-01

    grado de precariedad laboral de los jóvenes. En la explicación del fenómeno estudiado tomamos en cuenta aspectos socioespaciales, laborales, familiares e individuales. Por medio de la aplicación de modelos de regresión describimos los perfiles laborales y sociodemográficos de los jóvenes que trabajan.

  4. Proteomic Biomarkers for Spontaneous Preterm Birth

    DEFF Research Database (Denmark)

    Kacerovsky, Marian; Lenco, Juraj; Musilova, Ivana

    2014-01-01

    This review aimed to identify, synthesize, and analyze the findings of studies on proteomic biomarkers for spontaneous preterm birth (PTB). Three electronic databases (Medline, Embase, and Scopus) were searched for studies in any language reporting the use of proteomic biomarkers for PTB published...

  5. [Progesterone and prevention of preterm birth].

    Science.gov (United States)

    Fuchs, F; Senat, M-V

    2015-10-01

    The literature confirms the interest of progesterone for prevention of preterm delivery in specific indications for patients carrying a singleton pregnancy. In contrast, randomized trials have shown no benefit using progesterone in the prevention of prematurity in twins and even an adverse effect. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Pulmonary oedema after hexoprenaline administration in preterm ...

    African Journals Online (AJOL)

    Despite the widespread use of ,a-sympathomimetic agents for preterm labour there appears to be a limited appreciation of the need for cardiovascular monitoring in the mother. Four patients in whom pulmonary oedema developed during tocolysis with hexoprenaline are described and the aetiological factors and ...

  7. Morbidities, concordance, and predictors of preterm premature ...

    African Journals Online (AJOL)

    2015-12-05

    Dec 5, 2015 ... accompany PPROM include prematurity, umbilical cord prolapse and compression, neonatal sepsis, respiratory. Morbidities, concordance, and predictors of preterm premature rupture of membranes among pregnant women at the University of Nigeria Teaching Hospital. (UNTH), Enugu, Nigeria. TC Okeke ...

  8. ACHIEVING OPTIMAL FEEDS FOR PRETERM BABIES ...

    African Journals Online (AJOL)

    Colonization of the gut by bacteria and the introduction of nutrients into the gut affect postnatal gastrointestinal and .... inflammatory response syndrome20. The anatomically and functionally immature intestine ... milk are significantly diminished by storage and heat processing of the donor milk. Preterm maternal milk.

  9. Faith, existence and birth of preterm babies

    DEFF Research Database (Denmark)

    Rasmussen, Christina Prinds

    The aim is to explore if becoming a mother preterm of a premature baby, actualises existential and religious issues, and to explore the impact of the considerations in their way of coping. It is thus to shed light on these issues, that can both function as a positive coping-resource and the oppos...

  10. PRETERM LABOUR - IS BACTERIAL VAGINOSIS INVOLVED?

    African Journals Online (AJOL)

    metronidazole, or 100 mg vitamin C orally twice daily for. 2 days. The Gram's stain was repeated after 4 weeks. If BV. W?S found again, treatment with the same drug was repeated. Outcome measures. Preterm delivery, birth weight and perinatal deaths. Results. One thousand and five patients entered the study, but. 40 were ...

  11. Pulmonary oedema after hexoprenaline administration in preterm ...

    African Journals Online (AJOL)

    1991-05-18

    May 18, 1991 ... Complications associ~ted with the use of j:l-sympathomimetic agents in preterm labour have been reviewed by Benederti.1. Pulmonary oedema, myocardial ischaemia, cardiac arrhythmia, cerebral vasospasm, hypotension, hyperglycaemia and hypo- kalaemia have all been reponed. Pulmonary oedema is ...

  12. Neutral oligosaccharide content of preterm human milk.

    Science.gov (United States)

    Nakhla, T; Fu, D; Zopf, D; Brodsky, N L; Hurt, H

    1999-11-01

    Human milk oligosaccharides are known to play a role in protection against certain infectious diseases. Previous reports indicate that the content of human milk oligosaccharides varies widely among individuals at term but such information on preterm milk is lacking. After removal of the fat, protein and most of the lactose from non-pooled human milk samples, a total neutral oligosaccharide fraction was isolated by ion-exchange chromatography followed by gel filtration. A Dionex high-performance anion-exchange chromatography system equipped with a pulsed electrometric detector was then employed to measure the levels of ten neutral oligosaccharides in the individual milk samples. Twenty-three milk samples from thirteen mothers who delivered at a mean gestational age of 29.5 (SD 3.1) weeks were collected between days 0 and 33 of lactation, and compared with three samples of term milk from two mothers. The ranges of the total and individual levels of the ten neutral oligosaccharides in preterm milk were similar to those in term milk. Further, as previously described in term milk, preterm milk exhibited a quantitative individual variation. This variation was independent of the gestational age, day of lactation, and postconceptional age. In conclusion, levels of ten neutral oligosaccharides did not differ between preterm and term human milk.

  13. Preterm birth, osteoporosis, and periodontal disease.

    Science.gov (United States)

    Jeffcoat, M K

    2000-01-01

    The purpose of this two-part article is to review two major events in the life span of a woman. These include the putative relationship between oral health, pregnancy, and postmenopausal osteoporosis. Current knowledge about risk factors for preterm birth and for osteoporosis are discussed. The newest studies that address the relationship between oral and systemic health are also reviewed.

  14. Ontogeny of midazolam glucuronidation in preterm infants

    NARCIS (Netherlands)

    S.N. de Wildt (Saskia); G.L. Kearns (Greg); D.J. Murry (Darryl); G. Koren (Gideon); J.N. van den Anker (John)

    2010-01-01

    textabstractPurpose: In preterm infants, the biotransformation of midazolam (M) to 1-OH-midazolam (OHM) by cytochrome P450 3A4 (CYP3A4) is developmentally immature, but it is currently unknown whether the glucuronidation of OHM to 1-OH-midazolam glucuronide (OHMG) is also decreased. The aim of our

  15. Diaphragmatic electromyography monitoring in preterm infants

    NARCIS (Netherlands)

    Kraaijenga, J.V.S.

    2017-01-01

    This thesis starts in Chapter 1 with general aspects of prematurity and its consequences on the respiratory system. Thereby, common types of respiratory failure in preterm infants, the physiology of respiratory muscles and different cardiorespiratory monitoring techniques used in the neonatal

  16. Ultrasonically detectable cerebellar haemorrhage in preterm infants.

    LENUS (Irish Health Repository)

    McCarthy, Lisa Kenyon

    2011-07-01

    To determine the frequency and pattern of cerebellar haemorrhage (CBH) on routine cranial ultrasound (cUS) imaging in infants of ≤32 weeks gestation, and to investigate how extremely preterm infants with CBH differ from those with severe intraventricular haemorrhage (IVH).

  17. Preterm labour - Is Mycoplasma hominis involved? | Odendaal ...

    African Journals Online (AJOL)

    Gram's stains were done on smears taken from the posterior vaginal fornix, at the first antenatal visit, between 16 and 26 weeks' gestation, in primigravidae and multigravidae at risk for preterm labour. Cultures for M. hominis and other commonly occurring organisms were done ·from endocervical swabs taken at the same ...

  18. Maternal serum C-reactive protein in early pregnancy and occurrence of preterm premature rupture of membranes and preterm birth.

    Science.gov (United States)

    Moghaddam Banaem, Lida; Mohamadi, Bita; Asghari Jaafarabadi, Mohamad; Aliyan Moghadam, Narges

    2012-05-01

    The aim of this study was to determine the relationship between maternal serum C-reactive protein (CRP) levels in the first 20 weeks of pregnancy and later occurrence of preterm premature rupture of membranes and preterm birth. A prospective cohort study that measured maternal serum CRP levels in 778 pregnant women in the first half of pregnancy was performed in the city of Noor (north Iran), and included follow-up of patients up to time of delivery. Preterm premature rupture of membranes and preterm birth were defined as the occurrence of membranes rupture and birth, respectively before 37 weeks of gestation. Of the 778 pregnancies studied, 19 (2.41%) preterm premature rupture of membranes and 58 (7.3%) preterm births were seen. Median CRP levels in preterm premature rupture of membranes and preterm birth cases were much higher than in term deliveries (7 and 6.8 respectively vs 2.4 mg/L; 66.67 and 64.76, respectively vs 24.38 nmol/L). CRP levels >4 mg/L had statistically significant relationships with preterm premature rupture of membranes (OR 5.91, 95% CI 2.07-16.89) and preterm birth (OR 8.95, 95% CI 4.60-17.43). With a cut-off level of 4 mg/L of CRP, sensitivity, specificity, and likelihood ratios (LR(+) and LR(-) ) for preterm birth were 81, 70, 2.70, 0.28%, respectively, and for preterm premature rupture of membranes they were 79, 67, 2.41 and 0.31%, respectively. It seems that the inflammatory marker, CRP, can be used in the early stages of pregnancy to identify women at risk of experiencing preterm premature rupture of membranes and preterm birth. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  19. [Bacterial vaginosis and spontaneous preterm birth].

    Science.gov (United States)

    Brabant, G

    2016-12-01

    To determine if bacterial vaginosis is a marker for risk of spontaneous preterm delivery and if its detection and treatment can reduce this risk. Consultation of the database Pubmed/Medline, Science Direct, and international guidelines of medical societies. Bacterial vaginosis (BV) is a dysbiosis resulting in an imbalance in the vaginal flora through the multiplication of anaerobic bacteria and jointly of a disappearance of well-known protective Lactobacilli. His diagnosis is based on clinical Amsel criteria and/or a Gram stain with establishment of the Nugent score. The prevalence of the BV extraordinarily varies according to ethnic and/or geographical origin (4-58 %), in France, it is close to 7 % in the first trimester of pregnancy (EL2). The link between BV and spontaneous premature delivery is low with an odds ratio between 1.5 and 2 in the most recent studies (EL3). Metronidazole or clindamycin is effective to treat BV (EL3). It is recommended to prescribe one of these antibiotics in the case of symptomatic BV (Professional Consensus). The testing associated with the treatment of BV in the global population showed no benefit in the prevention of the risk of spontaneous preterm delivery (EL2). Concerning low-risk asymptomatic population (defined by the absence of antecedent of premature delivery), it has been failed profit to track and treat the BV in the prevention of the risk of spontaneous preterm delivery (EL1). Concerning the high-risk population (defined by a history of preterm delivery), it has been failed profit to track and treat the VB in the prevention of the risk of spontaneous preterm delivery (EL3). However, in the sub population of patients with a history of preterm delivery occurred in a context of materno-fetal bacterial infection, there may be a benefit to detect and treat early and systematically genital infection, and in particular the BV (Professional Consensus). The screening and treatment of BV during pregnancy in asymptomatic low

  20. [Periodontal disease, tobacco and preterm delivery].

    Science.gov (United States)

    Resende, Marta; Pinto, Elisabete; Pinto, Miguel; Montenegro, Nuno

    2011-12-01

    Preterm delivery is associated with high mortality and morbility perinatal, being the costs dispended by the family and the National Health System with preterm newborns extremely high. However, it has been difficult to reduce its incidence due to the various factors involved. There is scientific evidence which support the relationship between periodontal disease and preterm delivery. There is also evidence of tobacco as a risk factor for periodontal disease, even though the relationship with preterm delivery is not yet clear. The aims of our study were to evaluate, in women in a post-partum period, dental and periodontal status as well as the exposure to tobacco and to establish the relationship between these two factors with preterm delivery. We performed a case control study with 237 parturient women from the Department of Obstetrics and Gynecology of Hospital S. João, E.P.E., during the first 48 hours after birth. A total of 86 gave birth at a gestational age under 37 weeks (case group ) and 151 gave birth to term newborns with birthweight equal or superior 2500 g (control group). The prevalence of some indicators of periodontal disease in the studied population was extremely high, namely gingival inflammation and gingival recession, and more of 30% had values of probing depth equal or higher than 4 mm significantly. Based on these periodontal indicators, only the presence of recession in more than two teeth seems to increase the risk of preterm delivery in fivefold (OR = 5,28; IC95%: 1,63-17,04). There is a statistically significant association between probing depth equal or higher than 4mm and smoking during pregnancy. This association might be relevant because 20% of preterm newborns mothers smoked during pregnancy and the proportion that stopped smoking during pregnancy in this group of mothers was almost half of the number of the control group. Therefore it is necessary to embody the information about this thematic in the health education, not only in

  1. 76 FR 22921 - Child Labor, Forced Labor, and Forced or Indentured Child Labor in the Production of Goods in...

    Science.gov (United States)

    2011-04-25

    ... submission to the Office of Child Labor, Forced Labor and Human Trafficking (OCFT) at the e-mail or physical... Trafficking Victims Protection Reauthorization Act of 2005 (``TVPRA of 2005''), Public Law 109-164 (2006...

  2. 78 FR 72714 - Child Labor, Forced Labor, and Forced or Indentured Child Labor in the Production of Goods in...

    Science.gov (United States)

    2013-12-03

    ... submission to the Office of Child Labor, Forced Labor and Human Trafficking (OCFT) at the email or physical... contact information above). SUPPLEMENTARY INFORMATION: I. Section 105(b)(1) of the Trafficking Victims...

  3. 77 FR 9267 - Child Labor, Forced Labor, and Forced or Indentured Child Labor in the Production of Goods in...

    Science.gov (United States)

    2012-02-16

    ... the Office of Child Labor, Forced Labor and Human Trafficking (OCFT) at the email or physical address... Trafficking Victims Protection Reauthorization Act of 2005 (``TVPRA of 2005''), Public Law 109-164 (2006...

  4. Total and differential leukocyte count percentiles in healthy singleton term women during the first stage of labor.

    Science.gov (United States)

    Lurie, Samuel; Weiner, Eran; Golan, Abraham; Sadan, Oscar

    2014-01-01

    To establish leukocyte count and differential percentiles in healthy singleton term laboring women during spontaneous normal vaginal labor following an uncomplicated pregnancy. An analysis of the records of all women (n = 762) who delivered at our delivery ward during a 2-month period was performed. After exclusion for cesarean delivery, induction of labor, pregnancy complications, preterm labor, multiple pregnancy, fever on admission, and lack of full blood count on admission, 365 parturient women during the 1st stage of labor were included in the final analysis. The total and differential leukocyte counts were determined by standard procedure by an automated cell counter. The leukocyte count range on admission to the delivery ward during the 1st stage of labor in healthy parturient women was between 4.4 × and 21.7 × 10(3)/µl and the 99th percentile limit was 20.06 × 10(3)/µl. The total leukocyte count was not influenced by cervical dilatation, ruptured membranes, or the presence and regularity of uterine contractions. An observed leukocyte count within the 99th percentile limit (20.06 × 10(3)/µl) in an otherwise normal parturient woman is reassuring in the absence of other clinical evidence. © 2014 S. Karger AG, Basel.

  5. Pregnancy Outcomes Complicated by Preterm Premature Rupture of Membranes: Retrospective Review of Cases in Three Institutions in Kazakhstan

    Directory of Open Access Journals (Sweden)

    Balkenzhe Imankulova

    2015-06-01

    Full Text Available Introduction. Pre-term premature rupture of membranes (PPROM is one of the leading causes of perinatal morbidity and mortality. This complication is diagnosed in 3% of pregnant women in Kazakhstan, and it is the leading cause of pre-term deliveries. The aim of this study was to determine the outcomes of pregnancies complicated by PPROM in gestation periods between 24 to 32 weeks among three institutions in Kazakhstan.Methods. This is descriptive analysis of 154 cases with PPROM observed between 24 to 32 weeks of gestation at Perinatal Centers #2 and #3 and the National Research Center for Maternal and Child Health, Astana, Kazakhstan. Cases were selected on the basis of retrospective chart review where PPROM diagnosis occurred in 2013. Descriptive statistics were utilized for data analysis.Results. The most frequent complications associated with PPROM were threat of miscarriage (13.6% of cases and chronic placental insufficiency (7.8%. The mean time between PPROM and onset of spontaneous labor was 12.1 ± 2.3 days.  Spontaneous labor within 3 days after PPROM started in patients with an amniotic fluid index of 3.0 ± 0.2 cm. Complications experienced by PPROM women during delivery and early postpartum period included: precipitous labor (6.4%, weakness of labor activity (16.2%, atonic hemorrhage (1.2%, and chorioamnionitis (3.2%. 37.6% of newborns in this study were admitted to the Intensive Care Unit. Their health complications included pneumonia (7.7%, conjunctivitis (1.3%, omphalitis and infectious-toxic shock (3.8%, intraventricular hemorrhage  (7.8%, and respiratory distress (10.3% .Conclusion. Thus, preterm rupture of membranes is associated with preterm delivery and an increase of neonatal morbidity. Therefore, it is necessary to find ways to effectively manage PPROM, including developing new techniques to restore the amniotic fluid volume in women experiencing PPROM during 24 to 32 weeks of gestation. 

  6. Joint Laxity in Preschool Children Born Preterm.

    Science.gov (United States)

    Romeo, Domenico M; Velli, Chiara; Lucibello, Simona; Ferrantini, Gloria; Leo, Giuseppina; Brogna, Claudia; Cota, Francesco; Ricci, Daniela; Gallini, Francesca; Romagnoli, Costantino; Vento, Giovanni; Mercuri, Eugenio

    2018-04-09

    To evaluate the prevalence of joint laxity in children born preterm assessed in the first 2 years, the relationship between joint laxity and motor performance at preschool age, and possible changes over time in a subgroup of children followed longitudinally. The revised scale of Beighton Score was used to evaluate joint laxity in a population of 132 preschool children born preterm between 24 and 32 weeks of gestational age. All were assessed for joint laxity between 12 and 24 months of age. Children also performed the Movement Assessment Battery for Children-Second Edition between the age of 3 years and 6 months and 4 years; the age at onset of independent walking also was recorded. The total Beighton Score ranged between 0 and 8. Twenty percent of the cohort showed joint laxity. No differences related to sex or gestational age were observed. Children born preterm with joint laxity achieved later independent walking and achieved lower scores on Movement Assessment Battery for Children-Second Edition than those without joint laxity. In 76 children born preterm, an assessment for joint laxity was repeated once between 25 and 36 months and again after >36 months. No statistically significant difference was observed between the 3 assessments. The Beighton Score can be used to assess generalized joint laxity in children born preterm. As the presence of joint laxity influenced motor competences, the possibility to early identify these infants in the first 2 years is of interest to benefit from early intervention and potentially improve gross motor skills and coordination. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Preterm Life in Sterile Conditions: A Study on Preterm, Germ-Free Piglets.

    Science.gov (United States)

    Splichalova, Alla; Slavikova, Vera; Splichalova, Zdislava; Splichal, Igor

    2018-01-01

    Preterm infants born with immature organ systems, which can impede normal development, can also be highly sensitive to different biological and/or environmental factors. Animal models could aid in investigating and understanding the effects of different conditions on the health of these immunocompromised infants. The epitheliochorial placentation of the pig prevents the prenatal transfer of protective colostral immunoglobulins. Surgical colostrum-deprived piglets are free of maternal immunoglobulins, and the cells that are normally provided via colostrum. We bred preterm germ-free piglets in sterile conditions and compared them with their term counterparts. Enterocyte development and intestinal morphology, tight junction proteins claudin-1 and occludin, pattern-recognizing receptors, adaptor molecules and coreceptors (RAGE, TLR2, TLR4, TLR9, MyD88, TRIF, MD2, and CD14), and inflammasome NLRP3 transcription were all evaluated. The production of inflammatory mediators IFN-α, IL-4, IL-6, IL-8, IL-10, IL-12/23 p40, TNF-α, IFN-γ, and high mobility group box 1 (HMGB1) in the intestine of germ-free piglets was also assessed. In the preterm germ-free piglets, the ileum showed decreased lamina propria cellularity, reduced villous height, and thinner and less distinct stratification - especially muscle layer, in comparison with their term counterparts. Claudin-1 transcription increased in the intestine of the preterm piglets. The transcription levels of pattern-recognizing receptors and adaptor molecules showed ambiguous trends between the groups. The levels of IL-6, IL-8, IL-10, and TNF-α were increased in the preterm ileum numerically (though not significantly), with statistically significant increases in the colon. Additionally, IL-12/23 p40 and IFN-γ were statistically significantly higher in the preterm colon. Both blood plasma and intestinal HMGB1 levels were nonsignificantly higher in the preterm group. We propose that the intestine of the preterm germ

  8. Labor Dystocia: A Common Approach to Diagnosis.

    Science.gov (United States)

    Neal, Jeremy L; Lowe, Nancy K; Schorn, Mavis N; Holley, Sharon L; Ryan, Sharon L; Buxton, Margaret; Wilson-Liverman, Angela M

    2015-01-01

    Contemporary labor and birth population norms should be the basis for evaluating labor progression and determining slow progress that may benefit from intervention. The aim of this article is to present guidelines for a common, evidence-based approach for determination of active labor onset and diagnosis of labor dystocia based on a synthesis of existing professional guidelines and relevant contemporary publications. A 3-point approach for diagnosing active labor onset and classifying labor dystocia-related labor aberrations into well-defined, mutually exclusive categories that can be used clinically and validated by researchers is proposed. The approach comprises identification of 1) an objective point that strictly defines active labor onset (point of active labor determination); 2) an objective point that identifies when labor progress becomes atypical, beyond which interventions aimed at correcting labor dystocia may be justified (point of protraction diagnosis); and 3) an objective point that identifies when interventions aimed at correcting labor dystocia, if used, can first be determined to be unsuccessful, beyond which assisted vaginal or cesarean birth may be justified (earliest point of arrest diagnosis). Widespread adoption of a common approach for diagnosing labor dystocia will facilitate consistent evaluation of labor progress, improve communications between clinicians and laboring women, indicate when intervention aimed at speeding labor progress or facilitating birth may be appropriate, and allow for more efficient translation of safe and effective management strategies into clinical practice. Correct application of the diagnosis of labor dystocia may lead to a decrease in the rate of cesarean birth, decreased health care costs, and improved health of childbearing women and neonates. © 2015 by the American College of Nurse-Midwives.

  9. Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria.

    Science.gov (United States)

    Butali, Azeez; Ezeaka, Chinyere; Ekhaguere, Osayame; Weathers, Nancy; Ladd, Jenna; Fajolu, Iretiola; Esezobor, Christopher; Makwe, Christian; Odusanya, Bukola; Anorlu, Rose; Adeyemo, Wasiu; Iroha, Edna; Egri-Okwaji, Mathias; Adejumo, Prisca; Oyeneyin, Lawal; Abiodun, Moses; Badejoko, Bolaji; Ryckman, Kelli

    2016-01-01

    Preterm birth is a dire complication of pregnancy that poses huge long-term medical and financial burdens for affected children, their families, and the health care system. The aim of the present study was to identify characteristics associated with preterm births at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria from 2011 to 2013. We obtained Information from 5,561 maternal, fetal/neonatal and obstetric records from the labor ward. We excluded delivery at less than 22 weeks (0.25%), post-term birth at ≥42 weeks gestation (1.3%), and unknown gestation (1.4%). Additionally, we excluded records of multiple births (5.4%) and stillbirths (8.3%) leaving 4,691 records of singleton live-births for analysis. Logistic regression analysis was performed comparing preterm birth (22-36 weeks gestation) to term birth (37-41 weeks gestation). Multiple variable models adjusting for maternal age, parity, fetal position, delivery method and booking status were also evaluated. Multinomial regression was used to identify characteristics associated with preterm birth (PTB) defined as early PTB (22-31 weeks gestation), moderate PTB (32-34 weeks gestation), late PTB (35-36 weeks gestation), compared to term birth (37-41 completed weeks gestation). From our data, 16.8% of the singleton live-birth deliveries were preterm (<37 weeks gestation). Of these, 4.7% were early (22-31 weeks), 4.5% were moderate (32-34 weeks) and 7.7% were late (35-36) PTBs. Older maternal age (≥35 years) [odds ratio (OR) = 1.41], hypertension (OR = 3.44) and rupture of membranes (OR = 4.03) were significantly associated with increased odds of PTB. Women being treated for the prevention of mother-to-child transmission of HIV were at a significantly decreased risk for PTB (OR = 0.70). Sixteen percent of women in this cohort were not registered for antenatal care in LUTH. These non-registered subjects had significantly greater odds of all categories of PTB, including early (odds ratio (OR) = 20

  10. The size of the labor wards

    DEFF Research Database (Denmark)

    Milland, Maria; Christoffersen, Jens; Hedegaard, Morten

    2013-01-01

    To assess possible associations between the size of labor units and the frequency of approved obstetric claims.......To assess possible associations between the size of labor units and the frequency of approved obstetric claims....

  11. Water Breaking: Understand This Sign of Labor

    Science.gov (United States)

    Healthy Lifestyle Labor and delivery, postpartum care Water breaking worries? Prepare yourself for childbirth by getting the facts about this important sign of labor. By Mayo Clinic Staff If you're ...

  12. Race, Regional Labor Markets and Earnings.

    Science.gov (United States)

    Parcel, Toby L.

    1979-01-01

    A contextual analysis of individual labor earnings as a function of both background/investment variables and specific dimensions of areal labor market social and economic organization suggests specific factors which influence Black and White earning levels. (Author/EB)

  13. "A Welcome Debate" over Labor Reform

    Science.gov (United States)

    Warren, Cat

    2010-01-01

    This article presents an interview with Wilma B. Liebman, the new chair of the National Labor Relations Board (NLRB). In this interview, Liebman talks about labor law, academics, and reversing ossification.

  14. Fetal Heart Rate Monitoring during Labor

    Science.gov (United States)

    f AQ FREQUENTLY ASKED QUESTIONS FAQ015 LABOR, DELIVERY, AND POSTPARTUM CARE Fetal Heart Rate Monitoring During Labor • What is fetal heart rate monitoring? • Why is fetal heart rate monitoring ...

  15. Failed labor induction: toward an objective diagnosis.

    LENUS (Irish Health Repository)

    Rouse, Dwight J

    2011-02-01

    To evaluate maternal and perinatal outcomes in women undergoing labor induction with an unfavorable cervix according to duration of oxytocin administration in the latent phase of labor after ruptured membranes.

  16. Maritime Policy and the Seafaring Labor Market

    DEFF Research Database (Denmark)

    Lobrigo, Enrico; Pawlik, Thomas

    2015-01-01

    The reports highlighting the foreseen lack of merchant marine officers for the expanding world’s fleet calls for a review in evaluating the impact of maritime policy in the seafaring labor market. This paper aims to clarify the particular characteristics of the seafaring labor market and how it can...... be shaped by specific maritime labor policies. The seafaring labor market in the Philippines, Poland, Germany, and Brazil as well as the general maritime labor policies in these countries is discussed. The focus on these countries leads to a comparative observation of maritime labor as a factor...... of production in an exporting market, in an importing market, and in a closed market, respectively, as shaped by various relevant maritime policies. Since a global policy that can regulate the maritime labor market does not exist, the trend on maritime labor supply is dynamic on a per country basis wherein crew...

  17. Epidural Analgesia and Fever at Labor

    Directory of Open Access Journals (Sweden)

    Ye. M. Shifman

    2008-01-01

    Full Text Available Objective: to study the incidence of labor fever under epidural analgesia (EA and to evaluate its impact on the courses of puerperium and early neonatality. Subjects and methods. The paper presents the data of a prospective study of the course of labor, puerperium, and early neonatality in 397 women in whom labors occurred at the Republican Peritoneal Center in 2006. A study group included 324 parturients in whom labor pain was relieved by EA. A comparison group comprised 55 parturients in whom no analgesics were used at labor. Results. There were no significant statistical differences between the groups in the incidence of labor fever and complicated puerperium and in that of neonatal pyoseptic diseases. Key words: labor hyperthermia, epidural analgesia, labor pain relief.

  18. 29 CFR 500.41 - Farm labor contractor is responsible for actions of his farm labor contractor employee.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Farm labor contractor is responsible for actions of his farm labor contractor employee. 500.41 Section 500.41 Labor Regulations Relating to Labor (Continued... PROTECTION Registration of Farm Labor Contractors and Employees of Farm Labor Contractors Engaged in Farm...

  19. Institutional components of public labor potential

    OpenAIRE

    Filippova, Irina H.

    2012-01-01

    Labor potential of a society is a complex system of elements such as a labor potential of demographic system and an institutional capacity of a social system. An institutional element provides a labor division and human’s integration in the process of public production. The paper presents an analytical approach to the problem of alienation through public division of labor taking into account the social costs of this process.

  20. LABOR RELATIONS. THEORETICAL AND METHODOLOGICAL ASPECTS

    Directory of Open Access Journals (Sweden)

    ION GLODEANU

    2014-12-01

    Full Text Available The field of labor and employment relations in industrial environments is very complex. Moreover, it is the subject of transforming complex processes. From this perspective, the study aims to present some theoretical and methodological aspects of research and analysis of enterprise as social space of labor, of relationships between employees and employers, superiors and subordinates, labor groups, employer organizations and trade unions. It also suggests possible research methods and techniques of this field defining labor market

  1. Solar Installation Labor Market Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Friedman, B.; Jordan, P.; Carrese, J.

    2011-12-01

    The potential economic benefits of the growing renewable energy sector have led to increased federal, state, and local investments in solar industries, including federal grants for expanded workforce training for U.S. solar installers. However, there remain gaps in the data required to understand the size and composition of the workforce needed to meet the demand for solar power. Through primary research on the U.S. solar installation employer base, this report seeks to address that gap, improving policymakers and other solar stakeholders understanding of both the evolving needs of these employers and the economic opportunity associated with solar market development. Included are labor market data covering current U.S. employment, expected industry growth, and employer skill preferences for solar installation-related occupations. This study offers an in-depth look at the solar installation sectors. A study published by the Solar Foundation in October 2011 provides a census of labor data across the entire solar value chain.

  2. Tax policy and labor market performance

    NARCIS (Netherlands)

    A.L. Bovenberg (Lans)

    2003-01-01

    textabstractIn exploring the impact of tax policy on labor-market performance, the paper first investigates how tax reform impacts labor supply and equilibrium unemployment in representative agent models. The impact of tax policy on labor market performance depends importantly on various other

  3. Labor for thinning--trends and prospects

    Science.gov (United States)

    James E. Granskog

    1980-01-01

    The labor supply for timber harvesting has been a chronic issue for the southern pulp and paper industry since the mid-1950s. Whenever woodyard inventories drop substantially below desired levels, a renewed chorus of "Wood Labor Crisis" laments the dwindling labor force in a time of rising wood needs. Now that large acreages of pine plantations are reaching...

  4. Macroeconomic shocks and firms' labor adjustment

    DEFF Research Database (Denmark)

    Eriksson, Tor

    2013-01-01

    , but a brief discussion of cross-country differences and similarities in firmlevel labor adjustment is also provided. For Denmark, remarkable long-term stability in firms’ labor adjustment technologies is observed and the cross-country comparisons reveal striking similarities between countries with very...... diverse labor market institutions....

  5. Child Labor and School Attendance in Kenya

    Science.gov (United States)

    Moyi, Peter

    2011-01-01

    Sub-Saharan Africa has the highest incidence of child labor in the world and estimates show that it continues to grow. This paper examines the causes and magnitude of child labor in Kenya. Unlike previous studies that examined child labor as only an economic activity, this paper includes household chores. Including household chores is important…

  6. Age-specific labor market dynamics

    NARCIS (Netherlands)

    Gielen, A. C.

    2008-01-01

    One important finding concerns the fact that job separations for older workers constitute mostly a one-way exit out of the labor force, despite the fact that an ageing society calls for an active labor market participation from us all. Also, the allocation of labor for younger workers has shown to

  7. The Formation of Laborer's Movement in Thailand

    OpenAIRE

    Onozawa, Nitaya

    2002-01-01

    The formation of labore's movement in Thailand cannnot be viewed without regard to the development of capitalization.Thus this consists of two parts,the historical background of capitalization and organizing process of the labores'movement.Ⅰ.The Historical Background of Capitalization, The trend of number of hired laborers and the expansion of Thai industry will be discussed.According to change ...

  8. 24 CFR 92.354 - Labor.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Labor. 92.354 Section 92.354... INVESTMENT PARTNERSHIPS PROGRAM Other Federal Requirements § 92.354 Labor. (a) General. (1) Every contract... prevailing in the locality, as predetermined by the Secretary of Labor pursuant to the Davis-Bacon Act (40 U...

  9. Early Smoking, Education, and Labor Market Performance

    NARCIS (Netherlands)

    Palali, Ali

    2015-01-01

    This study investigates the effects of early smoking on educational attainment and labor market performance. The results show that early smoking adversely affects educational attainment and initial labor market performance, but only for males. The effect of early smoking on initial labor market

  10. Intersectoral labor mobility and deforestation in Ghana

    NARCIS (Netherlands)

    Owusu, V.; Yerfi Fosu, K.; Burger, C.P.J.

    2012-01-01

    This paper quantifies the effects of the determinants of intersectoral labor mobility and the effect of intersectoral labor mobility on deforestation in Ghana over the period 1970–2008. A cointegration and error correction modeling approach is employed. The empirical results show that labor mobility

  11. 23 CFR 140.906 - Labor costs.

    Science.gov (United States)

    2010-04-01

    ... the company, a fixed rate of 8 percent of direct labor costs for worker compensation and public... 23 Highways 1 2010-04-01 2010-04-01 false Labor costs. 140.906 Section 140.906 Highways FEDERAL... Railroad Work § 140.906 Labor costs. (a) General. (1) Salaries and wages, at actual or average rates, and...

  12. INTERLEUKIN-6 TRANS-SIGNALING SYSTEM IN INTRA-AMNIOTIC INFLAMMATION, PRETERM BIRTH AND PRETERM PREMATURE RUPTURE OF THE MEMBRANES

    Science.gov (United States)

    Lee, Sarah Y.; Buhimschi, Irina A.; Dulay, Antonette T.; Ali, Unzila A.; Zhao, Guomao; Abdel-Razeq, Sonya S.; Bahtiyar, Mert O.; Thung, Stephen F.; Funai, Edmund F.; Buhimschi, Catalin S.

    2013-01-01

    Classic IL-6 signaling is conditioned by the transmembrane receptor (IL-6R) and homodimerization of gp130. During trans-signaling, IL-6 binds to soluble IL-6R (sIL-6R) enabling activation of cells expressing solely gp130. Soluble gp130 (sgp130) selectively inhibits IL-6 trans-signaling. To characterize amniotic fluid IL-6 trans-signaling molecules (IL-6, sIL-6R, sgp130) in normal gestations and pregnancies complicated by intra-amniotic inflammation (IAI) we studied 301 women during second trimester (n=39), third trimester (n=40) and preterm labor with intact (n=131, 85 IAI negative & 46 IAI positive) or preterm premature rupture of membranes (PPROM: n=91, 61 IAI negative & 30 IAI positive). ELISA, Western blotting and RT-PCR were used to investigate amniotic fluid, placenta and amniochorion for protein and mRNA expression of sIL-6R, sgp130, IL-6R and gp130. Tissues were immunostained for IL-6R, gp130, CD15+ (polymorphonuclear) and CD3+ (T-cell) inflammatory cells. The ability of sIL-6R and sgp130 to modulate basal and LPS-stimulated release of amniochorion matrix-metalloprotease-9 (MMP-9) was tested ex-vivo. We showed that in physiologic gestations amniotic fluid sgp130 decreases toward term. Amniotic fluid IL-6 and sIL-6R were elevated in IAI whereas sgp130 was decreased in PPROM. Our results suggested that fetal membranes are the probable source of amniotic fluid sIL-6R and sgp130. Immunohistochemistry and RT-PCR revealed increased IL-6R and decreased gp130 expression in amniochorion of women with IAI. Ex-vivo, sIL-6R and LPS augmented amniochorion MMP-9 release whereas sgp130 opposed this effect. We conclude that IL-6 trans-signaling molecules are physiologic constituents of the amniotic fluid regulated by gestational age and inflammation. PPROM likely involves functional loss of sgp130. PMID:21282511

  13. IL-6 trans-signaling system in intra-amniotic inflammation, preterm birth, and preterm premature rupture of the membranes.

    Science.gov (United States)

    Lee, Sarah Y; Buhimschi, Irina A; Dulay, Antonette T; Ali, Unzila A; Zhao, Guomao; Abdel-Razeq, Sonya S; Bahtiyar, Mert O; Thung, Stephen F; Funai, Edmund F; Buhimschi, Catalin S

    2011-03-01

    Classic IL-6 signaling is conditioned by the transmembrane receptor (IL-6R) and homodimerization of gp130. During trans-signaling, IL-6 binds to soluble IL-6R (sIL-6R), enabling activation of cells expressing solely gp130. Soluble gp130 (sgp130) selectively inhibits IL-6 trans-signaling. To characterize amniotic fluid (AF) IL-6 trans-signaling molecules (IL-6, sIL-6R, sgp130) in normal gestations and pregnancies complicated by intra-amniotic inflammation (IAI), we studied 301 women during second trimester (n = 39), third trimester (n = 40), and preterm labor with intact (n = 131, 85 negative IAI and 46 positive IAI) or preterm premature rupture of membranes (PPROM; n = 91, 61 negative IAI and 30 positive IAI). ELISA, Western blotting, and real-time RT-PCR were used to investigate AF, placenta, and amniochorion for protein and mRNA expression of sIL-6R, sgp130, IL-6R, and gp130. Tissues were immunostained for IL-6R, gp130, CD15(+) (polymorphonuclear), and CD3(+) (T cell) inflammatory cells. The ability of sIL-6R and sgp130 to modulate basal and LPS-stimulated release of amniochorion matrix metalloprotease-9 was tested ex vivo. We showed that in physiologic gestations, AF sgp130 decreases toward term. AF IL-6 and sIL-6R were increased in IAI, whereas sgp130 was decreased in PPROM. Our results suggested that fetal membranes are the probable source of AF sIL-6R and sgp130. Immunohistochemistry and RT-PCR revealed increased IL-6R and decreased gp130 expression in amniochorion of women with IAI. Ex vivo, sIL-6R and LPS augmented amniochorion matrix metalloprotease-9 release, whereas sgp130 opposed this effect. We conclude that IL-6 trans-signaling molecules are physiologic constituents of the AF regulated by gestational age and inflammation. PPROM likely involves functional loss of sgp130.

  14. The relationship between preterm birth and underweight in Asian women.

    Science.gov (United States)

    Neggers, Yasmin H

    2015-08-15

    Although vast improvements have been made in the survival of preterm infants, the toll of preterm birth (PTB) is particularly severe in Asia, with the Indian subcontinent leading the preterm birth rate. Despite the obesity epidemic, maternal underweight remains a common occurrence in developing countries. An association between maternal underweight and preterm birth has been reported in developed countries. A review of epidemiological studies in Asian women in whom association between maternal body mass index (BMI) and risk of PTB was measured, indicated no significant association between low maternal BMI and preterm birth. A hindrance in comparison of these studies is the use of different cut-off point for BMI in defining maternal underweight. As a commentary on published studies it is proposed that that country-specific BMI cut points should be applied for defining underweight for Asian women for the purpose of evaluating the association between maternal underweight and preterm birth. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Preterm Birth and Adult Wealth: Mathematics Skills Count.

    Science.gov (United States)

    Basten, Maartje; Jaekel, Julia; Johnson, Samantha; Gilmore, Camilla; Wolke, Dieter

    2015-10-01

    Each year, 15 million babies worldwide are born preterm. Preterm birth is associated with adverse neurodevelopmental outcomes across the life span. Recent registry-based studies suggest that preterm birth is associated with decreased wealth in adulthood, but the mediating mechanisms are unknown. This study investigated whether the relationship between preterm birth and low adult wealth is mediated by poor academic abilities and educational qualifications. Participants were members of two British population-based birth cohorts born in 1958 and 1970, respectively. Results showed that preterm birth was associated with decreased wealth at 42 years of age. This association was mediated by decreased intelligence, reading, and, in particular, mathematics attainment in middle childhood, as well as decreased educational qualifications in young adulthood. Findings were similar in both cohorts, which suggests that these mechanisms may be time invariant. Special educational support in childhood may prevent preterm children from becoming less wealthy as adults. © The Author(s) 2015.

  16. Indonesian Labor Reform Since 1998

    OpenAIRE

    Uwiyono, Aloysius

    2008-01-01

    The development of labor law in the world essentially influenced by the newest models in industrial relations in each county. In general, there are two models, Corporatist Model/Regulatory Model and Contractual Model. The first model frequently meets in the countries whose use the civil law like France, Netherlands, Germany, and Indonesia, while the second model frequently meet in common law countries like the United States of America's, England, Australia, and Malaysia. Based on the two theo...

  17. Surfactant therapy in late preterm infants

    Directory of Open Access Journals (Sweden)

    Murat Yurdakök

    2013-06-01

    Full Text Available Late preterm (LPT neonates are at a high risk for respiratory distress soon after birth due to respiratory distress syndrome (RDS, transient tachypnea of the newborn, persistent pulmonary hypertension, and pneumonia along with an increased need for surfactant replacement therapy, continuous positive airway pressure, and ventilator support when compared with the term neonates. In the past, studies on outcomes of infants with respiratory distress have primarily focused on extremely premature infants, leading to a gap in knowledge and understanding of the developmental biology and mechanism of pulmonary diseases in LPT neonates. Surfactant deficiency is the most frequent etiology of RDS in very preterm and moderately preterm infants, while cesarean section and lung infection play major roles in RDS development in LPT infants. The clinical presentation and the response to surfactant therapy in LPT infants may be different than that seen in very preterm infants. Incidence of pneumonia and occurrence of pneumothorax are significantly higher in LPT and term infants. High rates of pneumonia in these infants may result in direct injury to the type II alveolar cells of the lung with decreasing synthesis, release, and processing of surfactant. Increased permeability of the alveolar capillary membrane to both fluid and solutes is known to result in entry of plasma proteins into the alveolar hypophase, further inhibiting the surface properties of surfactant. However, the oxygenation index value do not change dramatically after ventilation or surfactant administration in LPT infants with RDS compared to very preterm infants. These finding may indicate a different pathogenesis of RDS in late preterm and term infants. In conclusion, surfactant therapy may be of significant benefit in LPT infants with serious respiratory failure secondary to a number of insults. However, optimal timing and dose of administration are not so clear in this group. Additional

  18. 76 FR 61289 - Public Hearing on Child Labor Regulations, Orders and Statements of Interpretation; Child Labor...

    Science.gov (United States)

    2011-10-04

    ... DEPARTMENT OF LABOR Wage and Hour Division 29 CFR Parts 570 and 579 RIN 1235-AA06 Public Hearing on Child Labor Regulations, Orders and Statements of Interpretation; Child Labor Violations--Civil Money Penalties AGENCY: Wage and Hour Division, Labor. ACTION: Notice of public hearing. SUMMARY: The...

  19. 76 FR 28730 - Notice of Intent To Suspend the Agricultural Labor Survey and Farm Labor Reports

    Science.gov (United States)

    2011-05-18

    ... Agricultural Labor Survey and Farm Labor Reports AGENCY: National Agricultural Statistics Service, USDA. ACTION... collection, the Agricultural Labor Survey, and its associated publication. FOR FURTHER INFORMATION CONTACT... Agriculture, (202) 720-4333. SUPPLEMENTARY INFORMATION: Title: Agricultural Labor Survey. OMB Control Number...

  20. 76 FR 67104 - Child Labor Regulations, Orders and Statements of Interpretation; Child Labor Violations-Civil...

    Science.gov (United States)

    2011-10-31

    ... DEPARTMENT OF LABOR Wage and Hour Division 29 CFR Parts 570 and 579 RIN 1235-AA06 Child Labor Regulations, Orders and Statements of Interpretation; Child Labor Violations--Civil Money Penalties AGENCY: Wage and Hour Division, Labor. ACTION: Notice and Extension of comment period. SUMMARY: This document...

  1. Not by Labor Alone: Considerations for Value Influence Use of the Labor Rule in Ownership Transfers

    Science.gov (United States)

    Kanngiesser, Patricia; Hood, Bruce

    2014-01-01

    People often assign ownership to the person who has invested labor into making an object (labor rule). However, labor usually improves objects and increases their value, and it has not been investigated whether these considerations underlie people's use of the labor rule. We presented participants with third-party ownership conflicts between…

  2. Progestogens to prevent preterm birth in twin pregnancies

    DEFF Research Database (Denmark)

    Schuit, Ewoud; Stock, Sarah; Groenwold, Rolf H H

    2012-01-01

    Preterm birth is the principal factor contributing to adverse outcomes in multiple pregnancies. Randomized controlled trials of progestogens to prevent preterm birth in twin pregnancies have shown no clear benefits. However, individual studies have not had sufficient power to evaluate potential...... benefits in women at particular high risk of early delivery (for example, women with a previous preterm birth or short cervix) or to determine adverse effects for rare outcomes such as intrauterine death....

  3. [Research progress of the application of probiotics in preterm infants].

    Science.gov (United States)

    Gan, Xin; Li, Juan

    2016-09-01

    The gastrointestinal structure, function and immunity of preterm infants are immature. Furthermore the gastrointestinal microbe colonization is abnormal. Therefore the preterm infants are prone to a variety of gastrointestinal diseases. Probiotics can regulate gastrointestinal microbe constitute, improve gastrointestinal barrier function, reduce gastrointestinal inflammation response and regulate the immunity. At present, it is used for the prevention of necrotizing enterocolitis, late-onset sepsis, and feeding intolerance. The safety and efficacy of probiotics for preterm infants are still controversial.

  4. Alcohol consumption during pregnancy and the risk of preterm delivery

    DEFF Research Database (Denmark)

    Albertsen, Katrine; Andersen, Anne-Marie Nybo; Olsen, Jørn

    2004-01-01

    The authors evaluated the association between amount and type of alcohol consumed during pregnancy and the risk of preterm delivery and whether the relation differs among very (... of alcohol, no increased risk of preterm delivery was found. Among women who consumed seven or more drinks per week, the relative risk of very preterm delivery was 3.26 (95% confidence interval: 0.80, 13.24) compared with that of nondrinkers. There were no differences in the associations between type...

  5. Differences in Risk Factors for Recurrent Versus Incident Preterm Delivery

    OpenAIRE

    Grantz, Katherine L.; Hinkle, Stefanie N.; Mendola, Pauline; Sjaarda, Lindsey A.; Leishear, Kira; Albert, Paul S.

    2015-01-01

    Risk factors for preterm delivery have been described, but whether risk factors differ in the context of prior preterm delivery history is less understood. We assessed whether known risk factors were different in women with versus without prior preterm delivery using medical records of the first and second singleton deliveries in 25,820 Utah women (2002–2010). Longitudinal transition models with modified Poisson regression calculated adjusted relative risks and 95% confidence intervals, with ...

  6. Contribution of Histologic Chorioamnionitis and Fetal Inflammatory Response Syndrome to Increased Risk of Brain Injury in Infants With Preterm Premature Rupture of Membranes.

    Science.gov (United States)

    Lu, Hong-Yan; Zhang, Qiang; Wang, Qiu-Xia; Lu, Jun-Ying

    2016-08-01

    To determine the association of histologic chorioamnionitis (HCA) and fetal inflammatory response syndrome (FIRS) with brain injuries in infants born to mothers with preterm premature rupture of membranes. A total of 103 singleton infants born to mothers with preterm premature rupture of membranes were enrolled. The placental inflammation was confirmed by HCA, and FIRS was defined in fetuses with preterm labor and an elevation of the fetal plasma interleukin-6 concentration. Examination of brain images was conducted to confirm the existence of brain injuries. Based on placental HCA and umbilical cord blood interleukin-6 level, all patients were divided into three groups: HCA(-)FIRS(+), HCA(+)FIRS(-), and HCA(+)FIRS(+). Among all infants with preterm premature rupture of membranes, 53.40% were exposed to HCA, 20.38% experienced FIRS, and the overall incidence of brain injuries was 38.83%. The incidence of brain injury in HCA(-)FIRS(+), HCA(+)FIRS(-), and HCA(+)FIRS(+) groups were 20.83%, 41.18%, and 76.19%, respectively. HCA at the advanced grades and stages was associated with increased risk of brain injury. Umbilical cord blood levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-α), and granulocyte-colony stimulating factor (G-CSF) in premature infants with brain injuries were significantly higher than in those without brain injuries. Infants diagnosed with both HCA and FIRS showed significantly higher levels of IL-8, TNF-α, and G-CSF than those with HCA alone. Preterm infants exposed to severe chorioamnionitis had an increased risk of brain injury. IL-6, IL-8, TNF-α, and G-CSF in cord blood were associated with brain injuries in preterm infants and may be used as extradiagnostic criteria. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Proximal and distal adjustments of reaching behavior in preterm infants.

    Science.gov (United States)

    de Toledo, Aline Martins; Soares, Daniele de Almeida; Tudella, Eloisa

    2011-01-01

    The authors aimed to investigate proximal and distal adjustments of reaching behavior and grasping in 5-, 6-, and 7-month-old preterm infants. Nine low-risk preterm and 10 full-term infants participated. Both groups showed the predominance of unimanual reaching, an age-related increase in the frequency of vertical-oriented and open hand movement, and also an increase in successful grasping from 6 to 7 months. The frequency of open hand was higher in the preterm group at 6 months. Intrinsic restrictions imposed by prematurity did not seem to have impaired reaching performance of preterm infants throughout the months of age.

  8. Validity and efficacy of the labor contract

    Directory of Open Access Journals (Sweden)

    Jorge Toyama

    2012-12-01

    Full Text Available The validity and efficacy of the labor contract as well as cases of nullity and defeasibility import an analysis of scopes of the supplementary application of Civil Code taking into account the peculiarities of Labor Law. Labor contract, while legal business has as regulatory framework to the regulations of Civil Code but it is necessary to determine, in each case, whether to apply fully this normative body, or modulate its supplemental application, or simply conclude that it doesn’t result compatible its regulation due to the special nature of labor relations. Specifically, this issue will be analyzed from cases of nullity and defeasibility of the labor contract.

  9. Wage and Labor Union in Manufacturing Sector

    OpenAIRE

    Pipit Pitriyan; Adiatma Y.M Siregar

    2012-01-01

    The presence of Labor Unions is expected to provide a higher bargaining power for its members so that the rights of workers can be better acknowledged. In Indonesia, presently, the role of unions is more highlighted in the determination of the minimum wage. This study aims to estimate the the role of labor union on wage determination of Indonesia’s labor intensive manufacturing sector and whether wage differentials occurs among labor union member/non-member of Indonesia’s labor intensive manu...

  10. Modern Neuraxial Anesthesia for Labor and Delivery.

    Science.gov (United States)

    Meng, Marie-Louise; Smiley, Richard

    2017-01-01

    The availability of safe, effective analgesia during labor has become an expectation for women in most of the developed world over the past two or three decades. More than 60% of women in the United States now receive some kind of neuraxial procedure during labor. This article is a brief review of the advantages and techniques of neuraxial labor analgesia along with the recent advances and controversies in the field of labor analgesia. For the most part, we have aimed the discussion at the non-anesthesiologist to give other practitioners a sense of the state of the art and science of labor analgesia in the second decade of the 21st century.

  11. Gender analysis of the Russian labor market

    OpenAIRE

    Aleksandr Mikhailovich Panov

    2014-01-01

    The issue of gender inequality in the labor market affects all world countries to some extent. As salary is the basis of population’s sources of income in Russia, unequal pay to men and women for equal work can trigger gender discrimination in the labor market and beyond. The article focusses on the gender analysis of the Russian labor market. It focuses on conjunctural conditions of the labor market in a gender aspect, socio-economic characteristics of men and women as subjects of the labor ...

  12. Prevention of preterm delivery in twin pregnancy

    DEFF Research Database (Denmark)

    Rode, Line; Tabor, Ann

    2014-01-01

    The incidence of twin gestation has increased markedly over the past decades, mostly because of increased use of assisted reproductive technologies. Twin pregnancies are at increased risk of preterm delivery (i.e. birth before 37 weeks of gestation). Multiple gestations therefore account for 2...... sequelae such as abnormal neurophysiological development in early childhood and underachievement in school. Several treatment modalities have been proposed in singleton high-risk pregnancies. The mechanism of initiating labour may, however, be different in singleton and twin gestations. Therefore......, it is mandatory to evaluate the proposed treatments in randomised trials of multiple gestations. In this chapter, we describe the results of trials to prevent preterm delivery in twin pregnancies....

  13. Microbiome in parturition and preterm birth.

    Science.gov (United States)

    Mysorekar, Indira U; Cao, Bin

    2014-01-01

    Preterm parturition is a one of the most significant global maternal-child health problem. In recent years, there has been an explosion in reports on a role for microbiomes (i.e., a microbial biomass) on a plethora of physiologic and pathologic human conditions. This review aims to describe our current understanding of the microbiome and its impact on parturition, with particular emphasis on preterm birth. We will focus on the roles of vaginal and oral mucosal microbiomes in premature parturition and describe the state-of-the-art methodologies used in microbiome studies. Next, we will present new studies on a potential microbiome in the placenta and how it may affect pregnancy outcomes. Finally, we will propose that host genetic factors can perturb the normal "pregnancy microbiome" and trigger adverse pregnancy outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes

    Science.gov (United States)

    Toprak, Erzat; Bozkurt, Murat; Dinçgez Çakmak, Burcu; Özçimen, Emel Ebru; Silahlı, Musa; Ender Yumru, Ayşe; Çalışkan, Eray

    2017-01-01

    Objective: Preterm premature rupture of membranes (PPROM) is closely related with maternal and fetal complications. Therefore, early diagnosis is extremely important to provide maternal and fetal well-being. Many inflammatory markers have been evaluated for their ability to diagnose membrane rupture at early stages. We aimed to investigate the relationship between the platelet-to-lymphocyte ratio (PLR) and preterm premature membrane rupture. Material and Methods: In this study, 121 pregnant women with PPROM and 96 age-matched pregnant women with spontaneous preterm labor who were admitted to our hospital between January 2014 and December 2015 were enrolled. Demographic data, complete blood cell count results, and neonatal outcomes were recorded. Results: The neutrophil and platelet counts were higher in the PPROM group (9948.4±3393.2 vs. 7466.1±1698.5/mm3 and 244.5±60 vs. 210.6±64.8/mm3, respectively, ppremature rupture of membranes was evaluated using an ROC curve. The sensitivity and specificity of the PLR was 57.8% and 73.7%, respectively, at a threshold >117.14 (p<0.001). Conclusion: The PLR might be a cost effective, easy to use, and practical marker for the early diagnosis of PPROM, which can help to determine the appropriate waiting time for delivery and provide maternal and fetal well-being. PMID:28890425

  15. PRETERM BIRTH ASSOCIATION WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-04-01

    Full Text Available INTRODUCTION: Cerebral palsy ( CP is a group of permanent movement disorders that appear in early childhood. Preterm birth is the birth of baby before 37 completed weeks, a full term birth is birth at 37 to 42 weeks of gestation . AIM: To show the extent of association of preterm deliveries as a risk factor in development of cerebral palsy. MATERIALS AND METHODS: This r etrospective cohort study was conducted by eliciting history from the mothers of 99 cerebral palsy children who w ere treated in Rani Chandra Mani Devi Hospital, Visakhapatnam, Andhra Pradesh, India. De tailed history was taken from the mothers of 99 cerebral palsy children who were treated in this hospital. History regarding the period of gestation at which the child was born (preterm or full term, any previous history of pre - term delivery or abortions, was obtained from the mothers and the data analyzed . RESULTS: From this study it was observed the proportional association of pre - term births to cerebral palsy is 33 out 99 i.e., about 33.33%, Of these 33 cerebral palsy children highest association being with birth at 28 wks gestation (51 %. This study also shows th at the mothers with a previous history of preterm delivery have 14.4 times higher risk of subsequent pre term delivery; those with previous history of abortions have 5.7 times risk of pre - term delivery than mothers without such history. CONCLUSION: From th is study it was concluded that the pre - term birth plays a major role as a risk factor in the development of cerebral palsy with mothers having previous pre term delivery and previous abortions adding further to this risk.

  16. Does exposure to flame retardants increase the risk for preterm birth?

    Science.gov (United States)

    Peltier, Morgan R; Koo, Hschi-Chi; Getahun, Darios; Menon, Ramkumar

    2015-02-01

    During the past 40 years, polybrominated diphenyl ethers (PBDEs) have been widely used as flame retardants and nearly all women have some level of exposure. PBDEs have been isolated from amniotic fluid and cord plasma indicating vertical transmission; however, their effects on pregnancy outcome are largely unknown. Therefore, we quantified PBDE-47, the most common congener in maternal plasma samples collected at the time of labor from women who subsequently had term or preterm birth (PTB). Women were then scored based on whether or not they had very low, low, medium, high or very high peripheral plasma concentrations of PBDE-47. Probit regression analysis suggested that women in the PTB group had a greater chance of scoring higher on this scale (Pmaternal exposure to PBDEs might increase the risk for PTB. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Candida Chorioamnionitis Leads to Preterm Birth and Adverse Fetal-Neonatal Outcome

    Directory of Open Access Journals (Sweden)

    Yohei Maki

    2017-01-01

    Full Text Available Candida chorioamnionitis is rare but can lead to neonatal infection, high mortality, and neurodevelopmental impairment. We aimed to investigate maternal clinical features and perinatal outcomes and discuss future management strategies. We reviewed the medical records of women with Candida chorioamnionitis at our hospital over a 10-year period (n=9 and previous published case reports and case series. The most prevalent Candida species was C. albicans (71.3% of the all cases. The most prevalent predisposing condition was preterm premature rupture of membranes (31/123, 25.2%, followed by pregnancy with a retained intrauterine contraceptive device (26/123, 21.1% and pregnancy after in vitro fertilization (25/123, 20.3%. Preterm labor was the most common symptom (52/123, 42.3%, and only 13% of cases involved fever. Of the infants, 27% of the singletons and 23.8% of the twins were born before 22 gestational weeks, while 60% of the singletons and 76.2% of the twins were born at 22–36 weeks. The median birth weight of the babies born after 22 weeks was 1230 g. The mortality rates of the singletons and twins born after 22 weeks of gestation in the year 2000 or later were 28.6% and 52.4%, respectively. Antenatal treatment for Candida chorioamnionitis has not been established.

  18. Antenatal Corticosteroids for Preterm Premature Rupture of Membranes: Single or Repeat Course?

    Science.gov (United States)

    Brookfield, Kathleen F.; El-Sayed, Yasser Y.; Chao, Lisa; Berger, Victoria; Naqvi, Mariam; Butwick, Alexander J.

    2015-01-01

    Objective The aim of this article is to determine the risk of maternal chorioamnionitis and neonatal morbidity in women with preterm premature rupture of membranes (PPROM) exposed to one corticosteroid course versus a single repeat corticosteroid steroid course. Study Design Secondary analysis of a cohort of women with singleton pregnancies and PPROM. The primary outcome was a clinical diagnosis of maternal chorioamnionitis. Using multivariate logistic regression, we controlled for maternal age, race, body mass index, diabetes, gestational age at membrane rupture, preterm labor, and antibiotic administration. Neonatal morbidities were compared between groups controlling for gestational age at delivery. Results Of 1,652 women with PPROM, 1,507 women received one corticosteroid course and 145 women received a repeat corticosteroid course. The incidence of chorioamnionitis was similar between groups (single course = 12.3% vs. repeat course = 11.0%; p = 0.8). Women receiving a repeat corticosteroid course were not at increased risk of chorioamnionitis (adjusted odds ratio, 1.28; 95% confidence interval, 0.69–2.14). A repeat course of steroids was not associated with an increased risk of any neonatal morbidity. Conclusion Compared with a single steroid course, our findings suggest that the risk of maternal chorioamnionitis or neonatal morbidity may not be increased for women with PPROM receiving a repeat corticosteroid course. PMID:25545441

  19. Effect of Antenatal Steroids on Respiratory Morbidity of Late Preterm Newborns: A Randomized Controlled Trial.

    Science.gov (United States)

    Ontela, Vijaya; Dorairajan, Gowri; Bhat, Vishnu B; Chinnakali, Palanivel

    2018-01-22

    The objective of this article was to study the effect of antenatal dexamethasone on the respiratory morbidity of late preterm newborns. A randomized controlled trial, conducted in Obstetrics and Gynecology Department in collaboration with Neonatology department at JIPMER, India. In total, 155 women were studied in each group. Intention to treat analysis and per protocol analysis were done. Overall 31 (10%) newborns were admitted to intensive care unit. The composite respiratory morbidity (defined as respiratory distress syndrome and/or transient tachypnea of newborn) was observed in 64 (41.6%) infants in the study and 56 (36.2%) infants in the control group. On multivariable-adjusted analysis, use of steroids was not found to be associated with decrease in composite respiratory morbidity [adjusted relative risk 0.91 (95% confidence interval: 0.7-1.2)]. Antenatal dexamethasone does not reduce the composite respiratory morbidity of babies born vaginally or by emergency cesarean to women with late preterm labor. © The Author(s) [2018]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  20. Evaluation of a quantitative fetal fibronectin test for spontaneous preterm birth in symptomatic women.

    Science.gov (United States)

    Abbott, Danielle S; Radford, Samara K; Seed, Paul T; Tribe, Rachel M; Shennan, Andrew H

    2013-02-01

    The purpose of this study was to determine whether quantification of cervicovaginal fluid fetal fibronectin (fFN) improves diagnostic accuracy of spontaneous preterm birth (sPTB) in symptomatic women. A prospective blinded predefined secondary analysis of a larger study of cervicovaginal fluid fFN concentration (nanograms per milliliter) in women symptomatic of preterm labor (n =300 women; 22-35 weeks' gestation) with a Hologic 10Q system (Hologic, Marlborough, MA). Clinicians were blinded to the result until after the delivery, but the qualitative Hologic TLI(IQ) fFN result was made available. The positive predictive value for sPTB (<34 weeks' gestation) increased from 19%, 32%, 61%, and 75% with increasing thresholds (10, 50, 200, and 500 ng/mL, respectively). Compared with <10 ng/mL fFN, the relative risk of delivery was 5.6 (95% confidence interval [CI], 1.05-29.57), 7.9 (95% CI, 1.38-45.0), 22.8 (95% CI, 3.84-135.5), and 51.3 (95% CI, 12.49-211.2; P < .01). Quantitative fFN provides thresholds (10 and 200 ng/mL) in addition to the qualitative method (50 ng/mL) to discriminate the risk of sPTB in symptomatic women. Copyright © 2013 Mosby, Inc. All rights reserved.

  1. Unexpected behavioural consequences of preterm newborns' clothing.

    Science.gov (United States)

    Durier, Virginie; Henry, Séverine; Martin, Emmanuelle; Dollion, Nicolas; Hausberger, Martine; Sizun, Jacques

    2015-03-17

    Restrictions of preterm newborns' movements could have consequences ranging from stress enhancement to impairment of their motor development. Therefore, ability to freely express motor activities appears crucial for their behavioural and physiological development. Our aim was to evaluate behavioural issues of two types of clothing used in NICU. We observed 18 healthy 34-37 post-conception week-old preterm newborns, during resting periods, when they were undisturbed by any interventions. Newborns wore either light clothing (bodysuit and a light wrapping) or heavy clothing (pyjamas, cardigan and sleep-sack). The percentages of time each subject spent in different postures were compared between clothing situations. Arm and hand postures differed in relation to clothing: babies bent their arms more and held their hands nearer their heads when in bodysuits than when in sleepwear. Consequently, babies in bodysuits spent more time touching their body or their environment whereas the others generally were touching nothing. Self-touch is an important way to comfort one's self. Heavy clothing may impair self-soothing behaviours of preterm newborn babies that already lack other forms of contact. Results suggest that more attention should be paid to apparently routine and marginal decisions such as choice of clothes.

  2. Physiologic brain dysmaturity in late preterm infants

    Science.gov (United States)

    Scher, Mark S.; Johnson, Mark W.; Ludington, Susan M.; Loparo, Kenneth

    2011-01-01

    Neonatal EEG sleep was used to determine if differences are expressed between healthy late preterm and full term groups. Twenty-seven 24-channel multi-hour studies were recorded at similar post–menstrual ages (PMA) and analyzed for eight asymptomatic late preterm infants (LPT) compared with nineteen healthy full term (FT) infants as a preliminary analysis, followed by a comparison of a subset of 8 FT infants, matched for gender, race, and PMA. Z scores were performed on data sets from each group pair comparing each of seven EEG/Sleep measures for entire recordings, active (AS) and quiet sleep (QS) segments and artifact-free intervals. Six of seven measures showed differences between the 8 LPT and 8 matched FT cohort pair comparisons of >0.3; REMs, arousals during QS, spectral correlations between homologous centro-temporal regions during QS, spectral beta/alpha power ratios during AS and QS, a spectral measure of respiratory regularity during QS, and sleep cycle length. Quantitative neurophysiologic analyses define differences in brain maturation between LPT and FT infants at similar PMA. Altered EEG/Sleep behaviors in the LPT are biomarkers of developmental neuroplasticity involving interconnected neuronal networks adapting to conditions of prematurity for this largest segment of the preterm neonatal population. PMID:21796018

  3. Cervical gland area as an ultrasound marker for prediction of preterm delivery: A cohort study

    Directory of Open Access Journals (Sweden)

    Vajiheh Marsoosi

    2017-11-01

    Full Text Available Background: Preterm labor is a major cause of perinatal morbidity and mortality and it might be predicted by assessing the cervical change. Objective: To assess the association between absence of cervical gland area (CGA and spontaneous preterm labor (SPTL. Materials and Methods: This prospective cohort study was performed on 200 singleton pregnant women with a history of SPTL, second-trimester abortion in the previous pregnancy or lower abdominal pain in current pregnancy. Each patient underwent one transvaginal ultrasound examination between 14-28 wk of gestation. Cervical length was measured and CGA was identified and their relationship with SPTL before 35 and 37 wk gestation was evaluated using STATA software version 10. Results: The mean of cervical length was 36.5 mm (SD=8.4, the shortest measurement was 9 mm, and the longest one was 61 mm. Short cervical length (≤18mm was significantly associated with SPTL before 35 and 37 wk gestation. Cervical gland area (the hypoechogenic or echogenic area around the cervical canal was present in 189 (94.5% patients. Absent of CGA had a significant relationship with SPTL before 35 and 37 wk gestation (p=0.01 and p<0.001, respectively. Cervical length was shorter in women with absent CGA in comparison with subjects with present CGA: 37±10 mm in CGA present group and 23±9 mm in CGA absent group (p<0.001. Conclusion: Our study showed that cervical gland area might be an important predictor of SPTL which should be confirmed with further researches.

  4. RISK FACTORS FOR VERY PRETERM DELIVERY

    Directory of Open Access Journals (Sweden)

    Наталья Витальевна Батырева

    2018-01-01

    Full Text Available The aim of the research – assess risk factors for very preterm delivery in the Omsk region. Materials and methods. The main group comprised women with very preterm delivery (n = 64; сomparison group – pregnant women with a threat of interruption in terms of 22-27 weeks and successful preserving therapy (n = 63; control group – pregnant women in whom this pregnancy was taking place without the threat of interruption (n = 62. Results. Risk factors for very preterm delivery were bacterial vaginosis, specific vaginitis, kidney disease and the threat of interruption. There was a significant lead in streptococci (32.3 ± 5.8 %, especially group B (19.0 ± 4.9 % in the main group. The risk factor for very preterm delivery was infectious viral diseases transferred during pregnancy, observed in 12.7 ± 4.2 % of women in the main group, in 7.8 ± 3.3 % in the comparison group (p < 0.01 and in 4.8 ± 2,7 % – control (p < 0,001. In the main group, placental insufficiency was 2 times more common than in the comparison group and 13 times than in the control group. Every sixth pregnant of the main group had manifestations of gestosis. Such complications of gestation as the premature detachment of the normally inserted placenta (7.8 ± 3.3 % and inborn malformations of a fruit (1.6 ± 1.6 % were observed only in the main group. Conclusion. The results of the research and literature data showed that the significant influence on the level of very early premature births is due to: the age of the parents, the abuse of nicotine, alcohol, drugs, abortion, preterm birth, urinary tract and genital tract infections, severe somatic diseases, multiple pregnancies. In the structure of complications of gestation during miscarriages, placental insufficiency predominates, the threat of abortion, fetal growth retardation, and polyhydramnios.

  5. FADIGA LABORAL EM TRABALHADORES RURAIS

    OpenAIRE

    Karla Nayalle de Souza Oliveira; Leilson Rocha Bezerra; Maria Augusta Rocha Bezerra; Kaline Nayanne de Souza Oliveira; Cristianne Teixeira Carneiro

    2013-01-01

    El objetivo fue identificar la existencia de estrés laboral de trabajadores rurales del Bom Jesus-PI, Brasil. Estudio descriptivo exploratorio llevado acabo entre abril y junio de 2011, con 47 trabajadores. Recopilación de datos se realizó por instrumento para evaluación del estrés llamado Cuestionario Bipolar y guión de entrevista semiestructurada con la caracterización del perfil sociodemográfico y de las condiciones de trabajo. Se tabularon los cuestionarios, que se compararon por Chi-Cuad...

  6. ACOSO LABORAL EN COSTA RICA

    OpenAIRE

    VARGAS MORÚA, ELIZARDA

    2014-01-01

    Este artículo constituye un análisis descriptivo de las resoluciones judiciales de Costa Rica respecto al acoso laboral. De acuerdo con el Sistema Costarricense de Información Jurídica son 23 resoluciones clasificadas bajo el tema de “acoso laboral” relativas a procesos iniciados desde el año 1998 al presente. También se analiza la información suministrada por el Ministerio de Trabajo y Seguridad Social de las denuncias que se tramitaron por la vía administrativa. Aunque el ordenamiento costa...

  7. Labor report 1997-1998

    International Nuclear Information System (INIS)

    Instituto Nacional de Investigaciones Nucleares

    1998-01-01

    In agreement with the disposition in the 93 rd Article of the Mexican United States Constitution Policy, the National Institute for Nuclear Research, which is directed as decentralized public organization of the Federal Government presents its labor report corresponding to the period 1997-1998. The Institution purpose is to perform research and development in the nuclear sciences and technology fields, as well as to promote the peaceful uses of the nuclear energy and divulging the advances reached for entailing them to the economic, social, scientific and technological development of the country. (Author)

  8. Korean Emotional Laborers' Job Stressors and Relievers: Focus on Work Conditions and Emotional Labor Properties.

    Science.gov (United States)

    Lee, Garam

    2015-12-01

    The present study aims to investigate job stressors and stress relievers for Korean emotional laborers, specifically focusing on the effects of work conditions and emotional labor properties. Emotional laborers are asked to hide or distort their real emotions in their interaction with clients. They are exposed to high levels of stress in the emotional labor process, which leads to serious mental health risks including burnout, depression, and even suicide impulse. Exploring job stressors and relieving factors would be the first step in seeking alternatives to protect emotional laborers from those mental health risks. Using the third wave data of Korean Working Conditions Survey, logistic regression analysis was conducted for two purposes: to examine the relations of emotional labor and stress, and to find out job stressors and relievers for emotional laborers. The chances of stress arousal are 3.5 times higher for emotional laborers; emotional laborers experience double risk-burden for stress arousal. In addition to general job stressors, emotional laborers need to bear burdens related to emotional labor properties. The effect of social support at the workplace is not significant for stress relief, unlike common assumptions, whereas subjective satisfaction (wage satisfaction and work-life balance) is proven to have relieving effects on emotional laborers' job stress. From the results, the importance of a balanced understanding of emotional labor for establishing effective policies for emotional laborer protection is stressed.

  9. Temporal Trends in Late Preterm and Early Term Birth Rates in 6 High-Income Countries in North America and Europe and Association With Clinician-Initiated Obstetric Interventions

    DEFF Research Database (Denmark)

    Richards, Jennifer L.; Kramer, Michael S.; Deb-Rinker, Paromita

    2016-01-01

    : Use of clinician-initiated obstetric intervention (either labor induction or prelabor cesarean delivery) during delivery. Main Outcomes and Measures: Annual country-specific late preterm (34-36 weeks) and early term (37-38 weeks) birth rates. Results: The study population included 2 415 432 Canadian......Importance: Clinicians have been urged to delay the use of obstetric interventions (eg, labor induction, cesarean delivery) until 39 weeks or later in the absence of maternal or fetal indications for intervention. Objective: To describe recent trends in late preterm and early term birth rates in 6...... high-income countries and assess association with use of clinician-initiated obstetric interventions. Design: Retrospective analysis of singleton live births from 2006 to the latest available year (ranging from 2010 to 2015) in Canada, Denmark, Finland, Norway, Sweden, and the United States. Exposures...

  10. A global perspective on foreign contract labor.

    Science.gov (United States)

    Smart, J E; Casco, R R

    1988-01-01

    This paper provides a general overview on foreign contract labor. The growth in the use of foreign contract labor is described with reference to other types of international labor movements such as 1) illegal, undocumented, or irregular migration; 2) free migration; and 3) permanent settlement migration. Within this general context, the various national advantages and disadvantages of contract labor are outlined. Particular issues like the role of trade unions and the likely future international labor circulation are noted. The 1984 World Labour Report estimates a global stock of almost 22 million foreign workers. Despite lack of reliable data, the size of irregular labor flows is considerable. More than 4 million undocumented workers, primarily Mexicans, can be found in the US alone. Other major flows of illegal labor go from China to Hong Kong, Malaysia to Singapore, Columbia to Venezuela, and poor Arab countries to oil-exporting countries in the Middle East. Laws are often poorly enforced and contradictory. Employers often actively recruit illegal migrants. While permanent migration was formerly the primary source of foreign workers, the numbers migrating in this manner are decreasing significantly. In absolute terms, host countries gain considerably more through the use of contract labor than sending countries. The pervasive commitment of national governments to economic growth is a prime consideration in the decision to import foreign labor. In general, trade unions have created an environment wherein the use of foreign labor in the formal as opposed to the informal labor market is more difficult. The disadvantages of labor export include the costs of family separation, worker exploitation, and cultural alienation. Remittances constitute the most tangible return of labor export. In many countries they have made a very considerable impact on the balance of payments deficit.

  11. The impact of time of delivery on gestations complicated by preterm premature rupture of membranes: daytime versus nighttime.

    Science.gov (United States)

    Moussa, Hind; Hosseini Nasab, Susan; Fournie, David; Ontiveros, Alejandra; Alkawas, Rim; Chauhan, Suneet; Blackwell, Sean; Sibai, Baha

    2018-04-09

    Perinatal death, in particular intrapartum stillbirth and short-term neonatal death, as well as neonatal short term and long term morbidity have been associated with the time of day that the birth occurs. Indeed, evening and nighttime deliveries were associated with an increased risk of an adverse perinatal outcome when compared to similar daytime deliveries. Impact of shift change, as well as time of day delivery have been extensively studied in the context of maternal and neonatal complications of cesarean delivery, however, no studies were previously performed on timing of delivery and its effect on the outcome of pregnancies complicated by preterm premature rupture of membranes. Our objective was to compare obstetric, neonatal as well as long-term outcomes between women delivered in the daytime versus nighttime, in singleton gestations whose pregnancies were complicated by preterm premature rupture of membranes. This was a secondary analysis of a trial of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network "A Randomized Clinical Trial of the Beneficial Effects of Antenatal Magnesium Sulfate for the Prevention of Cerebral Palsy". For this analysis, the time of delivery was divided into the daytime, from 07:01 to 19:00, and the nighttime, from 19:01 to 07:00. Epidemiological, obstetric characteristics as well as neonatal and long-term outcomes were compared between deliveries occurring during the daytime versus the nighttime periods. Inclusion criteria consisted of singleton gestations diagnosed with preterm premature rupture of membranes (PPROM). Multifetal gestations and pregnancies with preterm labor without preterm premature rupture of membranes were excluded. A total of 1752 patients met inclusion criteria, 881 delivering during the daytime, while 871 during the nighttime. There were no differences in demographic maternal variables. There were no differences in the number of patients

  12. Identification of preterm birth in women with threatened preterm labour between 34 and 37 weeks of gestation.

    Science.gov (United States)

    Gezer, Cenk; Ekin, Atalay; Solmaz, Ulas; Sahingoz Yildirim, Alkim Gulsah; Dogan, Askin; Ozeren, Mehmet

    2018-02-09

    The aim of this study was to assess whether serum markers would be useful as a new predictor of preterm birth in patients with spontaneous, late preterm labour. Patients diagnosed with late preterm labour were divided into preterm delivery (229 patients) and term delivery (178 patients) groups. The two groups were compared in terms of clinical characteristics and levels of serum markers (leukocyte subtypes, platelet, C-reactive protein [CRP], neutrophil to lymphocyte ratio [NLR] and platelet to lymphocyte ratio [PLR]), which were obtained at admission. The levels of leukocyte (p preterm delivery group, compared to the term delivery group. On multivariate regression analysis, NLR positive was the most powerful predictive variable (OR = 1.41; 95%CI: 1.32-1.51; p = .005). NLR had the highest area under curve (0.711; 95%CI 0.662-0.760) in predicting preterm birth and a NLR >6.2 had the highest sensitivity (65.1%) and specificity (62.5%). High NLR at admission is an independent predictor of preterm birth in patients with spontaneous, late preterm labour. Impact statement What is already known on this subject: Preterm birth accounts for 5-12% of all births, and is a major factor associated with perinatal morbidity and mortality worldwide. However, more than 70% of preterm births occur at late preterm between 34 0/7 and 36 6/7 weeks of gestation. The central role of systemic and subclinical infections in preterm labour is well documented. Intrauterine infection leading to delivery can be measured by using a variety of laboratory parameters. What do the results of this study add: Neutrophil to lymphocyte ratio is an inexpensive, easily interpretable and promising haematologic parameter that is widely available. This study explored the association of high neutrophil to lymphocyte ratio with the risk of preterm birth in women with preterm labour between 34 and 37 weeks of gestation. What are the implications of these findings for clinical practice and/or further

  13. Prenatal stress alters amygdala functional connectivity in preterm neonates.

    Science.gov (United States)

    Scheinost, Dustin; Kwon, Soo Hyun; Lacadie, Cheryl; Sze, Gordon; Sinha, Rajita; Constable, R Todd; Ment, Laura R

    2016-01-01

    Exposure to prenatal and early-life stress results in alterations in neural connectivity and an increased risk for neuropsychiatric disorders. In particular, alterations in amygdala connectivity have emerged as a common effect across several recent studies. However, the impact of prenatal stress exposure on the functional organization of the amygdala has yet to be explored in the prematurely-born, a population at high risk for neuropsychiatric disorders. We test the hypothesis that preterm birth and prenatal exposure to maternal stress alter functional connectivity of the amygdala using two independent cohorts. The first cohort is used to establish the effects of preterm birth and consists of 12 very preterm neonates and 25 term controls, all without prenatal stress exposure. The second is analyzed to establish the effects of prenatal stress exposure and consists of 16 extremely preterm neonates with prenatal stress exposure and 10 extremely preterm neonates with no known prenatal stress exposure. Standard resting-state functional magnetic resonance imaging and seed connectivity methods are used. When compared to term controls, very preterm neonates show significantly reduced connectivity between the amygdala and the thalamus, the hypothalamus, the brainstem, and the insula (p amygdala and the thalamus, the hypothalamus, and the peristriate cortex (p amygdala connectivity associated with preterm birth. Functional connectivity from the amygdala to other subcortical regions is decreased in preterm neonates compared to term controls. In addition, these data, for the first time, suggest that prenatal stress exposure amplifies these decreases.

  14. Prognostic Significance of Preterm Isolated Decreased Fetal Movement

    Directory of Open Access Journals (Sweden)

    Ertuğrul Karahanoğlu

    2017-12-01

    Full Text Available Objective: Our aim is to evaluate the prognostic significance of isolated, preterm decreased fetal movement following normal initial full diagnostic workup. Study design: A retrospective observational study was conducted at a tertiary centre. The applied protocol was approved by the Medical Research Ethics Department of the hospital where the research was conducted. Obstetrics outcomes of preterm- and term-decreased fetal movement were compared following an initial, normal diagnostic work up. Evaluated outcomes were birth weight, mode of delivery, stillbirth rate, induction of labour, development of gestational hypertension, small for gestational age and oligohydramnios, polyhydramnios during the follow up period. Result: Obstetric complications related to placental insufficiency develops more frequently for decreased fetal movement in preterm cases with respect to that of in term cases. Following the diagnosis of decreased fetal movement, pregnancy hypertension occurred in 17% of preterm decreased fetal movement cases and in 4.7% of term decreased fetal movement cases. Fetal growth restriction developed in 6.6% of preterm decreased fetal movement and in 2.3% of term decreased fetal movement. Amniotic fluid abnormalities more frequently developed in preterm decreased fetal movement. Conclusion: Following an initial normal diagnostic workup, preterm decreased fetal movement convey a higher risk for the development of pregnancy complications associated with placental insufficiency. The patient should be monitored closely and management protocols must be developed for initial normal diagnostic workups in cases of preterm decreased fetal movement.

  15. Preterm birth in rural Malawi — high incidence. in

    African Journals Online (AJOL)

    6.32, 95%CI 3.21,12.45). Conclusions: This population has a very high rate of preterm birth, which is probably infection-related. It may be representative of many rural populations in sub-Saharan Africa. Tackling the problem of neonatal mortality in low income countries will require effective methods to prevent preterm birth.

  16. Development of postural adjustments during reaching in preterm infants

    NARCIS (Netherlands)

    Van der Fits, IBM; Flikweert, ER; Stremmelaar, EF; Martijn, A; Hadders-Algra, M

    Preterm infants often show postural abnormalities, such as hyperextension of neck and trunk, which can interfere with motor and cognitive development. Little is, however, known on the pathophysiology of postural development in preterm infants. Therefore, we longitudinally studied the development of

  17. Nutritional requirements and parenteral nutrition in preterm infants ...

    African Journals Online (AJOL)

    Provision of appropriate nutritional requirements soon after birth is critical for normal development and growth of preterm infants. Preterm infants are often not able to tolerate volumes of oral feeds that will provide adequate daily requirements for growth within the first week or two of life, therefore parenteral nutrition is often ...

  18. Less Stress : Oxidative stress and glutathione kinetics in preterm infants

    NARCIS (Netherlands)

    D. Rook (Denise)

    2013-01-01

    textabstractDue to immature antioxidant defenses, preterm infants are at susceptible to oxidative stress, which is associated with bronchopulmonary dysplasia, retinopathy of prematurity and periventricular leukomalacia. The general aim of this thesis was to study oxidative stress in preterm infants

  19. Multilevel factors influencing preterm birth in an urban setting

    Directory of Open Access Journals (Sweden)

    Saba W. Masho

    2014-01-01

    Full Text Available Racial disparity in preterm is a major problem in the US. Although significant strides have been made in identifying some of the risk factors, the complexities between community and individual factors are not understood. This study examines the influence of individual and community level factors affecting preterm birth among Black and White women in an urban setting. A 10-year live birth registry dataset from a mid-sized, racially diverse city was analyzed (N = 30,591. Data were geocoded and merged with block group level Census data. Five hierarchical models were examined using PROC GLIMMIX. Education, illicit drug use, pregnancy complications, previous preterm birth, paternal presence, inadequate and adequate plus prenatal care, and poverty were associated with preterm births in both Blacks and Whites. In Black women, increasing maternal age, maternal smoking, and a previous infant death were significant predictors of preterm births, which was not the case for White women. Residing in medium or high poverty neighborhoods resulted in 19% and 28% higher odds, respectively, of preterm birth for Black women. In addition to individual level factors, neighborhood poverty is an important risk factor influencing preterm birth. It is essential to engage multisectoral agencies in addressing factors influencing preterm birth.

  20. Transient hypothyroxinaemia associated with developmental delay in very preterm infants

    NARCIS (Netherlands)

    Meijer, W.J.; Verloove-Vanhorick, S.P.; Brand, R.; Brande, J.L. van den

    1992-01-01

    In 563 surviving very preterm (<32 weeks gestational age) and/or very low birthweight (<1500 g) infants the relationship between neonatal thyroxine concentration and psychomotor development at 2 years of age (corrected for preterm birth) was studied. A significant association was found between low

  1. Thymic size in preterm neonates: a sonographic study

    DEFF Research Database (Denmark)

    Jeppesen, Dorthe Lisbeth; Hasselbalch, H; Poulsen, Susanne Dam

    2003-01-01

    AIM: To assess the variation in size of the thymus in vivo in preterm neonates and to identify relations between thymic size and gestational age (GA), birthweight, occurrence of postnatal infections and maternal alcohol and tobacco intake during pregnancy. METHODS: Eighty preterm neonates with a ...

  2. A Review of Fetomaternal Outcome of Preterm Prelabour Rupture of ...

    African Journals Online (AJOL)

    Preterm prelabour rupture of membranes(PPROM) is an important obstetric complication. It accounts for a third of all preterm deliveries with associated increased risks of fetomaternal and neonatal morbidity and mortality. To review the fetomatermal outcome of PPROM in a tertiary hospital in Lagos, South-west, Nigeria.

  3. Antenatal corticosteroid use in preterm birth at Kenyatta National ...

    African Journals Online (AJOL)

    Background: Preterm birth causes about 75% of neonatal deaths that are not attributable to congenital malformations. Antenatal corticosteroids (ACS) given to mothers at risk of preterm birth reduce the incidence/severity of RDS, intraventricular haemmorhage, necrotizing enterocolitis and neonatal deaths. The WHO ...

  4. 60 Review Article PRETERM RUPTURE OF MEMBRANES: THE ...

    African Journals Online (AJOL)

    Preterm rupture of membranes: the vitamin c factor. 60. Review Article. PRETERM RUPTURE OF MEMBRANES: THE VITAMIN C FACTOR. *J.A. Osaikhuwuomwan. *Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital,. PMB 1111, Benin City, Nigeria. Correspondence: Osaikhuwuomwan J.A.

  5. Post partum emotional distress in mothers of preterm infants: a ...

    African Journals Online (AJOL)

    More mothers of preterm neonates(27.3%) had GHQ-30 scores which categorised them as having significant emotional distress than mothers of full term normal infants(3.7%). Similarly more mothers of preterm neonates(15.1%) were more depressed than mothers of full term normal infants(3.7%). These differences were ...

  6. Does perinatal asphyxia contribute to neurological dysfunction in preterm infants?

    NARCIS (Netherlands)

    van Iersel, Patricia A. M.; Bakker, Saskia C. M.; Jonker, Arnold J. H.; Hadders-Algra, Mijna

    Background: Children born preterm are known to be at risk for neurodevelopmental disorders. The role of perinatal asphyxia in this increased risk is still a matter of debate. Aim: To analyze the contribution of perinatal asphyxia in a population of preterm infants admitted to a secondary paediatric

  7. Therapeutic touch with preterm infants: composing a treatment.

    Science.gov (United States)

    Hanley, Mary Anne

    2008-01-01

    Therapeutic touch (TT), a complementary therapy, has been shown to decrease stress, anxiety, and pain in adults and children, as well as improve mobility in patients with arthritis and fibromyalgia. However, less has been reported about the effectiveness of this therapy with infants, particularly preterm infants. The aims of this research study were to explore the nature of the use of TT with preterm infants and describe a TT treatment process for this vulnerable population. Narrative inquiry and qualitative descriptive methods were used to discover knowledge about how TT is used with preterm infants. Telephone/in-person interviews and written narratives provided the data describing nurses' use of TT with preterm infants. The participants were registered nurses who practiced TT with preterm infants for varying years of experience. The participants described the responses of infants, 25 to 37 weeks postgestational age, whom they treated with TT. The infants' responses to TT included reduced heart and respiratory rates, enhanced ability to rest, improved coordination in sucking, swallowing, and breathing, and a greater ability to engage with the environment. The practitioners described the phases and elements of TT for preterm infants, which revealed unique patterns, for example, the treatment phase included the elements of smoothing and containing. The description that emerged from the practitioners' narratives of the TT treatment process for preterm infants provides preliminary data for the systematic use and evaluation of TT as an adjunct to facilitating preterm infants' physiological, behavioral, energy field development, and well-being.

  8. Early postnatal calcium and phosphorus metabolism in preterm infants

    NARCIS (Netherlands)

    Christmann, V.; Grauw, A.M. de; Visser, R.; Matthijsse, R.P.; Goudoever, J.B. van; Heijst, A.F.J. van

    2014-01-01

    OBJECTIVES: Bone mineralisation in preterm infants is related to the supply of calcium (Ca) and phosphorus (P). We increased the amount of minerals in parenteral nutrition (PN) for preterm infants and evaluated postnatal Ca and P metabolism in relation to mineral and vitamin D (vitD) intake.

  9. Changes in globus pallidus with (pre)term kernicterus

    NARCIS (Netherlands)

    P. Govaert (Paul); R.M.C. Swarte (Renate); S.G.F. Robben (Simon); I.F.M. de Coo (René); N. Weisglas-Kuperus (Nynke); M. Sinaasappel (Maarten); J. Barkovich (James); Y.B. de Rijke (Yolanda); M.H. Lequin (Maarten)

    2003-01-01

    textabstractOBJECTIVE: We report serial magnetic resonance (MR) and sonographic behavior of globus pallidus in 5 preterm and 3 term infants with kernicterus and describe the clinical context in very low birth weight preterm infants. On the basis of this information, we suggest

  10. Achieving optimal feeds for preterm babies, recommendations and ...

    African Journals Online (AJOL)

    Preterm deaths are responsible for the highest number of neonatal mortality in Nigeria. Preterm nutrition contributes significantly to overall outcome particularly as it relates to neurodevelopment. Recently, new guidelines for enteral feedings in premature infants were issued by the American Academy of Paediatrics and ...

  11. Bowel Habits of Preterm Infants in Ilorin | Adegboye | Nigerian ...

    African Journals Online (AJOL)

    Objective: To determine the pattern of bowel habits of preterm infants in the first 10 days of postnatal life. Methods: One hundred and forty preterm infants delivered at the University of Ilorin Teaching Hospital (UITH) or referred to it within twelve hours of delivery, were studied. The babies were divided into two equal groups ...

  12. Early Postnatal Growth Of Preterm Low Birth Weight, Appropriately ...

    African Journals Online (AJOL)

    Background: Postnatal growth monitoring is useful in assessing the health of preterm babies but their growth patterns have not been sufficiently studied in Africans. Aim: To describe the growth achievements of preterm, low birth weight, appropriately-sized, Nigerian infants. Study design: The subjects were prospectively ...

  13. Malaria Parasitaemia and the Risk of Preterm Labour: A Re ...

    African Journals Online (AJOL)

    The evidence suggesting that malaria increases the risk of preterm labour has been based on descriptive studies with conflicting conclusions. This case-control assessment consists of 420 pregnant women in Yaounde (Cameroon) between 28 and 34 completed weeks of gestation. The cases were experiencing preterm ...

  14. The effects of preterm birth on visual development.

    Science.gov (United States)

    Leung, Myra Ps; Thompson, Benjamin; Black, Joanna; Dai, Shuan; Alsweiler, Jane M

    2018-01-01

    Children born very preterm are at a greater risk of abnormal visual and neurological development when compared to children born at full term. Preterm birth is associated with retinopathy of prematurity (a proliferative retinal vascular disease) and can also affect the development of brain structures associated with post-retinal processing of visual information. Visual deficits common in children born preterm, such as reduced visual acuity, strabismus, abnormal stereopsis and refractive error, are likely to be detected through childhood vision screening programs, ophthalmological follow-up or optometric care. However, routine screening may not detect other vision problems, such as reduced visual fields, impaired contrast sensitivity and deficits in cortical visual processing, that may occur in children born preterm. For example, visual functions associated with the dorsal visual processing stream, such as global motion perception and visuomotor integration, may be impaired by preterm birth. These impairments can continue into adolescence and adulthood and may contribute to the difficulties in learning (particularly reading and mathematics), attention, behaviour and cognition that some children born preterm experience. Improvements in understanding the mechanisms by which preterm birth affects vision will inform future screening and interventions for children born preterm. © 2017 Optometry Australia.

  15. Preterm Admissions in a Special Care Baby Unit: The Nnewi ...

    African Journals Online (AJOL)

    A review of all preterm admissions into the Special Care Bay Unit of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, over a period of 29 months (May 1998 October 2000) was carried out. Out of a total of 699 neonatal admissions, 133 (19 percent) were preterms with gestational ages ranging from 24 to ...

  16. Cytokines and the Risk of Preterm Delivery in Twin Pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Klein, Katharina; Larsen, Helle

    2012-01-01

    To estimate the association between cytokine levels in twin pregnancies and risk of spontaneous preterm delivery, including the effect of progesterone treatment.......To estimate the association between cytokine levels in twin pregnancies and risk of spontaneous preterm delivery, including the effect of progesterone treatment....

  17. Nutritional requirements and parenteral nutrition in preterm infants

    African Journals Online (AJOL)

    the fact that appropriate nutritional support ameliorates the protein and carbohydrate deficit and improves growth of preterm infants. The risk of growth failure increases with decreasing gestational age and birth weight. Therefore, very preterm and extreme low birth weight infants will need more intensive nutritional support.

  18. Management of preterm delivery in women with abnormal fetal presentation

    NARCIS (Netherlands)

    Bergenhenegouwen, L.A.

    2015-01-01

    The aim of the thesis was to answer the following questions. 1. What is the optimal mode of delivery in preterm breech presentation? 2. Does an intended caesarean section reduce the risk of perinatal mortality and morbidity as compared to intended vaginal delivery in preterm breech presentation? 3.

  19. La reforma del proceso laboral en Uruguay. El regreso al proceso laboral autónomo

    Directory of Open Access Journals (Sweden)

    Hugo Fernández

    2012-12-01

    Full Text Available The reform of the labor process in Uruguay. The return to the autonomous labor processThe reform of the Uruguayan labor process and the return to an autonomous legal regime represent a radical and fundamental change in the national legislation. The simplicity of new procedural structures governed by principles and owns norms of labor discipline give the new regime a dogmatic autonomous space lost for many years. The procedural labor reform is built on the adjectival character of its nature prioritizing the substantive law and adjusting the procedural rule to its characteristics. The principles of Labor Law (substantive and procedural are the foundation of the new regime

  20. Protecting labor rights: roles for public health.

    Science.gov (United States)

    Bhatia, Rajiv; Gaydos, Megan; Yu, Karen; Weintraub, June

    2013-11-01

    Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some public health agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine public health functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards.