WorldWideScience

Sample records for spontaneous preterm labour

  1. Low dose aspirin in the prevention of recurrent spontaneous preterm labour the APRIL study : a multicenter randomized placebo controlled trial

    NARCIS (Netherlands)

    Visser, Laura; de Boer, Marjon A.; de Groot, Christianne J. M.; Nijman, Tobias A. J.; Hemels, Marieke A. C.; Bloemenkamp, Kitty W. M.; Bosmans, Judith E.; Kok, Marjolein; van Laar, Judith O.; Sueters, Marieke; Scheepers, Hubertina; van Drongelen, Joris; Franssen, Maureen T. M.; Sikkema, J. Marko; Duvekot, Hans J. J.; Bekker, Mireille N.; van der Post, Joris A. M.; Naaktgeboren, Christiana; Mol, Ben W. J.; Oudijk, Martijn A.

    2017-01-01

    Background: Preterm birth (birth before 37 weeks of gestation) is a major problem in obstetrics and affects an estimated 15 million pregnancies worldwide annually. A history of previous preterm birth is the strongest risk factor for preterm birth, and recurrent spontaneous preterm birth affects more

  2. Low dose aspirin in the prevention of recurrent spontaneous preterm labour - the APRIL study: a multicenter randomized placebo controlled trial

    NARCIS (Netherlands)

    Visser, L de; Boer, M.A. de; Groot, C.J. de; Nijman, T.A.; Hemels, M.A.C.; Bloemenkamp, K.W.; Bosmans, J.E.; Kok, M. de; Laar, J.O. van; Sueters, M.; Scheepers, H.; Drongelen, J. van; Franssen, M.T.; Sikkema, J.M.; Duvekot, H.J.; Bekker, M.N.; Post, J.A. van der; Naaktgeboren, C.; Mol, B.W.; Oudijk, M.A.

    2017-01-01

    BACKGROUND: Preterm birth (birth before 37 weeks of gestation) is a major problem in obstetrics and affects an estimated 15 million pregnancies worldwide annually. A history of previous preterm birth is the strongest risk factor for preterm birth, and recurrent spontaneous preterm birth affects more

  3. Low dose aspirin in the prevention of recurrent spontaneous preterm labour - the APRIL study : a multicenter randomized placebo controlled trial

    NARCIS (Netherlands)

    Visser, Laura; de Boer, Marjon A; de Groot, Christianne J M; Nijman, Tobias A J; Hemels, Marieke A C; Bloemenkamp, Kitty W M; Bosmans, Judith E; Kok, Marjolein; van Laar, Judith O; Sueters, Marieke; Scheepers, Hubertina; van Drongelen, Joris; Franssen, Maureen T M; Sikkema, J Marko; Duvekot, Hans J J; Bekker, Mireille N; van der Post, Joris A M; Naaktgeboren, Christiana; Mol, Ben W J; Oudijk, Martijn A

    2017-01-01

    BACKGROUND: Preterm birth (birth before 37 weeks of gestation) is a major problem in obstetrics and affects an estimated 15 million pregnancies worldwide annually. A history of previous preterm birth is the strongest risk factor for preterm birth, and recurrent spontaneous preterm birth affects more

  4. Low dose aspirin in the prevention of recurrent spontaneous preterm labour - the APRIL study: a multicenter randomized placebo controlled trial

    NARCIS (Netherlands)

    Visser, Laura; de Boer, Marjon A.; de Groot, Christianne J. M.; Nijman, Tobias A. J.; Hemels, Marieke A. C.; Bloemenkamp, Kitty W. M.; Bosmans, Judith E.; Kok, Marjolein; van Laar, Judith O.; Sueters, Marieke; Scheepers, Hubertina; van Drongelen, Joris; Franssen, Maureen T. M.; Sikkema, J. Marko; Duvekot, Hans J. J.; Bekker, Mireille N.; van der Post, Joris A. M.; Naaktgeboren, Christiana; Mol, Ben W. J.; Oudijk, Martijn A.

    2017-01-01

    Preterm birth (birth before 37 weeks of gestation) is a major problem in obstetrics and affects an estimated 15 million pregnancies worldwide annually. A history of previous preterm birth is the strongest risk factor for preterm birth, and recurrent spontaneous preterm birth affects more than 2.5

  5. 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.

  6. Low dose aspirin in the prevention of recurrent spontaneous preterm labour - the APRIL study: a multicenter randomized placebo controlled trial.

    Science.gov (United States)

    Visser, Laura; de Boer, Marjon A; de Groot, Christianne J M; Nijman, Tobias A J; Hemels, Marieke A C; Bloemenkamp, Kitty W M; Bosmans, Judith E; Kok, Marjolein; van Laar, Judith O; Sueters, Marieke; Scheepers, Hubertina; van Drongelen, Joris; Franssen, Maureen T M; Sikkema, J Marko; Duvekot, Hans J J; Bekker, Mireille N; van der Post, Joris A M; Naaktgeboren, Christiana; Mol, Ben W J; Oudijk, Martijn A

    2017-07-14

    Preterm birth (birth before 37 weeks of gestation) is a major problem in obstetrics and affects an estimated 15 million pregnancies worldwide annually. A history of previous preterm birth is the strongest risk factor for preterm birth, and recurrent spontaneous preterm birth affects more than 2.5 million pregnancies each year. A recent meta-analysis showed possible benefits of the use of low dose aspirin in the prevention of recurrent spontaneous preterm birth. We will assess the (cost-)effectiveness of low dose aspirin in comparison with placebo in the prevention of recurrent spontaneous preterm birth in a randomized clinical trial. Women with a singleton pregnancy and a history of spontaneous preterm birth in a singleton pregnancy (22-37 weeks of gestation) will be asked to participate in a multicenter, randomized, double blinded, placebo controlled trial. Women will be randomized to low dose aspirin (80 mg once daily) or placebo, initiated from 8 to 16 weeks up to maximal 36 weeks of gestation. The primary outcome measure will be preterm birth, defined as birth at a gestational age (GA) aspirin is effective in preventing preterm birth, we expect that there will be cost savings, because of the low costs of aspirin. To evaluate this, a cost-effectiveness analysis will be performed comparing preventive treatment with aspirin with placebo. This trial will provide evidence as to whether or not low dose aspirin is (cost-) effective in reducing recurrence of spontaneous preterm birth. Clinical trial registration number of the Dutch Trial Register: NTR 5675 . EudraCT-registration number: 2015-003220-31.

  7. MRC ORACLE Children Study. Long term outcomes following prescription of antibiotics to pregnant women with either spontaneous preterm labour or preterm rupture of the membranes

    Directory of Open Access Journals (Sweden)

    Salt Alison

    2008-04-01

    Full Text Available Abstract Background The Medical Research Council (MRC ORACLE trial evaluated the use of co-amoxiclav 375 mg and/or erythromycin 250 mg in women presenting with preterm rupture of membranes (PROM ORACLE I or in spontaneous preterm labour (SPL ORACLE II using a factorial design. The results showed that for women with a singleton baby with PROM the prescription of erythromycin is associated with improvements in short term neonatal outcomes, although co-amoxiclav is associated with prolongation of pregnancy, a significantly higher rate of neonatal necrotising enterocolitis was found in these babies. Prescription of erythromycin is now established practice for women with PROM. For women with SPL antibiotics demonstrated no improvements in short term neonatal outcomes and are not recommended treatment. There is evidence that both these conditions are associated with subclinical infection so perinatal antibiotic administration may reduce the risk of later disabilities, including cerebral palsy, although the risk may be increased through exposure to inflammatory cytokines, so assessment of longer term functional and educational outcomes is appropriate. Methods The MRC ORACLE Children's Study will follow up UK children at age 7 years born to 4809 women with PROM and the 4266 women with SPL enrolled in the earlier ORACLE trials. We will use a parental questionnaire including validated tools to assess disability and behaviour. We will collect the frequency of specific medical conditions: cerebral palsy, epilepsy, respiratory illness including asthma, diabetes, admission to hospital in last year and other diseases, as reported by parents. National standard test results will be collected to assess educational attainment at Key Stage 1 for children in England. Discussion This study is designed to investigate whether or not peripartum antibiotics improve health and disability for children at 7 years of age. Trial registration The ORACLE Trial and Children

  8. 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

  9. 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

  10. Association between preterm labour and pelvic floor muscle function.

    Science.gov (United States)

    Aran, Turhan; Pekgöz, Ipek; Bozkaya, Hasan; Osmanagaoglu, Mehmet A

    2018-03-23

    We hypothesised that the pressure on the cervix increases with advancing gestation and it may lead to a cervical shortening and cause preterm labour in women with weak pelvic floor muscles. The aim of this prospective study was to measure vaginal resting pressure and pelvic floor muscle strength in the first trimester of pregnancy and to investigate their effects on labour. A study was conducted on the pregnant women with a low risk for preterm birth. The pelvic floor muscle strength and vaginal resting pressure were assessed in 320 pregnant women at their first trimester with a vaginal pressure measurement device. Fifty-two pregnant women were hospitalised for tocolytic therapy because of spontaneous preterm labour. Thirty-two of them (10.2%) had a preterm delivery despite the tocolytic therapy. Both the vaginal resting pressure (p = .009, 95%CI: 0.8; 5.9) and the pelvic floor muscle strength (p = .01, 95%CI: 3.5; 13.1) were significantly lower in the women with a preterm labour. Impact statement What is already known on this subject? The pelvic floor muscles have an essential role in continence and provide support to the pelvic organs. They also have an impact on labour. The pelvic floor muscles should distend to allow the passage of the foetus during labour. The rotation and flexion of the foetal head is due to the pelvic floor resistance. The effect of a vaginal birth on the pelvic floor's function is readily understood. On the other hand, the effect of the pelvic floor muscle function on labour is still controversial. What do the results of this study add? This prospective study showed that there is a negative association between the pelvic floor muscle strength and preterm labour. This is the first clinical study indicating that weak pelvic floor muscles may cause a preterm labour. What are the implications of these findings for clinical practice and/or further research? Pelvic floor physical therapy may be an alternative preventive strategy to reduce

  11. 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 ...

  12. 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.

  13. 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

  14. 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

  15. 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...

  16. PREVALENCE OF BACTERIAL VAGINOSIS IN CASES OF PRETERM LABOUR AND ITS EFFECTS ON OBSTETRIC OUTCOME

    Directory of Open Access Journals (Sweden)

    Mini Chenicheri

    2017-04-01

    Full Text Available BACKGROUND Abnormal vaginal flora is an important cause of preterm labour with subsequent delivery of a preterm newborn, which is associated with significant morbidity and mortality. Bacterial vaginosis is a condition where there is a decrease in concentration of Lactobacillus and an increase in pathogenic bacteria. The aim of the study is to study the- 1. Prevalence of bacterial vaginosis in preterm labour in comparison with term pregnant women in labour. 2. Adverse obstetric outcome associated with bacterial vaginosis. MATERIALS AND METHODS Study was carried out in the Department of Obstetrics and Gynaecology and Microbiology, Government Medical College, Kozhikode. It is a prospective, cross-sectional descriptive study from August 2012 to January 2013. Subjects included 100 women in spontaneous preterm labour. 100 term women in labour were the controls. All patients had vaginal discharge collected from the posterior vaginal fornix with cotton swabs. Clinical composite criteria by Amsel’s and Nugent’s scoring was used to diagnose bacterial vaginosis. The saline wet mount of the discharge was examined microscopically for ‘clue’ cells, 10% KOH added to get an amine odour. Vaginal smear was Gram stained and evaluated by Nugent’s criteria. Obstetric outcome noted in both groups. RESULTS Prevalence was more (38% in the preterm group. Bacterial vaginosis detected by Amsel’s criteria was 30% in preterm and 7% in term group. Sensitivity of Amsel’s criteria was 48.7%, specificity was 88.8% with a positive predictive value of 51.4% and negative predictive value of 87.7%. With Nugent’s criteria, number of patients with score >7 was significantly higher (19% in preterm than term (4% patients. CONCLUSION Prevalence of bacterial vaginosis was higher in the preterm group. Clinical method using Amsel’s criteria together with Gram stain is a simple, inexpensive, easily reproducible method for diagnosis. Bacterial vaginosis in pregnancy has a

  17. Identical Twin Primigravid Sisters -Spontaneous Labour and ...

    African Journals Online (AJOL)

    We report 2 cases of identical twin sisters, the older sibling getting married 14 months earlier but both got pregnant for their first child at about the same time and were managed by the same Obstetrician and fell into spontaneous labour within a few hours of each other. Both were delivered by emergency caesarean section ...

  18. 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.

  19. 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

  20. 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 ...

  1. 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

  2. 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...

  3. [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

  4. Human Papillomavirus Infection as a Possible Cause of Spontaneous Abortion and Spontaneous Preterm Delivery

    DEFF Research Database (Denmark)

    Ambühl, Lea Maria Margareta; Baandrup, Ulrik; Dybkær, Karen

    2016-01-01

    , and 10.9% (95% CI; 10.1–11.7) for umbilical cord blood. Summary estimates for HPV prevalence of spontaneous abortions and spontaneous preterm deliveries, in cervix (spontaneous abortions: 24.5%, and pretermdeliveries: 47%, resp.) and placenta (spontaneous abortions: 24.9%, and preterm deliveries: 50......%, resp.), were identified to be higher compared to normal full-term pregnancies (푃 spontaneous abortion, spontaneous preterm...

  5. Do vaginal lactobacilli prevent preterm labour? | Kotze | South ...

    African Journals Online (AJOL)

    South African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 87, No 8 (1997) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Do vaginal lactobacilli prevent preterm labour? I.R. Kotze ...

  6. 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 ...

  7. [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.

  8. Efficacy of transdermal nitroglycerine in idiopathic pre-term labour.

    Science.gov (United States)

    Shaikh, Shahida; Shaikh, Abdul Hameed; Akhter, Saleem; Isran, Basma

    2012-01-01

    To determine the efficacy of transdermal Nitroglycerine patch in idiopathic pre-term labour and foetomaternal outcome. This quasi-experimental study was conducted at the Obstetrics Unit-II of Shaikh Zayed Hospital for Women, Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, from Jan 1 to June 30, 2010. Sixtyfive pregnant women at 28-34 weeks of gestation were recruited after they met the selection criteria based on non-probability consecutive sampling. Initially, 73 patients were selected, but 65 of them completed the treatment, while 8 patients refused to continue. Patients diagnosed with pre-term labour were given glyceryl trinitrate (GTN) 5 mg/12 hours transdermal patch which was applied on the anterior abdominal wall. The second patch of same dose was given after 12 hours. Arrest of labour, prolongation of pregnancy in days or weeks along with side effects of the agent were monitored. Patients were followed till delivery to know the foeto-maternal outcome. Dramatic effects were seen in around 60 (92.3%), of the total patients who had felt relief from premature labour pains within the first hour and only 5 (7.6%) patients could not go beyond 24 hours, as among them 3 (4.61%) had previous uterine scar and 2 (3.07%) developed ruptured membranes after 12 hours of admission and their babies also could not survive. Mean pregnancy prolongation was 15.35 +/- 9.45 days (min: 4 max: 35), so delivery was deferred up to 48 hours, 3 to 7 days and more than 7 days in 4 (6.15%), 6 (9.23%) and 50 (76.92%) respectively. Glyceryl trinitrate, trans dermal patch is effective and safe tocolytic in idiopathic preterm labour. By prolonging pregnancy it improves neonatal outcome.

  9. The Th1:Th2 Dichotomy of Pregnancy and Preterm Labour

    Directory of Open Access Journals (Sweden)

    Lynne Sykes

    2012-01-01

    Full Text Available Pregnancy is a unique immunological state in which a balance of immune tolerance and suppression is needed to protect the fetus without compromising the mother. It has long been established that a bias from the T helper 1 cytokine profile towards the T helper 2 profile contributes towards successful pregnancy maintenance. The majority of publications that report on aberrant Th1:Th2 balance focus on early pregnancy loss and preeclampsia. Over the last few decades, there has been an increased awareness of the role of infection and inflammation in preterm labour, and the search for new biomarkers to predict preterm labour continues. In this paper, we explore the evidence for an aberrant Th1:Th2 profile associated with preterm labour. We also consider the potential for its use in screening women at high risk of preterm labour and for prophylactic therapeutic measures for the prevention of preterm labour and associated neonatal adverse outcomes.

  10. Spontaneous Pre-Labour Rupture of Membranes at Term ...

    African Journals Online (AJOL)

    BACKGROUND: Spontaneous pre-labour rupture of membranes (SPROM) at term is one of the most common complications of pregnancy. It is an important cause of perinatal morbidity and mortality, particularly because it is associated with a latency period from membrane rupture to delivery. OBJECTIVE: To compare the ...

  11. 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

  12. Slit2 is decreased after spontaneous labour in myometrium and regulates pro-labour mediators.

    Science.gov (United States)

    Lim, Ratana; Liong, Stella; Barker, Gillian; Lappas, Martha

    2014-12-01

    Preterm birth, a global healthcare problem, is commonly associated with inflammation. As Slit2 plays an emerging role in inflammation, the purpose of this study was to determine the effect of Slit2 on labour mediators in human gestational tissues. Slit2 mRNA and protein expression were assessed using qRT-PCR and immunohistochemistry in foetal membranes and myometrium obtained before and after labour. Slit2 silencing was achieved using siRNA in primary myometrial cells. Pro-inflammatory and pro-labour mediators were evaluated by qRT-PCR, ELISA and gelatin zymography. Slit2 mRNA and protein expression were found to be significantly lower in myometrium after labour onset. There was no effect of term or preterm labour on Slit2 expression in foetal membranes. Slit2 mRNA expression was decreased in myometrium treated with LPS and IL-1β. Slit2 siRNA in myometrial cells increased IL-1β-induced pro-inflammatory cytokine gene expression and release (IL-6 and IL-8), COX-2 expression and prostaglandin PGE2 and PGF2α release, and MMP-9 gene expression and pro MMP-9 release. There was no effect of Slit2 siRNA on IL-1β-induced NF-κB transcriptional activity. Our results demonstrate that Slit2 is decreased in human myometrium after labour and our knock-down studies describe an anti-inflammatory effect of Slit2 in myometrial cells. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Intake of probiotic food and risk of spontaneous preterm delivery.

    Science.gov (United States)

    Myhre, Ronny; Brantsæter, Anne Lise; Myking, Solveig; Gjessing, Håkon Kristian; Sengpiel, Verena; Meltzer, Helle Margrete; Haugen, Margaretha; Jacobsson, Bo

    2011-01-01

    Preterm delivery represents a substantial problem in perinatal medicine worldwide. Current knowledge on potential influences of probiotics in food on pregnancy complications caused by microbes is limited. We hypothesized that intake of food with probiotics might reduce pregnancy complications caused by pathogenic microorganisms and, through this, reduce the risk of spontaneous preterm delivery. This study was performed in the Norwegian Mother and Child Cohort on the basis of answers to a food-frequency questionnaire. We studied intake of milk-based products containing probiotic lactobacilli and spontaneous preterm delivery by using a prospective cohort study design (n = 950 cases and 17,938 controls) for the pregnancy outcome of spontaneous preterm delivery (delivery were associated with any intake of milk-based probiotic products in an adjusted model [odds ratio (OR): 0.857; 95% CI: 0.741, 0.992]. By categorizing intake into none, low, and high intakes of the milk-based probiotic products, a significant association was observed for high intake (OR: 0.820; 95% CI: 0.681, 0.986). Women who reported habitual intake of probiotic dairy products had a reduced risk of spontaneous preterm delivery.

  14. A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour

    Directory of Open Access Journals (Sweden)

    Kehinde S. Okunade

    2014-01-01

    Full Text Available Objectives. The study was aimed to assess the association between low maternal serum magnesium levels and preterm labour. Methods. It is a cross-sectional case-control study in which eligible participants were pregnant women admitted in labour within the labour ward complex of a Lagos tertiary hospital. Relevant data were extracted from the case records of these women and blood samples were obtained from all participants and serum magnesium levels measured. Results. The study showed that 36% of the study patients had varying degrees of hypomagnesaemia. The relative risk indicates that preterm labour is 1.83 times higher among the patients with low serum magnesium (less than 1.6 mg/dL. The mean difference in serum magnesium levels in both groups was statistically significant (P<0.05. Conclusion. We can infer that low serum magnesium (hypomagnesaemia is associated with preterm onset of labour. We can, also from this finding, formulate a proposition that would help in preventing preterm labour and birth with the use of prophylactic oral magnesium supplementation among patients with higher risk for development of preterm labour.

  15. The safety of tocolytics used for the inhibition of preterm labour

    DEFF Research Database (Denmark)

    Lamont, Callum D.; Jørgensen, J. S.; Lamont, R. F.

    2016-01-01

    of the literature, we have provided an overview of the use of tocolytics for the prevention of preterm birth and have examined the fetal and maternal adverse effects of the various tocolytic agents currently in use. Expert opinion: No tocolytic currently in use was developed specifically to treat preterm labour so...

  16. 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

    Evidence from family and twin-based studies provide strong support for a significant contribution of maternal and fetal genetics to the timing of parturition and spontaneous preterm birth. However, there has been only modest success in the discovery of genes predisposing to preterm birth, despite increasing sophistication of genetic and genomic technology. In contrast, DNA variants associated with other traits/diseases have been identified. For example, there is overwhelming evidence that suggests that the nature and intensity of an inflammatory response in adults and children are under genetic control. Because inflammation is often invoked as an etiologic factor in spontaneous preterm birth, the question of whether spontaneous preterm birth has a genetic predisposition in the case of pathologic inflammation has been of long-standing interest to investigators. Here, we review various genetic approaches used for the discovery of preterm birth genetic variants in the context of inflammation-associated spontaneous preterm birth. Candidate gene studies have sought genetic variants that regulate inflammation in the mother and fetus; however, the promising findings have often not been replicated. Genome-wide association studies, an approach to the identification of chromosomal loci responsible for complex traits, have also not yielded compelling evidence for DNA variants predisposing to preterm birth. A recent genome-wide association study that included a large number of White women (>40,000) revealed that maternal loci contribute to preterm birth. Although none of these loci harbored genes directly related to innate immunity, the results were replicated. Another approach to identify DNA variants predisposing to preterm birth is whole exome sequencing, which examines the DNA sequence of protein-coding regions of the genome. A recent whole exome sequencing study identified rare mutations in genes encoding for proteins involved in the negative regulation (dampening) of the

  17. [Relation Between Stress During Pregnancy and Spontaneous Preterm Birth].

    Science.gov (United States)

    Ortiz Martínez, Roberth Alirio; Castillo, Alejandro

    2016-01-01

    Preterm birth occurs before 37 completed weeks, its causes are multifactorial and vary according to the gestational age, ethnicity and geographical context. Although several medical/social factors have been clearly identified, over 50% of cases are unknown or unclear; however, psychopathological components emerge as potentially important risk factors. To determine the relationship between the presence of stress during pregnancy and spontaneous preterm birth. Through a study of cases and controls in a level III hospital, with a sample of 360 patients during the period from March to November of 2013, where sociodemographic characteristics were collected. In addition, they were applied scales social adjustment, coping strategies and social support. Logistic regression models were developed; psychological, biological and social. Based on the significant variables in each of these generated a final one. The final model was found that stress during pregnancy increases the odds of spontaneous preterm birth 1.91 times (adjusted OR=2.91; 95%CI, 1.67-5.08; P<.05). Other significant variables were: history of preterm delivery, unplanned pregnancy, no emotional support, rural residence, inadequate prenatal care and non-stable partner. The findings support the hypothesis that stress during pregnancy is associated with spontaneous preterm delivery. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Case Report: Spontaneous gastric perforation in preterm low ...

    African Journals Online (AJOL)

    Two cases of spontaneous gastric perforation in preterm low birthweight newborn infants are reported. The patients were referred within a short period from the same maternity hospital. They presented with gross abdominal distension of sudden onset. The abdominal X-rays showed typical saddle-bag configuration with ...

  19. 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.

  20. Placental histology in spontaneous and indicated preterm birth: A case control study

    NARCIS (Netherlands)

    Nijman, Tobias A. J.; van Vliet, Elvira O. G.; Benders, Manon J. N.; Mol, Ben Willem J.; Franx, Arie; Nikkels, Peter G. J.; Oudijk, Martijn A.

    2016-01-01

    Placental pathology is an important contributor in preterm birth, both spontaneous and indicated. The aim of this study was to describe and compare placental histological features of spontaneous preterm birth versus indicated preterm birth. A case control study was performed at the University

  1. Placental histology in spontaneous and indicated preterm birth : A case control study

    NARCIS (Netherlands)

    Nijman, Tobias A J; van Vliet, Elvira O G; Benders, Manon J N; Mol, Ben Willem J; Franx, Arie; Nikkels, Peter G J; Oudijk, Martijn A

    2016-01-01

    INTRODUCTION: Placental pathology is an important contributor in preterm birth, both spontaneous and indicated. The aim of this study was to describe and compare placental histological features of spontaneous preterm birth versus indicated preterm birth. METHODS: A case control study was performed

  2. Antenatal steroids in preterm labour for the prevention of neonatal deaths due to complications of preterm birth.

    Science.gov (United States)

    Mwansa-Kambafwile, Judith; Cousens, Simon; Hansen, Thomas; Lawn, Joy E

    2010-04-01

    In high-income countries, administration of antenatal steroids is standard care for women with anticipated preterm labour. However, although >1 million deaths due to preterm birth occur annually, antenatal steroids are not routine practice in low-income countries where most of these deaths occur. To review the evidence for and estimate the effect on cause-specific neonatal mortality of administration of antenatal steroids to women with anticipated preterm labour, with additional analysis for the effect in low- and middle-income countries. We conducted systematic reviews using standardized abstraction forms. Quality of evidence was assessed using an adapted GRADE approach. Existing meta-analyses were reviewed for relevance to low/middle-income countries, and new meta-analysis was performed. We identified 44 studies, including 18 randomised control trials (RCTs) (14 in high-income countries) in a Cochrane meta-analysis, which suggested that antenatal steroids decrease neonatal mortality among preterm infants (preterm babies currently receive little or no medical care. It is plausible that antenatal steroids may be of even greater effect when tested in these settings. Based on high-grade evidence, antenatal steroid therapy is very effective in preventing neonatal mortality and morbidity, yet remains at low coverage in low/middle-income countries. If fully scaled up, this intervention could save up to 500 000 neonatal lives annually.

  3. 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

  4. Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study

    NARCIS (Netherlands)

    Heus, R.; Mol, B.W.; Erwich, J.J.; Geijn, van H.; Gyselaers, W.J.; Hanssens, M.; Harmark, L.; Holsbeke, van C.D.; Duvekot, J.J.; Schobben, F.F.; Wolf, de H.; Visser, G.H.A.

    2009-01-01

    OBJECTIVE: To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. DESIGN: Prospective cohort study. SETTING: 28 hospitals in the Netherlands and Belgium. PARTICIPANTS: 1920 consecutive

  5. Adverse drug reactions to tocolytic treatment for preterm labour : prospective cohort study

    NARCIS (Netherlands)

    de Heus, R.; Mol, B.W.; Erwich, J.J.H.M.; van Geijn, H.P.; Gyselaers, W.J.; Hanssens, M.; Harmark, L.; van Holsbeke, C.D.; Duvekot, J.J.; Schobben, F.F.A.M.; Wolf, Hans; Visser, G. H. A.

    2009-01-01

    Objective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920 consecutive women

  6. Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study

    NARCIS (Netherlands)

    de Heus, Roel; Mol, Ben Willem; Erwich, Jan-Jaap H. M.; van Geijn, Herman P.; Gyselaers, Wilfried J.; Hanssens, Myriam; Härmark, Linda; van Holsbeke, Caroline D.; Duvekot, Johannes J.; Schobben, Fred F. A. M.; Wolf, Hans; Visser, Gerard H. A.

    2009-01-01

    Objective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920 consecutive women

  7. 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 ...

  8. Adverse drug reactions to tocolytic treatment for preterm labour: Prospective cohort study

    NARCIS (Netherlands)

    R. de Heus (Roel); B.W.J. Mol (Ben); J.J.H.M. Erwich; H.P. van Geijn (Herman); W.J. Gyselaers (Wilfried); M. Hanssens (Myriam); L. Harmark (Linda); C.D. van Holsbeke (Caroline); J.J. Duvekot (Hans); F. Famschobben; H. Wolf (Hans Uwe); G.H. Visser (Gerhard Henk)

    2009-01-01

    textabstractObjective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920

  9. The effects of heart rate variability biofeedback in patients with preterm labour.

    Science.gov (United States)

    Siepmann, Martin; Hennig, Una-Dorothea; Siepmann, Timo; Nitzsche, Katharina; Mück-Weymann, Michael; Petrowski, Katja; Weidner, Kerstin

    2014-03-01

    Preterm birth is a highly prevalent phenomenon that was shown to be associated with mental stress during pregnancy (Rich-Edwards and Grizzard in Am J Obstet Gynecol 192(5 Suppl):S30-S35, 2005). We aimed to assess the effects of heart rate variability (HRV)-biofeedback in patients with preterm labour. Therefore, we conducted a controlled randomized parallel group study in 48 female patients aged 19-38 years (median = 29) with preterm labour at gestational week 24th-32nd (median = 29th). In this study, one group (n = 24) attended six sessions of HRV-biofeedback over 2 weeks whereas patients of the other group (n = 24) were assigned to control sessions. In the HRV-biofeedback treated group, perception of chronic stress was decreased 4 weeks after completion of training compared to baseline (p stress in patients with preterm labour when administered as an adjunct to routine care. However, it remains unclear whether stress reduction through HRV-biofeedback has a beneficial effect on preterm birth.

  10. Effects of socioeconomic position and clinical risk factors on spontaneous and iatrogenic preterm birth.

    Science.gov (United States)

    Joseph, K S; Fahey, John; Shankardass, Ketan; Allen, Victoria M; O'Campo, Patricia; Dodds, Linda; Liston, Robert M; Allen, Alexander C

    2014-03-27

    The literature shows a variable and inconsistent relationship between socioeconomic position and preterm birth. We examined risk factors for spontaneous and iatrogenic preterm birth, with a focus on socioeconomic position and clinical risk factors, in order to explain the observed inconsistency. We carried out a retrospective population-based cohort study of all singleton deliveries in Nova Scotia from 1988 to 2003. Data were obtained from the Nova Scotia Atlee Perinatal Database and the federal income tax T1 Family Files. Separate logistic models were used to quantify the association between socioeconomic position, clinical risk factors and spontaneous preterm birth and iatrogenic preterm birth. The study population included 132,714 singleton deliveries and the rate of preterm birth was 5.5%. Preterm birth rates were significantly higher among the women in the lowest (versus the highest) family income group for spontaneous (rate ratio 1.14, 95% confidence interval (CI) 1.03, 1.25) but not iatrogenic preterm birth (rate ratio 0.95, 95% CI 0.75, 1.19). Adjustment for maternal characteristics attenuated the family income-spontaneous preterm birth relationship but strengthened the relationship with iatrogenic preterm birth. Clinical risk factors such as hypertension were differentially associated with spontaneous (rate ratio 3.92, 95% CI 3.47, 4.44) and iatrogenic preterm (rate ratio 14.1, 95% CI 11.4, 17.4) but factors such as diabetes mellitus were not (rate ratio 4.38, 95% CI 3.21, 5.99 for spontaneous and 4.02, 95% CI 2.07, 7.80 for iatrogenic preterm birth). Socioeconomic position and clinical risk factors have different effects on spontaneous and iatrogenic preterm. Recent temporal increases in iatrogenic preterm birth appear to be responsible for the inconsistent relationship between socioeconomic position and preterm birth.

  11. 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.

  12. Antiplatelet Agents and the Prevention of Spontaneous Preterm Birth A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    van Vliet, Elvira O. G.; Askie, Lisa A.; Mol, Ben W. J.; Oudijk, Martijn A.

    2017-01-01

    OBJECTIVE: Spontaneous preterm birth is an important cause of neonatal mortality and morbidity. An increasing body of evidence suggests that uteroplacental ischemia plays an important role in the etiology of spontaneous preterm birth. We aimed to study whether antiplatelet agents reduce the risk of

  13. Trial protocol OPPTIMUM– Does progesterone prophylaxis for the prevention of preterm labour improve outcome?

    Directory of Open Access Journals (Sweden)

    Norman Jane E

    2012-08-01

    Full Text Available Abstract Background Preterm birth is a global problem, with a prevalence of 8 to 12% depending on location. Several large trials and systematic reviews have shown progestogens to be effective in preventing or delaying preterm birth in selected high risk women with a singleton pregnancy (including those with a short cervix or previous preterm birth. Although an improvement in short term neonatal outcomes has been shown in some trials these have not consistently been confirmed in meta-analyses. Additionally data on longer term outcomes is limited to a single trial where no difference in outcomes was demonstrated at four years of age of the child, despite those in the “progesterone” group having a lower incidence of preterm birth. Methods/Design The OPPTIMUM study is a double blind randomized placebo controlled trial to determine whether progesterone prophylaxis to prevent preterm birth has long term neonatal or infant benefit. Specifically it will study whether, in women with singleton pregnancy and at high risk of preterm labour, prophylactic vaginal natural progesterone, 200 mg daily from 22 – 34 weeks gestation, compared to placebo, improves obstetric outcome by lengthening pregnancy thus reducing the incidence of preterm delivery (before 34 weeks, improves neonatal outcome by reducing a composite of death and major morbidity, and leads to improved childhood cognitive and neurosensory outcomes at two years of age. Recruitment began in 2009 and is scheduled to close in Spring 2013. As of May 2012, over 800 women had been randomized in 60 sites. Discussion OPPTIMUM will provide further evidence on the effectiveness of vaginal progesterone for prevention of preterm birth and improvement of neonatal outcomes in selected groups of women with singleton pregnancy at high risk of preterm birth. Additionally it will determine whether any reduction in the incidence of preterm birth is accompanied by improved childhood outcome. Trial

  14. 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.

  15. Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double-blind placebo-controlled trial.

    Science.gov (United States)

    Martinez de Tejada, B; Karolinski, A; Ocampo, M C; Laterra, C; Hösli, I; Fernández, D; Surbek, D; Huespe, M; Drack, G; Bunader, A; Rouillier, S; López de Degani, G; Seidenstein, E; Prentl, E; Antón, J; Krähenmann, F; Nowacki, D; Poncelas, M; Nassif, J C; Papera, R; Tuma, C; Espoile, R; Tiberio, O; Breccia, G; Messina, A; Peker, B; Schinner, E; Mol, B W; Kanterewicz, L; Wainer, V; Boulvain, M; Othenin-Girard, V; Bertolino, M V; Irion, O

    2015-01-01

    To evaluate the effectiveness of 200 mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour. Multicentre, randomised, double-blind, placebo-controlled trial. Twenty-nine centres in Switzerland and Argentina. A total of 385 women with preterm labour (24(0/7) to 33(6/7) weeks of gestation) treated with acute tocolysis. Participants were randomly allocated to either 200 mg daily of self-administered vaginal progesterone or placebo within 48 hours of starting acute tocolysis. Primary outcome was delivery before 37 weeks of gestation. Secondary outcomes were delivery before 32 and 34 weeks, adverse effects, duration of tocolysis, re-admissions for preterm labour, length of hospital stay, and neonatal morbidity and mortality. The study was ended prematurely based on results of the intermediate analysis. Preterm birth occurred in 42.5% of women in the progesterone group versus 35.5% in the placebo group (relative risk [RR] 1.2; 95% confidence interval [95% CI] 0.93-1.5). Delivery at <32 and <34 weeks did not differ between the two groups (12.9 versus 9.7%; [RR 1.3; 95% CI 0.7-2.5] and 19.7 versus 12.9% [RR 1.5; 95% CI 0.9-2.4], respectively). The duration of tocolysis, hospitalisation, and recurrence of preterm labour were comparable between groups. Neonatal morbidity occurred in 44 (22.8%) cases on progesterone versus 35 (18.8%) cases on placebo (RR: 1.2; 95% CI 0.82-1.8), whereas there were 4 (2%) neonatal deaths in each study group. There is no evidence that the daily administration of 200 mg vaginal progesterone decreases preterm birth or improves neonatal outcome in women with preterm labour. © 2014 Royal College of Obstetricians and Gynaecologists.

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

    Directory of Open Access Journals (Sweden)

    Erez Offer

    2012-08-01

    Full Text Available Abstract 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 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.

  17. Loop electrosurgical excision of the cervix and risk for spontaneous preterm delivery in twin pregnancies

    DEFF Research Database (Denmark)

    Noehr, Bugge; Jensen, Allan; Frederiksen, Kirsten

    2009-01-01

    OBJECTIVE: To investigate the association between three cervical procedures (biopsy with no treatment, ablation, and loop electrosurgical excision procedure [LEEP]) and subsequent spontaneous preterm delivery in twin pregnancies using population-based data from various nationwide registries. METH...

  18. Induction of labour versus expectant management in women with preterm prelabour rupture of membranes between 34 and 37 weeks (the PPROMEXIL-trial

    Directory of Open Access Journals (Sweden)

    Kars Michael M

    2007-07-01

    Full Text Available Abstract Background Preterm prelabour rupture of the membranes (PPROM is an important clinical problem and a dilemma for the gynaecologist. On the one hand, awaiting spontaneous labour increases the probability of infectious disease for both mother and child, whereas on the other hand induction of labour leads to preterm birth with an increase in neonatal morbidity (e.g., respiratory distress syndrome (RDS and a possible rise in the number of instrumental deliveries. Methods/Design We aim to determine the effectiveness and cost-effectiveness of immediate delivery after PPROM in near term gestation compared to expectant management. Pregnant women with preterm prelabour rupture of the membranes at a gestational age from 34+0 weeks until 37+0 weeks will be included in a multicentre prospective randomised controlled trial. We will compare early delivery with expectant monitoring. The primary outcome of this study is neonatal sepsis. Secondary outcome measures are maternal morbidity (chorioamnionitis, puerperal sepsis and neonatal disease, instrumental delivery rate, maternal quality of life, maternal preferences and costs. We anticipate that a reduction of neonatal infection from 7.5% to 2.5% after induction will outweigh an increase in RDS and additional costs due to admission of the child due to prematurity. Under these assumptions, we aim to randomly allocate 520 women to two groups of 260 women each. Analysis will be by intention to treat. Additionally a cost-effectiveness analysis will be performed to evaluate if the cost related to early delivery will outweigh those of expectant management. Long term outcomes will be evaluated using modelling. Discussion This trial will provide evidence as to whether induction of labour after preterm prelabour rupture of membranes is an effective and cost-effective strategy to reduce the risk of neonatal sepsis. Controlled clinical trial register ISRCTN29313500

  19. Maternal obesity, fish intake, and recurrent spontaneous preterm birth.

    Science.gov (United States)

    Smid, Marcela C; Stuebe, Alison M; Manuck, Tracy A; Sen, Sarbattama

    2018-02-21

    Moderate fish intake in early pregnancy is associated with decreased risk of preterm birth (PTB). Obesity during pregnancy is characterized by inflammation and insufficiency of essential fatty acids. The objective of this study was to measure the association between fish intake during pregnancy and risk of recurrent spontaneous (s) PTB among lean, overweight, and obese women. This is secondary analysis of a randomized controlled trial of omega-3 fatty acid supplementation for recurrent PTB prevention, 2005-2006. The primary exposure was fish intake at time of enrollment (16-22.9-week gestation). The primary outcomes were sPTB <37 weeks and sPTB <35 weeks. Maternal prepregnancy body mass index was treated as an effect modifier. Eight hundred and fifty-two women were included, 47% were lean, 25% overweight, and 28% obese. In this cohort, among lean, but not overweight or obese women, ≥1 serving of fish per week was associated with decreased frequency of sPTB <37 weeks compared with <1 serving of fish per week (45.1% versus 27.5%, p = .001) and spontaneous PTB <35 (21.4% versus 11.6%, p = .01). In adjusted models, as fish intake increased, the predicted probability of sPTB decreased in lean women but increased in overweight and obese women (p for interaction < .10). Fish intake was associated with lower probability of sPTB in lean women and higher probability in obese women. These findings warrant further investigation to understand the dietary or metabolic factors associated with obesity that may modulate benefit of fish intake during pregnancy.

  20. A controlled clinical trial of home care management versus hospital care management for preterm labour.

    Science.gov (United States)

    Goulet, C; Gévry, H; Gauthier, R J; Lepage, L; Fraser, W; Aita, M

    2001-06-01

    Prenatal hospitalisation has not been shown to reduce perinatal morbidity and mortality, yet it is still the treatment of choice for women who experience preterm labour. Home care management may be an alternative means of delivering safe, efficacious and care for these women. The objectives of this controlled clinical trial were to examine differences in neonate's gestational age and birthweight, and antenatal stress, social support satisfaction, and family functioning among pregnant women receiving home care and those receiving hospital care management. Pregnant women experiencing preterm labour (N=250) were randomly assigned to home care management (the experimental group [EG]) or hospital care management (the control group [CG]). A Perinatal Information Form was used to collect data on sociodemographic and pregnancy variables. The High-Risk Pregnancy Stress Scale, Brown's Social Behaviors Inventory, and the Family Assessment Measure III Dyadic Relationships Scale were administered to the women at randomisation (T1) and at 1-week (T2) and 2-weeks (T3) after randomisation. Gestational age and birthweight were similar in the two groups of neonates. Women in the EG reported that antenatal stress was significantly lower at T3 than at T1 and T2, while for those in the CG, antenatal stress was significantly lower at T3 than at T1, and significantly lower at T2 than at T1. Women in the EG were more satisfied with support from the male partner at T3 than women in the CG. There was no significant difference between the two groups in family functioning at T1, T2 and T3. These findings indicate that home care management is a safe and efficacious mode of health care delivery for women experiencing preterm labour.

  1. Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study.

    Science.gov (United States)

    Bukowski, Radek; Malone, Fergal D; Porter, Flint T; Nyberg, David A; Comstock, Christine H; Hankins, Gary D V; Eddleman, Keith; Gross, Susan J; Dugoff, Lorraine; Craigo, Sabrina D; Timor-Tritsch, Ilan E; Carr, Stephen R; Wolfe, Honor M; D'Alton, Mary E

    2009-05-05

    Low plasma folate concentrations in pregnancy are associated with preterm birth. Here we show an association between preconceptional folate supplementation and the risk of spontaneous preterm birth. In a cohort of 34,480 low-risk singleton pregnancies enrolled in a study of aneuploidy risk, preconceptional folate supplementation was prospectively recorded in the first trimester of pregnancy. Duration of pregnancy was estimated based on first trimester ultrasound examination. Natural length of pregnancy was defined as gestational age at delivery in pregnancies with no medical or obstetrical complications that may have constituted an indication for delivery. Spontaneous preterm birth was defined as duration of pregnancy between 20 and 37 wk without those complications. The association between preconceptional folate supplementation and the risk of spontaneous preterm birth was evaluated using survival analysis. Comparing to no supplementation, preconceptional folate supplementation for 1 y or longer was associated with a 70% decrease in the risk of spontaneous preterm delivery between 20 and 28 wk (41 [0.27%] versus 4 [0.04%] spontaneous preterm births, respectively; HR 0.22, 95% confidence interval [CI] 0.08-0.61, p = 0.004) and a 50% decrease in the risk of spontaneous preterm delivery between 28 and 32 wk (58 [0.38%] versus 12 [0.18%] preterm birth, respectively; HR 0.45, 95% CI 0.24-0.83, p = 0.010). Adjustment for maternal characteristics age, race, body mass index, education, marital status, smoking, parity, and history of prior preterm birth did not have a material effect on the association between folate supplementation for 1 y or longer and spontaneous preterm birth between 20 and 28, and 28 to 32 wk (adjusted HR 0.31, 95% CI 0.11-0.90, p = 0.031 and 0.53, 0.28-0.99, p = 0.046, respectively). Preconceptional folate supplementation was not significantly associated with the risk of spontaneous preterm birth beyond 32 wk. The association between shorter duration

  2. Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study.

    Directory of Open Access Journals (Sweden)

    Radek Bukowski

    2009-05-01

    Full Text Available Low plasma folate concentrations in pregnancy are associated with preterm birth. Here we show an association between preconceptional folate supplementation and the risk of spontaneous preterm birth.In a cohort of 34,480 low-risk singleton pregnancies enrolled in a study of aneuploidy risk, preconceptional folate supplementation was prospectively recorded in the first trimester of pregnancy. Duration of pregnancy was estimated based on first trimester ultrasound examination. Natural length of pregnancy was defined as gestational age at delivery in pregnancies with no medical or obstetrical complications that may have constituted an indication for delivery. Spontaneous preterm birth was defined as duration of pregnancy between 20 and 37 wk without those complications. The association between preconceptional folate supplementation and the risk of spontaneous preterm birth was evaluated using survival analysis. Comparing to no supplementation, preconceptional folate supplementation for 1 y or longer was associated with a 70% decrease in the risk of spontaneous preterm delivery between 20 and 28 wk (41 [0.27%] versus 4 [0.04%] spontaneous preterm births, respectively; HR 0.22, 95% confidence interval [CI] 0.08-0.61, p = 0.004 and a 50% decrease in the risk of spontaneous preterm delivery between 28 and 32 wk (58 [0.38%] versus 12 [0.18%] preterm birth, respectively; HR 0.45, 95% CI 0.24-0.83, p = 0.010. Adjustment for maternal characteristics age, race, body mass index, education, marital status, smoking, parity, and history of prior preterm birth did not have a material effect on the association between folate supplementation for 1 y or longer and spontaneous preterm birth between 20 and 28, and 28 to 32 wk (adjusted HR 0.31, 95% CI 0.11-0.90, p = 0.031 and 0.53, 0.28-0.99, p = 0.046, respectively. Preconceptional folate supplementation was not significantly associated with the risk of spontaneous preterm birth beyond 32 wk. The association between

  3. Short and inflamed cervix predicts spontaneous preterm birth (COLIBRI study).

    Science.gov (United States)

    Raiche, Evelyne; Ouellet, Annie; Berthiaume, Maryse; Rousseau, Éric; Pasquier, Jean-Charles

    2014-07-01

    To develop a new strategy of predicting spontaneous preterm birth (sPTB) by combination of transvaginal ultrasound (TVUS) assessment and inflammatory proteins detection in vaginal secretions. Prospective study of 87 women referred for cervical length assessment with a standardized TVUS combined to vaginal secretions sampling. Samples were analyzed for presence of 10 cytokines. Main outcome was sPTB (cervix (cervix and IL-8 in vaginal secretions were independently associated with sPTB (OR 3.58 (95%CI 1.02; 12.61) and 14.55 (95%CI 1.64; 128.83), respectively) as their combination (OR 4.33 (95%CI 1.25; 14.95)). By categorizing cervical length by presence of IL-8, sPTB occurred in 55.6% of women with a short inflamed cervix. COLIBRI study used a novel, single-step method of vaginal secretions sampling during TVUS and demonstrated that combination of short cervix and IL-8 in vaginal secretions is a promising sPTB predictive test.

  4. Fundamental Frequency Variation of Neonatal Spontaneous Crying Predicts Language Acquisition in Preterm and Term Infants.

    Science.gov (United States)

    Shinya, Yuta; Kawai, Masahiko; Niwa, Fusako; Imafuku, Masahiro; Myowa, Masako

    2017-01-01

    Spontaneous cries of infants exhibit rich melodic features (i.e., time variation of fundamental frequency [ F 0 ]) even during the neonatal period, and the development of these characteristics might provide an essential base for later expressive prosody in language. However, little is known about the melodic features of spontaneous cries in preterm infants, who have a higher risk of later language-related problems. Thus, the present study investigated how preterm birth influenced melodic features of spontaneous crying at term-equivalent age as well as how these melodic features related to language outcomes at 18 months of corrected age in preterm and term infants. At term, moderate-to-late preterm (MLP) infants showed spontaneous cries with significantly higher F 0 variation and melody complexity than term infants, while there were no significant differences between very preterm (VP) and term infants. Furthermore, larger F 0 variation within cry series at term was significantly related to better language and cognitive outcomes, particularly expressive language skills, at 18 months. On the other hand, no other melodic features at term predicted any developmental outcomes at 18 months. The present results suggest that the additional postnatal vocal experience of MLP preterm infants increased F 0 variation and the complexity of spontaneous cries at term. Additionally, the increases in F 0 variation may partly reflect the development of voluntary vocal control, which, in turn, contributes to expressive language in infancy.

  5. Fundamental Frequency Variation of Neonatal Spontaneous Crying Predicts Language Acquisition in Preterm and Term Infants

    Directory of Open Access Journals (Sweden)

    Yuta Shinya

    2017-12-01

    Full Text Available Spontaneous cries of infants exhibit rich melodic features (i.e., time variation of fundamental frequency [F0] even during the neonatal period, and the development of these characteristics might provide an essential base for later expressive prosody in language. However, little is known about the melodic features of spontaneous cries in preterm infants, who have a higher risk of later language-related problems. Thus, the present study investigated how preterm birth influenced melodic features of spontaneous crying at term-equivalent age as well as how these melodic features related to language outcomes at 18 months of corrected age in preterm and term infants. At term, moderate-to-late preterm (MLP infants showed spontaneous cries with significantly higher F0 variation and melody complexity than term infants, while there were no significant differences between very preterm (VP and term infants. Furthermore, larger F0 variation within cry series at term was significantly related to better language and cognitive outcomes, particularly expressive language skills, at 18 months. On the other hand, no other melodic features at term predicted any developmental outcomes at 18 months. The present results suggest that the additional postnatal vocal experience of MLP preterm infants increased F0 variation and the complexity of spontaneous cries at term. Additionally, the increases in F0 variation may partly reflect the development of voluntary vocal control, which, in turn, contributes to expressive language in infancy.

  6. Characteristics of antigravity spontaneous movements in preterm infants up to 3 months of corrected age.

    Science.gov (United States)

    Miyagishima, Saori; Asaka, Tadayoshi; Kamatsuka, Kaori; Kozuka, Naoki; Kobayashi, Masaki; Igarashi, Risa; Hori, Tsukasa; Yoto, Yuko; Tsutsumi, Hiroyuki

    2016-08-01

    We investigated whether spontaneous antigravity limbs movements in very low birth weight preterm infants were insufficient compared to those in term infants. The relationship between the quality of general movements (GMs) and antigravity limbs movements was also examined. Preterm infants with very low birth weight without central nervous system disorders nor severe respiration disorders, and healthy term infants were recruited. The infants were set in a supine position. The distance between both hands and between both feet, and the height of both hands and feet from the floor were recorded at 1-3 corrected months for preterm infants, and at 1-3 months for term infants by a 3D motion capture system. The measurements were adjusted for body proportions. GMs in preterm and term infants were assessed similarly. Thirteen preterm and 15 term infants completed the study. In preterm infants, the distance between both hands and between both feet were longer, and the height of both hands and feet were lower than those in term infants in all measurements. In term infants, the height of both hands and feet increased as they developed, but no change was observed in preterm infants. In preterm infants with abnormal GMs, the distance between both hands was longer, and the height of both hands and feet was lower than that in those with normal GMs. There were no such differences between preterm infants with normal GMs and term infants with normal GMs. Antigravity limbs movements in preterm infants within the first 3 month of corrected age were insufficient compared with those in term infants. Furthermore, no improvement with development was observed in preterm infants. In addition, preterm infants with abnormal GMs showed worse antigravity limbs movements than preterm and term infants with normal GMs. The preterm infants with normal GMs could behave similar to the full term infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. How to identify twins at low risk of spontaneous preterm delivery

    DEFF Research Database (Denmark)

    Sperling, Lene; Kiil, C; Larsen, L U

    2005-01-01

    OBJECTIVE: The aim of this study was to evaluate transvaginal sonographic assessment of cervical length at 23 weeks as a screening test for spontaneous preterm delivery in order to define a cut-off value that could be used to select twin pregnancies at low risk of spontaneous preterm delivery....... METHODS: In a prospective multicenter study of 383 twin pregnancies included before 14 + 6 weeks a cervical scan with measurement of the cervical length was performed at 23 weeks' gestation. The results were blinded for the clinicians if the cervical length was > or = 15 mm. The rates of spontaneous...... delivery at different cut-off levels of cervical length were determined. RESULTS: Eighty-nine percent of the twins had dichorionic placentation and 58% were conceived after assisted reproduction. The rate of spontaneous preterm delivery was 2.3% (1.5% for dichorionic (DC) and 9.1% for (MC) monochorionic...

  8. Large social disparities in spontaneous preterm birth rates in transitional Russia.

    Science.gov (United States)

    Grjibovski, A M; Bygren, L O; Yngve, A; Sjöström, M

    2005-02-01

    This study estimated the effect of maternal sociodemographic, obstetric and lifestyle factors on the risk of spontaneous preterm birth in a Russian town. All women with singleton pregnancies registered at prenatal care centres in Severodvinsk in 1999 comprised the cohort for this study (n=1559). Analysis was based on spontaneous live singleton births at the maternity home (n=1103). Multivariable logistic regression was applied to quantify the effect of the studied factors on the risk of preterm birth. Differences in gestation duration were studied using multiple linear regression. In total, 5.6% of all spontaneous births were preterm. Increased risks of preterm delivery were found in women with lower levels of education and in students. Placental complications, stress and a history of fetal death in previous pregnancies were also associated with elevated risks for preterm delivery. Smoking, hypertension and multigravidity were associated with reduced length of pregnancy in metric form. In addition to medical risk factors, social factors are important determinants of preterm birth in transitional Russia. Large disparities in preterm birth rates may reflect the level of inequalities in transitional Russia. Social variations in pregnancy outcomes should be monitored.

  9. [Prolonged hospitalization versus home management for women with arrested preterm labour: a before-after study].

    Science.gov (United States)

    Salzmann, M; Gaucherand, P; Doret, M

    2013-04-01

    To compare gestational age at birth and incidence of preterm birth inferior to 37 weeks of gestation (WG) in single pregnancies with either prolonged hospitalization, or early home discharge after arrested preterm labour. Management of preterm labour was changed in our public academic hospital because no evidence of benefits for prolonged hospitalization was found and because adverse effects related to long-term hospitalization were described. In this retrospective before-after study, we compare the attitude A (December 2006 to April 2008), a prolonged hospitalization until 32 or 34WG, with new attitude B (May 2008 to February 2010), an early discharge home if the cervical exam was unchanged since admission. A total of 140 patients were included: 70 in each group. Initial hospitalization stay was significantly shorter in Group B (respectively, 5.4±5.4 days and 11.4±12.1 days; P0.05). Gestational ages at birth were 33(5/7) and 33(0/7) WG in groups A and B, respectively (P>0.05). If we focus on patients who were discharged home in the two groups (women who did not deliver no matter the hospitalization length), the gestational age at birth (38(4/7) and 38WG; ns) and the prematurity rate inferior to 37WG (17.2% and 22.4%; ns) were statistically similar. This study suggests that shorter hospitalization does not decrease the delivery term, nor does it increase the premature delivery incidence. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  10. Can Preterm Labour Be Predicted in Low Risk Pregnancies? Role of Clinical, Sonographic, and Biochemical Markers

    Directory of Open Access Journals (Sweden)

    Reva Tripathi

    2014-01-01

    Full Text Available Background and Objectives. This is a prospective nested cohort study conducted over a period of 3 years. 2644 women were recruited, out of which final analysis was done for 1884 women. Methods. Cervicovaginal and blood samples were collected for all recruited women. Out of these, 137 women who delivered before 35 weeks were treated as cases and equal number of matched controls were chosen. Analysis of samples for serum G-CSF, AFP, ferritin, and cervicovaginal interleukin-6 and IGFBP-1 was done. Results. Poor orodental hygiene, which can be a social marker, was significantly more common in women who delivered preterm (P=0.008. Serum alkaline phosphatase and serum ferritin were found to be significantly associated with preterm deliveries. The 90th percentile value of these parameters was considered as cut-off as there is no specific cut-off. Conclusions. Our study did not prove usefulness of any predictive marker. Serum ferritin and alkaline phosphatase were found to have correlation but their values are affected in many conditions and need to be elucidated with caution. Larger studies are needed for predicting preterm labour in asymptomatic women.

  11. Long-term follow up of children exposed in utero to nifedipine or ritodrine for the management of preterm labour

    NARCIS (Netherlands)

    Houtzager, B. A.; Hogendoorn, S. M.; Papatsonis, D. N. M.; Samsom, J. F.; van Geijn, H. P.; Bleker, O. P.; van Wassenaer, A. G.

    2006-01-01

    OBJECTIVE: To compare the long-term psychosocial and motor effects on children exposed in utero to nifedipine or ritodrine for the management of preterm labour. DESIGN: Randomised controlled trial. SETTING: Multicentre study in two university and one primary hospital in the Netherlands. POPULATION:

  12. Effects of socioeconomic position and clinical risk factors on spontaneous and iatrogenic preterm birth

    OpenAIRE

    Joseph, KS; Fahey, John; Shankardass, Ketan; Allen, Victoria M; O’Campo, Patricia; Dodds, Linda; Liston, Robert M; Allen, Alexander C

    2014-01-01

    Background The literature shows a variable and inconsistent relationship between socioeconomic position and preterm birth. We examined risk factors for spontaneous and iatrogenic preterm birth, with a focus on socioeconomic position and clinical risk factors, in order to explain the observed inconsistency. Methods We carried out a retrospective population-based cohort study of all singleton deliveries in Nova Scotia from 1988 to 2003. Data were obtained from the Nova Scotia Atlee Perinatal Da...

  13. Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review

    NARCIS (Netherlands)

    Kazemier, B. M.; Buijs, P. E.; Mignini, L.; Limpens, J.; de Groot, C. J. M.; Mol, B. W. J.; von Dadelszen, P.; Magee, L.; Sawchuck, D.; Gao, E.; Oude Rengerink, K.; Zamora, J.; Fox, C.; Daniels, J.; Khan, K. S.; Thangaratinam, S.; Meads, C.

    2014-01-01

    Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered. To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies. An electronic literature search in OVID MEDLINE and EMBASE,

  14. Cardiovascular disease risk in women with a history of spontaneous preterm delivery : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Heida, Karst Y.; Velthuis, Birgitta K.; Oudijk, Martijn A.; Reitsma, Johannes B.; Bots, Michiel L.; Franx, Arie; van Dunne, Frederique M.; Hoek, Annemieke

    Background Increasing evidence suggests a relation between having had spontaneous preterm delivery and cardiovascular disease in the future. We performed a systematic review and meta-analysis to assess the relation between a history of spontaneous preterm delivery and risk of ischaemic heart disease

  15. Cardiovascular disease risk in women with a history of spontaneous preterm delivery: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Heida, Karst Y.; Velthuis, Birgitta K.; Oudijk, Martijn A.; Reitsma, Johannes B.; Bots, Michiel L.; Franx, Arie; van Dunné, Frederique M.; Cohen, Miriam; de Groot, Christianne J. M.; Hammoud, Nurah M.; Hoek, Annemiek; Laven, Joop S. E.; Maas, Angela H. E. M.; van Lennep, Jeanine E. Roeters; van Barneveld, Teus A.

    2016-01-01

    Background Increasing evidence suggests a relation between having had spontaneous preterm delivery and cardiovascular disease in the future. We performed a systematic review and meta-analysis to assess the relation between a history of spontaneous preterm delivery and risk of ischaemic heart disease

  16. Cardiovascular disease risk in women with a history of spontaneous preterm delivery : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Heida, Karst Y.; Velthuis, Birgitta K.; Oudijk, Martijn A.; Reitsma, Johannes B.; Bots, Michiel L.; Franx, Arie; Van Dunné, Frederique M.

    2016-01-01

    Background Increasing evidence suggests a relation between having had spontaneous preterm delivery and cardiovascular disease in the future. We performed a systematic review and meta-analysis to assess the relation between a history of spontaneous preterm delivery and risk of ischaemic heart disease

  17. 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.

  18. 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

  19. Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth

    NARCIS (Netherlands)

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

    2012-01-01

    Objective. To describe ethnic disparities in the risk of spontaneous preterm birth and related adverse neonatal outcome. Design. Nationwide prospective cohort study. Setting. The Netherlands, 19992007. Population. Nine hundred and sixty-nine thousand, four hundred and ninety-one singleton

  20. Genetic Associations with Gestational Duration and Spontaneous Preterm Birth

    DEFF Research Database (Denmark)

    Zhang, Ge; Feenstra, Bjarke; Bacelis, Jonas

    2017-01-01

    Background Despite evidence that genetic factors contribute to the duration of gestation and the risk of preterm birth, robust associations with genetic variants have not been identified. We used large data sets that included the gestational duration to determine possible genetic associations. Me...

  1. The influence of septicaemia on spontaneous motility in preterm infants

    NARCIS (Netherlands)

    Bos, AF; van Asperen, RM; de Leeuw, DM; Prechtl, HFR

    1997-01-01

    The qualitative assessment of general movements (GMs) in preterm infants is a sensitive method to investigate the integrity of the central nervous system. The question arises whether systemic infections affect the quality of GMs in a similar fashion to brain lesions. We were able to provide an

  2. 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.

  3. 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).

  4. Effects of a relaxation training programme on immediate and prolonged stress responses in women with preterm labour.

    Science.gov (United States)

    Chuang, Li-Lan; Lin, Li-Chan; Cheng, Po-Jen; Chen, Chung-Hey; Wu, Shiao-Chi; Chang, Chuan-Lin

    2012-01-01

    This paper is a report of an experimental study of the effects of relaxation-training programme on immediate and prolonged stress responses in women with preterm labour. Hospitalized pregnant women with preterm labour experience developmental and situational stress. However, few studies have been performed on stress management in such women. An experimental pretest and repeated post-test design was used to compare the outcomes for two groups in northern Taiwan from December 2008, to May 2010. A total of 129 women were randomly assigned to an experimental (n = 68) or control (n = 61) group. The experimental group participants were instructed to listen daily to a 13-minute relaxation programme. Measurements involved the stress visual analogue scale, finger temperatures, State Trait Anxiety Inventory, Perceived Stress Scale and Pregnancy-related Anxiety. Two-way analysis of variance and hierarchical linear modelling were used to analyse the group differences. Compared with those in the control group, participants in the experimental group showed immediate improvements in the stress visual analogue scale scores and finger temperatures. The State Trait Anxiety Inventory-State subscale score for the experimental group was significantly lower than that for the control group (P = 0·03). However, no statistically significant differences for the Perceived Stress Scale and Pregnancy-related Anxiety scores were found between the experimental group and the control group. The relaxation-training programme could improve the stress responses of women with preterm labour. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  5. [Premature labour with or without preterm premature rupture of membranes: maternal, obstetric and neonatal features].

    Science.gov (United States)

    Brandão, Ana Maria Simões; Domingues, Ana Patrícia Rodrigues; Fonseca, Etelvina Morais Ferreira; Miranda, Teresa Maria Antunes; Belo, Adriana; Moura, José Paulo Achando Silva

    2015-09-01

    Evaluation of maternal, obstetrics e neonatal features in both spontaneous preterm births (PTB) with or without preterm premature rupture of membranes (PPROM). Retrospective study of single fetus pregnancies with PTB between 2003 and 2012. PTB associated with ou without PPROM. Exclusion criterias: PTB by medical indication due to fetal/maternal disease and all non accessible or incomplete clinical files. Different characteristics were compared between two groups of PTB: spontaneous PTB without PPROM (sPTB) versusPPROM. Kolmogorov-Smirnov, Levene, χ2, t Student and Mann-Withney tests were used for statistical analysis. From 2,393 PTB of single fetus, 1,432 files were analysed, from which 596 were sPTB and 836 PPROM. The socioeconomic conditions were similar in both groups. Multiparity (50.7 versus 40.3%), personal history of previous PTB (20.8 versus10.2%), cervical length (18.2 versus27.2 mm), lower body index mass (23.4 versus 24.3 kg/m2) and higher infectious parameters (Protein C Reactive: 2.2 versus1.2 mg/L; Leukocytes: 13.3 versus 12.4 x109) were more frequent in PBTs (p<0,001). Neonatal outcomes, specially neurologic outcomes (4.7 versus2.8%, p<0,001), were worst in PBTs. PTB with or without PPROM has a complex etiology. From all evaluated features in our study, only maternal thinness, multiparity with a previous PTB, the cervical length and worst systemic infections parameters were significant in sPTB. This group also showed worst neonatal outcomes, specially on neurological outcomes.

  6. 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.

  7. Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review.

    Science.gov (United States)

    Kazemier, B M; Buijs, P E; Mignini, L; Limpens, J; de Groot, C J M; Mol, B W J

    2014-09-01

    Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered. To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies. An electronic literature search in OVID MEDLINE and EMBASE, complemented by PubMed, to find recent studies. Studies comparing the risk of spontaneous preterm birth after a previous preterm and previous term pregnancy. The absolute risk of recurrence with a 95% confidence interval and the absolute risk of preterm birth after a term delivery were calculated. Data from studies were pooled using the Mantel-Haenszel method. We detected 13 relevant studies. The risk of recurrence of preterm birth was significantly increased in all preterm pregnancy subtypes, compared with their term counterparts. Women pregnant with twins after a previous preterm singleton had the highest absolute risk of recurrence (57.0%, 95% CI 51.9-61.9%), and after a previous term singleton their absolute risk was 25% (95% CI 24.3-26.5%). Women pregnant with a singleton after a previous preterm twin pregnancy have an absolute recurrence risk of 10% (95% CI 8.2-12.3%), whereas a singleton pregnancy after delivering a previous twin up to term yields a low absolute risk of only 1.3% (95% CI 0.8-2.2). Women pregnant with a singleton after a previous preterm singleton have an absolute recurrence risk of 20% (95% CI 19.9-20.6). The risk of recurrence of preterm birth is influenced by the singleton/twin order in both pregnancies, and varies between 10% for a singleton after previous preterm twins to 57% for twins after a previous preterm singleton. © 2014 Royal College of Obstetricians and Gynaecologists.

  8. 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.

  9. Progression of the first stage of spontaneous labour: A prospective cohort study in two sub-Saharan African countries

    Science.gov (United States)

    Fawole, Bukola; Mugerwa, Kidza; Alves, Domingos; Souza, Hayala; Reis, Rodrigo; Oliveira-Ciabati, Livia; Maiorano, Alexandre; Akintan, Adesina; Alu, Francis E.; Oyeneyin, Lawal; Adebayo, Amos; Byamugisha, Josaphat; Idris, Hadiza A.; Okike, Ola; Althabe, Fernando; Hundley, Vanora; Pattinson, Robert; Sanghvi, Harshadkumar C.; Tunçalp, Özge; Vogel, Joshua P.; Stanton, Mary Ellen; Liljestrand, Jerker; ten Hoope-Bender, Petra; Mathai, Matthews; Bahl, Rajiv

    2018-01-01

    Background Escalation in the global rates of labour interventions, particularly cesarean section and oxytocin augmentation, has renewed interest in a better understanding of natural labour progression. Methodological advancements in statistical and computational techniques addressing the limitations of pioneer studies have led to novel findings and triggered a re-evaluation of current labour practices. As part of the World Health Organization's Better Outcomes in Labour Difficulty (BOLD) project, which aimed to develop a new labour monitoring-to-action tool, we examined the patterns of labour progression as depicted by cervical dilatation over time in a cohort of women in Nigeria and Uganda who gave birth vaginally following a spontaneous labour onset. Methods and findings This was a prospective, multicentre, cohort study of 5,606 women with singleton, vertex, term gestation who presented at ≤ 6 cm of cervical dilatation following a spontaneous labour onset that resulted in a vaginal birth with no adverse birth outcomes in 13 hospitals across Nigeria and Uganda. We independently applied survival analysis and multistate Markov models to estimate the duration of labour centimetre by centimetre until 10 cm and the cumulative duration of labour from the cervical dilatation at admission through 10 cm. Multistate Markov and nonlinear mixed models were separately used to construct average labour curves. All analyses were conducted according to three parity groups: parity = 0 (n = 2,166), parity = 1 (n = 1,488), and parity = 2+ (n = 1,952). We performed sensitivity analyses to assess the impact of oxytocin augmentation on labour progression by re-examining the progression patterns after excluding women with augmented labours. Labour was augmented with oxytocin in 40% of nulliparous and 28% of multiparous women. The median time to advance by 1 cm exceeded 1 hour until 5 cm was reached in both nulliparous and multiparous women. Based on a 95th percentile threshold

  10. Second-Trimester Anterior Cervical Angle in a Low-Risk Population as a Marker for Spontaneous Preterm Delivery.

    Science.gov (United States)

    Sepúlveda-Martínez, Alvaro; Díaz, Francisco; Muñoz, Hernán; Valdés, Enrique; Parra-Cordero, Mauro

    2017-01-01

    The aim of this article is to assess the use of the anterior cervical angle (ACA) as a predictor of spontaneous preterm delivery (sPTD) at 20+0-24+6 weeks of gestation in an unselected population. We conducted a nested case-control study that included 93 women who later delivered spontaneously history, CL and ACA at 20+0-24+6 weeks of gestation can predict approximately 40% of the severe preterm births. © 2016 S. Karger AG, Basel.

  11. Spontaneous movements in the supine position of preterm infants with intellectual disability.

    Science.gov (United States)

    Kouwaki, Masanori; Yokochi, Mitsuko; Kamiya, Takeshi; Yokochi, Kenji

    2014-08-01

    Spontaneous movements at 2 months of corrected age in preterm infants with intellectual disability (ID) were investigated by assessing individual motor elements separated from movements involving the entire body. Video recordings of 20 preterm infants with ID (16 males, 4 females; median gestational age 26 weeks; median birth weight 810 g) were analyzed and were compared with those of 21 normal preterm infants (8 males, 13 females; median gestational age 30 weeks; median birth weight 1216 g). In the preterm infants with ID at 2 months corrected age, startle response, lateral decumbent position, predominant shoulder rotation, and maintaining hip adduction were more frequently observed and hand sucking, maintaining shoulder abduction, to-and-fro shoulder abduction, to-and-fro elbow flexion, isolated hip adduction, to-and-fro hip abduction, and leg lift were less frequently seen than in the normal preterm infants (Fisher's exact test, ppreterm infants with ID result from persistent immature movements and non-emergence of mature movements. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  12. Kinematic analysis of preterm newborns' spontaneous movements for postural activity assessment.

    Science.gov (United States)

    Halek, Jan; Muckova, Anita; Svoboda, Zdenek; Janura, Miroslav; Marikova, Jana; Horakova, Katerina; Kantor, Lumir; Nemcova, Nina

    2015-12-01

    The objectives of this pilot study were to assess the potential use of 3D videography for analyzing the motion of the body center of mass (COM) in newborns and to determine differences in spontaneous movements between preterm and full-term infants. The group comprised 10 preterm newborns (gestational age at birth between 26 and 37 weeks; birth weight 800 to 2960 g; gestational age at the time of examination 34 to 39 weeks) and 10 full-term infants (gestational week 38 to 41; birth weight 2810 to 4360 g). To determine the range of motion of the COM, 3D videography was used (2 cameras, 25 Hz). When recording their movements, the infants were in the supine position, calm and awake. The recordings were processed using the APAS software. Selected points on the body were marked to obtain data for calculating the basic parameters of COM trajectories. The range of motion of the COM in both craniocaudal and anteroposterior directions was significantly greater in premature infants (P preterm babies. This was also valid for the velocity of motion of the COM in the craniocaudal direction (P preterm infants. Basic kinematic characteristics of the motion of the COM (range, variability, velocity) are greater in preterm infants.

  13. A computational model of lipopolysaccharide-induced nuclear factor kappa B activation: a key signalling pathway in infection-induced preterm labour.

    Directory of Open Access Journals (Sweden)

    Gemma C Sharp

    Full Text Available Preterm birth is the single biggest cause of significant neonatal morbidity and mortality, and the incidence is rising. Development of new therapies to treat and prevent preterm labour is seriously hampered by incomplete understanding of the molecular mechanisms that initiate labour at term and preterm. Computational modelling provides a new opportunity to improve this understanding. It is a useful tool in (i identifying gaps in knowledge and informing future research, and (ii providing the basis for an in silico model of parturition in which novel drugs to prevent or treat preterm labour can be "tested". Despite their merits, computational models are rarely used to study the molecular events initiating labour. Here, we present the first attempt to generate a dynamic kinetic model that has relevance to the molecular mechanisms of preterm labour. Using published data, we model an important candidate signalling pathway in infection-induced preterm labour: that of lipopolysaccharide (LPS -induced activation of Nuclear Factor kappa B. This is the first model of this pathway to explicitly include molecular interactions upstream of Nuclear Factor kappa B activation. We produced a formalised graphical depiction of the pathway and built a kinetic model based on ordinary differential equations. The kinetic model accurately reproduced published in vitro time course plots of Lipopolysaccharide-induced Nuclear Factor kappa B activation in mouse embryo fibroblasts. In this preliminary work we have provided proof of concept that it is possible to build computational models of signalling pathways that are relevant to the regulation of labour, and suggest that models that are validated with wet-lab experiments have the potential to greatly benefit the field.

  14. A computational model of lipopolysaccharide-induced nuclear factor kappa B activation: a key signalling pathway in infection-induced preterm labour.

    Science.gov (United States)

    Sharp, Gemma C; Ma, Hongwu; Saunders, Philippa T K; Norman, Jane E

    2013-01-01

    Preterm birth is the single biggest cause of significant neonatal morbidity and mortality, and the incidence is rising. Development of new therapies to treat and prevent preterm labour is seriously hampered by incomplete understanding of the molecular mechanisms that initiate labour at term and preterm. Computational modelling provides a new opportunity to improve this understanding. It is a useful tool in (i) identifying gaps in knowledge and informing future research, and (ii) providing the basis for an in silico model of parturition in which novel drugs to prevent or treat preterm labour can be "tested". Despite their merits, computational models are rarely used to study the molecular events initiating labour. Here, we present the first attempt to generate a dynamic kinetic model that has relevance to the molecular mechanisms of preterm labour. Using published data, we model an important candidate signalling pathway in infection-induced preterm labour: that of lipopolysaccharide (LPS) -induced activation of Nuclear Factor kappa B. This is the first model of this pathway to explicitly include molecular interactions upstream of Nuclear Factor kappa B activation. We produced a formalised graphical depiction of the pathway and built a kinetic model based on ordinary differential equations. The kinetic model accurately reproduced published in vitro time course plots of Lipopolysaccharide-induced Nuclear Factor kappa B activation in mouse embryo fibroblasts. In this preliminary work we have provided proof of concept that it is possible to build computational models of signalling pathways that are relevant to the regulation of labour, and suggest that models that are validated with wet-lab experiments have the potential to greatly benefit the field.

  15. 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.

  16. The quality of preterm infants' spontaneous movements : an early indicator of intelligence and behaviour at school age

    NARCIS (Netherlands)

    Butcher, Phillipa R.; van Braeckel, Koen; Bouma, Anke; Einspieler, Christa; Stremmelaar, Elisabeth F.; Bos, Arend F.

    Background: The quality of very preterm infants' spontaneous movements at 11 to 16 weeks post-term age is a powerful predictor of their later neurological status. This study investigated whether early spontaneous movements also have predictive value for the intellectual and behavioural problems that

  17. Cervical length measurement in nulliparous women at term by ultrasound & its relationship to spontaneous onset of labour

    Directory of Open Access Journals (Sweden)

    Joydev Mukherji

    2017-01-01

    Interpretation & conclusions: Inter-individual variations in CL and in CL changes were large. Thus, it was not practical to predict spontaneous onset of labour by sonographic CL measurement near term. Post-dated pregnancy may be predicted with limited success. Further studies should explore other parameters, in addition to CL.

  18. 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

  19. 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

  20. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery

    Science.gov (United States)

    Lenco, Juraj; Vajrychova, Marie; Link, Marek; Tambor, Vojtech; Liman, Victor; Bullarbo, Maria; Nilsson, Staffan; Tsiartas, Panagiotis; Cobo, Teresa; Kacerovsky, Marian; Jacobsson, Bo

    2016-01-01

    Objective The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD) in mid-trimester amniotic fluid from asymptomatic women. Methods This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14–19 weeks of gestation) was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases) and 40 randomly selected healthy women delivering at term (controls). An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples. Results The median (interquartile range (IQR: 25th; 75th percentiles) gestational age at delivery was 35+5 (33+6–36+6) weeks in women with spontaneous PTD and 40+0 (39+1–40+5) weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP) levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR) CRP level was 95.2 ng/mL (64.3; 163.5) in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8) in women delivering at term (p = 0.37; t-test). Conclusions Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA. PMID:27214132

  1. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery.

    Science.gov (United States)

    Hallingström, Maria; Lenco, Juraj; Vajrychova, Marie; Link, Marek; Tambor, Vojtech; Liman, Victor; Bullarbo, Maria; Nilsson, Staffan; Tsiartas, Panagiotis; Cobo, Teresa; Kacerovsky, Marian; Jacobsson, Bo

    2016-01-01

    The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD) in mid-trimester amniotic fluid from asymptomatic women. This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14-19 weeks of gestation) was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases) and 40 randomly selected healthy women delivering at term (controls). An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples. The median (interquartile range (IQR: 25th; 75th percentiles) gestational age at delivery was 35+5 (33+6-36+6) weeks in women with spontaneous PTD and 40+0 (39+1-40+5) weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP) levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR) CRP level was 95.2 ng/mL (64.3; 163.5) in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8) in women delivering at term (p = 0.37; t-test). Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA.

  2. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery.

    Directory of Open Access Journals (Sweden)

    Maria Hallingström

    Full Text Available The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD in mid-trimester amniotic fluid from asymptomatic women.This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14-19 weeks of gestation was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases and 40 randomly selected healthy women delivering at term (controls. An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples.The median (interquartile range (IQR: 25th; 75th percentiles gestational age at delivery was 35+5 (33+6-36+6 weeks in women with spontaneous PTD and 40+0 (39+1-40+5 weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR CRP level was 95.2 ng/mL (64.3; 163.5 in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8 in women delivering at term (p = 0.37; t-test.Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA.

  3. A debate about ultrasound and anatomic aspects of the cervix in spontaneous preterm birth.

    Science.gov (United States)

    Bohîlțea, R E; Munteanu, O; Turcan, N; Baros, A; Bodean, O; Voicu, D; Cîrstoiu, M M

    2016-01-01

    Preterm birth is the legal first global cause of neonatal death. The cervix has two roles: it has to stay closed to allow the fetus to undergo a normal development during gestation, and at term, the cervix has to dilate under the pressure of uterine contractions to allow the delivery. The purpose of this article is to establish if the ultrasound measured length of the cervix and its appearance are predictive for the spontaneous preterm birth. Cervical insufficiency can be described by painless cervical dilatation leading to pregnancy losses/ births, with no other risk factors present. During gestation, the physiological softening of the cervix is determined by the extracellular matrix components, particular decorin, and thrombospondin 2. The direction of the collagen fibers remains the same - circumferential direction, but the collagen solubility increases. Therefore, during pregnancy, the cervical tissue is more hydrated and has higher collagen extractability than non-pregnant tissue. Women with cervical incompetence have increased levels of smooth muscle cells than normal pregnant women, the number of elastic fibers is low, and also the concentration of hydroxyproline is decreased. Transvaginal ultrasound is the suitable gold standard exam that can offer essential information about the cervical length and state of the internal os in early asymptomatic stage of cervical insufficiency for predicting and preventing preterm birth. In our experience, a transvaginal ultrasound screening for the measurement of the cervix is required. We consider that the proper gestational age for the prediction of a preterm birth is at 18-22 weeks of gestation for the general population and earlier for patients with a history of preterm birth. Just from an observational point of view, we concluded with the fact that the cerclage of the cervix is unnecessary if the cervical length is above 2 cm and if the internal cervical os is closed. In the absence of funneling, the probability of

  4. [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

  5. Association of Vac A- and Cag A-specific Helicobacter pylori strain infection with spontaneous preterm birth.

    Science.gov (United States)

    Yang, Seung Woo; Kwon, Han Sung; Sohn, In Sook; Kim, Young Ju; Hwang, Han Sung

    2017-04-01

    To better understand the correlation between Helicobacter pylori (H. pylori) seropositivity and spontaneous preterm birth. A total of 320 pregnant women were classified into two groups: normal control singleton pregnant group (n = 264) and singleton spontaneous preterm birth group (n = 56). Blood samples were collected at the time of delivery, and the H. pylori IgG, various virulence factors and systemic inflammation status were compared between the two groups. Between the two groups, the serum H. pylori IgG, Cytotoxin-associated agntigen A (Cag A), Vacuolating cytotoxin A (Vac A) significantly increased in spontaneous preterm birth group than in the control group. Also, in preterm group, highly sensitive C-reactive protein (hsCRP) as a systemic inflammatory marker is statistically elevated at inflammatory status range. Whereas in the term pregnant group, hsCRP was normal range even though high incidence of H. pylori IgG seropositivity. Also, in the seropositive group, hsCRP is statistically correlated with H. pylori IgG, Cag A and Vac A. There is an association between the presence of antibodies against H. pylori in maternal serum and the development of preterm birth. Furthermore, serology type of H. pylori with Vac A, Cag A relates to preterm birth even though high H. pylori prevalence rate.

  6. Cervical dilatation patterns of 'low-risk' women with spontaneous labour and normal perinatal outcomes: a systematic review.

    Science.gov (United States)

    Oladapo, O T; Diaz, V; Bonet, M; Abalos, E; Thwin, S S; Souza, H; Perdoná, G; Souza, J P; Gülmezoglu, A M

    2017-09-11

    The call for women-centred approaches to reduce labour interventions, particularly primary caesarean section, has renewed an interest in gaining a better understanding of natural labour progression. To synthesise available data on the cervical dilatation patterns during spontaneous labour of 'low-risk' women with normal perinatal outcomes. PubMed, EMBASE, CINAHL, POPLINE, Global Health Library, and reference lists of eligible studies. Observational studies and other study designs. Two authors extracted data on: maternal characteristics; labour interventions; the duration of labour centimetre by centimetre; and the duration of labour from dilatation at admission through to 10 cm. We pooled data across studies using weighted medians and employed the Bootstrap-t method to generate the corresponding confidence bounds. Seven observational studies describing labour patterns for 99 971 women met our inclusion criteria. The median time to advance by 1 cm in nulliparous women was longer than 1 hour until a dilatation of 5 cm was reached, with markedly rapid progress after 6 cm. Similar labour progression patterns were observed in parous women. The 95th percentiles for both parity groups suggest that it was not uncommon for some women to reach 10 cm, despite dilatation rates that were much slower than the 1-cm/hour threshold for most part of their first stage of labours. An expectation of a minimum cervical dilatation threshold of 1 cm/hour throughout the first stage of labour is unrealistic for most healthy nulliparous and parous women. Our findings call into question the universal application of clinical standards that are conceptually based on an expectation of linear labour progress in all women. UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, and the United States Agency for International Development (USAID

  7. Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour: a systematic review and cost analysis

    NARCIS (Netherlands)

    N.V. Deshpande (Niteen Vijay); A.D.I. van Asselt (Antoinette); F. Tomini; N. Armstrong (Nigel); A. Allen (Alex); C. Noake; K.S. Khan (Kalid); J.L. Severens (Hans); J. Kleijnen (Jos); M. Westwood (Marie)

    2013-01-01

    markdownabstract__Background__: Premature birth is defined as birth of before 37 completed weeks' gestation. Not all pregnant women showing symptoms of preterm labour will go on to deliver before 37weeks' gestation. Hence, addition of fetal fibronectin (fFN) testing to the diagnostic workup of

  8. Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour : a systematic review and cost analysis

    NARCIS (Netherlands)

    Deshpande, S N; van Asselt, A D I; Tomini, F; Armstrong, N; Allen, A; Noake, C; Khan, K; Severens, J L; Kleijnen, J; Westwood, M E

    2013-01-01

    BACKGROUND: Premature birth is defined as birth of before 37 completed weeks' gestation. Not all pregnant women showing symptoms of preterm labour will go on to deliver before 37 weeks' gestation. Hence, addition of fetal fibronectin (fFN) testing to the diagnostic workup of women with suspected

  9. 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

  10. Cervical length measurement in nulliparous women at term by ultrasound & its relationship to spontaneous onset of labour.

    Science.gov (United States)

    Mukherji, Joydev; Bhadra, Avishek; Ghosh, Suhas Kumar; Hazra, Avijit; Anant, Monika; Bhattacharya, Subir Kumar; Das, Bibekananda; Banu, Shabnam

    2017-10-01

    Data on serial cervical length (CL) measurements in pregnancy at term to predict spontaneous labour onset are scarce and conflicting. This study was conducted to observe CL changes preceding spontaneous onset of labour, by serial transvaginal sonography (TVS) and transabdominal sonography (TAS), in nulliparous Indian women near term. Only nulliparous women with a singleton foetus in cephalic presentation and who confirmed their gestational age were recruited. Sonographic CL measurements were taken at weekly intervals from 36 wk gestation onwards by a single ultrasonologist. Transabdominal and transvaginal measurements were undertaken using the suitable transducer probes with the women in the supine position. A total of 104 women with spontaneous onset of labour were evaluated. There was substantial variation in CL measurements, both by TVS and by TAS, from 36 to 40 wk gestation, although the two sets of measurements correlated closely. Mean CL changed significantly over the last three weeks before delivery. However, only one-third of the women showed CL change of >5 mm per week in the last three weeks. There was poor correlation between gestational age at delivery and the last measured CL, either by TVS or TAS. Length >3.1 mm, measured by TVS at 38 wk gestation, predicted post-dated pregnancy to a limited extent. Inter-individual variations in CL and in CL changes were large. Thus, it was not practical to predict spontaneous onset of labour by sonographic CL measurement near term. Post-dated pregnancy may be predicted with limited success. Further studies should explore other parameters, in addition to CL.

  11. Oxidative stress damage-associated molecular signaling pathways differentiate spontaneous preterm birth and preterm premature rupture of the membranes.

    Science.gov (United States)

    Dutta, Eryn H; Behnia, Faranak; Boldogh, Istvan; Saade, George R; Taylor, Brandie D; Kacerovský, Marian; Menon, Ramkumar

    2016-02-01

    In women with preterm premature rupture of the membranes (PPROM), increased oxidative stress may accelerate premature cellular senescence, senescence-associated inflammation and proteolysis, which may predispose them to rupture. We demonstrate mechanistic differences between preterm birth (PTB) and PPROM by revealing differences in fetal membrane redox status, oxidative stress-induced damage, distinct signaling pathways and senescence activation. Oxidative stress-associated fetal membrane damage and cell cycle arrest determine adverse pregnancy outcomes, such as spontaneous PTB and PPROM. Fetal membranes and amniotic fluid samples were collected from women with PTB and PPROM. Molecular, biochemical and histologic markers were used to document differences in oxidative stress and antioxidant enzyme status, DNA damage, secondary signaling activation by Ras-GTPase and mitogen-activated protein kinases, and activation of senescence between membranes from the two groups. Oxidative stress was higher and antioxidant enzymes were lower in PPROM compared with PTB. PTB membranes had minimal DNA damage and showed activation of Ras-GTPase and ERK/JNK signaling pathway with minimal signs of senescence. PPROM had higher numbers of cells with DNA damage, prosenescence stress kinase (p38 MAPK) activation and signs of senescence. Samples were obtained retrospectively after delivery. The markers of senescence that we tested are specific but are not sufficient to confirm senescence as the pathology in PPROM. Oxidative stress-induced DNA damage and senescence are characteristics of fetal membranes from PPROM, compared with PTB with intact membranes. PTB and PPROM arise from distinct pathophysiologic pathways. Oxidative stress and oxidative stress-induced cellular damages are likely determinants of the mechanistic signaling pathways and phenotypic outcome. This study is supported by developmental funds to Dr R. Menon from the Department of Obstetrics and Gynecology at The University of

  12. Spontaneous preterm birth and single nucleotide gene polymorphisms: a recent update

    Directory of Open Access Journals (Sweden)

    Ishfaq A. Sheikh

    2016-10-01

    Full Text Available Abstract Background Preterm birth (PTB, birth at <37 weeks of gestation, is a significant global public health problem. World-wide, about 15 million babies are born preterm each year resulting in more than a million deaths of children. Preterm neonates are more prone to problems and need intensive care hospitalization. Health issues may persist through early adulthood and even be carried on to the next generation. Majority (70 % of PTBs are spontaneous with about a half without any apparent cause and the other half associated with a number of risk factors. Genetic factors are one of the significant risks for PTB. The focus of this review is on single nucleotide gene polymorphisms (SNPs that are reported to be associated with PTB. Results A comprehensive evaluation of studies on SNPs known to confer potential risk of PTB was done by performing a targeted PubMed search for the years 2007–2015 and systematically reviewing all relevant studies. Evaluation of 92 studies identified 119 candidate genes with SNPs that had potential association with PTB. The genes were associated with functions of a wide spectrum of tissue and cell types such as endocrine, tissue remodeling, vascular, metabolic, and immune and inflammatory systems. Conclusions A number of potential functional candidate gene variants have been reported that predispose women for PTB. Understanding the complex genomic landscape of PTB needs high-throughput genome sequencing methods such as whole-exome sequencing and whole-genome sequencing approaches that will significantly enhance the understanding of PTB. Identification of high risk women, avoidance of possible risk factors, and provision of personalized health care are important to manage PTB.

  13. Social disadvantage and the black-white disparity in spontaneous preterm delivery among California births.

    Directory of Open Access Journals (Sweden)

    Suzan L Carmichael

    Full Text Available We examined the contribution of social disadvantage to the black-white disparity in preterm birth. Analyses included linked vital and hospital discharge records from 127,358 black and 615,721 white singleton California births from 2007-11. Odds ratios (OR were estimated by 4 logistic regression models for 2 outcomes: early (<32 wks and moderate (32-36 wks spontaneous preterm birth (ePTB, mPTB, stratified by 2 race-ethnicity groups (blacks and whites. We then conducted a potential impact analysis. The OR for less than high school education (vs. college degree was 1.8 (95% confidence interval 1.6, 2.1 for ePTB among whites but smaller for the other 3 outcome groups (ORs 1.3-1.4. For all 4 groups, higher census tract poverty was associated with increased odds (ORs 1.03-1.05 per 9% change in poverty. Associations were less noteworthy for the other variables (payer, and tract percent black and Gini index of income inequality. Setting 3 factors (education, poverty, payer to 'favorable' values was associated with lower predicted probability of ePTB (25% lower among blacks, 31% among whites but a 9% higher disparity, compared to probabilities based on observed values; for mPTB, respective percentages were 28% and 13% lower probability, and 17% lower disparity. Results suggest that social determinants contribute to preterm delivery and its disparities, and that future studies should focus on ePTB and more specific factors related to social circumstances.

  14. 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.

  15. Biomarkers of spontaneous preterm birth: an overview of the literature in the last four decades.

    Science.gov (United States)

    Menon, Ramkumar; Torloni, Maria Regina; Voltolini, Chiara; Torricelli, Michela; Merialdi, Mario; Betrán, Ana Pilar; Widmer, Mariana; Allen, Tomas; Davydova, Iulia; Khodjaeva, Zulfiya; Thorsen, Poul; Kacerovsky, Marian; Tambor, Vojtìch; Massinen, Tytti; Nace, Judith; Arora, Chander

    2011-11-01

    Understanding spontaneous preterm birth ([PTB] < 37 weeks) is difficult due to heterogeneities associated with multitudes of risk factors and pathophysiological pathways. Several biomarkers are routinely used clinically for predicting preterm labor; however, these factors are either nonspecific or detected too late. Systematic review of literature on PTB biomarkers in the last 40 years to map out the existing knowledge and gaps in understanding PTB biomarkers. Five electronic databases were searched for human studies on PTB biomarkers published in any language between 1965 and 2008. The phenotype of interest for final data extraction was exclusively spontaneous PTB with no rupture of membranes. Data extraction included (a) general characteristics of the study (clinical setting, period, and study design), (b) study/participant characteristics (inclusion and exclusion criteria, race/ethnicity, number of participants, gestational age at sampling, (c) characteristics of the biomarker (type, rationale for its selection, type of biological sample, and assay used, and (d) concentration of biomarkers in cases and controls. The search yielded 7255 citations and data were extracted from 217 articles which met our inclusion and exclusion criteria. A total of 116 different biomarkers were reported and these were assayed 578 times in the 217 included studies. Over two thirds of the 217 studies were performed on North American or European populations. No reliable biomarkers emerged as a risk predictor of PTB. Identifying similar studies on biomarkers for the prediction of PTB was a very challenging task due heterogeneities in study design, sampling issues (types, timing and processing), assay methods, and analyses. Major areas of concern identified in this review include poor phenotype definition, nonideal study designs and poor rationale for biomarker selection and assays and population stratification issues.

  16. 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.

  17. Associations between respiratory arrhythmia and fundamental frequency of spontaneous crying in preterm and term infants at term‐equivalent age

    Science.gov (United States)

    Shinya, Yuta; Kawai, Masahiko; Niwa, Fusako

    2016-01-01

    ABSTRACT This study investigated whether lower vagal function in preterm infants is associated with increased fundamental frequency (F 0; frequency of vocal fold vibration) of their spontaneous cries. We assessed respiratory sinus arrhythmia (RSA) during quiet sleep as a measure of vagal function, and its relationship with the F 0 of spontaneous cries in healthy preterm and term infants at term‐equivalent age. The results showed that preterm infants have significantly lower RSA, and higher overall F 0 than term infants. Moreover, lower RSA was associated with higher overall F 0 in preterm infants, whereas higher RSA was positively associated with mean and maximum F 0, and a larger F 0 range in term infants. These results suggest that individual differences in vagal function may be associated with the F 0 of spontaneous cries via modulation of vocal fold tension in infants at an early developmental stage. © 2016 The Authors. Developmental Psychobiology Published by Wiley Periodicals, Inc. Dev Psychobiol 58:724–733, 2016. PMID:27037599

  18. Prediction of spontaneous preterm delivery from maternal factors, obstetric history and placental perfusion and function at 11-13 weeks.

    Science.gov (United States)

    Beta, Jarek; Akolekar, Ranjit; Ventura, Walter; Syngelaki, Argyro; Nicolaides, Kypros H

    2011-01-01

    To develop a model for prediction of spontaneous delivery before 34 weeks based on maternal factors, placental perfusion and function at 11-13 weeks' gestation. Two groups of studies: first, screening study of maternal characteristics, serum pregnancy-associated plasma protein-A (PAPP-A), free β-human chorionic gonadotrophin (β-hCG) and uterine artery pulsatility index (PI). Second, case-control studies of maternal serum or plasma concentration of placental growth factor (PlGF), placental protein 13 (PP13), a disintegrin and metalloprotease 12 (ADAM12), inhibin-A and activin-A. Regression analysis was used to develop a model for the prediction of spontaneous early delivery. Spontaneous early delivery occurred in 365 (1.1%) of the 34 025 pregnancies. A model based on maternal factors could detect 38.2% of the preterm deliveries in women with previous pregnancies at or beyond 16 weeks and 18.4% in those without, at a false positive rate (FPR) of 10%. In the preterm delivery group, compared with unaffected pregnancies there were no significant differences in the markers of placental perfusion or function, except for PAPP-A which was reduced. Patient-specific risk of preterm delivery is provided by maternal factors and obstetric history. Placental perfusion and function at 11-13 weeks are not altered in pregnancies resulting in spontaneous early delivery. Copyright © 2011 John Wiley & Sons, Ltd.

  19. 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

  20. The Effect of Prior Term Birth on Risk of Recurrent Spontaneous Preterm Birth.

    Science.gov (United States)

    Purisch, Stephanie E; Turitz, Amy L; Elovitz, Michal A; Levine, Lisa D

    2018-03-01

     The objective of this study was to evaluate the effect of prior term birth on recurrent spontaneous preterm birth (sPTB) risk.  Retrospective cohort study of 211 women with prior sPTB, comparing women with and without prior term births. The primary outcome was recurrent sPTB term births (28.9 vs. 37.7%, p  = 0.2). Among women with prior second-trimester loss (16-23 6/7 weeks), those with a term birth had a decreased sPTB rate (15.4 vs. 43.2%, p  = 0.02), which persisted after adjusting for age and 17-α hydroxyprogesterone caproate use. For women with prior sPTB ≥24 weeks, there was no difference in sPTB with and without prior term births (29.5 vs. 26.6%, p  = 0.7). A term birth as the most recent delivery lowered, but did not eliminate, the sPTB risk (19.1 vs. 36.4%, p  = 0.1).  Prior term birth lowers the risk of recurrent sPTB for women with prior second-trimester loss, but not for women with prior sPTB ≥24 weeks. Women with prior preterm and term births should be counseled accordingly and all sPTB prevention strategies should be recommended. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  1. Spontaneous movements in the supine position of healthy term infants and preterm infants with or without periventricular leukomalacia.

    Science.gov (United States)

    Kouwaki, Masanori; Yokochi, Mitsuko; Togawa, Yasuko; Kamiya, Takeshi; Yokochi, Kenji

    2013-04-01

    The individual motor elements presumed to be essential for motor development were determined from spontaneous movements involving the entire body of normal term and preterm infants. Then, diagnostic items for motor abnormality in infants with periventricular leukomalacia (PVL) were investigated. Video recordings of 24 healthy term infants, 21 normal preterm infants (8 males, 13 females; median gestational age 30 weeks; median birth weight 1216g) and 14 preterm infants with PVL (6 males, 8 females; median gestational age 30 weeks; median birth weight 1360g) were analyzed. In healthy term infants, predominant shoulder rotation was noticed until 1 month of age. After 2 months of age, isolated movements of the shoulder, elbow, hip, knee, and ankle frequently emerged. In preterm infants with PVL at the corrected age of 2 months, startle response and predominant shoulder rotation were more frequently seen and isolated neck, shoulder, elbow, hip, knee, and ankle movements were less frequently seen than in the normal preterm infants (Fisher's exact test, p<0.025). At 2 months of age, isolated movements evolve, and their failure to occur is suggested to be a useful sign for the diagnosis of cerebral motor disorders. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  2. 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.

  3. Efficacy of two regimens of dexamethasone for management of preterm labour: pilot study

    International Nuclear Information System (INIS)

    Rasool, A.; Farooq, U.

    2017-01-01

    Background: Dexamethasone is widely used for prevention of respiratory distress syndrome (RDS), necrotising enterocolitis (NEC) and intra-ventricular haemorrhage (IVH) in preterm babies; decreasing the neonatal mortality rate. There is no consensus on the dose of corticosteroid administered to the mother expected to have a preterm baby. This study is conducted to compare the effectiveness of two popular regimens of dexamethasone administration in decreasing incidence of RDS, necrotizing enterocolitis, IVH and neonatal mortality rate. Methods: Randomized control trial was conducted at Ayub Teaching Hospital, Abbottabad from 1st to 31st August, 2014. Sample size was set at 50. Block randomization was employed in the trial to allocate the patients into corresponding groups 'A' and 'B'. Group A was administered 6mg dexamethasone in 4 doses 12 hours apart and group B was administered 2 doses 12 hours apart. Results: Forty-eight patients participated in the study with 24 patients in each group. Mean age and period gestation of participants were 28.4 years±4.3 SD and 34 weeks±1.9 SD respectively. Four patients in group A gave birth to neonate with RDS compared to two cases in group B. Group B had higher incidence of necrotizing enterocolitis and neonatal mortalities. However, none of these differences observed were statistically significant. No case of IVH was reported in either of the groups. Conclusion: Both the popular regimens of dexamethasone administration are equally effective in decreasing the incidence of neonatal diseases. (author)

  4. [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

  5. Less invasive surfactant administration is associated with improved pulmonary outcomes in spontaneously breathing preterm infants.

    Science.gov (United States)

    Göpel, Wolfgang; Kribs, Angela; Härtel, Christoph; Avenarius, Stefan; Teig, Norbert; Groneck, Peter; Olbertz, Dirk; Roll, Claudia; Vochem, Matthias; Weller, Ursula; von der Wense, Axel; Wieg, Christian; Wintgens, Jürgen; Preuss, Michael; Ziegler, Andreas; Roth, Bernhard; Herting, Egbert

    2015-03-01

    Providing less invasive surfactant administration (LISA) to spontaneously breathing preterm infants has been reported to reduce mechanical ventilation and bronchopulmonary dysplasia (BPD) in randomised controlled trials. This large cohort study compared these outcome measures between LISA-treated infants and controls. Infants receiving LISA, who were born before 32 gestational weeks and enrolled in the German Neonatal Network, were matched to control infants by gestational age, umbilical cord pH, Apgar-score at 5 min, small for gestational age status, antenatal treatment with steroids, gender and highest supplemental oxygen during the first 12 h of life. Outcome data were compared with chi-square and Mann-Whitney U-tests and adjusted for multiple comparisons. Between 2009 and 2012, 1103 infants were treated with LISA at 37 centres. LISA infants had lower rates of mechanical ventilation (41% versus 62%, p mechanical ventilation and BPD. Additional large-scale randomised controlled trials are needed to assess the possible long-term benefits of LISA. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  6. Proteomic biomarkers for spontaneous preterm birth: a systematic review of the literature.

    Science.gov (United States)

    Kacerovsky, Marian; Lenco, Juraj; Musilova, Ivana; Tambor, Vojtech; Lamont, Ronald; Torloni, Maria Regina; Menon, Ramkumar

    2014-03-01

    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 between January 1994 and December 2012. Retrieved citations were screened, and relevant studies were selected for full-text reading, in triplicate. The search yielded 529 citations, 51 were selected for full-text reading and 8 studies were included in the review. A total of 64 dysregulated proteins were reported. Only 14-3-3 protein sigma, annexin A5, protein S100-A8, protein S100-A12, and inter-α-trypsin inhibitor heavy chain H4 were reported in more than 1 study, but results could not be combined due to heterogeneity in type of sample and analytical platform. In conclusion, according to the existing literature, there are no specific proteomic biomarkers capable of accurately predicting PTB.

  7. Effect of early amniotomy on the outcome of spontaneous labour: a ...

    African Journals Online (AJOL)

    Edwin Musinguzi

    Background: Early amniotomy is common in obstetric practice but, its effectiveness has not been proven. Objectives: To determine the effects of ... However, the effectiveness of this intervention in aug- menting labour has not been proven4, .... oxytocin argumentation, Apgar scores, and need for. New Born Special Care Unit ...

  8. Spontaneous breathing or mechanical ventilation alters lung compliance and tissue association of exogenous surfactant in preterm newborn rabbits.

    Science.gov (United States)

    Bohlin, Kajsa; Bouhafs, Rabea K L; Jarstrand, Connie; Curstedt, Tore; Blennow, Mats; Robertson, Bengt

    2005-05-01

    In preterm infants with respiratory distress syndrome, surfactant administration followed by immediate extubation to spontaneous breathing with nasal continuous positive airway pressure reduces the need for mechanical ventilation. With this treatment approach, repeated doses of surfactant are rarely indicated. We used a rabbit model to test the hypothesis that exogenous surfactant therapy followed by spontaneous breathing results in a more sustained initial treatment response compared with treatment followed by mechanical ventilation. Preterm rabbits (gestational age 28.5 d) were treated with pharyngeal deposition of 200 mg/kg radiolabeled surfactant (14C-Curosurf) and randomized to 4 h of spontaneous breathing or mechanical ventilation or to a control group, killed immediately after surfactant administration. With pharyngeal deposition, 46 +/- 10% (mean +/- SEM) of the administered surfactant reached the lungs. The dynamic lung-thorax compliance was higher in spontaneously breathing compared with mechanically ventilated animals (median, 9.9 and 0.75 ml x cm H2O(-1) x kg(-1), respectively; p mechanically ventilated animals (p mechanically ventilated animals. We conclude that the initial lung tissue association of exogenous surfactant is impaired by mechanical ventilation. This is associated with a reduction of dynamic compliance and evidence of increased surfactant inactivation.

  9. [A case-control study on association between OAS1 polymorphism and susceptibility to spontaneous preterm birth and preterm premature rupture of membranes].

    Science.gov (United States)

    Yang, Xiao; Zhang, Xiao-Ai; Wu, Zhi-Hao; Peng, Wei; Zhu, Li-Na; Wang, Yan

    2015-09-01

    To investigate the association between the genetic polymorphism of 2',5'-oligoadenylate synthetase 1 (OAS1) and susceptibility to spontaneous preterm birth (SPTB) and preterm premature rupture of membranes (PPROM). The case-control study consisted of 599 preterm infants including 171 cases of PPROM, and 673 full-term infants without maternal histories of SPTB and PPROM as controls. The single nucleotide polymorphism (SNP) at OAS1 intron 5, rs10774671, was analyzed by polymerase chain reaction-restriction fragment length polymorphism. No significant differences were observed between the case and control groups in the frequencies of genotypes (AA, GA, and GG) and alleles (A and G) of OAS1 rs10774671. When the case group was divided into two subgroups with or without PPROM, no significant differences in the genotype and allele frequencies were found between each subgroup and the control group. When the case group was divided into three subgroups with different gestational ages at SPTB, no significant differences in the genotype and allele frequencies were detected between each subgroup and the control group. No association is identified between OAS1 SNP and susceptibility to SPTB and PPROM.

  10. Evaluation of proteomic biomarkers associated with circulating microparticles as an effective means to stratify the risk of spontaneous preterm birth.

    Science.gov (United States)

    Cantonwine, David E; Zhang, Zhen; Rosenblatt, Kevin; Goudy, Kevin S; Doss, Robert C; Ezrin, Alan M; Page, Gail; Brohman, Brian; McElrath, Thomas F

    2016-05-01

    The analysis of circulating microparticles in pregnancy is of revolutionary potential because it represents an in vivo biopsy of active gestational tissues. We hypothesized that circulating microparticle signaling will differ in pregnancies that experience spontaneous preterm birth from those delivering at term and that these differences will be evident many weeks in advance of clinical presentation. Utilizing plasma specimens obtained between 10 and 12 weeks' gestation as part of a prospectively collected birth cohort in which pregnancy outcomes are independently validated by 2 board-certified maternal-fetal medicine physicians, 25 singleton cases of spontaneous preterm birth ≤ 34 weeks were matched by maternal age, race, and gestational age of sampling (±2 weeks) with 50 uncomplicated term deliveries. Circulating microparticles from these first-trimester specimens were isolated and analyzed by multiple reaction monitoring mass spectrometry for potential protein biomarkers following previous studies. Markers with robust univariate performance in correlating spontaneous preterm birth were further evaluated for their biological relevance via a combined functional profiling/pathway analysis and for multivariate performance. Among the 132 proteins evaluated, 62 demonstrated robust power of detecting spontaneous preterm birth in a bootstrap receiver-operating characteristic curve analysis at a false discovery rate of deliver spontaneously ≤ 34 weeks. These changes, with further validation, will allow the stratification of patients at risk of spontaneous preterm birth before clinical presentation. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. 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.

  12. Mid-pregnancy circulating cytokine levels, histologic chorioamnionitis and spontaneous preterm birth

    Science.gov (United States)

    Gargano, Julia Warner; Holzman, Claudia; Senagore, Patricia; Thorsen, Poul; Skogstrand, Kristin; Hougaard, David M.; Rahbar, Mohammad H.; Chung, Hwan

    2008-01-01

    Some spontaneous preterm deliveries (PTD) are caused by occult infections of the fetal membranes (histologic chorioamnionitis [HCA]). High levels of infection-related markers, including some cytokines, sampled from maternal circulation in mid-pregnancy have been linked to PTD, but whether these specifically identify HCA has not been established. We have tested associations between thirteen Th1, Th2 and Th17 cytokines and PTD with and without HCA in a prospective cohort study. The study sample included 926 Pregnancy Outcomes and Community Health Study subcohort women; women with medically indicated PTD or incomplete data excluded. A panel of cytokines was assessed using a multiplex assay in maternal plasma collected at 15–27 weeks of gestation. Severe HCA was scored by a placental pathologist blinded to clinical variables. Multivariable polytomous logistic regression was used to estimate adjusted odds ratios (OR) per 1 standard deviation (SD) increase in cytokine levels using a 5 level outcome variable: PTD <35 weeks with HCA, PTD <35 weeks without HCA, PTD 35–36 weeks with HCA, PTD 35–36 weeks without HCA, and term (referent). Interleukin (IL)-1β, IL-2, IL-12, interferon-γ, IL-4, IL-6 and transforming growth factor-β were all significantly associated with PTD <35 weeks with HCA, with ORs of 1.6 – 2.3 per SD increase. None of these were associated with PTD <35 weeks without HCA or PTD 35–36 weeks with HCA. Although the tissues of origin of circulating cytokines are unclear, the observed elevations across many cytokines among women who later delivered <35 weeks with HCA may represent a robust immune response to infection within gestational tissues. These results suggest that women with HCA could be identified using relatively non-invasive means. PMID:18814919

  13. Folic acid supplementation, dietary folate intake during pregnancy and risk for spontaneous preterm delivery: a prospective observational cohort study.

    Science.gov (United States)

    Sengpiel, Verena; Bacelis, Jonas; Myhre, Ronny; Myking, Solveig; Devold Pay, Aase Serine; Haugen, Margaretha; Brantsæter, Anne-Lise; Meltzer, Helle Margrete; Nilsen, Roy Miodini; Magnus, Per; Vollset, Stein Emil; Nilsson, Staffan; Jacobsson, Bo

    2014-11-02

    Health authorities in numerous countries recommend periconceptional folic acid supplementation to prevent neural tube defects. The objective of this study was to examine the association of dietary folate intake and folic acid supplementation during different periods of pregnancy with the risk of spontaneous preterm delivery (PTD). The Norwegian Mother and Child Cohort Study is a population-based prospective cohort study. A total of 66,014 women with singleton pregnancies resulting in live births in 2002-2009 were included. Folic acid supplementation was self-reported from 26 weeks before pregnancy until pregnancy week 24. At gestational week 22, the women completed a food frequency questionnaire, which allowed the calculation of their average total folate intake from foods and supplements for the first 4-5 months of pregnancy. Spontaneous PTD was defined as the spontaneous onset of delivery between weeks 22+0 and 36+6 (n = 1,755). The median total folate intake was 313 μg/d (interquartile range IQR 167-558) in the overall population and 530 μg/d (IQR 355-636) in the supplement users. Eighty-five percent reported any folic acid supplementation from effect of dietary folate intake or folic acid supplementation on spontaneous PTD. Preconceptional folic acid supplementation starting more than 8 weeks before conception was associated with an increased risk of spontaneous PTD. These results require further investigation before discussing an expansion of folic acid supplementation guidelines.

  14. Ureaplasma parvum genotype, combined vaginal colonisation with Candida albicans, and spontaneous preterm birth in an Australian cohort of pregnant women.

    Science.gov (United States)

    Payne, Matthew S; Ireland, Demelza J; Watts, Rory; Nathan, Elizabeth A; Furfaro, Lucy L; Kemp, Matthew W; Keelan, Jeffrey A; Newnham, John P

    2016-10-18

    Detection of Ureaplasma, Mycoplasma and Candida spp. in the vagina during pregnancy has previously been associated with preterm birth (PTB). However, the prevalence of these microorganisms and the associated obstetric risks (likely to be population-specific) have not been determined in Australian women; furthermore, in the case of Ureaplasma spp., very few studies have attempted characterisation at the species level and none have examined genotype/serovar status to further refine risk assessment. In order to address these issues we sampled the vaginal fluid of 191 pregnant Australian women at three time points in pregnancy. Culture methods were used for detection of Ureaplasma spp. and Candida spp., and real-time PCR was used for speciation of U. parvum and U. urealyticum, non-albicans Candida spp., Mycoplasma hominis and Mycoplasma genitalium. High-resolution melt PCR was used to genotype U. parvum. Data on various lifestyle factors (including sex during pregnancy and smoking), antimicrobial use and pregnancy outcome were collected on all participants. Chi-square tests were used to assess the association of vaginal microorganisms with PTB. Detection of Ureaplasma spp. was higher among spontaneous PTB cases, specifically in the presence of U. parvum [77 % preterm (95 % confidence interval (CI) 50-100 %) vs. 36 % term (CI: 29-43 %), p = 0.004], but not U. urealyticum. The association with PTB strengthened when U. parvum genotype SV6 was detected (54 % preterm (CI: 22-85 %) vs. 15 % term (CI: 10-20 %), p = 0.002); this genotype was also present in 80 % (4/5) of cases of PTB Candida albicans in the same sample, the association with PTB remained strong for both U. parvum [46 % preterm (CI: 15-78 %) vs. 13 % term (CI: 8-18 %), p = 0.005] and U. parvum genotype SV6 [39 % preterm (CI: 8-69 %) vs. 7 % term (CI: 3-11 %), p = 0.003]. With the exception of Candida glabrata, vaginal colonisation status for all organisms was stable throughout

  15. Effect of Cervical Pessary on Spontaneous Preterm Birth in Women With Singleton Pregnancies and Short Cervical Length: A Randomized Clinical Trial.

    Science.gov (United States)

    Saccone, Gabriele; Maruotti, Giuseppe Maria; Giudicepietro, Antonia; Martinelli, Pasquale

    2017-12-19

    Spontaneous preterm birth is a major cause of perinatal morbidity and mortality. It is unclear if a cervical pessary can reduce the risk of spontaneous preterm delivery. To test whether in asymptomatic women with singleton pregnancies and no prior spontaneous preterm birth but with short cervical length on transvaginal ultrasound, use of a cervical pessary would reduce the rate of spontaneous preterm birth at less than 34 weeks of gestation. Parallel-group, nonblinded, randomized clinical trial conducted from March 1, 2016, to May 25, 2017, at a single center in Italy. Asymptomatic women with singleton gestations, no previous spontaneous preterm births, and cervical lengths of 25 mm or less at 18 weeks 0 days to 23 weeks 6 days of gestation were eligible. Patients were randomized 1:1 to receive either cervical pessary (n = 150) or no pessary (n = 150). The pessary was removed between 37 weeks 0 days and 37 weeks 6 days of gestation or earlier if clinically indicated. The control group received standard care. For cervical length of 20 mm or shorter, women in both groups were prescribed vaginal progesterone, 200 mg/d, until 36 weeks 6 days of gestation. No bed rest or activity restriction was recommended. The primary end point was spontaneous preterm birth at less than 34 weeks of gestation. Secondary outcomes were adverse events. Among 300 women who were randomized (mean age, 29 [SD, 6.3] years; mean gestational age, 22 [SD, 1.3] weeks), 100% completed the trial. The primary end point occurred in 11 women (7.3%) in the pessary group and 23 women (15.3%) in the control group (between-group difference, -8.0% [95% CI, -15.7% to -0.4]; relative risk, 0.48 [95% CI, 0.24-0.95]). During follow-up, the pessary group had a higher rate of increased or new vaginal discharge (86.7% vs 46.0%; between-group difference, +40.7% [95% CI, +30.1%-+50.3%]; relative risk, 1.88 [95% CI, 1.57-2.27]). Among women without prior spontaneous preterm birth who had asymptomatic

  16. Maternal Whole Blood Gene Expression at 18 and 28 Weeks of Gestation Associated with Spontaneous Preterm Birth in Asymptomatic Women.

    Directory of Open Access Journals (Sweden)

    Yujing J Heng

    Full Text Available The heterogeneity of spontaneous preterm birth (SPTB requires an interdisciplinary approach to determine potential predictive risk factors of early delivery. The aim of this study was to investigate maternal whole blood gene expression profiles associated with spontaneous preterm birth (SPTB, <37 weeks in asymptomatic pregnant women. The study population was a matched subgroup of women (51 SPTBs, 114 term delivery controls who participated in the All Our Babies community based cohort in Calgary (n = 1878. Maternal blood at 17-23 (sampling time point 1, T1 and 27-33 weeks of gestation (T2 were collected. Total RNA was extracted and microarray was performed on 326 samples (165 women. Univariate analyses determined significant clinical factors and differential gene expression associated with SPTB. Thirteen genes were validated using qRT-PCR. Three multivariate logistic models were constructed to identify gene expression at T1 (Model A, T2 (Model B, and gene expression fold change from T1 to T2 (Model C associated with SPTB. All models were adjusted for clinical factors. Model C can predict SPTB with 65% sensitivity and 88% specificity in asymptomatic women after adjusting for history of abortion and anaemia (occurring before T2. Clinical data enhanced the sensitivity of the Models to predict SPTB. In conclusion, clinical factors and whole blood gene expression are associated with SPTB in asymptomatic women. An effective screening tool for SPTB during pregnancy would enable targeted preventive approaches and personalised antenatal care.

  17. Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour : APOSTEL III-Trial)

    NARCIS (Netherlands)

    van Vliet, Elvira O. G.; Schuit, Ewoud; Heida, Karst Y.; Opmeer, Brent C.; Kok, Marjolein; Gyselaers, Wilfried; Porath, Martina M.; Woiski, Mallory; Bax, Caroline J.; Bloemenkamp, Kitty W. M.; Scheepers, Hubertina C. J.; Jaquemyn, Yves; van Beek, Erik; Duvekot, Hans J. J.; Franssen, Maureen T. M.; Bijvank, Bas N.; Kok, Joke H.; Franx, Arie; Mol, Ben Willem J.; Oudijk, Martijn A.

    2014-01-01

    Background: Preterm birth is the most common cause of neonatal morbidity and mortality. Postponing delivery for 48 hours with tocolytics to allow for maternal steroid administration and antenatal transportation to a centre with neonatal intensive care unit facilities is the standard treatment for

  18. A mouse model of spontaneous preterm birth based on the genetic ablation of biglycan and decorin

    Science.gov (United States)

    Calmus, Megan L.; Macksoud, Elyse E.; Tucker, Richard; Iozzo, Renato V.; Lechner, Beatrice E.

    2011-01-01

    Preterm premature rupture of membranes is responsible for one third of preterm births. Ehlers-Danlos syndrome (EDS) is associated with preterm premature rupture of membranes in humans. Notably, an EDS variant is caused by a genetic mutation resulting in abnormal secretion of biglycan and decorin, two small leucine-rich proteoglycans highly expressed in reproductive tissues. Because biglycan/decorin null mutant (Bgn−/−Dcn−/−) mice demonstrate phenotypic changes similar to EDS, we utilized this model to test whether either or both biglycan and decorin play a role in the attainment of successful term gestation. Wild-type, biglycan null mutant, decorin null mutant and biglycan/decorin null mutant pregnancies were assessed for length of gestation, pup and placenta weight and litter size. Quantitative real-time polymerase chain reaction was performed to measure biglycan and decorin gene expression and immunohistochemistry was performed to assess protein expression in placenta and fetal membranes at embryonic day E12, E15 and E18. Bgn−/−Dcn−/− dams displayed preterm birth, whereas the possession of at least two biglycan or decorin wild-type alleles was protective of preterm birth. Bgn−/−Dcn−/− pups were decreased at postnatal day P1 but not at E18. Biglycan and decorin were upregulated in the placenta in each other’s absence and were developmentally regulated in fetal membranes, suggesting that these two proteoglycans demonstrate genetic complementation and contribute to gestational success in a dose dependent manner. Thus, the biglycan/decorin null mutant mouse is a model of genetically induced preterm birth and perinatal loss. This model presents novel targets for preventive or therapeutic manipulation of preterm birth. PMID:21502335

  19. The association among cytochrome P450 3A, progesterone receptor polymorphisms, plasma 17-alpha hydroxyprogesterone caproate concentrations, and spontaneous preterm birth.

    Science.gov (United States)

    Bustos, Martha L; Caritis, Steve N; Jablonski, Kathleen A; Reddy, Uma M; Sorokin, Yoram; Manuck, Tracy; Varner, Michael W; Wapner, Ronald J; Iams, Jay D; Carpenter, Marshall W; Peaceman, Alan M; Mercer, Brian M; Sciscione, Anthony; Rouse, Dwight J; Ramin, Susan M

    2017-09-01

    Infants born preterm birth are the leading cause of mortality in children preterm birth by 33% in women with history of spontaneous preterm birth. We demonstrated previously that plasma concentrations of 17-alpha hydroxyprogesterone caproate vary widely among pregnant women and that women with 17-alpha hydroxyprogesterone caproate plasma concentrations in the lowest quartile had spontaneous preterm birth rates of 40% vs rates of 25% in those women with higher concentrations. Thus, plasma concentrations are an important factor in determining drug efficacy but the reason 17-alpha hydroxyprogesterone caproate plasma concentrations vary so much is unclear. Predominantly, 17-alpha hydroxyprogesterone caproate is metabolized by CYP3A4 and CYP3A5 enzymes. We sought to: (1) determine the relation between 17-alpha hydroxyprogesterone caproate plasma concentrations and single nucleotide polymorphisms in CYP3A4 and CYP3A5; (2) test the association between progesterone receptor single nucleotide polymorphisms and spontaneous preterm birth; and (3) test whether the association between plasma concentrations of 17-alpha hydroxyprogesterone caproate and spontaneous preterm birth varied by progesterone receptor single nucleotide polymorphisms. In this secondary analysis, we evaluated genetic polymorphism in 268 pregnant women treated with 17-alpha hydroxyprogesterone caproate, who participated in a placebo-controlled trial to evaluate the benefit of omega-3 supplementation in women with history of spontaneous preterm birth. Trough plasma concentrations of 17-alpha hydroxyprogesterone caproate were measured between 25-28 weeks of gestation after a minimum of 5 injections of 17-alpha hydroxyprogesterone caproate. We extracted DNA from maternal blood samples and genotyped the samples using TaqMan (Applied Biosystems, Foster City, CA) single nucleotide polymorphism genotyping assays for the following single nucleotide polymorphisms: CYP3A4*1B, CYP3A4*1G, CYP3A4*22, and CYP3A5*3; and rs

  20. Behavioural and neurodevelopmental outcome of 2-year-old children after preterm premature rupture of membranes: follow-up of a randomised clinical trial comparing induction of labour and expectant management

    NARCIS (Netherlands)

    van der Heyden, Jantien L.; Willekes, Christine; van Baar, Anneloes L.; van Wassenaer-Leemhuis, Aleid G.; Pajkrt, Eva; Oudijk, Martijn A.; Porath, Martina M.; Duvekot, Hans J. J.; Bloemenkamp, Kitty W. M.; Groenewout, Mariette; Woiski, Mallory; Nij Bijvank, Bas; Bax, Caroline J.; van 't Hooft, Janneke; Sikkema, Marko J. M.; Akerboom, Bettina M. C.; Mulder, Twan A. L. M.; Nijhuis, Jan G.; Mol, Ben Willem J.; van der Ham, David P.

    2015-01-01

    We recently reported that induction of labour does not improve short term neonatal outcome in women with late preterm premature rupture of membranes (PPROM) as compared to expectant management (PPROMEXIL trial). In this study the neurodevelopmental and behavioural outcome of the children from this

  1. Loop electrosurgical excision of the cervix and subsequent risk for spontaneous preterm delivery: a population-based study of singleton deliveries during a 9-year period

    DEFF Research Database (Denmark)

    Noehr, Bugge; Jensen, Allan; Frederiksen, Kirsten

    2009-01-01

    OBJECTIVE: Our aim was to assess the association between loop electrosurgical excision procedure (LEEP) and the subsequent risk for spontaneous preterm delivery, with the use of population-based data from various nationwide registries. STUDY DESIGN: The study population consisted of all singleton...

  2. Aging of intrauterine tissues in spontaneous preterm birth and preterm premature rupture of the membranes: A systematic review of the literature.

    Science.gov (United States)

    Polettini, J; Dutta, E H; Behnia, F; Saade, G R; Torloni, M R; Menon, R

    2015-09-01

    Many adverse pregnancy outcomes (APOs), including spontaneous preterm birth (PTB), are associated with placental dysfunction. Recent clinical and experimental evidences suggest that premature aging of the placenta may be involved in these events. Although placental aging is a well-known concept, the mechanisms of aging during normal pregnancy and premature aging in APOs are still unclear. This review was conducted to assess the knowledge on placental aging related biochemical changes leading to placental dysfunction in PTB and/or preterm premature rupture of membranes (pPROM). We performed a systematic review of studies published over the last 50 years in two electronic databases (Pubmed and Embase) on placental aging and PTB or pPROM. The search yielded 554 citations, 30 relevant studies were selected for full-text review and three were included in the review. Only one study reported oxidative stress-related aging and degenerative changes in human placental membranes and telomere length reduction in fetal cells as part of PTB and/or pPROM mechanisms. Similarly, two animal studies reported findings of decidual senescence and referred to PTB mechanisms. Placental and fetal membrane oxidative damage and telomere reduction are linked to premature aging in PTB and pPROM but the risk factors and biomolecular pathways causing this phenomenon are not established in the literature. However, no biomarkers or clinical indicators of premature aging as a pathology of PTB and pPROM have been reported. We document major knowledge gaps and propose several areas for future research to improve our understanding of premature aging linked to placental dysfunction. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. [Prognostic value of chosen parameters of mechanical and bioelectrical uterine activity in prediction of threatening preterm labour].

    Science.gov (United States)

    Zietek, Jerzy; Sikora, Jerzy; Horoba, Krzysztof; Matonia, Adam; Jezewski, Janusz; Magnucki, Jacek; Kobielska, Lucyna

    2009-03-01

    To record and analyse bioelectrical activity of the uterine muscle in the course of physiological pregnancy, labour and threatening premature labour; to define which parameters from the analysis of both electrohysterogram and mechanical activity signal allow us to predict threatening premature labour. Material comprised 62 pregnant women: Group I--27 patients in their first physiological pregnancy, Group II--21 patients in their first pregnancy with symptoms of threatening premature labour, and Group III--14 patients in the first labour period. The on-line analysis of the mechanical (TOCO) and electrical (EHG) contraction activity relied on determination of quantitative parameters of detected uterine contractions. The obtained statistical results demonstrated a possibility to differentiate between Group I and II through the amplitude and contraction area for EHG signal, and only the contraction amplitude for TOCO signal. Additionally, significant differentiating parameters for electrohysterogram are: contraction power and its median frequency. Analyzing Group I and III, significant differences were noted for contraction amplitude and area obtained both from EHG and TOCO signals. Similarly, the contraction power (from EHG) enables us to assign the contractions either to records from Group I or to labour type. There was no significant difference noted between Group II and III. Identification of pregnant women at risk of premature labour should lead to their inclusion in rigorous perinatal surveillance. This requires novel, more sensitive methods that are able to detect early symptoms of the uterine contraction activity increase. Electrohysterography provides complete information on principles of bioelectrical uterine activity. Quantitative parameters of EHG analysis enable the detection of records (contractions) with the symptoms of premature uterine contraction activity.

  4. Is vitamin D binding protein a novel predictor of labour?

    Directory of Open Access Journals (Sweden)

    Stella Liong

    Full Text Available Vitamin D binding protein (VDBP has previously been identified in the amniotic fluid and cervicovaginal fluid (CVF of pregnant women. The biological functions of VDBP include acting as a carrier protein for vitamin D metabolites, the clearance of actin that is released during tissue injury and the augmentation of the pro-inflammatory response. This longitudinal observational study was conducted on 221 healthy pregnant women who spontaneously laboured and delivered either at term or preterm. Serial CVF samples were collected and VDBP was measured by ELISA. Binary logistic regression analysis was performed to assess the utility of VDBP as a predictor of labour. VDBP in the CVF did not change between 20 and 35 weeks' gestation. VDBP measured in-labour was significantly increased 4.2 to 7.4-fold compared to 4-7, 8-14 and 15-28 days before labour (P<0.05. VDBP concentration was 4.3-fold significantly higher at 0-3 days compared to 15-28 days pre-labour (P<0.05. The efficacy of VDBP to predict spontaneous labour onset within 3 days provided a positive and negative predictive value of 82.8% and 95.3% respectively (area under receiver operator characteristic curve  = 0.974. This longitudinal study of pregnant women suggests that VDBP in the CVF may be a useful predictor of labour.

  5. 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.

  6. Human cathelicidin antimicrobial protein 18 (hCAP18/LL-37) is increased in foetal membranes and myometrium after spontaneous labour and delivery.

    Science.gov (United States)

    Lim, Ratana; Barker, Gillian; Lappas, Martha

    2015-02-01

    Infection and/or inflammation are most commonly associated with preterm birth. Studies have shown that antimicrobial peptides can modulate the inflammatory response in non-gestational tissues; the human cathelicidin hCAP18 (and its active component LL-37) has such anti-microbial and immunomodulatory properties. The aim of this study was to determine the effect of human labour on hCAP18 expression in foetal membranes and myometrium, and to determine the effect of the synthetic LL-37 peptide on pro-inflammatory and pro-labour mediators in foetal membranes and myometrium. The localisation and expression of hCAP18 in non-labouring and labouring tissues was determined by immunohistochemistry and Western blot, respectively. Tissue explants were used to determine the effect of LL-37 on pro-labour mediators. hCAP18 was localised to the amnion epithelium, cytotrophoblasts and decidua in the foetal membranes, and in the longitudinal and transverse muscle fibres of the myometrium. Additional hCAP18 staining was present in leukocytes. In foetal membranes and myometrium, human labour was associated with significantly higher hCAP18 protein expression. Treatment of foetal membranes and myometrium with LL-37 significantly induced the expression and secretion of the pro-inflammatory cytokines IL-6 and TNF-α, and the chemokines IL-8 and MCP-1. LL-37 also induced expression of MMP-9 mRNA and pro MMP-9 expression in foetal membranes. Co-treatment with BAY 11-7082 was associated with a decrease in LL-37-induced pro-inflammatory cytokine expression. Moreover, inhibition of MyD88 in myometrial cells decreased LL-37-induced pro-inflammatory cytokine expression and release. LL-37 also significantly increased NF-κB transcriptional activity. In conclusion, hCAP18/LL-37 induces pro-inflammatory and pro-labour mediators, via the MyD88/NF-κB pathway. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Delivery of a baby with severe combined immunodeficiency at 31 weeks gestation following an extreme preterm prelabour spontaneous rupture of the membranes: a case report

    Directory of Open Access Journals (Sweden)

    Watkinson Sally J

    2009-11-01

    Full Text Available Abstract Introduction If left untreated, severe combined immunodeficiency can lead to an acute susceptibility to infection. The intrauterine environment is sterile until the amniotic membranes rupture. The vaginal flora then ascends into the genital tract, thus increasing the risk of chorioamnionitis. An extremely premature and prolonged membrane rupture is associated with a dismal prognosis for an immunocompetent preterm fetus. There are no case reports to date that detail the outcome of an immunocompromised preterm baby following prolonged rupture of membranes. Case presentation We present the case of a 32-year-old Indian woman who delivered a 31-week gestational baby who had a severe combined immunodeficiency following premature prelabour prolonged rupture of the membranes at the 14th week of gestation. Conclusion Extreme preterm prelabour spontaneous rupture of membranes in an underlying condition of severe combined immunodeficiency does not necessarily lead to an unfavourable outcome.

  8. A novel role for GSK3 in the regulation of the processes of human labour.

    Science.gov (United States)

    Lim, Ratana; Lappas, Martha

    2015-02-01

    Preterm birth remains the largest single cause of neonatal death and morbidity. Infection and/or inflammation are strongly associated with preterm delivery. Glycogen synthase kinase 3 (GSK3) is known to be a crucial mediator of inflammation homeostasis. The aims of this study were to determine the effect of spontaneous human labour in foetal membranes and myometrium on GSK3α/β expression, and the effect of inhibition of GSK3α/β on pro-labour mediators in foetal membranes and myometrium stimulated with Toll-like receptor (TLR) ligands and pro-inflammatory cytokines. Term and preterm labour in foetal membranes was associated with significantly decreased serine phosphorylated GSK3α and β expression, and thus increased GSK3 activity. There was no effect of term labour on serine phosphorylated GSK3β expression in myometrium. The specific GSK3α/β inhibitor CHIR99021 significantly decreased lipopolysaccharide (ligand to TLR4)-stimulated pro-inflammatory cytokine gene expression and release; COX2 gene expression and prostaglandin release; and MMP9 gene expression and pro MMP9 release in foetal membranes and/or myometrium. CHIR99021 also decreased FSL1 (TLR2 ligand) and flagellin (TLR5 ligand)-induced pro-inflammatory cytokine gene expression and release and COX2 mRNA expression and prostaglandin release. GSK3β siRNA knockdown in primary myometrial cells was associated with a significant decrease in IL1β and TNFα-induced pro-inflammatory cytokine and prostaglandin release. In conclusion, GSK3α/β activity is increased in foetal membranes after term and preterm labour. Pharmacological blockade of the kinase GSK3 markedly reduced pro-inflammatory and pro-labour mediators in human foetal membranes and myometrium, providing a possible therapeutics for the management of preterm labour. © 2015 Society for Reproduction and Fertility.

  9. Specific characteristics of spontaneous movements in preterm infants at term age are associated with developmental delays at age 3 years.

    Science.gov (United States)

    Kanemaru, Nao; Watanabe, Hama; Kihara, Hideki; Nakano, Hisako; Takaya, Rieko; Nakamura, Tomohiko; Nakano, Junji; Taga, Gentaro; Konishi, Yukuo

    2013-08-01

    The aim of this study was to investigate the relationship between the characteristics of spontaneous movements in preterm infants at term age and developmental delay at 3 years of age. We analysed video recordings of the spontaneous movements in the supine position of 124 preterm infants (44 males, 80 females) at 36 to 44 weeks postmenstrual age (PMA). The infants were born preterm (22-36wks PMA; birthweight 489-1696g) and had not received a diagnosis of a neurological or developmental disorder by the age of 3 years. The recorded spontaneous movements were quantified using six movement indices, which were calculated from two-dimensional trajectories of all limbs. The infants were divided into three developmental groups, normal, borderline, or delayed, based on their developmental quotient as calculated using the Kyoto Scale of Psychological Development 2001 (Kyoto Scale) at 3 years of age. Group differences in the movement indices were analysed. In the delayed group, average velocity of arms and legs were significantly lower (ppreterm infants. © 2013 Mac Keith Press.

  10. Activation of AMPK in human fetal membranes alleviates infection-induced expression of pro-inflammatory and pro-labour mediators.

    Science.gov (United States)

    Lim, R; Barker, G; Lappas, M

    2015-04-01

    In non-gestational tissues, the activation of adenosine monophosphate (AMP)-activated kinase (AMPK) is associated with potent anti-inflammatory actions. Infection and/or inflammation, by stimulating pro-inflammatory cytokines and matrix metalloproteinase (MMP)-9, play a central role in the rupture of fetal membranes. However, no studies have examined the role of AMPK in human labour. Fetal membranes, from term and preterm, were obtained from non-labouring and labouring women, and after preterm pre-labour rupture of membranes (PPROM). AMPK activity was assessed by Western blotting of phosphorylated AMPK expression. To determine the effect of AMPK activators on pro-inflammatory cytokines, fetal membranes were pre-treated with AMPK activators then stimulated with bacterial products LPS and flagellin or viral dsDNA analogue poly(I:C). Primary amnion cells were used to determine the effect of AMPK activators on IL-1β-stimulated MMP-9 expression. AMPK activity was decreased with term labour. There was no effect of preterm labour. AMPK activity was also decreased in preterm fetal membranes, in the absence of labour, with PROM compared to intact membranes. AMPK activators AICAR, phenformin and A769662 significantly decreased IL-6 and IL-8 stimulated by LPS, flagellin and poly(I:C). Primary amnion cells treated with AMPK activators significantly decreased IL-1β-induced MMP-9 expression. The decrease in AMPK activity in fetal membranes after spontaneous term labour and PPROM indicates an anti-inflammatory role for AMPK in human labour and delivery. The use of AMPK activators as possible therapeutics for threatened preterm labour would be an exciting future avenue of research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Inhibition of PIM1 kinase attenuates inflammation-induced pro-labour mediators in human foetal membranes in vitro.

    Science.gov (United States)

    Lim, Ratana; Barker, Gillian; Lappas, Martha

    2017-06-01

    Does proviral integration site for Moloney murine leukaemic virus (PIM)1 kinase play a role in regulating the inflammatory processes of human labour and delivery? PIM1 kinase plays a critical role in foetal membranes in regulating pro-inflammatory and pro-labour mediators. Infection and inflammation have strong causal links to preterm delivery by stimulating pro-inflammatory cytokines and collagen degrading enzymes, which can lead to rupture of membranes. PIM1 has been shown to have a role in immune regulation and inflammation in non-gestational tissues; however, its role has not been explored in the field of human labour. PIM1 expression was analysed in myometrium and/or foetal membranes obtained at term and preterm (n = 8-9 patients per group). Foetal membranes, freshly isolated amnion cells and primary myometrial cells were used to investigate the effect of PIM1 inhibition on pro-labour mediators (n = 5 patients per treatment group). Foetal membranes, from term and preterm, were obtained from non-labouring and labouring women, and from preterm pre-labour rupture of membranes (PPROM) (n = 9 per group). Amnion was collected from women with and without preterm chorioamnionitis (n = 8 per group). Expression of PIM1 kinase was determined by qRT-PCR and western blotting. To determine the effect of PIM1 kinase inhibition on the expression of pro-inflammatory and pro-labour mediators induced by bacterial products lipopolysaccharide (LPS) (10 μg/ml) and flagellin (1 μg/ml) and pro-inflammatory cytokine tumour necrosis factor (TNF) (10 ng/ml), chemical inhibitors SMI-4a (20 μM) and AZD1208 (50 μM) were used in foetal membrane explants and siRNA against PIM1 was used in primary amnion cells. Statistical significance was set at P membranes after spontaneous term labour compared to no labour at term and in amnion with preterm chorioamnionitis compared to preterm with no chorioamnionitis. There was no change in PIM1 expression with preterm labour or PPROM

  12. Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour: a systematic review and cost analysis.

    Science.gov (United States)

    Deshpande, S N; van Asselt, A D I; Tomini, F; Armstrong, N; Allen, A; Noake, C; Khan, K; Severens, J L; Kleijnen, J; Westwood, M E

    2013-09-01

    Premature birth is defined as birth of before 37 completed weeks' gestation. Not all pregnant women showing symptoms of preterm labour will go on to deliver before 37 weeks' gestation. Hence, addition of fetal fibronectin (fFN) testing to the diagnostic workup of women with suspected preterm labour may help to identify those women who do not require active management, and thus avoid unnecessary interventions, hospitalisations and associated costs. To assess the clinical effectiveness and cost-effectiveness of rapid fFN testing in predicting preterm birth (PTB) in symptomatic women. Bibliographic databases (including EMBASE, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials) were searched from 2000 to September/November 2011. Trial registers were also searched. Systematic review methods followed published guidance; we assessed clinical effectiveness and updated a previous systematic review of test accuracy. Risk of bias was assessed using the Cochrane tool (randomised controlled trials; RCTs) and a modification of QUADAS-2 (diagnostic test accuracy studies; DTAs). Summary risk ratios or weighted mean difference were calculated using random-effects models. Summary sensitivity and specificity used a bivariate summary receiver operating characteristic model. Heterogeneity was investigated using subgroup and sensitivity analyses. Health economic analysis focused on cost consequences. The time horizon was hospital admission for observation. A main structural assumption was that, compared with usual care, fFN testing doesn't increase adverse events or negative pregnancy outcomes. Five RCTs and 15 new DTAs were identified. No RCT reported significant effects of fFN testing on maternal or neonatal outcomes. One study reported a subgroup analysis of women with negative fFN test observed > 6 hours, which showed a reduction in length of hospital stay where results were known to clinicians. Combining data from new studies and the

  13. Elevated maternal serum-free β-human chorionic gonadotropin (β-hCG) and reduced risk of spontaneous preterm delivery.

    Science.gov (United States)

    Soni, Shelly; Krantz, David A; Blitz, Matthew J; Vohra, Nidhi; Rochelson, Burton

    2018-04-12

    To evaluate the relationship between first and second trimester maternal serum-free β-hCG and the risk of spontaneous preterm delivery (PTD). This was a case-control study of women evaluated and delivered at our institution from 2011 to 2015. Spontaneous PTD was defined as delivery before 37 weeks due to spontaneous preterm labor or premature rupture of membranes. Patient with multifetal gestation and those with medically indicated term or PTD were excluded. Of 877 women meeting the inclusion criteria, 173 delivered preterm and 704 delivered at term, and 8.1% had high free β-hCG in one or both trimesters. High maternal first and/or second trimester free β-hCG (≥95th percentile) was associated with lower rates of PTD. Thirty-two women with high free β-hCG in both first and second trimesters delivered at term. Gestational age at delivery and birth weights were lower in women who did not have high free β-hCG in any trimester. Low free β-hCG (≤5th percentile) in either trimester was not associated with an increased or decreased likelihood of PTD. Logistic regression demonstrated an independent association of high free β-hCG (≥95th percentile) with a reduced likelihood of PTD. Stratified analysis revealed a stronger impact of this association in women with no prior history of PTD. High free β-hCG, in the absence of risk factors for medically indicated PTD, is associated with a reduced likelihood of spontaneous PTD and may represent a marker indicating lower risk.

  14. Amniopatch treatment for spontaneous previable, preterm premature rupture of membranes associated or not with incompetent cervix.

    Science.gov (United States)

    Kwak, Hye-Min; Choi, Hyun-Jin; Cha, Hyun-Hwa; Yu, Hee-Jun; Lee, Jee-Hun; Choi, Suk-Joo; Oh, Soo-Young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2013-01-01

    We reviewed women with previable spontaneous premature rupture of membranes (sPPROM) in whom an amniopatch was performed and compared their pregnancy outcomes with a conservative management group. Amniopatch, an amnioinfusion of autologous platelet concentrate followed by cryoprecipitate, was performed in 7 women with sPPROM diagnosed at 17-23 weeks' gestation, including one twin pregnancy. Three patients had incompetent cervices and the other 4 patients had sPPROM without incompetent cervices. Pregnancy outcomes of the cases were compared with the controls who were managed conservatively (n = 22). Amniopatch treatment was successful in 1 of 7 cases (14.3%), in which the ruptured membranes were completely sealed and the patient delivered a healthy baby at 39 weeks' gestation. No procedure-related complications were observed. Overall, neonatal outcome was similar in the amniopatch and conservatively managed groups, although the incidences of early neonatal sepsis and respiratory distress syndrome were lower in the amniopatch group. The overall success rate of amniopatch among our small number of cases was low. However, if successful, amniopatch may prolong a pregnancy with previable sPPROM to term. Copyright © 2012 S. Karger AG, Basel.

  15. Quantitative analysis of the cervical texture by ultrasound in the mid-pregnancy is associated with spontaneous preterm birth.

    Science.gov (United States)

    Baños, Núria; Perez-Moreno, Alvaro; Julià, Carla; Murillo-Bravo, Clara; Coronado, David; Gratacos, Eduard; Deprest, Jan; Palacio, Montse

    2017-05-15

    New tools are required to identify women at increased risk of spontaneous preterm birth (sPTB). Quantitative texture analysis by ultrasound has been used to extract robust features from the ultrasound image of a given tissue to detect subtle changes in its microstructure. This may also be applied to the cervix. We aimed to determine if there is an association between quantitative analysis of the cervical texture (CTx) by ultrasound in the mid-trimester of pregnancy and sPTB quantitative analysis of the CTx. A learning algorithm was developed to obtain the best combination of cervical textures features associated with sPTB based on feature transformation and discriminant analysis-regression. The ability of the learning algorithm to predict sPTB was evaluated using a leave-one-out cross-validation technique, obtaining a CTx-based score for each individual. Receiver-operating characteristic (ROC) curves were drawn and sensitivity, specificity, positive and negative likelihood ratios were calculated for the optimal cut-off based on the ROC curve. The results were compared to those obtained with the CL. At all points the investigators studying the images were blinded to pregnancy outcome. Images of 310 women (27 cases and 283 controls) were of sufficient quality and included in the study. Median CTx-based score (-1.01 vs -0.07, p = Quantitative analysis of the cervical texture is able to extract information from the ultrasound images related to sPTB and generate a CTx-based score which is independently associated to sPTB. This article is protected by copyright. All rights reserved.

  16. Effects of Prenatal Micronutrient Supplementation on Spontaneous Preterm Birth: A Double-Blind Randomized Controlled Trial in China.

    Science.gov (United States)

    Li, Zhiwen; Mei, Zuguo; Zhang, Le; Li, Hongtian; Zhang, Yali; Li, Nan; Ye, Rongwei; Ren, Aiguo; Liu, Jian-Meng; Serdula, Mary K

    2017-08-01

    In this secondary analysis of data from a double-blind randomized controlled trial carried out in northern China, we aimed to assess the effect of prenatal supplementation with multiple micronutrients (MMN) or iron + folic acid (IFA), versus folic acid (FA) alone, on risk of spontaneous preterm birth (SPB) and the impact of supplementation timing on SPB. A total of 18,775 nulliparous pregnant women enrolled between 2006 and 2009 were randomly assigned to receive daily FA, IFA, or MMN from the period before 20 weeks' gestation to delivery. The incidences of SPB for women consuming FA, IFA, and MMN were 5.7%, 5.6% and 5.1%, respectively. Compared with women given FA, the relative risks of SPB for those using MMN and IFA were 0.99 (95% confidence interval: 0.85, 1.16) and 0.89 (95% confidence interval: 0.79, 1.05), respectively. SPB incidence in women who started consuming FA, IFA, and MMN before the 12th week of gestation (4.6%, 4.2%, and 3.9%, respectively) was significantly reduced compared with starting supplement use on or after the 12th gestational week (6.9%, 7.2%, and 6.4%, respectively). Starting use of FA, IFA, or MMN supplements before the 12th week of gestation produced a 41%-45% reduction in risk of SPB. Early prenatal enrollment and micronutrient use during the first trimester of pregnancy appeared to be of particular importance for prevention of SPB, regardless of supplement group. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Increased oxidative stress in human fetal membranes overlying the cervix from term non-labouring and post labour deliveries.

    Science.gov (United States)

    Chai, M; Barker, G; Menon, R; Lappas, M

    2012-08-01

    Enzymatic breakdown of the collagen-rich extracellular matrix (ECM) that connects the amnion and chorion layers of the fetal membranes is one of the key events leading to rupture of membranes. Oxidant stress caused by increased formation of reactive oxygen species and/or reduced antioxidant capacity may predispose to membrane rupture, a major cause of preterm birth. The aim of this study was to determine the effect of human labour and supracervical (SC) apposition on antioxidant enzymes and 8-isoprostane (a marker of lipid peroxidation). To determine the effect of human labour on oxidative stress status, fetal membranes from the SC site (SCS) were collected from women at term Caesarean section (no labour), and from the site of membrane rupture (SOR) after spontaneous labour onset and delivery (post labour). To determine the effect of SC apposition on oxidative stress status, amnion was collected from the SCS and a distal site (DS) in women at term Caesarean section in the absence of labour. The release of 8-isoprostane was significantly higher in amnion from the SCS compared to DS, and in fetal membranes from the SOR compared to the SCS. Glutathione peroxidase (GPx) and superoxide dismutase (SOD) activity were lower in amnion from the SC compared to DS. SOD gene expression and enzyme activity were lower in fetal membranes after labour. There was no difference in expression or activity in catalase, GPx and glutathione reductase (GSR) between no labour and post labour fetal membranes. In primary amnion cells, SOD supplementation significantly augmented IL-1β induced MMP-9 expression and activity. In summary, non-labouring SC fetal membranes are characterised by reduced antioxidant enzyme activity when compared to distal membranes, and, as such, may be more susceptible to oxidative damage and thus membrane rupture. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Preterm infants undergoing laparotomy for necrotizing enterocolitis or spontaneous intestinal perforation display evidence of impaired cerebrovascular autoregulation

    NARCIS (Netherlands)

    Kuik, Sara J; van der Laan, Michelle E; Brouwer-Bergsma, Margot T; Hulscher, Jan B F; Absalom, Anthony R; Bos, Arend F; Kooi, Elisabeth M W

    BACKGROUND: Preterm infants requiring surgery are at risk of impaired neurocognitive development caused, possibly, by cerebral ischemia associated with impaired cerebrovascular autoregulation (CAR). We evaluated CAR before, during, and after laparotomy. STUDY DESIGN: This was a hypothesis generating

  19. 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.

  20. 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...

  1. 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...

  2. Associação da Vaginose Bacteriana com o Parto Prematuro Espontâneo Association of Bacterial Vaginosis with Spontaneous Preterm Delivery

    Directory of Open Access Journals (Sweden)

    Mário Henrique Burlacchini de Carvalho

    2001-09-01

    Full Text Available Objetivo: relacionar a presença de vaginose bacteriana em gestantes com a ocorrência de parto prematuro espontâneo. Método: foram estudadas 611 gestantes do serviço pré-natal da Clínica Obstétrica do HCFMUSP. Foram incluídas gestantes com idade gestacional confirmada por ultra-sonografia no primeiro trimestre de gestação ou duas ultra-sonografias até a 20ª semana quando havia discordância da idade gestacional no primeiro exame. Os partos prematuros eletivos foram excluídos. A pesquisa da vaginose foi realizada na 23ª ou 24ª semana de gestação por meio da técnica de coloração de Gram. O pH vaginal foi pesquisado utilizando-se fita de pH Universal 0-14 produzida pela Merck. O conteúdo vaginal foi coletado com a paciente em posição ginecológica, utilizando-se espéculo não-lubrificado. O pH foi medido na parede lateral da vagina e o conteúdo para Gram foi coletado do fundo de saco vaginal utilizando-se de cotonete estéril. Resultado: das 611 gestantes envolvidas inicialmente no estudo, foram obtidos os resultados do parto em 541. A vaginose bacteriana foi diagnosticada por bacterioscopia em 19% dos casos. No grupo de gestantes com vaginose, 9,7% (10/103 evoluíram com parto prematuro, contra apenas 3,2% (14/438 no grupo negativo (p=0,008. A sensibilidade da bacterioscopia positiva para vaginose bacteriana para predição do parto prematuro foi de 41,7%, a especificidade de 82%, a acurácia de 80,2%, com taxa de falso-positivos de 18% e risco relativo de 1,8. Conclusão: a vaginose bacteriana diagnosticada pelo Gram do conteúdo vaginal representa fator de risco para o parto prematuro, com risco relativo de 1,8.Purpose: to evaluate the relationship between bacterial vaginosis (BV and spontaneous preterm delivery. Method: a total of 611 pregnant women from the general antenatal clinic of the "Clínica Obstétrica do Hospital das Clínicas da Universidade de São Paulo" were enrolled in this study. All pregnancies were

  3. 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 ...

  4. Health behaviors, periodontal conditions, and periodontal pathogens in spontaneous preterm birth: a case-control study in Korea.

    Science.gov (United States)

    Ryu, Jae-In; Oh, Kyungjoon; Yang, Hyejin; Choi, Bong-Kyu; Ha, Jung-Eun; Jin, Bo-Hyoung; Kim, Hyun-Duck; Bae, Kwang-Hak

    2010-06-01

    This study aims to determine whether periodontal conditions or dental health behaviors are risk factors for preterm birth (PTB), and whether periodontal pathogens are risk indicators for PTB among Korean mothers. This study was designed as a hospital-based case-control study. Examiner masking was ensured for the validity of the examinations. The mothers included those who gave birth between November 2007 and July 2009 at the obstetrics clinic of a general hospital in Seoul, Korea. Information on demographic and health conditions, periodontal conditions, and microbacterial data was collected. A total of 172 women met the inclusion criteria, 59 mothers who delivered a preterm neonate were assigned to the case group while the other 113 were assigned to the control group. There were no significant differences in demographic information, oral health conditions, and obstetric characteristics. Among health-related behaviors, only scaling within 12 months before pregnancy showed a significant difference (P = 0.031). Even in the adjusted logistic model, only the difference in the experience of scaling before pregnancy was significant between the PTB cases and the controls (P = 0.039). Periodontal disease did not exhibit a significant relationship with PTB even after adjustment for potential confounding factors. Among the microbacterial factors, only Porphyromonas gingivalis showed a slight difference (P = 0.060). There was a significant difference in scaling experience within 12 months before pregnancy and P. gingivalis showed a marginal difference between the PTB and the control groups but clinical periodontal conditions showed no association with PTB.

  5. The labour ward analgesic service at King Edward VIII Hospital ...

    African Journals Online (AJOL)

    In addition to pain relief, there are a number of obstetric indications for epidural analgesia, including first deliveries, breech presentations, preterm labour, induced labour, hyper- tensive disorders of pregnancy and multiple gestation. The provision of an adequate epidural service is there- fore warranted for any labour ward.

  6. Opium use during pregnancy and risk of preterm delivery: A population-based cohort study.

    Science.gov (United States)

    Maghsoudlou, Siavash; Cnattingius, Sven; Montgomery, Scott; Aarabi, Mohsen; Semnani, Shahriar; Wikström, Anna-Karin; Bahmanyar, Shahram

    2017-01-01

    Use of narcotic or "recreational" drugs has been associated with adverse pregnancy outcomes such as preterm delivery. However, the associations might be confounded by other factors related to high-risk behaviours. This is the first study to investigate the association between traditional opium use during pregnancy and risk of preterm delivery. We performed a population-based cohort study in the rural areas of the Golestan province, Iran between 2008 and 2010. We randomly selected 920 women who used (usually smoked) opium during pregnancy and 920 women who did not. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations between the opium use during pregnancy and preterm delivery and adjustment was made for potential confounding factors. This study shows compared with non-use of opium and tobacco, use of only opium during pregnancy was associated with an increased risk of preterm delivery (OR = 1.56; 95% CI 1.05-2.32), and the risk was more than two-fold increased among dual users of opium and tobacco (OR = 2.31; 95% CI 1.37-3.90). We observed that opium use only was associated with a doubled risk for preterm caesarean delivery (OR = 2.05; 95% CI 1.10-3.82) but not for preterm vaginal delivery (OR = 1.25; 95% CI 0.75-2.07). Dual use of opium and tobacco was associated with a substantially increased risk of vaginal preterm delivery (OR = 2.58; 95% CI 1.41-4.71). Opium use during pregnancy among non-tobacco smokers is associated with an increased risk of preterm caesarean delivery, indicating an increased risk of a compromised foetus before or during labour. Women who use both opium and smoked during pregnancy have an increased risk of preterm vaginal delivery, indicating an increased risk of spontaneous preterm delivery.

  7. Association Between Endometriosis and Preterm Birth in Women With Spontaneous Conception or Using Assisted Reproductive Technology: A Systematic Review and Meta-Analysis of Cohort Studies.

    Science.gov (United States)

    Pérez-López, Faustino R; Villagrasa-Boli, Pablo; Muñoz-Olarte, María; Morera-Grau, Álex; Cruz-Andrés, Pablo; Hernandez, Adrian V

    2018-03-01

    To perform a systematic review and meta-analysis to estimate the effect of endometriosis on preterm birth (PB) risk. Searches were conducted in PubMed-MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, Google Scholar, and SciELO for studies published in all languages from inception through April 2017. We included cohort studies evaluating pregnant women with and without endometriosis and conception either by spontaneous conception (SC) or with assisted reproductive technology (ART). Primary outcome was PB (women with endometriosis, the PB risk was significantly increased in both SC (OR: 1.59; 95% CI: 1.32-1.90) and ART (OR: 1.43; 95% CI: 1.14-1.79). The SGA risk was increased in women with endometriosis (OR: 1.16; 95% CI: 1.05-1.28), while the IUGR and low birthweight risks and birthweight were not affected by endometriosis. Endometriosis is associated with increased PB risk in both SC and women who obtained pregnancy using ART. Prospective studies evaluating relevant outcomes are needed to confirm these results.

  8. Intraplacental Choriocarcinoma: Rare or Underdiagnosed? Report of 2 Cases Diagnosed after an Incomplete Miscarriage and a Preterm Spontaneous Vaginal Delivery

    Science.gov (United States)

    Oliveira, Paula; Scigliano, Horácio; Nogueira, Rosete; Araújo, Célia; Ferreira, Soledade

    2017-01-01

    Intraplacental choriocarcinoma is a rare malignant tumor diagnosed after an abortion, an ectopic pregnancy, or a term or preterm pregnancy or following the diagnosis of a hydatidiform mole. During pregnancy, it may be more common than reported, as most patients are asymptomatic and placental choriocarcinomas are usually inconspicuous macroscopically and are often mistaken for an infarct. Based upon a case study methodology, we describe 2 cases of intraplacental choriocarcinoma: the first case was identified in the product of a uterine curettage following an incomplete miscarriage and the second in one of the placentas of a bichorionic twin pregnancy. Maternal investigation did not reveal evidence of metastatic disease and neither did the infants' one in the second case. The two cases underwent maternal surveillance with serum hCG and remained disease-free until the present. In conclusion, intraplacental choriocarcinoma is easily underdiagnosed but with current treatment, even in the presence of metastasis, the prognosis is excellent. A routine microscopic examination of all the placentas and products of miscarriage can increase the real incidence of this entity and consequently improve its management. PMID:28567059

  9. 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 ...

  10. Association between maternal comorbidity and preterm birth by severity and clinical subtype: retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Le Thi

    2011-10-01

    Full Text Available Abstract Background Preterm birth (PTB is a major cause of infant morbidity and mortality, but the relationship between comorbidity and PTB by clinical subtype and severity of gestational age remains poorly understood. We evaluated associations between maternal comorbidities and PTB by clinical subtype and gestational age. Methods We conducted a retrospective cohort study of 1,329,737 singleton births delivered in hospitals in the province of Québec, Canada, 1989-2006. PTB was classified by clinical subtype (medically indicated, preterm premature rupture of membranes (PPROM, spontaneous preterm labour and gestational age ( Results PTB rates were higher among mothers with comorbidity (10.9% compared to those without comorbidity (4.7%. Several comorbidities were associated with greater odds of medically indicated PTB compared with no comorbidity, but only comorbidities localized to the reproductive system were associated with spontaneous PTB. Drug dependence and mental disorders were strongly associated with PPROM and spontaneous PTBs across all gestational ages (OR > 2.0. At the population level, several major comorbidities (placental abruption, chorioamnionitis, oliogohydramnios, structural abnormality, cervical incompetence were key contributors to all clinical subtypes of PTB, especially at Conclusions The relationship between comorbidity and clinical subtypes of PTB depends on gestational age. Prevention of PPROM and spontaneous PTB may benefit from greater attention to preeclampsia, anemia and comorbidities localized to the reproductive system.

  11. Is there a role for cervical assessment and uterine artery Doppler in the first trimester of pregnancy as a screening test for spontaneous preterm delivery?

    Science.gov (United States)

    Parra-Cordero, M; Sepúlveda-Martínez, A; Rencoret, G; Valdés, E; Pedraza, D; Muñoz, H

    2014-03-01

    To evaluate the role of cervical length (CL) and uterine artery pulsatility index (UtA-PI) at 11+0 to 13+6 weeks as predictors of spontaneous preterm delivery (sPTD) in a Chilean population. This was a prospective study of asymptomatic women with singleton pregnancies attending for a nuchal translucency scan at 11+0 to 13+6 weeks' gestation and who underwent a transvaginal scan for evaluation of CL and UtA-PI. Exclusion criteria were fetal and pregnancy complications (other than sPTD) and iatrogenic delivery atUtA-PI were adjusted for fetal crown-rump length and maternal characteristics and expressed as multiples of the median (MoM) of the unaffected group. Prediction of sPTD using maternal and pregnancy characteristics was studied using logistic regression analysis. A total of 3480 women were recruited into the study and, after application of exclusion criteria, 3310 were included in the analysis. The rate of sPTD atUtA-PI between pregnancies with and without subsequent sPTD. Logistic regression analysis showed that smoking and previous PTD were significantly associated with sPTD atUtA-PI nor CL during the first trimester was shown to be a useful predictor of early sPTD. However, a combined model that includes smoking and previous PTD predicts approximately one-quarter of those women destined to deliver at<34 weeks, with a false-positive rate of 8%. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

  12. 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.

  13. female labour

    International Development Research Centre (IDRC) Digital Library (Canada)

    story about the exploitation of migrant workers and their function as a reserve labour force. When the government in Thailand wanted rice mills to switch away from their use of migrant labour, in this case mainly from Myanmar, to Thai workers in the aftermath of the economic crisis, it found appalling conditions, including the ...

  14. The effect of gestational age and cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies : an individual patient level meta-analysis

    NARCIS (Netherlands)

    Kindinger, L M; Poon, L C; Cacciatore, S; MacIntyre, D A; Fox, N S; Schuit, E; Mol, B W; Liem, S; Lim, A C; Serra, V; Perales, A; Hermans, F; Darzi, A; Bennett, P; Nicolaides, K H; Teoh, T G

    2016-01-01

    OBJECTIVE: To assess the effect of gestational age (GA) and cervical length (CL) measurements at transvaginal ultrasound (TVUS) in the prediction of preterm birth in twin pregnancy. DESIGN: Individual patient data (IPD) meta-analysis. SETTING: International multicentre study. POPULATION:

  15. On the Significance of New Biochemical Markers for the Diagnosis of Premature Labour

    Directory of Open Access Journals (Sweden)

    Rafał Rzepka

    2014-01-01

    Full Text Available Preterm labour is defined as a birth taking place between 22nd and 37th weeks of gestation. Despite numerous studies on the aetiology and pathogenesis of preterm labour, its very cause still remains unclear. The importance of the cytokines and acute inflammation in preterm labour aetiology is nowadays well-proven. However, chronic inflammation as an element of the pathogenesis of premature labour is still unclear. This paper presents a literature review on the damage-associated molecular patterns (DAMPs, receptors for advanced glycation end products (RAGE, negative soluble isoforms of RAGE, chemokine-stromal cell-derived factor-1 (SDF-1 and one of the adipokines, resistin, in the pathogenesis of preterm labour. We conclude that the chronic inflammatory response can play a much more important role in the pathogenesis of preterm delivery than the acute one.

  16. Application of ICD-PM to preterm-related neonatal deaths in South Africa and United Kingdom.

    Science.gov (United States)

    Allanson, E R; Vogel, J P; Tunçalp, Ӧ; Gardosi, J; Pattinson, R C; Francis, A; Erwich, Jjhm; Flenady, V J; Frøen, J F; Neilson, J; Quach, A; Chou, D; Mathai, M; Say, L; Gülmezoglu, A M

    2016-11-01

    We explore preterm-related neonatal deaths using the WHO application of the International Classification of Disease (ICD-10) to deaths during the perinatal period: ICD-PM as an informative case study, where ICD-PM can improve data use to guide clinical practice and programmatic decision-making. Retrospective application of ICD-PM. South Africa, and the UK. Perinatal death databases. Descriptive analysis of neonatal deaths and maternal conditions present. Causes of preterm neonatal mortality and associated maternal conditions. We included 98 term and 173 preterm early neonatal deaths from South Africa, and 956 term and 3248 preterm neonatal deaths from the UK. In the South African data set, the main causes of death were respiratory/cardiovascular disorders (34.7%), low birthweight/prematurity (29.2%), and disorders of cerebral status (25.5%). Amongst preterm deaths, low birthweight/prematurity (43.9%) and respiratory/cardiovascular disorders (32.4%) were the leading causes. In the data set from the UK, the leading causes of death were low birthweight/prematurity (31.6%), congenital abnormalities (27.4%), and deaths of unspecified cause (26.1%). In the preterm deaths, the leading causes were low birthweight/prematurity (40.9%) and deaths of unspecified cause (29.6%). In South Africa, 61% of preterm deaths resulted from the maternal condition of preterm spontaneous labour. Among the preterm deaths in the data set from the UK, no maternal condition was present in 36%, followed by complications of placenta, cord, and membranes (23%), and other complications of labour and delivery (22%). ICD-PM can be used to appraise the maternal and newborn conditions contributing to preterm deaths, and can inform practice. ICD-PM can be used to appraise maternal and newborn contributors to preterm deaths to improve quality of care. © 2016 Royal College of Obstetricians and Gynaecologists The World Health Organization retains copyright and all other rights in the manuscript of this

  17. Morning versus evening induction of labour for improving outcomes

    NARCIS (Netherlands)

    Bakker, Jannet J. H.; van der Goes, Birgit Y.; Pel, Maria; Mol, Ben Willem J.; van der Post, Joris A. M.

    2013-01-01

    Background Induction of labour is a common intervention in obstetric practice. Traditionally, inmost hospitals induction of labour with medication starts early in the morning, with the start of the working day for the day shift. In human and animal studies spontaneous onset of labour is proven to

  18. Candidate gene analysis of spontaneous preterm delivery: New insights from re-analysis of a case-control study using case-parent triads and control-mother dyads

    Directory of Open Access Journals (Sweden)

    Myking Solveig

    2011-12-01

    Full Text Available Abstract Background Spontaneous preterm delivery (PTD has a multifactorial etiology with evidence of a genetic contribution to its pathogenesis. A number of candidate gene case-control studies have been performed on spontaneous PTD, but the results have been inconsistent, and do not fully assess the role of how two genotypes can impact outcome. To elucidate this latter point we re-analyzed data from a previously published case-control candidate gene study, using a case-parent triad design and a hybrid design combining case-parent triads and control-mother dyads. These methods offer a robust approach to genetic association studies for PTD compared to traditional case-control designs. Methods The study participants were obtained from the Norwegian Mother and Child Cohort Study (MoBa. A total of 196 case triads and 211 control dyads were selected for the analysis. A case-parent triad design as well as a hybrid design was used to analyze 1,326 SNPs from 159 candidate genes. We compared our results to those from a previous case-control study on the same samples. Haplotypes were analyzed using a sliding window of three SNPs and a pathway analysis was performed to gain biological insight into the pathophysiology of preterm delivery. Results The most consistent significant fetal gene across all analyses was COL5A2. The functionally similar COL5A1 was significant when combining fetal and maternal genotypes. PON1 was significant with analytical approaches for single locus association of fetal genes alone, but was possibly confounded by maternal effects. Focal adhesion (hsa04510, Cell Communication (hsa01430 and ECM receptor interaction (hsa04512 were the most constant significant pathways. Conclusion This study suggests a fetal association of COL5A2 and a combined fetal-maternal association of COL5A1 with spontaneous PTD. In addition, the pathway analysis implied interactions of genes affecting cell communication and extracellular matrix.

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

    Science.gov (United States)

    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.

  20. 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

  1. Ethnic variation between white European women in labour outcomes in a setting in which the management of labour is standardised-a healthy migrant effect?

    LENUS (Irish Health Repository)

    Walsh, J

    2011-05-01

    To test the hypothesis that women from Eastern European countries have lower caesarean delivery rates and higher spontaneous labour rates relative to Irish women in a setting in which the management of labour is standardised.

  2. Coding Labour

    Directory of Open Access Journals (Sweden)

    Anthony McCosker

    2014-03-01

    Full Text Available As well as introducing the Coding Labour section, the authors explore the diffusion of code across the material contexts of everyday life, through the objects and tools of mediation, the systems and practices of cultural production and organisational management, and in the material conditions of labour. Taking code beyond computation and software, their specific focus is on the increasingly familiar connections between code and labour with a focus on the codification and modulation of affect through technologies and practices of management within the contemporary work organisation. In the grey literature of spreadsheets, minutes, workload models, email and the like they identify a violence of forms through which workplace affect, in its constant flux of crisis and ‘prodromal’ modes, is regulated and governed.

  3. Transcription Analysis of the Myometrium of Labouring and Non-Labouring Women.

    Science.gov (United States)

    Sharp, Gemma C; Hutchinson, James L; Hibbert, Nanette; Freeman, Tom C; Saunders, Philippa T K; Norman, Jane E

    2016-01-01

    An incomplete understanding of the molecular mechanisms that initiate normal human labour at term seriously hampers the development of effective ways to predict, prevent and treat disorders such as preterm labour. Appropriate analysis of large microarray experiments that compare gene expression in non-labouring and labouring gestational tissues is necessary to help bridge these gaps in our knowledge. In this work, gene expression in 48 (22 labouring, 26 non-labouring) lower-segment myometrial samples collected at Caesarean section were analysed using Illumina HT-12 v4.0 BeadChips. Normalised data were compared between labouring and non-labouring groups using traditional statistical methods and a novel network graph approach. We sought technical validation with quantitative real-time PCR, and biological replication through inverse variance-weighted meta-analysis with published microarray data. We have extended the list of genes suggested to be associated with labour: Compared to non-labouring samples, labouring samples showed apparent higher expression at 960 probes (949 genes) and apparent lower expression at 801 probes (789 genes) (absolute fold change ≥1.2, rank product percentage of false positive value (RP-PFP) genes and network analysis suggested a strong neutrophil signature. Our analysis also suggested that labour is characterised by a decrease in the expression of muscle-specific processes, which has not been explicitly discussed previously. We validated these findings through the first formal meta-analysis of raw data from previous experiments and we hypothesise that this represents a change in the composition of myometrial tissue at labour. Further work will be necessary to reveal whether these results are solely due to leukocyte infiltration into the myometrium as a mechanism initiating labour, or in addition whether they also represent gene changes in the myocytes themselves. We have made all our data available at www

  4. Labour status approach to labour statistics.

    OpenAIRE

    Standing G

    1983-01-01

    ILO pub-WEP pub. Working paper presenting a theoretical framework for an employment status approach to data collecting on labour force - discusses the definition of exploitation, underemployment, division of labour, occupation, skill, labour force, etc.; proposes a taxonomy of labour status including forced labour, feudalism, sharecropper, skilled worker, wages and family workers, peasant farmer, payment by result, apprentice, landowner and employer; and outlines forms of labour control. Refe...

  5. 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

  6. Copper metabolism domain-containing 1 represses the mediators involved in the terminal effector pathways of human labour and delivery.

    Science.gov (United States)

    Lappas, Martha

    2016-04-01

    conclusions are based on in vitro experiments with cells isolated from myometrium. Animal models, however, will be required to establish whether COMMD1 activators can prevent spontaneous preterm birth in vivo. The control of COMMD1 activation may provide an alternative therapeutic strategy for reducing the release of pro-labour mediators in spontaneous preterm labour. Not applicable. Associate Professor Martha Lappas is supported by a Career Development Fellowship from the National Health and Medical Research Council (NHMRC; grant no. 1047025). Additional funding was provided by the Medical Research Foundation for Women and Babies and the Mercy Research Foundation. The author has no conflict of interest. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. 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 ...

  8. Smoking and other pre-gestational risk factors for spontaneous preterm birth Tabagismo e outros fatores de risco pré-gestacional para nascimento espontâneo prematuro

    Directory of Open Access Journals (Sweden)

    Eugênio Grillo

    2011-12-01

    Full Text Available OBJECTIVES: to investigate pre-gestational risk factors for spontaneous preterm birth and, the role of smoking and its cumulative effects on prematurity. METHODS: a case-control study analyzed a data set of all births occurring in a tertiary maternity hospital between April 2002 and July 2004. Spontaneous preterm births of single and live newborns without malformations were selected as cases. Controls were all the term births of live and single newborns without malformations during the same period. Three outcomes were studied: all preterm births (OBJETIVOS: investigar fatores de risco pré-gestacional para nascimento espontâneo prematuro e o papel do tabagismo e seus efeitos cumulativos na prematuridade. MÉTODOS: um estudo transversal baseado em um banco de dados maternos e perinatais, analisou todos os nascimentos ocorridos, em um hospital terciário, no período de abril de 2002 a julho de 2004. Nascimentos prematuros, únicos e espontâneos, de nascidos vivos, sem malformações, foram selecionados como casos. Controles foram selecionados como nascidos vivos e a termo, únicos e sem malformações durante o mesmo período. Três desfechos foram estudados: todos nascimentos prematuros com menos de 37 semanas, aqueles com menos de 35 e 32 semanas de gestação. Regressão Logística foi utilizada na determinação do efeito independente de cada um dos fatores de risco. RESULTADOS: idade materna de menos de 20 anos, baixa escolaridade, baixo índice de massa corporal pré-gestacional e tabagismo se mostraram independente e significativamente associados com nascimento espontâneo e prematuro para os três desfechos. Para todos os fatores de risco, exceto tabagismo materno, as razões de chance aumentaram linearmente com o decréscimo da idade gestacional. O teste para tendência linear se mostrou significante para idade materna de menos de 20 anos e para baixo índice de massa corporal pré-gestacional. CONCLUSÕES: os efeitos cumulativos do

  9. 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.

  10. Do vaginal lactobacilli prevent preterm labour?

    African Journals Online (AJOL)

    De Wet GH. Hool1 P, Gouban P. The association between Chlamydia cervicitis. chorioamnionitis ano neonatal complications. Arch. Gynecol Obster 1991: 249: 79-85. 19. Donders GGG. Desmyter J, De Wet OH. Van Assche AA. The association of gonorrhoea and syphilis with premature birth and low birth wi!"ight. Genitourin.

  11. Appendicectomy during pregnancy and the risk of preterm birth: A population data linkage study.

    Science.gov (United States)

    Ibiebele, Ibinabo; Schnitzler, Margaret; Nippita, Tanya; Ford, Jane B

    2018-03-30

    Suspected appendicitis is a common non-obstetric indication for emergency abdominal surgery during pregnancy. Assess the risk of preterm birth and other maternal and neonatal adverse birth outcomes following appendicectomy during pregnancy. Population-based data linkage study of women with singleton births in New South Wales, Australia, 2002-2014. Pregnancies with appendicitis and appendicectomy were compared to pregnancies without appendicitis. Crude and adjusted hazard ratios (aHR) with 95% confidence intervals (CI) for preterm birth were estimated. Modified Poisson regression with robust variance was used to estimate crude and adjusted risk ratios (aRR) with 99% CI for other outcomes. Of 1 124 551 eligible pregnancies, 1024 (0.9/1000 pregnancies) had appendicitis and appendicectomy. Of these, 566 (55.3%) had laparoscopic and 458 (44.7%) had open appendicectomy. Appendicectomy at later gestational ages was associated with increasing rates of preterm birth. After adjustment for maternal and pregnancy factors, appendicectomy was associated with increased risk of preterm birth (overall aHR 1.73, 95% CI 1.42-2.09; planned aHR 2.08, 95% CI 1.60-2.72), maternal morbidity (aRR 2.68, 99% CI 1.88-3.83) and neonatal morbidity (aRR 1.42, 99% CI 1.03-1.94). However, there was no difference in perinatal mortality rates. Appendicectomy during pregnancy is associated with increased risk of spontaneous and planned preterm birth, maternal and neonatal morbidity. Availability of resources to prevent or manage preterm labour should be considered when appendicectomy is performed at gestational ages of 20 weeks or more. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  12. 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....

  13. [Child labour].

    Science.gov (United States)

    Marsella, L T; Savastano, L; Saracino, V; Del Vecchio, R

    2005-01-01

    The authors emphasize the violation of children's and adolescents' rights as a result of the exploitation of child labour. Besides the legal aspect, they pointed out the medical features related to the delicate growing process of the child in the phases of development and adaptation of the main organs to hard work. Currently the problem is being supervised by those states that recognize the right for minors to be protected against any kind of physical, mental, spiritual and moral risk.

  14. Prevention of Preterm Birth with Pessary in Singletons (PoPPS): a randomized controlled trial.

    Science.gov (United States)

    Dugoff, Lorraine; Berghella, Vincenzo; Sehdev, Harish; Mackeen, A Dhanya; Goetzl, Laura; Ludmir, Jack

    2017-09-20

    To determine if pessary use prevents preterm birth in singleton gestations with a short transvaginal ultrasound cervical length and without a prior spontaneous preterm birth. In this open-label multicenter randomized trial we enrolled asymptomatic women with singleton gestations with a transvaginal ultrasound cervical length ≤ 25 mm at 18 0 -23 6 weeks and no prior spontaneous preterm birth. Subjects were randomized to receive the Bioteque cup pessary or no pessary. Pessaries were inserted by trained maternal fetal medicine staff.. Vaginal progesterone was recommended to women with a cervical length ≤20mm. The primary outcome was preterm birth preterm birth preterm birth preterm birth preterm birth in women with singleton gestations with a short transvaginal ultrasound cervical length and without a prior spontaneous preterm birth in this small underpowered randomized controlled trial. This trial was registered on ClinicalTrials.gov, number NCT 02056652. This article is protected by copyright. All rights reserved.

  15. 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 ...

  16. 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 ...

  17. Reproductive performance in the next pregnancy for nulliparous women with history of first trimester spontaneous abortion.

    Science.gov (United States)

    El Behery, Manal M; Siam, Soha; Seksaka, Mahmoud A; Ibrahim, Zakia M

    2013-10-01

    To determine whether interpregnancy interval after the first spontaneous abortion has an effect on reproductive performance of women in their next pregnancy. A prospective cohort study was conducted on 4,619 women with history of spontaneous abortion in their first pregnancy. Of them 2,422 (52.4 %) conceived within 6 months of the miscarriage (group A) and 2,197 47.6 % after 12 months (group B). The primary outcome was abortion, live birth, termination, or ectopic pregnancy in the next pregnancy. Secondary outcomes were preterm delivery, low birth weight infants, caesarean section rate and occurrence of preeclampsia, placental abruption and induced labour in the second pregnancy. Women who conceived again within 6 months were less likely to have another abortion, termination, or ectopic pregnancy compared with women with interpregnancy interval more than 12 months. Women with an interpregnancy interval more than 12 months were less likely to have live birth in the second pregnancy and more likely to have a caesarean section, preterm delivery, or infant of low birth weight compared with women who conceived again within 6 months. Women who conceive within 6 months after their first spontaneous abortion have better reproductive outcomes and the lowest complication rates in their subsequent pregnancy.

  18. Maternal Factors Associated With Early Spontaneous Singleton ...

    African Journals Online (AJOL)

    Background: Knowledge of the maternal factors predisposing to preterm deliveries should affect the anticipatory care of mothers at risk of delivering preterm babies and improve perinatal outcome. Objective: To determine the maternal socio-biological characteristics associated with the delivery of early spontaneous ...

  19. EU Labour Law

    DEFF Research Database (Denmark)

    Nielsen, Ruth

    The focus in this book is upon EU labour law and its interaction with national and international labour law. The book provides an analysis of the framework and sources of European labour law. It covers a number of substantive topics, notably collective labour law, individual employment contracts......, discrimination on grounds of sex and on other grounds, free movement of persons, restructuring of enterprises, working environment and enforcement of rights derived from EU labour law....

  20. EU Labour Law

    DEFF Research Database (Denmark)

    Nielsen, Ruth

    The focus in this book is upon EU labour law and its interaction with national and international labour law. The book provides an analysis of the framework and sources of European labour law. It covers a number of substantive topics, notably collective labour law, individual employment contracts,......, discrimination on grounds of sex and on other grounds, free movement of persons, restructuring of enterprises, working environment and enforcement of rights derived from EU labour law....

  1. 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.

  2. Vaginal progesterone vs intramuscular 17α-hydroxyprogesterone caproate for prevention of recurrent spontaneous preterm birth in singleton gestations: systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Saccone, G; Khalifeh, A; Elimian, A; Bahrami, E; Chaman-Ara, K; Bahrami, M A; Berghella, V

    2017-03-01

    Randomized controlled trials (RCTs) have recently compared intramuscular 17α-hydroxyprogesterone caproate (17-OHPC) with vaginal progesterone for reducing the risk of spontaneous preterm birth (SPTB) in singleton gestations with prior SPTB. The aim of this systematic review and meta-analysis was to evaluate the efficacy of vaginal progesterone compared with 17-OHPC in prevention of SPTB in singleton gestations with prior SPTB. Searches of electronic databases were performed to identify all RCTs of asymptomatic singleton gestations with prior SPTB that were randomized to prophylactic treatment with either vaginal progesterone (intervention group) or intramuscular 17-OHPC (comparison group). No restrictions for language or geographic location were applied. The primary outcome was SPTB EMBARAZOS CON FETO ÚNICO: REVISIÓN SISTEMÁTICA Y METAANÁLISIS DE ENSAYOS CONTROLADOS ALEATORIOS: RESUMEN OBJETIVO: Recientemente se han realizado varios ensayos controlados aleatorios (ECA) que comparaban el caproato de 17α-hidroxiprogesterona (17-OHPC, por sus siglas en inglés) por vía intramuscular con la progesterona por vía vaginal para la reducción del riesgo de parto pretérmino espontáneo (PPTE) en embarazos con feto único de gestantes con historial de PPTE. El objetivo de esta revisión sistemática y metaanálisis fue evaluar la eficacia de la progesterona vaginal en comparación con la 17-OHPC en la prevención de embarazos con feto único de gestantes con historial de PPTE. MÉTODOS: Se realizaron búsquedas en bases de datos electrónicas para identificar todos los ECA con embarazos de feto único asintomáticos con historial de PPTE antes de ser asignados al azar a un tratamiento profiláctico, ya fuera con progesterona vaginal (grupo de intervención) o con 17-OHPC intramuscular (grupo de control). No se aplicaron restricciones respecto al idioma o la ubicación geográfica. El resultado primario fue PPTE embarazos de feto único e historial de PPTE. Sin

  3. 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.

  4. Obesity, gestational weight gain and preterm birth: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Nøhr, Ellen Aagaard; Bech, Bodil Hammer; Vaeth, Michael

    2007-01-01

    prepregnancy body mass index (BMI) and gestational weight gain was available. Information about spontaneous preterm birth with or without preterm premature rupture of membranes (PPROM) and about induced preterm deliveries was obtained from national registers. Cox regression analyses were used to examine...

  5. 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

  6. The idiopathic preterm delivery methylation profile in umbilical cord blood DNA

    NARCIS (Netherlands)

    Fernando, Febilla; Keijser, Remco; Henneman, Peter; van der Kevie-Kersemaekers, Anne-Marie F.; Mannens, Marcel Mam; van der Post, Joris Am; Afink, Gijs B.; Ris-Stalpers, Carrie

    2015-01-01

    Preterm delivery is the leading cause of neonatal morbidity and mortality. Two-thirds of preterm deliveries are idiopathic. The initiating molecular mechanisms behind spontaneous preterm delivery are unclear. Umbilical cord blood DNA samples are an easy source of material to study the neonatal state

  7. MICROBIOLOGICAL STUDY ON ENDOCERVIX IN PRETERM PREMATURE RUPTURE OF MEMBRANE

    OpenAIRE

    Elizebeth V. Issac; Sareena Gilvaz; Neetha B. George

    2017-01-01

    BACKGROUND Preterm premature rupture of membrane (PPROM) is defined as premature rupture of membrane before 37 completed weeks. It is associated with 40% preterm deliveries and results in significant perinatal mortality and morbidity. Present study is an attempt to find the association between infection and PPROM. MATERIALS AND METHODS 100 pregnant women between 29 weeks and 34 weeks of gestation who were admitted in our labour room during a period from November 2012 to Nove...

  8. Prediction of preterm deliveries from EHG signals using machine learning.

    Directory of Open Access Journals (Sweden)

    Paul Fergus

    Full Text Available There has been some improvement in the treatment of preterm infants, which has helped to increase their chance of survival. However, the rate of premature births is still globally increasing. As a result, this group of infants are most at risk of developing severe medical conditions that can affect the respiratory, gastrointestinal, immune, central nervous, auditory and visual systems. In extreme cases, this can also lead to long-term conditions, such as cerebral palsy, mental retardation, learning difficulties, including poor health and growth. In the US alone, the societal and economic cost of preterm births, in 2005, was estimated to be $26.2 billion, per annum. In the UK, this value was close to £2.95 billion, in 2009. Many believe that a better understanding of why preterm births occur, and a strategic focus on prevention, will help to improve the health of children and reduce healthcare costs. At present, most methods of preterm birth prediction are subjective. However, a strong body of evidence suggests the analysis of uterine electrical signals (Electrohysterography, could provide a viable way of diagnosing true labour and predict preterm deliveries. Most Electrohysterography studies focus on true labour detection during the final seven days, before labour. The challenge is to utilise Electrohysterography techniques to predict preterm delivery earlier in the pregnancy. This paper explores this idea further and presents a supervised machine learning approach that classifies term and preterm records, using an open source dataset containing 300 records (38 preterm and 262 term. The synthetic minority oversampling technique is used to oversample the minority preterm class, and cross validation techniques, are used to evaluate the dataset against other similar studies. Our approach shows an improvement on existing studies with 96% sensitivity, 90% specificity, and a 95% area under the curve value with 8% global error using the polynomial

  9. 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

  10. The Pain of Labour

    Science.gov (United States)

    Labor, Simona

    2008-01-01

    Labour is an emotional experience and involves both physiological and psychological mechanisms. The pain of labour is severe but despite this its memory diminishes with time. Labour pain has two components: visceral pain which occurs during the early first stage and the second stage of childbirth, and somatic pain which occurs during the late first stage and the second stage. The pain of labour in the first stage is mediated by T10 to L1 spinal segments, whereas that in the second stage is carried by T12 to L1, and S2 to S4 spinal segments. Pain relief in labour is complex and often challenging without regional analgesia. Effective management of labour pain plays a relatively minor role in a woman's satisfaction with childbirth. PMID:26526404

  11. Exploration of preterm birth rates associated with different models of antenatal midwifery care in Scotland: Unmatched retrospective cohort analysis.

    Science.gov (United States)

    Symon, Andrew; Winter, Clare; Cochrane, Lynda

    2015-06-01

    preterm birth represents a significant personal, clinical, organisational and financial burden. Strategies to reduce the preterm birth rate have had limited success. Limited evidence indicates that certain antenatal care models may offer some protection, although the causal mechanism is not understood. We sought to compare preterm birth rates for mixed-risk pregnant women accessing antenatal care organised at a freestanding midwifery unit (FMU) and mixed-risk pregnant women attending an obstetric unit (OU) with related community-based antenatal care. unmatched retrospective 4-year Scottish cohort analysis (2008-2011) of mixed-risk pregnant women accessing (i) FMU antenatal care (n=1107); (ii) combined community-based and OU antenatal care (n=7567). Data were accessed via the Information and Statistics Division of the NHS in Scotland. Aggregates analysis and binary logistic regression were used to compare the cohorts׳ rates of preterm birth; and of spontaneous labour onset, use of pharmacological analgesia, unassisted vertex birth, and low birth weight. Odds ratios were adjusted for age, parity, deprivation score and smoking status in pregnancy. after adjustment the 'mixed risk' FMU cohort had a statistically significantly reduced risk of preterm birth (5.1% [n=57] versus 7.7% [n=583]; AOR 0.73 [95% CI 0.55-0.98]; p=0.034). Differences in these secondary outcome measures were also statistically significant: spontaneous labour onset (FMU 83.9% versus OU 74.6%; AOR 1.74 [95% CI 1.46-2.08]; p<0.001); minimal intrapartum analgesia (FMU 53.7% versus OU 34.4%; AOR 2.17 [95% CI 1.90-2.49]; p<0.001); spontaneous vertex delivery (FMU 71.9% versus OU 63.5%; AOR 1.46 [95% CI 1.32-1.78]; p<0.001). Incidence of low birth weight was not statistically significant after adjustment for other variables. There was no significant difference in the rate of perinatal or neonatal death. given this study׳s methodological limitations, we can only claim associations between the care model

  12. Women's perceptions, expectations and satisfaction with induced labour--a questionnaire-based study.

    Science.gov (United States)

    Shetty, Ashalatha; Burt, Rhona; Rice, Pat; Templeton, Allan

    2005-11-01

    To evaluate the understanding and expectations of women undergoing labour induction, to assess their actual experience of the process and to compare their satisfaction with labour to those labouring spontaneously. Four hundred and fifty women at term undergoing induction of labour and cervical ripening with prostaglandinE2 vaginal tablets and 450 women labouring spontaneously were recruited into the study. The induction group were requested to complete a questionnaire prior to the start of their induction process and another questionnaire post-delivery. The post-delivery questionnaire contained two sections, one pertaining to issues to do with the induction and the second with the actual labour process. The spontaneously labouring group was requested to complete a questionnaire post-delivery, which only contained the section pertaining to the actual labour process. The main outcome measures were satisfaction with labour, perception of pain and length of labour between the induced and spontaneous labour groups, and issues that the women might wish changed about their induction. In the induction group, 34.7% were not satisfied with the information they received about the induction prior to the procedure and 27.2% expected to deliver within 12h of the administration of the inducing agent. Post-induction, 40% of the women felt the most important aspect they would like to change about their induction were they to have another one, would be the speed of the induction, 13.6% felt they might wish to take the inducing agent orally, 7% to have fewer vaginal examinations and 9% to have fewer complications. Among the women who returned questionnaires, 26.3% had a caesarean delivery in the induction group and 21.4% in the spontaneous labour group. Significantly more women were satisfied with their labour in the spontaneous labour group 79.5% versus 70.4%, RR 0.89, 95% CI 0.8-0.96, P=0.006). Labour that is artificially induced does result in lower satisfaction rates as compared

  13. Zones of emotional labour

    DEFF Research Database (Denmark)

    Strøbæk, Pernille Solveig

    2011-01-01

    is put forth among 25 Danish public family law caseworkers. The study points to personal, professional, and social zones of emotional labour through which the caseworkers carry out their work. Emotional labour zones mark emotion structures that may be challenging due to complex emotional intersections......The paper suggests that due to the difficult nature of their work public family law caseworkers are to be included in the definition of emotional labour even though they are omitted by Hochschild. Based upon a review of the structures involved in emotional labour an explorative qualitative study...

  14. [The role of emotional labour in oncology].

    Science.gov (United States)

    Szluha, Kornélia; Lazányi, Kornélia; Molnár, Péter

    2007-01-01

    Oncologists and related health care professionals (HCPs) do not only have to follow professional protocols in their everyday work, but also have to communicate proper attitudes towards patients suffering from malignant diseases. This task is often a heavier load than the implementation of professional activities themselves. The present article is based on a survey on HCP work motivation, employment parameters and correlations with emotional labour. Fifty oncology HCPs at Debrecen University Medical Health Sciences Centre volunteered to participate in this survey containing 20 simple-choice questions. More than 90 percent of HCPs make an effort to hide their emotional state, giving way to possible negative side effects. The survey showed significant differences between the level of emotional labour of those working in the field of oncology longer or shorter than ten years. Surface and deep emotional labour is more frequent among professionals already working in oncology for a longer period of time. This can serve us with explanation to the burn-out syndrome so frequent in this profession. To diminish the load of emotional labour, healthcare institutes have to aim at hiring employees that spontaneously fit the emotional and behavioural norms facing them, and do not need officially prescribed behavioural norms for everyday work. Their constant need for respect and appreciation of their values must be kept in mind, because the capability of genuine emotional labour diminishes parallel to the number of years spent in work.

  15. Gestational age at initiation of 17-alpha hydroxyprogesterone caproate and recurrent preterm birth.

    Science.gov (United States)

    Ning, Angela; Vladutiu, Catherine J; Dotters-Katz, Sarah K; Goodnight, William H; Manuck, Tracy A

    2017-09-01

    Preterm birth is the leading cause of neonatal morbidity and mortality in nonanomalous neonates in the United States. Women with a previous early spontaneous preterm birth are at highest risk for recurrence. Weekly intramuscular 17-alpha hydroxyprogesterone caproate reduces the risk of recurrent prematurity. Although current guidelines recommend 17-alpha hydroxyprogesterone caproate initiation between 16 and 20 weeks, in clinical practice, 17-alpha hydroxyprogesterone caproate is started across a spectrum of gestational ages. The objective of the study was to examine the relationship between the gestational age at 17-alpha hydroxyprogesterone caproate initiation and recurrent preterm birth among women with a prior spontaneous preterm birth 16-28 weeks' gestation. This was a retrospective cohort study of women from a single tertiary care center, 2005-2016. All women with ≥1 singleton preterm births because of a spontaneous onset of contractions, preterm prelabor rupture of membranes, or painless cervical dilation between 16 and 28 weeks followed by a subsequent singleton pregnancy treated with 17-alpha hydroxyprogesterone caproate were included. Women were grouped based on quartiles of gestational age of 17-alpha hydroxyprogesterone caproate initiation (quartile 1, 14 0/7 to 16 1/7 ; quartile 2, 16 2/7 to 17 0/7 ; quartile 3, 17 1/7 to 18 6/7 ; and quartile 4, 19 0/7 to 27 5/7 ). Women with a gestational age of 17-alpha hydroxyprogesterone caproate initiation in quartiles 1 and 2 were considered to have early-start 17-alpha hydroxyprogesterone caproate; those in quartiles 3 and 4 were considered to have late-start 17-alpha hydroxyprogesterone caproate. The primary outcome was recurrent preterm birth preterm birth preterm birth preterm birth preterm birth preterm birth preterm birth among women with a prior spontaneous preterm birth 16-28 weeks are high. Women beginning 17-alpha

  16. 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

    1.06, 95% CI 0.31 to 3.58). Serious maternal adverse events and perinatal mortality were not reported by either of the two trials in this comparison. Maternal adverse events (overall) were not reported but one trial (42 women) reported that there were no maternal adverse events that required stopping or changing drug) in either group. One trial did report delay until delivery but this outcome was reported as a median with no mention of the standard deviation (median 19 days in ethanol group versus "less than 1" day in the glucose/water group). There were no differences in any secondary outcomes reported: preterm birth birth birth birth seen with other tocolytics, which for all these comparisons were betamimetics. Serious maternal adverse events were not reported in any of the nine trial reports. However, ethanol had a trend towards a lower rate of maternal adverse events requiring stopping or changing the drug (three trials, 214 women; RR 0.25, 95% CI 0.06 to 0.97). There were no differences in other secondary outcomes of preterm birth birth in threatened preterm labor.Ethanol is generally no longer used in current practice due to safety concerns for the mother and her baby. There is no need for new studies to evaluate the use of ethanol for preventing preterm birth in threatened preterm labour. However, it would be useful for long-term follow-up studies on the babies born to mothers from the existing studies in order to assess the risk of long-term neurodevelopmental status.

  17. Whither Asian Labour Education?

    Science.gov (United States)

    Leong, Apo

    2004-01-01

    Despite the initiatives from governments and unions alike, the need for worker-centred labour education still exists. Labour educators should have to be more creative in planning and running educational programs to empower workers so that they can be liberated from all forms of exploitation, no matter how such exploitation is disguised or…

  18. Domain: Labour market

    NARCIS (Netherlands)

    Oude Mulders, J.; Wadensjö, E.; Hasselhorn, H.M.; Apt, W.

    This domain chapter is dedicated to summarize research on the effects of labour market contextual factors on labour market participation of older workers (aged 50+) and identify research gaps. While employment participation and the timing of (early) retirement is often modelled as an individual

  19. Labour circulation and the urban labour process.

    Science.gov (United States)

    Standing, G

    1986-01-01

    The author investigates aspects of labor circulation, which he defines as "temporary movement between geographical areas for work or in search of work....[He attempts to determine] what roles have been played by labour circulation in the development of urban-industrial labour forces in the transition to industrial capitalism." Factors considered include the exploitation and oppression of labor migrants; the industrial-urban labor reserve; urban socioeconomic stratification and discrimination by age, sex, or race; the division of labor; and policy options. excerpt

  20. 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.

  1. Induction of labour versus expectant monitoring in women with pregnancy induced hypertension or mild preeclampsia at term: the HYPITAT trial

    Directory of Open Access Journals (Sweden)

    Mol Ben WJ

    2007-07-01

    Full Text Available Abstract Background Hypertensive disorders, i.e. pregnancy induced hypertension and preeclampsia, complicate 10 to15% of all pregnancies at term and are a major cause of maternal and perinatal morbidity and mortality. The only causal treatment is delivery. In case of preterm pregnancies conservative management is advocated if the risks for mother and child remain acceptable. In contrast, there is no consensus on how to manage mild hypertensive disease in pregnancies at term. Induction of labour might prevent maternal and neonatal complications at the expense of increased instrumental vaginal delivery rates and caesarean section rates. Methods/Design Women with a pregnancy complicated by pregnancy induced hypertension or mild preeclampsia at a gestational age between 36+0 and 41+0 weeks will be asked to participate in a multi-centre randomised controlled trial. Women will be randomised to either induction of labour or expectant management for spontaneous delivery. The primary outcome of this study is severe maternal morbidity, which can be complicated by maternal mortality in rare cases. Secondary outcome measures are neonatal mortality and morbidity, caesarean and vaginal instrumental delivery rates, maternal quality of life and costs. Analysis will be by intention to treat. In total, 720 pregnant women have to be randomised to show a reduction in severe maternal complications of hypertensive disease from 12 to 6%. Discussion This trial will provide evidence as to whether or not induction of labour in women with pregnancy induced hypertension or mild preeclampsia (nearly at term is an effective treatment to prevent severe maternal complications. Trial Registration The protocol is registered in the clinical trial register number ISRCTN08132825.

  2. Victorian paramedics' encounters and management of women in labour: an epidemiological study.

    Science.gov (United States)

    McLelland, Gayle; Morgans, Amee; McKenna, Lisa

    2015-02-05

    Although it is generally accepted that paramedics attend unexpected births, there is a paucity of literature about their management of women in labour. This study aimed to investigate the caseload of women in labour attended by a statewide ambulance service in Australia during one year and the management provided by paramedics. Retrospective clinical data collected on-scene by paramedics via in-field electronic patient care records were provided by Ambulance Victoria. Patient case reports were electronically extracted from the Ambulance Victoria's Clinical Data Warehouse via comprehensive filtering followed by manual sorting. Descriptive statistics were analysed using Statistical Package for Social Sciences (SPSS v.19). Over a 12-month period, paramedics were called to 1517 labouring women. Two thirds of women were at full-term gestation, and 40% of pre-term pregnancies were less than 32 weeks gestation. Paramedics documented 630 case reports of women in early labour and a further 767 in established labour. There were 204 women thought to be second stage labour, including 134 who progressed to childbirth under paramedic care. When paramedics assisted with births, the on-scene time was significantly greater than those patients transported in labour. Pain relief was provided significantly more often to women in established labour than in early labour. Oxygen was given to significantly more women in preterm labour. While paramedics performed a range of procedures including intravenous cannulation, administration of analgesia and oxygen, most women required minimal intervention. Paramedics needed to manage numerous obstetric and medical complications during their management. Paramedics provide emergency care and transportation for women in labour. Most of the women were documented to be at term gestation with minimal complications. To enable appropriate decision making about management and transportation, paramedics require a range of clinical assessment skills

  3. Twin transvaginal cervical length at 16-20 weeks and prediction of preterm birth.

    Science.gov (United States)

    Hester, Ashley E; Ankumah, Nana-Ama E; Chauhan, Suneet P; Blackwell, Sean C; Sibai, Baha M

    2017-10-08

    Our objective was to determine if transvaginal cervical length at 16-20 weeks is predictive of preterm birth preterm birth. Transvaginal cervical length was performed at 16-20-week gestation. The inclusion criteria were non-anomalous twins with transvaginal cervical length at 16-20 weeks. Receiver-operating characteristic (ROC) curves were generated to determine the transvaginal cervical length associated with preterm birth. Of 655 pregnancies, 27% (N = 178) women met our inclusion criteria. The rate of spontaneous preterm birth before 34 weeks was 16% (N = 29). A receiver operator characteristic curve was generated for all preterm birth preterm birth (n = 15) were excluded, the area under the curve was 0.59 (95% CI 0.47-0.70), indicating that transvaginal cervical length values were not a clinically useful test for the prediction of spontaneous preterm birth. A transvaginal cervical length of 30 mm from this model would produce a sensitivity of detecting spontaneous preterm birth of 95% and a specificity of 14%. In an asymptomatic twin population, a single transvaginal cervical length between 16 and 20 weeks was not predictive of spontaneous preterm birth before 34 weeks. Thus, our findings suggest that routine transvaginal cervical length screening of twins should not be performed between 16-20 weeks.

  4. 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.

  5. Conception, complicated pregnancy, and labour of gods and heroes in Greek mythology.

    Science.gov (United States)

    Iavazzo, Christos; Trompoukis, Constantinos; Sardi, Thalia; Falagas, Matthew E

    2008-01-01

    Pregnancy and labour are holy moments in a woman's life. Even in Greek mythology we can find descriptions of them. We searched in the Greek myths to find descriptions of labours of ancient heroes and gods. We identified descriptions of extracorporeal fertilization, superfecundation, ectopic pregnancy, preterm labour, prolonged pregnancy and Caesarean section. The use of imagination could help the reader to find similarities in present or future developments in the field of obstetrics. It could be concluded that various aspects of modern obstetrical practice are described in Greek mythology.

  6. Cardiopulmonary Collapse during Labour

    Directory of Open Access Journals (Sweden)

    Vasilis Sitras

    2010-01-01

    Full Text Available Cardiopulmonary collapse during labour is a catastrophic event caused by various medical, surgical and obstetrical conditions. It is an emergency that threatens the life of the mother and her unborn child. We present a case of a pregnant woman who suffered from preeclampsia and underwent induction of labour. Severe lung edema occurred early in labour that caused cardiopulmonary collapse. Advanced heart-lung resuscitation was established immediately and continued until an emergency cesarean section was performed few minutes later. The outcome was favourable for both mother and child. We further discuss some aspects of the pathophysiology and appropriate treatment of cardiorespiratory arrest during labour, which involves the coordinated action of the obstetric, pediatric and surgical ward personnel.

  7. Footballer on labour market

    OpenAIRE

    Konečný, Miroslav

    2017-01-01

    Bachelor thesis si about footballer on labour market and main aim is to determine his wage determinants, mainly his performance as its main determinant. In teoretical part I describe structure of market on which footbalist supplies his labour. After that I describe superstar effect, moral hazard, education influence and efficiency wage on the market with football players. In practical part I analyse determinants of footballer wage with regresion analysis on datas from english Premier League f...

  8. Post-hemorrhagic hydrocephalus and diabetes insipidus in preterm infants.

    Science.gov (United States)

    Borenstein-Levin, Liron; Koren, Ilana; Kugelman, Amir; Bader, David; Toropine, Arina; Riskin, Arieh

    2014-11-01

    We present two cases of transient central diabetes insipidus in preterm neonates with post-hemorrhagic hydrocephalus. Although the association between intraventricular hemorrhage and diabetes insipidus has been described in preterm infants, the association between diabetes insipidus and hydrocephalus, and the fact that such central diabetes insipidus could be reversible with the reduction of ventricular size, either because of spontaneous resolution or the placement of ventriculo-peritoneal shunt is first described here in neonates.

  9. Efficacy of birth ball exercises on labour pain management.

    Science.gov (United States)

    Leung, R W C; Li, J F P; Leung, M K M; Fung, B K Y; Fung, L C W; Tai, S M; Sing, C; Leung, W C

    2013-10-01

    To evaluate the efficacy of a birth ball exercise programme conducted by physiotherapists on pain relief, psychological care, and facilitation of the labour process at a labour ward in a regional hospital. Case series with before-after comparisons. Kwong Wah Hospital, Hong Kong. Chinese women admitted to the labour ward for spontaneous vaginal delivery between April and August 2012 were recruited. Physiotherapists taught birth ball exercises in groups or individually for 30 minutes. Labour pain intensity, back pain intensity, frequency of labour pain, stress and anxiety levels, and subjective pressure level over the lower abdomen were captured before and after birth ball exercises. Most of the parameters were measured using self-reported visual analogue scales. After the exercise session, physiotherapists measured the women's satisfaction level. Midwives recorded pethidine usage. A total of 203 pregnant women participated in this programme; 181 were in the latent phase group, whereas 22 were categorised into the no-labour-pain group. In both groups, there were statistically and clinically significant differences in back pain level, stress and anxiety levels, as well as pressure level over the lower abdomen before and after the exercise (Plabour pain and frequency of labour pain were demonstrated. Mean satisfaction scores were high, with visual analogue scale scores higher than 8.2 in both groups. Pethidine usage showed a further decreasing trend (6.4%) compared with the past 2 years. Birth ball exercise could be an alternative means of relieving back pain and labour pain in the labour ward, and could decrease pethidine consumption in labouring women.

  10. Cervical pessary placement for prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial.

    Science.gov (United States)

    Nicolaides, Kypros H; Syngelaki, Argyro; Poon, Liona C; de Paco Matallana, Catalina; Plasencia, Walter; Molina, Francisca S; Picciarelli, Gemma; Tul, Natasa; Celik, Ebru; Lau, Tze Kin; Conturso, Roberto

    2016-01-01

    Preterm birth is the leading cause of neonatal death and handicap in survivors. Although twins are found in 1.5% of pregnancies they account for about 25% of preterm births. Randomized controlled trials in singleton pregnancies reported that the prophylactic use of progestogens, cervical cerclage and cervical pessary reduce significantly the rate of early preterm birth. In twin pregnancies, progestogens and cervical cerclage have been shown to be ineffective in reducing preterm birth. The objective of this study was to test the hypothesis that the insertion of a cervical pessary in twin pregnancies would reduce the rate of spontaneous early preterm birth. This was a multicenter, randomized controlled trial in unselected twin pregnancies of cervical pessary placement from 20(+0)-24(+6) weeks' gestation until elective removal or delivery vs. expectant management. Primary outcome was spontaneous birth control groups in rates of spontaneous birth birth. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. 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....

  12. Preterm Labor and Birth

    Science.gov (United States)

    ... 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 ...

  13. 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....

  14. Posture and movement in healthy preterm infants in supine position in and outside the nest

    NARCIS (Netherlands)

    Ferrari, F.; Bertoncelli, N.; Gallo, C.; Roversi, M. F.; Guerra, M. P.; Ranzi, A.; Madders-Algra, M.

    Objective: To evaluate whether lying in a nest affects the posture and spontaneous movements of healthy preterm infants. Method: 10 healthy preterm infants underwent serial video recording in the supine position, when lying in a nest and outside it, at three ages: 30-33 weeks postmenstrual age (PMA)

  15. 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

  16. Induction of labour.

    Science.gov (United States)

    Leduc, Dean; Biringer, Anne; Lee, Lily; Dy, Jessica

    2013-09-01

    To review the most current literature in order to provide evidence-based recommendations to obstetrical care providers on induction of labour. Intervention in a pregnancy with induction of labour. Appropriate timing and method of induction, appropriate mode of delivery, and optimal maternal and perinatal outcomes. Published literature was retrieved through searches of PubMed, CINAHL, and The Cochrane Library in 2010 using appropriate controlled vocabulary (e.g., labour, induced, labour induction, cervical ripening) and key words (e.g., induce, induction, augmentation). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to the end of 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The evidence in this document was rated using criteria described in the Report of the Canadian Task Force on Preventative Health Care (Table 1). SUMMARY STATEMENTS: 1. Prostaglandins E(2) (cervical and vaginal) are effective agents of cervical ripening and induction of labour for an unfavourable cervix. (I) 2. Intravaginal prostaglandins E(2) are preferred to intracervical prostaglandins E(2) because they results in more timely vaginal deliveries. (I).

  17. 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.

  18. Spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Davari R

    1996-07-01

    Full Text Available A case with bilateral spontaneous pneumothorax was presented. Etiology, mechanism, and treatment were discussed on the review of literature. Spontaneous Pneumothorax is a clinical entity resulting from a sudden non traumatic rupture of the lung. Biach reported in 1880 that 78% of 916 patients with spontaneous pneumothorax had tuberculosis. Kjergaard emphasized 1932 the primary importance of subpleural bleb disease. Currently the clinical spectrum of spontaneous pneumothorax seems to have entered a third era with the recognition of the interstitial lung disease and AIDS as a significant etiology. Standard treatment is including: observation, thoracocentesis, tube thoracostomy. Chemical pleurodesis, bullectomy or wedge resection of lung with pleural abrasion and occasionally pleurectomy. Little information has been reported regarding the efficacy of such treatment in spontaneous pneumothorax secondary to non bleb disease

  19. Preterm labour - is bacterial vaginosis involved? | Odendaal | South ...

    African Journals Online (AJOL)

    Patients where BV was diagnosed clinically or on Gram's stain of a smear taken from the posterior vaginal fornix, received either 400 mg 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.

  20. Do vaginal lactobacilli prevent preterm labour? | Kotze | South ...

    African Journals Online (AJOL)

    South African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 87, No 8 (1997) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  1. Labour process and the division of labour, a reading

    OpenAIRE

    Bruno Tinel

    2009-01-01

    URL des Documents de travail : http://ces.univ-paris1.fr/cesdp/CESFramDP2009.htm; Documents de travail du Centre d'Economie de la Sorbonne 2009.74 - ISSN : 1955-611X; This article proposes an analysis of the labour process and the division of labour in capitalist production through a reading of Marx and a few others like Babbage and Braverman. The distinction between labour and labour power is used to expose the specificity of the labour process. Cooperation constitues the fundamental from of...

  2. Maternal temperature during labour

    NARCIS (Netherlands)

    Schouten, F. D.; Wolf, H.; Smit, B. J.; Bekedam, D. J.; de Vos, R.; Wahlen, I.

    2008-01-01

    OBJECTIVE: The aim of this study was to describe the variation of normal maternal temperature during labour. Design A prospective cohort study. SETTING: Two hospitals in Amsterdam, the Netherlands. POPULATION: All women with a live singleton pregnancy and a gestational age of 36 weeks or more

  3. Emotional Labour and Governmentality

    DEFF Research Database (Denmark)

    Monrad, Merete

    2017-01-01

    of control, status and resources but also productively in terms of the subjectivities enabled by organisations. The article draws upon the works of Foucault and Rose, particularly the concepts of productive power and governmentality and suggests that emotional labour may be conceptualised as a technology...... to the individualisation of work-related responsibilities....

  4. Organization of the Labour Market

    DEFF Research Database (Denmark)

    Filges, Trine

    1999-01-01

    across industries or within industries across labour types. If the organization structure is endogenous, the result will be joint unions of homogenous groups; the structure with the highest employmenIn this paper, we analyse the wage setting of a democratic labour union. The union members differ......In this paper, we analyse the organization of the labour market in a general equilibrium model of a closed economy with two industries and two types of labour input. Workers are organized in industry- and skill-specific unions. The wage is set in cooperation either between identical labour types...

  5. History of induced abortion as a risk factor for preterm birth in European countries: results of the EUROPOP survey.

    Science.gov (United States)

    Ancel, Pierre-Yves; Lelong, Nathalie; Papiernik, Emile; Saurel-Cubizolles, Marie-Josèphe; Kaminski, Monique

    2004-03-01

    The objective of this study was to investigate the relationship between history of induced abortion and preterm delivery in various parts of Europe, and according to the main cause of preterm birth. We used data from a case-control survey, the EUROPOP study; 2938 preterm births and 4781 controls at term from ten European countries were included. Based on national statistics, we distinguished three groups of countries with high, intermediate and low rates of induced abortion. Previous induced abortions were significantly associated with preterm delivery and the risk of preterm birth increased with the number of abortions. Odds ratios did not differ significantly between the three groups of countries. The extent of association with previous induced abortion varied according to the cause of preterm delivery. Previous induced abortions significantly increased the risk of preterm delivery after idiopathic preterm labour, preterm premature rupture of membranes and ante-partum haemorrhage, but not preterm delivery after maternal hypertension. The strength of the association increased with decreasing gestational age at birth. Identifying subgroups of preterm births on the basis of the complications involved in delivery increases our understanding of the mechanisms by which previous induced abortion affects subsequent pregnancy outcomes.

  6. Patent Ductus Arteriosus Treatment in Very Preterm Infants

    DEFF Research Database (Denmark)

    Edstedt Bonamy, Anna-Karin; Gudmundsdottir, Anna; Maier, Rolf F

    2017-01-01

    BACKGROUND: Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. OBJECTIVES: The aim of this work was to study regional variations in PDA treatment...

  7. Labour and Education

    DEFF Research Database (Denmark)

    Huggler, Jørgen; Oettingen, Alexander von

    2012-01-01

    . Niethammer, G. contrasted with some important philosophical theories; viz. considerations on ‘labour’ expressed by Kant, Hegel & Marx. In addition, some historical theories of education that negatively or positively refer to labour are presented. Kerschensteiner and J. Dewey, are discussed with focus...... on their didactical, institutional and political implications. In order to discuss the recent shift of raison d’être for education, our investigation takes three steps. The first part discusses some general didactical, anthropological, ethical and political issues related to labour. The second part queries...... that the historical relations between political economy and pedagogical visions have not been constant over time. However, since the times of J.-J. Rousseau and I. Kant, education has been dominated by ideals of a human, cultural and social development related to the individual, rather than by economic pursuits. Even...

  8. Labour Law in Denmark

    DEFF Research Database (Denmark)

    Hasselbalch, Ole

    Table of Contents: The Author List of Abbreviations General Introduction Chapter 1. General Background Chapter 2. Definitions and Notions Chapter 3. Historical Background Chapter 4. Role of Government Institutions in the Shaping and Administration of Labour and Industrial Relations Policy Chapter 5....... Definitions and Notions Chapter 4. Establishment of an EWC or a Procedure Chapter 5. Pre-existing Agreements Concluding Remarks Bibliography Part II. Documents Part III. Selected Agreements Establishing EWCs...

  9. Transformation of Labour Relations

    OpenAIRE

    Pillai, Rajasekharan

    2010-01-01

    One of the spill-over effects of globalization is the essential transformation of labour market structure. In the wake of service sector revolution, being backed by knowledge revolution, faster mobility and the growth of IT enabled services, the potential of tourism cannot be over looked. This paper attempts to disclose the changing notion of work in the current international scenario. The study focuses on tourism sector, both due to its growth potential and due to its employment significance...

  10. Progesterone supplementation and the prevention of preterm birth.

    Science.gov (United States)

    Norwitz, Errol R; Caughey, Aaron B

    2011-01-01

    Preterm birth is currently the most important problem in maternal-child health in the United States and possibly throughout the world. It complicates one in eight US deliveries, and accounts for over 85% of all perinatal morbidity and mortality. Although survival of preterm infants has increased steadily over the past four decades-due in large part to the use of antenatal corticosteroids, improvements in neonatal resuscitation, and the introduction of neonatal intensive care units-efforts to prevent preterm birth have been largely unsuccessful. On February 3, 2011, the US Food and Drug Administration (FDA) approved the use of progesterone supplementation (hydroxyprogesterone caproate) during pregnancy to reduce the risk of recurrent preterm birth in women with a history of at least one prior spontaneous preterm delivery. This is the first time that the FDA has approved a medication for the prevention of preterm birth, and represents the first approval of a drug specifically for use in pregnancy in almost 15 years. This article reviews the evidence behind the use of progesterone for the prevention of preterm birth, and provides guidelines for the use of progesterone supplementation in clinical practice. A number of areas of ongoing controversy are addressed, including the optimal formulation and route of administration, the safety of progesterone supplementation in pregnancy, and its proposed mode of action.

  11. Labour Market Models in the EU

    OpenAIRE

    Koster, F.; McQuinn, J.; Siedschlag, I.; Vliet, van, O.P.

    2011-01-01

    In the European Union, the most important labour market models that have been proposed for labour market reform are flexicurity and the transitional labour market. In this position paper, we conceptualise the models of flexicurity and the transitional labour market, and we outline potentially relevant research questions. These research questions focus on explaining the variations in labour market policies across EU countries and the impact of labour market institutions on labour market outcom...

  12. Folic acid supplementation, dietary folate intake and risk of preterm birth in China.

    Science.gov (United States)

    Liu, Xiaohui; Lv, Ling; Zhang, Hanru; Zhao, Nan; Qiu, Jie; He, Xiaochun; Zhou, Min; Xu, Xiaoying; Cui, Hongmei; Liu, Sufen; Lerro, Catherine; Lin, Xiaojuan; Zhang, Chong; Zhang, Honghong; Xu, Ruifeng; Zhu, Daling; Dang, Yun; Han, Xudong; Bai, Haiya; Chen, Ya; Tang, Zhongfeng; Lin, Ru; Yao, Tingting; Su, Jie; Wang, Wendi; Wang, Yueyuan; Ma, Bin; Huang, Huang; Liang, Jiaxin; Qiu, Weitao; Liu, Qing; Zhang, Yawei

    2016-06-01

    Folic acid supplementation has been suggested to reduce the risk of preterm birth. However, results from previous epidemiologic studies have been inconclusive. We investigated the hypothesis that folic acid supplementation and dietary folate intake during pre- and post-conception reduces the risk of preterm birth. We analyzed data from a birth cohort study conducted between 2010 and 2012 in Lanzhou, China, including 10,179 pregnant women with live singleton births. Compared to non-users, folic acid supplement users with >12-week duration had a reduced risk of preterm birth (OR 0.67, 95 % CI 0.55-0.83) with a significant dose-response relationship (P for trend = 0.01). A similar pattern was observed for spontaneous preterm birth. Stronger associations were seen for ever use of folic acid supplement and very preterm birth (OR 0.50, 95 % CI 0.36-0.69) and spontaneous very preterm birth (OR 0.42, 95 % CI 0.29-0.63). Dietary folate intake during preconception and pregnancy were also associated with reduced risk of preterm birth (OR 0.68, 95 % CI 0.56-0.83, OR 0.57, 95 % CI 0.47-0.70 for the highest quartiles, respectively), particularly for spontaneous very preterm (OR 0.41, 95 % CI 0.24-0.72, OR 0.26, 95 % CI 0.15-0.47 for the highest quartiles, respectively). There were also decreased risks of preterm birth observed per 10-µg increase in dietary folate intake, and similar associations were found after stratification by folic acid supplementation status. Our results suggest that folic acid supplementation and higher dietary folate intake during preconception and pregnancy reduces the risk of preterm birth, and the protective effect varies by preterm subtypes.

  13. 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

  14. LABOUR RELATIONS IN POSTINDUSTRIAL ECONOMY

    Directory of Open Access Journals (Sweden)

    Yuriy Rostislavovitch Chistyakov

    2013-09-01

    Full Text Available The article deals with inadequacy of present-day labour relations in economy. Out of date form of labour relations makes workforce dependable, causes social inequality, prevents economical development. The article gives results of theoretical and empiric research. The mechanism of guaranteed reproduction of labour to be realized as social partnership is offered.Purpose: the purpose is to give critical estimation of present-day labour relations in postindustrial economy.Method of studies: monographic, general theoretic economic analysis, correlation statistic analysisResults: a new modern adequate alternative form of labour relations guarantying the reproduction of labour is introducedField of application: industrial regulation both in economics in general and concrete businesses; motivation of workers.DOI: http://dx.doi.org/10.12731/2218-7405-2013-8-29

  15. ARE THE TWINS, BORN AFTER AN IVF-ET PROCEDURE ANY DIFFERENT THAN TWINS, BORN AFTER SPONTANEOUS CONCEPTION?

    Directory of Open Access Journals (Sweden)

    Sara Korošec

    2003-12-01

    Full Text Available Background. Multiple pregnancy is in itself already a risk factor for the course and outcome of the pregnancy and birth. Its frequency in in-vitro fertilisation is approximately twenty fold in comparison to natural conception which is also why it is one of the main problem areas of pregnancy and birth after an IVF-ET procedure. The aim of our research is to determine whether the twins, born after an IVF-ET procedure are any different than twins, born after spontaneous conception.Methods. The research was retrospective in nature. It included 1511 twin pregnancy patients who gave birth to twins between April 1987 and May 1995 and between January 1997 and December 1999. Our research group consisted of 255 mothers and 510 twins, born after an IVF-ET procedure. The research was divided into a cohort and controlled study. In the cohort study the research group was compared to the entire Ljubljana cohort of 1256 mothers and 2512 twins resulting from spontaneous conception. In the controlled study 93 mothers and 186 twins from the research group were compared with 93 mothers and 186 newborns after spontaneous conception. In this group the mothers matched the research group in age, parity and birth year. The course of and complications during the pregnancy, and the course, complications and outcome of the birth as well as the characteristics of the newborns were compared.Results. Certain serious complications during the course of the pregnancy, including hypertension, gestation diabetes and threatened preterm labours, were no more frequent with the IVF group of mothers with twin pregnancy than with the control group. However more bleeding in the first trimester and less proteinuria were determined in comparison to the control group. During the course of birth and its outcome more premature labours were determined (62.3–68.8% vs. 51.4– 50.5%, a 6 to 7 days lower average gestation age, a coresponding birth weight, three times more elective and urgent

  16. Spontaneous Fundal Uterine Rupture in a Pregnant Woman at 32 Weeks Gestation who had Two Previous Cesarean Sections

    Directory of Open Access Journals (Sweden)

    Metin Kaba

    2017-08-01

    Full Text Available Spontaneous uterine rupture during pregnancy can cause severe complications, even maternal and fetal demise. We report successful management of a spontaneous fundal uterine rupture in a 32 week pregnant who had undergone two previous cesarean sections due to preterm delivery. We explain causes of spontaneous uterine rupture and the management of this rare event in the presented case report.

  17. 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.

  18. Labour education the Nordic way

    DEFF Research Database (Denmark)

    Johansen, John Steen

    2007-01-01

    With its more than 75 years of experience, the Nordic Folk High School in Geneva has a strong tradition of labour education. Every year, about 35 trade union members from the Nordic countries take part in a course run alongside the International Labour Conference in Geneva.......With its more than 75 years of experience, the Nordic Folk High School in Geneva has a strong tradition of labour education. Every year, about 35 trade union members from the Nordic countries take part in a course run alongside the International Labour Conference in Geneva....

  19. How effective is amniotomy as a means of induction of labour?

    LENUS (Irish Health Repository)

    Cooley, S M

    2012-02-01

    BACKGROUND: Amniotomy or artificial rupture of membranes is routinely used for induction of labour. AIMS: To assess the efficacy of amniotomy alone for induction. METHODS: A retrospective descriptive study of 3,586 cases of amniotomy for induction of labour between July 1996 and December 1999. RESULTS: In total, 26,670 women delivered in the National Maternity Hospital during the study period. Of these 4,928 women required induction of labour and 72.8% of these (n = 3,586) underwent amniotomy only for induction of labour. Spontaneous labour occurred in 90.1% of the women who underwent amniotomy within 24 h. Oxytocin as an induction agent was employed in 9.8% of cases. Overall, 80.5% of the women had a spontaneous delivery, 7.3% had a ventouse delivery, 4.3% had a forceps delivery, and 7.9% underwent a caesarean section. In total, 90.5% of multips and 63.4% of primips had a spontaneous vaginal delivery. CONCLUSIONS: Amniotomy is a simple, safe and effective method of induction of labour.

  20. Castor oil for induction of labour: a retrospective study.

    Science.gov (United States)

    Neri, Isabella; Dante, Giulia; Pignatti, Lucrezia; Salvioli, Chiara; Facchinetti, Fabio

    2018-08-01

    The aim of this study is to investigate the safety and efficacy of castor oil to induce labour. A retrospective observational case control study was conducted over five years. Castor oil was proposed to women referred to the Birth Centre (Castor Oil group (COG)). They were compared to women who chose to be followed by the traditional doctor-led unit (control group (CG)). Castor oil was administered in a 60 ml single dose in 200 ml of warm water. Inclusion criteria were gestational age between 40 and 41 weeks plus premature rupture of membranes between 12 and 18 hours or amniotic fluid index ≤4 or Bishop Score of ≤4 or absence of spontaneous labour over 41 + 4 weeks. Pharmacological induction of labour was required for 18 women in the COG (45%) and 36 in the CG (90%) (p castor oil showed a higher incidence of vaginal delivery, whereas the incidence of caesarean section was lower in the COG, but no statistical significance was reached. The use of castor oil is related to a higher probability of labour initiation within 24 hours. Castor oil can be considered a safe non-pharmacological method for labour induction.

  1. Spontaneous deregulation

    NARCIS (Netherlands)

    Edelman, Benjamin; Geradin, Damien

    Platform businesses such as Airbnb and Uber have risen to success partly by sidestepping laws and regulations that encumber their traditional competitors. Such rule flouting is what the authors call “spontaneous private deregulation,” and it’s happening in a growing number of industries. The authors

  2. Labour Education and Job Security: Implications for Labour ...

    African Journals Online (AJOL)

    This paper examined the relationship between Labour Education and job security and implications for Labour-management Relations in private Organization in Nigeria. This was with the view to determining the effects of staff development and job security on Industrial relations practice in Nigeria. The findings of the study ...

  3. Labour market programmes and labour market outcomes: A study of the Swedish active labour market interventions

    OpenAIRE

    Adda, Jérôme; Costa Dias, Mónica; Meghir, Costas; Sianesi, Barbara

    2007-01-01

    This paper assesses the impact of Swedish welfare-to-work programmes on labour market performance including wages, labour market status, unemployment duration and future welfare-to-work participation. We develop a structural dynamic model of labour supply which incorporates detailed institutional features of these policies and allows for selection on observables and unobservables. We estimate the model from a rich administrative panel data set and show that training programmes - which account...

  4. Quantitative fetal fibronectin and cervical length to predict preterm birth in asymptomatic women with previous cervical surgery.

    Science.gov (United States)

    Vandermolen, Brooke I; Hezelgrave, Natasha L; Smout, Elizabeth M; Abbott, Danielle S; Seed, Paul T; Shennan, Andrew H

    2016-10-01

    Quantitative fetal fibronectin testing has demonstrated accuracy for prediction of spontaneous preterm birth in asymptomatic women with a history of preterm birth. Predictive accuracy in women with previous cervical surgery (a potentially different risk mechanism) is not known. We sought to compare the predictive accuracy of cervicovaginal fluid quantitative fetal fibronectin and cervical length testing in asymptomatic women with previous cervical surgery to that in women with 1 previous preterm birth. We conducted a prospective blinded secondary analysis of a larger observational study of cervicovaginal fluid quantitative fetal fibronectin concentration in asymptomatic women measured with a Hologic 10Q system (Hologic, Marlborough, MA). Prediction of spontaneous preterm birth (<30, <34, and <37 weeks) with cervicovaginal fluid quantitative fetal fibronectin concentration in primiparous women who had undergone at least 1 invasive cervical procedure (n = 473) was compared with prediction in women who had previous spontaneous preterm birth, preterm prelabor rupture of membranes, or late miscarriage (n = 821). Relationship with cervical length was explored. The rate of spontaneous preterm birth <34 weeks in the cervical surgery group was 3% compared with 9% in previous spontaneous preterm birth group. Receiver operating characteristic curves comparing quantitative fetal fibronectin for prediction at all 3 gestational end points were comparable between the cervical surgery and previous spontaneous preterm birth groups (34 weeks: area under the curve, 0.78 [95% confidence interval 0.64-0.93] vs 0.71 [95% confidence interval 0.64-0.78]; P = .39). Prediction of spontaneous preterm birth using cervical length compared with quantitative fetal fibronectin for prediction of preterm birth <34 weeks of gestation offered similar prediction (area under the curve, 0.88 [95% confidence interval 0.79-0.96] vs 0.77 [95% confidence interval 0.62-0.92], P = .12 in the cervical

  5. KLF5 regulates infection- and inflammation-induced pro-labour mediators in human myometrium.

    Science.gov (United States)

    Lappas, Martha

    2015-05-01

    The transcription factor Kruppel-like factor 5 (KLF5) has been shown to associate with nuclear factor kappa B (NFκB) to regulate genes involved in inflammation. However, there are no studies on the expression and regulation of KLF5 in the processes of human labour and delivery. Thus, the aims of this study were to determine the effect of i) human labour on KLF5 expression in both foetal membranes and myometrium; ii) the pro-inflammatory cytokine interleukin 1 beta (IL1β), bacterial product flagellin and the viral dsRNA analogue poly(I:C) on KLF5 expression and iii) KLF5 knockdown by siRNA in human myometrial primary cells on pro-inflammatory and pro-labour mediators. In foetal membranes, there was no effect of term or preterm labour on KLF5 expression. In myometrium, the term labour was associated with an increase in nuclear KLF5 protein expression. Moreover, KLF5 expression was also increased in myometrial cells treated with IL1β, flagellin or poly(IC), likely factors contributing to preterm birth. KLF5 silencing in myometrial cells significantly decreased IL1β-induced cytokine expression (IL6 and IL8 mRNA expression and release), COX2 mRNA expression, and subsequent release of prostaglandins PGE2 and PGF2 α. KLF5 silencing also significantly reduced flagellin- and poly(I:C)-induced IL6 and IL8 mRNA expression. Lastly, IL1β-, flagellin- and poly(I:C)-stimulated NFκB transcriptional activity was significantly suppressed in KLF5-knockout myometrial cells. In conclusion, this study describes novel data in which KLF5 is increased in labouring myometrium, and KLF5 silencing decreased inflammation- and infection-induced pro-labour mediators. © 2015 Society for Reproduction and Fertility.

  6. Essays on Labour Markets

    DEFF Research Database (Denmark)

    Buhai, Ioan Sebastian

    This book represents an eclectic combination of four independent, self-contained essays on various dimensions of the labour market. The main chapters focus on theoretically and empirically analyzing the dynamics of the employment relationship between workers and firms (chapters 2 and 3), on model......This book represents an eclectic combination of four independent, self-contained essays on various dimensions of the labour market. The main chapters focus on theoretically and empirically analyzing the dynamics of the employment relationship between workers and firms (chapters 2 and 3...... to its research topic with original and innovative theoretical and/or empirical insights, often building on techniques borrowed from other economic fields or disciplines. Such uncommon approaches are real options methodology applied to wage-tenure profile analysis; social network modelling...... of occupational segregation, income and employment differentials; or microeconometric estimation of firm production functions augmented with workplace health and safety indicators. Among the conclusions of this thesis, to be interpreted in the light of all corresponding assumptions and caveats extensively...

  7. Comparative Advantage, Trade and Labour Standards

    OpenAIRE

    Matthias Busse

    2002-01-01

    This paper empirically explores the relationship between labour standards and comparative advantage. Focusing on unskilled-labour-intensive goods and core labour standards, the results show that the effects of low standards depend on the type of standard: Weaker basic union rights are associated with a stronger comparative advantage. Forced and child labour also lead to an increase in the endowment of unskilled labour, and hence improve comparative advantage in unskilled-labour-intensive good...

  8. Manual Labour as praxis pietatis

    DEFF Research Database (Denmark)

    Bruun, Mette Birkedal

    2007-01-01

    This article describes the role played by the topos of manual labour in the Cistercian reform at La Trappe in the 1660s. According to the reformer Armand-Jean de Rancé, manual labour serves partly as a link from the reform to the Rule of Benedict's prescriptions about opus manuum, partly...

  9. Religion in the Labour Market

    DEFF Research Database (Denmark)

    Christoffersen, Lisbet

    overview over case law in Denmark regarding religion on the labour market. From pragmatism to ideological secularisation and confessionalisation as result of politisation......overview over case law in Denmark regarding religion on the labour market. From pragmatism to ideological secularisation and confessionalisation as result of politisation...

  10. Embodied labour in music work.

    Science.gov (United States)

    Pettinger, Lynne

    2015-06-01

    This paper frames the work of performance as embodied labour in order to understand the contingent production of particular music performances. It is an interdisciplinary account that sits at the intersection of the sociology of work, culture and the body. The concept of embodied labour is developed with reference to the complex account of materiality - of bodies and things - present in Tim Ingold's account of skill. This material account of skill is used to inform use to develop already of well established conceptualizations of body labour: craft, emotional and aesthetic labour through a reading of how these dimensions of embodied labour make possible the work of performance. © London School of Economics and Political Science 2015.

  11. Investigating the variations in survival rates for very preterm infants in ten European regions: the MOSAIC birth cohort

    DEFF Research Database (Denmark)

    Draper, Elizabeth S; Zeitlin, Jennifer; Fenton, Alan C

    2008-01-01

    OBJECTIVE: To investigate the variation in the survival rate and the mortality rates for very preterm infants across Europe. DESIGN: A prospective birth cohort of very preterm infants for ten geographically defined European regions during 2003 followed to discharge home from hospital. PARTICIPANTS...... for NIC. For babies babies alive at onset of labour were admitted to neonatal intensive care. CONCLUSIONS: There are wide variations in the survival rates to discharge from NIC for very preterm deliveries and in the timing of death across the MOSAIC regions. In order...

  12. Review of the Recent Literature on the Mode of Delivery for Singleton Vertex Preterm Babies

    Directory of Open Access Journals (Sweden)

    Smriti Ray Chaudhuri Bhatta

    2011-01-01

    Full Text Available Choosing the safest method of delivery and preventing preterm labour are obstetric challenges in reducing the number of preterm births and improving outcomes for mother and baby. Optimal route of delivery for preterm vertex neonates has been a controversial topic in the obstetric and neonatal community for decades and continues to be debated. We reviewed 22 studies, most of which have been published over the last five years with an aim to find answers to the clinical questions relevant to deciding the mode of delivery. Findings suggested that the neonatal outcome does not depend on the mode of delivery. Though Caesarean section rates are increasing for preterm births, it does not prevent neurodisability and cannot be recommended unless there are other obstetric indications to justify it. Therefore, clinical judgement of the obstetrician depending on the individual case still remains important in deciding the mode of delivery.

  13. Avaliação do risco para parto prematuro espontâneo pelo comprimento do colo uterino no primeiro e segundo trimestres da gravidez Risk assessment for spontaneous preterm delivery according to cervical length in the first and second trimesters of pregnancy

    Directory of Open Access Journals (Sweden)

    Mário Henrique Burlacchini de Carvalho

    2002-08-01

    Full Text Available Objetivos:avaliar, no primeiro e segundo trimestres da gravidez, a correlação entre o comprimento do colo uterino e a ocorrência de parto prematuro espontâneo. Métodos:em 641 grávidas do pré-natal geral, a medida do comprimento do colo uterino foi realizada em dois momentos: entre a 11ª e a 16ª e entre a 23ª e a 24ª semana da gravidez. A avaliação do colo uterino foi feita pela ultra-sonografia transvaginal, com a grávida em posição ginecológica e tendo realizado previamente esvaziamento da bexiga. O comprimento do colo uterino foi medido linearmente do seu orifício interno ao externo. A medida do comprimento do colo uterino foi correlacionada com a idade gestacional no momento do parto. Para comparação das médias do grupo de grávidas que tiveram parto prematuro e a termo utilizamos o teste t de Student. A sensibilidade, especificidade, taxa de falso-positivos, falso-negativos e acurácia para o parto prematuro foram calculadas para os comprimentos de colo menores ou iguais a 30 mm, 25 mm e 20 mm. Resultados:a medida do comprimento do colo uterino entre a 11ª e a 16ª semana de gestação não apresentou diferença significativa entre o grupo de parto prematuro e o grupo a termo (40,6 mm e 42,7 mm, respectivamente, p=0,2459. A diferença entre os grupos, no entanto, foi significativa quando o colo foi medido entre a 23ª e a 24ª semana de gravidez (37,3 mm para o grupo que evoluiu com parto prematuro e 26,7 mm para o grupo a termo, p=0,0001, teste t de Student. Conclusões:o comprimento do colo uterino entre a 11ª e a 16ª semana de gravidez não foi significativamente diferente entre as gestantes com parto prematuro ou a termo. No entanto, na 23ª e 24ª semana esta diferença foi significativa, podendo ser um método de predição da prematuridade.Purpose: to evaluate, in the first and second trimesters of pregnancy, the correlation between cervical length and spontaneous preterm delivery. Methods: cervical length was

  14. 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.

  15. 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, ...

  16. Article Commentary: Activity in Pregnancy for Patients with a History of Preterm Birth

    Directory of Open Access Journals (Sweden)

    Nichelle Satterfield

    2016-01-01

    Full Text Available Preterm birth remains a leading cause of neonatal morbidity and mortality throughout the world. Numerous risk factors for preterm birth have been identified, including non-Hispanic black race, a variety of social and behavioral factors, infections, and history of a prior preterm delivery. Of these, a history of prior spontaneous preterm birth is one of the strongest risk factors. Traditionally, women with a history of preterm birth or those deemed at high risk for preterm delivery have been placed on bed rest or a reduced activity regimen during their pregnancy. However, there is little evidence to support this recommendation. Recent research has suggested that regular physical activity and exercise during pregnancy is safe and does not increase the risk of preterm delivery. Therefore, physicians should encourage women with a history of preterm birth to exercise throughout pregnancy according to guidelines published by the American College of Obstetricians and Gynecologists as long as they are receiving regular prenatal care and their current health status permits exercise. However, there are no randomized controlled trials evaluating exercise prescription in women with a history of preterm birth, hence additional research is needed in this area.

  17. The Prevalence and Risk Factors for Preterm Delivery in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Najmeh Tehranian

    2016-02-01

    Full Text Available Background & aim: Preterm delivery is one of the most important problems in pregnancy, as it is the primary cause of 75% of prenatal mortality and morbidities. This study aimed to determine the prevalence and risk factors for preterm delivery in Tehran, Iran. Methods:In this cross-sectional study performed in eight random hospitals from five different regions of Tehran (North, South, West, East, and center, the prevalence of preterm delivery was evaluated and the most frequent risk factors were identified. Samples were divided into preterm delivery (n=140 and term delivery (n=100 groups. Questionnaires were completed through interviews with mothers and using patient records. To analyze the data, Chi-square test was run, using SPSS version 16. Results: About 13,281 deliveries were included in the study. The highest and lowest prevalence of preterm delivery were 6.30% and 0.77% in the North and East regions of Tehran, respectively.  The overall prevalence of preterm delivery was 1.52% in Tehran. In the preterm group, age ≥35 years, pre-mature rupture of membranes, bleeding, gestational hypertension, history of preterm delivery and abortion, multiple pregnancy, and preeclampsia were significantly more frequent than the term delivery group. Conclusion: Spontaneous preterm birth was one of the major causes of maternal and neonatal morbidity; therefore, identification of its risk factors would be beneficial.

  18. 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.

  19. Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth.

    Science.gov (United States)

    Felder, Jennifer N; Baer, Rebecca J; Rand, Larry; Jelliffe-Pawlowski, Laura L; Prather, Aric A

    2017-09-01

    To test the hypothesis that sleep disorder diagnosis would be associated with increased risk of preterm birth and to examine risk by gestational age, preterm birth type, and specific sleep disorder (insomnia, sleep apnea, movement disorder, and other). In this observational study, participants were from a cohort of nearly 3 million women in California between 2007 and 2012. Inclusion criteria were women with singleton neonates liveborn between 20 and 44 weeks of gestation without chromosomal abnormalities or major structural birth defects linked to a hospital discharge database maintained by the California Office of Statewide Health Planning and Development and without mental illness during pregnancy. Sleep disorder was defined based on International Classification of Diseases, 9th Revision, Clinical Modification diagnostic code (n=2,265). Propensity score matching was used to select a referent population at a one-to-one ratio. Odds of preterm birth were examined by gestational age (less than 34 weeks, 34-36 weeks, and less than 37 weeks of gestation) and type (spontaneous, indicated). Prevalence of preterm birth (before 37 weeks of gestation) was 10.9% in the referent group compared with 14.6% among women with a recorded sleep disorder diagnosis. Compared with the referent group, odds (95% CI, P value, percentage) of preterm birth were 1.3 (1.0-1.7, P=.023, 14.1%) for insomnia and 1.5 (1.2-1.8, P<.001, 15.5%) for sleep apnea. Risk varied by gestational age and preterm birth type. Odds of preterm birth were not significantly increased for sleep-related movement disorders or other sleep disorders. Insomnia and sleep apnea were associated with significantly increased risk of preterm birth. Considering the high prevalence of sleep disorders during pregnancy and availability of evidence-based nonpharmacologic interventions, current findings suggest that screening for severe presentations would be prudent.

  20. Hypnosis for induction of labour.

    Science.gov (United States)

    Nishi, Daisuke; Shirakawa, Miyako N; Ota, Erika; Hanada, Nobutsugu; Mori, Rintaro

    2014-08-14

    Induction of labour using pharmacological and mechanical methods can increase complications. Complementary and alternative medicine methods including hypnosis may have the potential to provide a safe alternative option for the induction of labour. However, the effectiveness of hypnosis for inducing labour has not yet been fully evaluated. To assess the effect of hypnosis for induction of labour compared with no intervention or any other interventions. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2014), handsearched relevant conference proceedings, contacted key personnel and organisations in the field for published and unpublished references. All published and unpublished randomised controlled trials (RCTs) and cluster-RCTs of acceptable quality comparing hypnosis with no intervention or any other interventions, in which the primary outcome is to assess whether labour was induced. Two review authors assessed the one trial report that was identified (but was subsequently excluded). No RCTs or cluster-RCTs were identified from the search strategy. There was no evidence available from RCTs to assess the effect of hypnosis for induction of labour. Evidence from RCTs is required to evaluate the effectiveness and safety of this intervention for labour induction. As hypnosis may delay standard care (in case standard care is withheld during hypnosis), its use in induction of labour should be considered on a case-by-case basis.Future RCTs are required to examine the effectiveness and safety of hypnotic relaxation for induction of labour among pregnant women who have anxiety above a certain level. The length and timing of the intervention, as well as the staff training required, should be taken into consideration. Moreover, the views and experiences of women and staff should also be included in future RCTs.

  1. Living with uncertainty: a Swedish qualitative interview study of women at home on sick leave due to premature labour.

    Science.gov (United States)

    Höglund, Eva; Dykes, Anna-Karin

    2013-05-01

    to highlight the experiences of pregnant women, experiencing preterm labour, being on sick leave at home and how they handled their daily life. qualitative, descriptive using open interviews. 10 antenatal clinics in the south of Sweden. 15 pregnant women who were on sick leave for premature labour. four categories were identified: how to interpret unpredictable contractions in the uterus? Having concern regarding premature labour of their child, handling the new situation and finding a balance, and from work to sick leave. to be on sick leave for premature contractions can be compared with enduring a situation of inactivity. The woman finds herself in a stressful situation which she must learn to handle this and find a balance. it appears that supportive information offers the women in premature labour the opportunity of increased participation and responsibility which thereby positively affects her well-being. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Labour and employment regulation in Europe

    DEFF Research Database (Denmark)

    Lind, Jens (ed.); Knudsen, Herman Lyhne (ed.); Jørgensen, Henning (ed.)

    The main focus iof the book is on labour interests, conditions and developments in trade union organisation and  political  regulation of the labour market.......The main focus iof the book is on labour interests, conditions and developments in trade union organisation and  political  regulation of the labour market....

  3. The debate on international revitalisation of labour

    DEFF Research Database (Denmark)

    Søborg, Henrik

    Globalisation has sparked off a new debate on international labour and trade unions in different disciplines such as industrrial relations, labour history, sociology and geography......Globalisation has sparked off a new debate on international labour and trade unions in different disciplines such as industrrial relations, labour history, sociology and geography...

  4. Functional Labour Market Areas for Chile

    OpenAIRE

    Francisco Rowe

    2017-01-01

    Administrative areas are arbitrarily designed and do not necessarily reflect the geographical patterns of socio-economic and labour market activity. Labour market areas (LMAs) are required to analyse spatial labour market activity and provide a framework to guide spatially-explicit employment policy development. This resource describes a data source of a set of recently created labour market areas for Chile.

  5. [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.

  6. Human labour is associated with decreased cytoplasmic FoxO4.

    Science.gov (United States)

    Lim, R; Riley, C; Barker, G; Rice, G E; Lappas, M

    2012-01-01

    Forkhead box O (FoxO) proteins function primarily as transcription factors in the nucleus where they bind to their cognate DNA targeting sequences. FoxO regulated genes include those involved in cellular stress responses, inflammation and apoptosis; all of which are involved in the processes of human labour and delivery. We have previously identified Forkhead box O4 (FoxO4) proteins in human gestational tissues; there is, however, no data is available on the role of FoxO4 in the processes of human labour and delivery. Thus the aim of this study was to determine the effect of (i) human labour, preterm chorioamnionitis and pro-inflammatory stimuli on the expression of FoxO4 in human placenta and fetal membranes; and (ii) FoxO4 knockdown by siRNA on the expression of pro-labour mediators. Quantitative RT-PCR (qRT-PCR), immunohistochemistry and/or Western blotting was used to analyse the expression of FoxO4 (n = 6 per group). Human labour and preterm chorioamnionitis significantly decreased cytoplasmic FoxO4 expression in placenta and/or choriodecidua. Knockdown of FoxO4 mRNA and protein in JEG-3 cells using siRNA was associated with decreased COX-2 mRNA expression concomitant with lower PGF(2α) secretion. However, in BeWo cells, siRNA inhibition of FoxO4 was not associated with inflammation, oxidative stress or apoptosis. In summary, human term labour and chorioamnionitis is characterised by lower FoxO4 mRNA and/or protein expression in placenta and/or choriodecidua. Although the exact role of FoxO4 in human pregnancy remains to be fully elucidated, our data demonstrate that it can regulate COX-2 expression and subsequent prostaglandin expression. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Effect of body position on ventilation distribution in preterm infants on continuous positive airway pressure.

    Science.gov (United States)

    Hough, Judith L; Johnston, Leanne; Brauer, Sandy G; Woodgate, Paul G; Pham, Trang M T; Schibler, Andreas

    2012-07-01

    Although continuous positive airway pressure is used extensively in neonatal intensive care units, and despite the belief that positioning is considered vital to the maintenance of good lung ventilation, no data exist on regional ventilation distribution in infants on continuous positive airway pressure ventilatory support. To investigate the effect of body position on regional ventilation in preterm infants on continuous positive airway pressure ventilatory support using electrical impedance tomography. Randomized crossover study design. Neonatal intensive care unit. Twenty-four preterm infants on continuous positive airway pressure were compared to six spontaneously breathing preterm infants. Random assignment of the order of the positions supine, prone, and quarter prone. Changes in global and regional lung volume were measured with electrical impedance tomography. Although there were no differences between positions, regional tidal volume was increased in the posterior compared with the anterior lung (p positive airway pressure. The posterior lung filled earlier than the anterior lung in the spontaneously breathing infants (p positive airway pressure the right lung filled before the left lung (p positive airway pressure than in the healthy infants (p preterm infants on continuous positive airway pressure using electrical impedance tomography. Gravity had little impact on regional ventilation distribution in preterm infants on continuous positive airway pressure or in spontaneously breathing infants in the supine or prone position, indicating that ventilation distribution in preterm infants is not gravity-dependent but follows an anatomical pattern. AUSTRALIA NEW ZEALAND CLINICAL TRIALS REGISTRY:: ACTRN12606000210572.

  8. Labour outcome in patients admitted in the second stage of labour at ...

    African Journals Online (AJOL)

    Conclusions: This study identified transportation problems, fast progress of labour, absence of husband at home when labour starts as major reasons for presenting in second stage of labour. Presenting in second stage of labour was associated with worse labour outcome. Keywords: Maternal complications; perinatal ...

  9. Labour outcome in patients admitted in the second stage of labour at ...

    African Journals Online (AJOL)

    Conclusions: This study identified transportation problems, fast progress of labour, absence of husband at home when labour starts as major reasons for presenting in second stage of labour. Presenting in second stage of labour was associated with worse labour outcome. Key words: Maternal complications; perinatal ...

  10. the structure of labour market and demand for hired labour for oil

    African Journals Online (AJOL)

    DEPT OF AGRICULTURAL ENGINEERING

    tions such as the structure of labour of the farmers, farm size, village wage rate and cost of other productive ... labour, respectively. Keywords: structure of labour, hired labour, oil palm production, demand elasticities. INTRODUCTION. Literature reveal how the structure of labour .... replace the direct effect of farm output in the.

  11. Labour in Capitalist Society : Marx's View

    OpenAIRE

    Tsuto, Masahiro

    2007-01-01

    Marx's view on labour is many-sided. I will argue the multiple character of labour in five aspects, based on his 1857-58 note. We can grasp his view in following five phases. Namely, (1) material metabolism between man and Nature, (2) abstract human labour, (3) labour and free time, (4) active and creative labour, and (5) painful labour. In general, Marx's statements on (3), (4) and (5) phases of labour are less in his "Capital" than in his 1857-58 note. This is the reason why we often deal w...

  12. 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

  13. Preterm birth rates in Japan from 1979 to 2014: Analysis of national vital statistics.

    Science.gov (United States)

    Sakata, Soyoko; Konishi, Shoko; Ng, Chris Fook Sheng; Watanabe, Chiho

    2018-03-01

    Secular trends of preterm birth in Japan between 1979 and 2014 were examined to determine whether changes could be explained by a shift in the distribution of maternal age at delivery and parity and/or by changes in age-specific preterm birth rates. Live birth data for 1979 to 2014 were obtained from the Japanese Ministry of Health, Labour and Welfare. Analyses were limited to singleton children born in Japan (n = 43 632 786). Preterm birth was defined using two cut-offs at < 37 or < 34 weeks of gestation. Crude and standardized rates of preterm birth were calculated for firstborn and later-born singletons by maternal age at delivery for specific time periods. Throughout the study period, the rates of preterm birth (both at < 37 and < 34 weeks of gestation) were higher among mothers aged 20 and younger, and mid-30s and older, compared to mothers in their 20s or early 30s. The rates of preterm birth at < 37 (but not at < 34) weeks decreased for mothers aged in their late 30s and 40s, and increased for mothers in their 20s and early 30s. Standardized rates of preterm birth showed a secular increase for preterm births at < 37 but not < 34 weeks of gestation. The rates of preterm birth among mothers aged in their 20s and early 30s increased between 1979 and 2014, which contributed to the secular increase in rates of preterm birth at < 37 weeks. © 2017 Japan Society of Obstetrics and Gynecology.

  14. Labour market driven learning analytics

    NARCIS (Netherlands)

    Kobayashi, V.; Mol, S.T.; Kismihók, G.

    2014-01-01

    This paper briefly outlines a project about integrating labour market information in a learning analytics goal-setting application that provides guidance to students in their transition from education to employment.

  15. Labour Market Driven Learning Analytics

    Science.gov (United States)

    Kobayashi, Vladimer; Mol, Stefan T.; Kismihók, Gábor

    2014-01-01

    This paper briefly outlines a project about integrating labour market information in a learning analytics goal-setting application that provides guidance to students in their transition from education to employment.

  16. Labour cost of radiation dose

    International Nuclear Information System (INIS)

    Cook, A.; Lockett, L.E.

    1978-01-01

    In order to optimise capital expenditure on measures to protect workers against radiation it would be useful to have a means to measure radiation dose in money terms. Because labour has to be employed to perform radiation work there must be some relationship between the wages paid and the doses received. Where the next increment of radiation dose requires additional labour to be recruited the cost will at least equal the cost of the extra labour employed. This paper examines some of the factors which affect the variability of the labour cost of radiation dose and notes that for 'in-plant' exposures the current cost per rem appears to be significantly higher than values quoted in ICRP Publication 22. An example is given showing how this concept may be used to determine the capital it is worth spending on installed plant to prevent regular increments of radiation dose to workers. (author)

  17. Aromatherapy for pain management in labour.

    Science.gov (United States)

    Smith, Caroline A; Collins, Carmel T; Crowther, Caroline A

    2011-07-06

    difference did not reach statistical significance. The trials found no differences between groups for the secondary outcomes of use of pharmacological pain relief (RR 0.35, 95% CI 0.04 to 3.32, one trial, 513 women; RR 2.50, 95% CI 0.31 to 20.45, one trial, 22 women), spontaneous vaginal delivery (RR 1.00, 95% CI 0.94 to 1.06, one trial, 513 women; RR 0.93, 95% CI 0.67 to 1.28, one trial, 22 women) or length of labour and augmentation (RR 1.14, 95% CI 0.90 to 1.45, one trial, 513 women). The risk of bias was low in the trials. There is a lack of studies evaluating the role of aromatherapy for pain management in labour. Further research is needed before recommendations can be made for clinical practice.

  18. 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

  19. Born Too Soon: Care during pregnancy and childbirth to reduce preterm deliveries and improve health outcomes of the preterm baby

    Science.gov (United States)

    2013-01-01

    Abstract Pregnancy and childbirth represent a critical time period when a woman can be reached through a variety of mechanisms with interventions aimed at reducing her risk of a preterm birth and improving her health and the health of her unborn baby. These mechanisms include the range of services delivered during antenatal care for all pregnant women and women at high risk of preterm birth, services provided to manage preterm labour, and workplace, professional and other supportive policies that promote safe motherhood and universal access to care before, during and after pregnancy. The aim of this paper is to present the latest information about available interventions that can be delivered during pregnancy to reduce preterm birth rates and improve the health outcomes of the premature baby, and to identify data gaps. The paper also focuses on promising avenues of research on the pregnancy period that will contribute to a better understanding of the causes of preterm birth and ability to design interventions at the policy, health care system and community levels. At minimum, countries need to ensure equitable access to comprehensive antenatal care, quality childbirth services and emergency obstetric care. Antenatal care services should include screening for and management of women at high risk of preterm birth, screening for and treatment of infections, and nutritional support and counselling. Health workers need to be trained and equipped to provide effective and timely clinical management of women in preterm labour to improve the survival chances of the preterm baby. Implementation strategies must be developed to increase the uptake by providers of proven interventions such as antenatal corticosteroids and to reduce harmful practices such as non-medically indicated inductions of labour and caesarean births before 39 weeks of gestation. Behavioural and community-based interventions that can lead to reductions in smoking and violence against women need to be

  20. Jenis dan Jumlah Mikroorganisme Aerob pada Persalinan Spontan Kurang dan Cukup Bulan tanpa Ketuban Pecah Dini

    Directory of Open Access Journals (Sweden)

    Yan O'Neil S. Meliala

    2012-03-01

    Full Text Available Preterm birth is the main cause of perinatal mortality and morbidity. Prevalence of preterm delivery which is caused by infection is 40–50%. The aim of this study was to determine that spontaneous preterm delivery without premature rupture of the membrane is initiated by chorioamnionitis and to find out the comparison of aerob microorganism species and number from spontaneous preterm and term delivery without premature rupture of the membrane. This was a comparative cross sectional study. This study was conducted in Dr. Hasan Sadikin Hospital Bandung and satelite hospital, from July to August 2009, the subjects were 53 patients. This study analyzed with chi-square and t-test to differentiate average of gestational age with p<0.05. There’s no significant difference of characteristic between two research subject groups, significant difference between two research subject groups with chorioamnionitis (p=0.004, significant difference of aerob microorganism species between two research subject groups (p=0.025 and significant difference number of aerob microorganism between two research subjects (p=0.003. In conclusions, chorioamnionitis can initiate a spontaneous preterm delivery without premature rupture of the membrane and the number of microorganism indicated the virulence of microorganism that caused chorioamnionitis which is initiated spontaneous preterm delivery without premature rupture.

  1. Danish Labour Market Activation Policies

    DEFF Research Database (Denmark)

    Kvist, Jon; Pedersen, Lisbeth

    2007-01-01

    Under the heading of flexicurity, Danish labour market activation policies are receiving international attention because of their perceived ability both to curb unemployment and to boost employment. Indeed, the objectives, target groups and design of activation policy have undergone a remarkable...... not only active labour market policies but also social and integration policies. Despite widespread popularity and belief in the positive effects of activation, little is actually known about its overall impact on the Danish economy....

  2. Induction of labour for improving birth outcomes for women at or beyond term.

    Science.gov (United States)

    Gülmezoglu, A M; Crowther, C A; Middleton, P

    2006-10-18

    As a pregnancy continues beyond term the risks of babies dying inside the womb or in the immediate newborn period increase. Whether a policy of labour induction at a predetermined gestational age can reduce this increased risk is the subject of this review. To evaluate the benefits and harms of a policy of labour induction at term or post-term compared to awaiting spontaneous labour or later induction of labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2006). Randomized controlled trials conducted in women at or beyond term. The eligible trials were those comparing a policy of labour induction to a policy of awaiting spontaneous onset of labour. Trials comparing cervical ripening methods, membrane stripping/sweeping or nipple stimulation without any commitment to delivery within a certain time were excluded. Two review authors independently evaluated potentially eligible trials and extracted data. Outcomes are analysed in two main categories: gestational age and cervix status. We included 19 trials reporting on 7984 women. A policy of labour induction at 41 completed weeks or beyond was associated with fewer (all-cause) perinatal deaths (1/2986 versus 9/2953; relative risk (RR) 0.30; 95% confidence interval (CI) 0.09 to 0.99). The risk difference is 0.00 (95% CI 0.01 to 0.00). If deaths due to congenital abnormality are excluded, no deaths remain in the labour induction group and seven deaths remain in the no-induction group. There was no evidence of a statistically significant difference in the risk of caesarean section (RR 0.92; 95% CI 0.76 to 1.12; RR 0.97; 95% CI 0.72 to 1.31) for women induced at 41 and 42 completed weeks respectively. Women induced at 37 to 40 completed weeks were more likely to have a caesarean section with expectant management than those in the labour induction group (RR 0.58; 95% CI 0.34 to 0.99). There were fewer babies with meconium aspiration syndrome (41+: RR 0.29; 95% CI 0.12 to 0.68, four trials

  3. Trade, Labour Markets and Health.

    Science.gov (United States)

    McNamara, Courtney; Labonté, Ronald

    2017-04-01

    Previous analyses indicate that there are a number of potentially serious health risks associated with the Trans-Pacific Partnership (TPP). The objective of this work is to provide further insight into the potential health impacts of the TPP by investigating labour market pathways. The impact of the TPP on employment and working conditions is a major point of contention in broader public debates. In public health literature, these factors are considered fundamental determinants of health, yet they are rarely addressed in analyses of trade and investment agreements. We therefore undertake a prospective policy analysis of the TPP through a content analysis of the agreement's Labour Chapter. Provisions of the Chapter are analyzed with reference to the health policy triangle and four main areas through which labour markets influence health: power relations, social policies, employment conditions and working conditions. Findings indicate that implementation of the TPP can have important impacts on health through labour market pathways. While the Labour Chapter is being presented by proponents of the agreement as a vehicle for improvement in labour standards, we find little evidence to support this view. Instead, we find several ways the TPP may weaken employment relations to the detriment of health.

  4. Recurrence of second trimester miscarriage and extreme preterm delivery at 16 to 27 weeks of gestation with a focus on cervical insufficiency and prophylactic cerclage

    DEFF Research Database (Denmark)

    Sneider, Kirstine; Christiansen, Ole Bjarne; Sundtoft, Iben Blaabjerg

    2016-01-01

    , multiple gestation, uterine anomaly, placental insufficiency, antepartum bleeding, cervical insufficiency, preterm premature rupture of membranes, and intrauterine fetal death. Recurrence rate after a second trimester miscarriage/spontaneous delivery in the period was calculated based on the register data...

  5. MICROBIOLOGICAL STUDY ON ENDOCERVIX IN PRETERM PREMATURE RUPTURE OF MEMBRANE

    Directory of Open Access Journals (Sweden)

    Elizebeth V. Issac

    2017-10-01

    Full Text Available BACKGROUND Preterm premature rupture of membrane (PPROM is defined as premature rupture of membrane before 37 completed weeks. It is associated with 40% preterm deliveries and results in significant perinatal mortality and morbidity. Present study is an attempt to find the association between infection and PPROM. MATERIALS AND METHODS 100 pregnant women between 29 weeks and 34 weeks of gestation who were admitted in our labour room during a period from November 2012 to November 2013 were included. Preterm Premature Rupture of Membrane (PPROM is confirmed by history, sterile per speculum examination demonstrating pooling of fluid in posterior vaginal fornix and vaginal pH. An ultrasound examination showing oligohydramnios also supports the diagnosis. RESULTS 62% of neonates had RDS; p value <0.001, strong significance. 16% had no morbidity. 10% had late sepsis. 6% had NHB; p value 0.090, moderate significance. 6% had PHTN. CONCLUSION Relation between infection and PPROM remains an association. So patients at risk for preterm delivery need to be watched more closely for infection as it is also associated with neonatal morbidity.

  6. Acupuncture or acupressure for induction of labour.

    Science.gov (United States)

    Smith, Caroline A; Armour, Mike; Dahlen, Hannah G

    2017-10-17

    had a moderate risk of bias.Overall, few trials reported on primary outcomes. No trial reported vaginal delivery not achieved within 24 hours and uterine hyperstimulation with fetal heart rate (FHR) changes. Serious maternal and neonatal death or morbidity were only reported under acupuncture versus sham control. Acupuncture versus sham control There was no clear difference in caesarean sections between groups (average risk ratio (RR) 0.80, 95% confidence interval (CI) 0.56 to 1.15, eight trials, 789 women; high-quality evidence). There were no reports of maternal death or perinatal death in the one trial that reported this outcome. There was evidence of a benefit from acupuncture in improving cervical readiness for labour (mean difference (MD) 0.40, 95% CI 0.11 to 0.69, one trial, 125 women), as measured by cervical maturity within 24 hours using Bishop's score. There was no evidence of a difference between groups for oxytocin augmentation, epidural analgesia, instrumental vaginal birth, meconium-stained liquor, Apgar score < 7 at five minutes, neonatal intensive care admission, maternal infection, postpartum bleeding greater than 500 mL, time from the trial to time of birth, use of induction methods, length of labour, and spontaneous vaginal birth. Acupuncture versus usual care There was no clear difference in caesarean sections between groups (average RR 0.77, 95% CI 0.51 to 1.17, eight trials, 760 women; low-quality evidence). There was an increase in cervical maturation for the acupuncture (electro) group compared with control (MD 1.30, 95% CI 0.11 to 2.49, one trial, 67 women) and a shorter length of labour (minutes) in the usual care group compared to electro-acupuncture (MD 124.00, 95% CI 37.39 to 210.61, one trial, 67 women).There appeared be a differential effect according to type of acupuncture based on subgroup analysis. Electro-acupuncture appeared to have more of an effect than manual acupuncture for the outcomes caesarean section (CS), and instrumental

  7. Unemployment, labour slack and labour market accounting. Theory, measurement and policy

    NARCIS (Netherlands)

    Neubourg, Christiaan Rita Jan de

    1987-01-01

    This study investigates how our understanding of unemployment and the utilisation of labour resources can be refined by the application of a system of labour market accounts and a new measure of labour slack. ... Zie: Summary

  8. The effect of labour taxes on labour demand: a comparison between Belgium and neighbouring countries

    OpenAIRE

    Laenen, Wout; Moons, Cindy; Persyn, Damiaan

    2011-01-01

    This study examines the evolution of labour costs and taxes in Belgium and neighbouring countries. We try to clarify the common issues in the current debate concerning labour costs and labour demand in Belgium and neighbouring countries and investigate the influence of labour costs on employment by using macroeconomic OECD data. We conclude that the tax wedge in Belgium is one of the highest of all OECD countries. Labour costs in Belgium rose at a moderate tempo, but labour productivity evolv...

  9. Epidural analgesia in labour and neonatal respiratory distress: a case-control study.

    Science.gov (United States)

    Kumar, Manoj; Chandra, Sue; Ijaz, Zainab; Senthilselvan, Ambikaipakan

    2014-03-01

    Epidural analgesia is the commonest mode for providing pain relief in labour, with a combination of bupivacaine and fentanyl most often used in practice. To test whether late-preterm and term neonates exposed to opioids in epidural analgesia in labour are more likely to develop respiratory distress in the immediate neonatal period. A case-control study was conducted of singleton infants born during January 2006 to December 2010. Cases were neonates ≥34 weeks gestation, who developed respiratory distress within 24 h of life requiring supplemental oxygen ≥2 h and/or positive pressure ventilation in the neonatal intensive care unit. Controls were gestation and site-matched neonates who did not develop any respiratory distress within the same period. The information on exposure to epidural analgesia and on potential confounding variables was obtained from the standardised delivery record, routinely filled out on all women admitted to the labour wards. In our study, 206 cases and 206 matched controls were enrolled. Exposure to epidural analgesia was present in 146 (70.9%) cases as compared with 131 (63.6%) of the controls. The association between exposure to epidural analgesia and respiratory distress in neonates was statistically significant upon adjustment for all potential confounders (adjusted OR: 1.75, 95% CI 1.03 to 2.99; p = 0.04). When data was separately analysed for term and late-preterm infants, the results were consistent across these subpopulations, showing no interaction effect. Late-preterm and term infants exposed to maternal epidural analgesia in labour are more likely to develop respiratory distress in the immediate neonatal period.

  10. Ultrasound cervical length in predicting preterm birth: Prospective study

    Directory of Open Access Journals (Sweden)

    Achour Radhouane

    2017-08-01

    Full Text Available Background Preterm birth is a leading cause of perinatal morbidity and mortality and represents a major public health problem. It is associated with a 15–20 per cent mortality rate and remains responsible for 75 per cent of perinatal deaths in foetuses without anomalies. Aims The aim of this study was to evaluate the importance of cervical length measured in the first trimester (11–14 Weeks of amenorrhea “WA” and the second trimester (20–24 Weeks of amenorrhea” WA” in an asymptomatic population of singleton pregnancies to assess the risk of spontaneous preterm birth compared to the digital assessment. Methods We conducted a prospective, longitudinal study involving 117 asymptomatic women with singleton pregnancies between January and December 2015. Results In our study, the clinical examination had a low positive predictive value and a low sensibility for screening women at risk of preterm delivery. Cervical length less than 35mm between 12–14WA and 30mm between 22–24WA predicts the occurrence of preterm birth with a high sensitivity (Se, and specificity (Sp. Conclusion We conclude that ultrasound screening of preterm delivery is now highly recommended.

  11. Causes and short-term outcomes of preterm infants

    Directory of Open Access Journals (Sweden)

    Xu Aiqun

    2017-01-01

    Full Text Available Introduction/Objective. Preterm birth (PB is the most important reason of neonatal mortality, and the second most common direct cause of death for children under the age of five years. The aim of this study was to analyze the clinical features and outcomes of preterm infants. Methods. The clinical data of 307 preterm infants delivered in the Qingdao University hospital from January 1, 2012 to December 31, 2012 were retrospectively analyzed. Results. The incidence of PB was 6.52%. There were 143 cases of preterm prelabour rupture of membranes (PPROM (46.58%, 66 cases of spontaneous PB (21.5%, and 98 cases of therapeutic PB (31.92%. Deliveries with gestational weeks (GW < 32 were mainly vaginal (60.72%, but deliveries with GW ≥ 32 exhibited higher C-section rate (60.99% than the vaginal delivery rate (p < 0.05. The birth weight was 2,340.46 ± 606.26 g, and the Z-score at birth was -0.15 ± 1.08. The Z-score in the group with GW within 28 to 31+6 weeks was less than that in the group with GW within 32 to 33+6 and with GW ≥ 34 (р < 0.05. The average hospital stay of preterm infants was 15.17 ± 12.35 days, and the most common complication in these preterm infants was respiratory distress syndrome with 13.92%. Conclusion. PB could cause a variety of serious complications in infants. The main causes of PB, such ас PPROM, should be actively prevented and treated; meanwhile, preterm infants should also be actively treated so as to improve their outcomes.

  12. What Interventions Are Being Used to Prevent Preterm Birth and When?

    Science.gov (United States)

    Feng, Yu Yang; Jarde, Alexander; Seo, Ye Rin; Powell, Anne; Nwebube, Nwachukwu; McDonald, Sarah D

    2018-01-04

    This study sought to determine the proportions of women at risk of preterm birth who received progesterone, elective and rescue cerclage, or pessary to prevent preterm birth, by using medical records. The authors also sought to determine whether these proportions differed among primary-, secondary-, and tertiary-level centres. The authors conducted a retrospective cohort study and extracted data from consecutive medical charts of women with an estimated date of confinement over 3 months in primary-, secondary-, and tertiary-level centres in Southern Ontario. The study identified women with a previous spontaneous preterm birth or a short cervix and determined whether they were offered and whether they received a preventive intervention for preterm birth. Descriptive statistics and Fisher exact tests were calculated. The authors reviewed 1024 consecutive charts at primary, secondary, and tertiary centres and identified 31 women with a previous spontaneous preterm birth or a short cervix. Of these women, less than one half (42%) received progesterone or cerclage for prevention of preterm birth, and none received pessary. One in four women (26%) were not referred to an obstetrician or maternal-fetal medicine specialist in time for an intervention, and among those referred before 24 weeks of gestation, an intervention was offered to 57% of the women. Less than half of women at risk of spontaneous preterm birth received progesterone, cerclage, or pessary, attesting to the importance of improving knowledge translation methods to encourage timely referral and use of progesterone for the prevention of preterm birth. Copyright © 2017 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  13. Preeclampsia mediates the association between shorter height and increased risk of preterm delivery.

    Science.gov (United States)

    Morisaki, Naho; Ogawa, Kohei; Urayama, Kevin Y; Sago, Haruhiko; Sato, Shoji; Saito, Shigeru

    2017-10-01

    Maternal short stature has been observed to increase the risk of preterm birth; however, the aetiology behind this phenomenon is unknown. We investigated whether preeclampsia, an obstetric complication that often leads to preterm delivery and is reported to have an inverse association with women's height, mediates this association. We studied 218 412 women with no underlying diseases before pregnancy, who delivered singletons from 2005 to 2011 and were included in the Japan Society of Obstetrics and Gynecology perinatal database, which is a national multi-centre-based delivery database among tertiary hospitals. We assessed the risk of preterm delivery in relation to height using multivariate analysis, and how the association was mediated by risk of preeclampsia using mediation analysis. Each 5-cm decrement in height was associated with significantly higher risk of preterm delivery [relative risk 1.20; 95% confidence interval (CI): 1.13, 1.27] and shorter gestational age (-0.30; 95% CI: -0.44, -0.16 weeks). Mediation analysis showed that the effect of shorter height on increased risk of preterm delivery, due to an indirect effect mediated through increased risk of preeclampsia, was substantial for shorter gestational age (48%), as well as risk of preterm delivery (28%). When examining the three subtypes of preterm delivery separately, mediated effect was largest for provider-initiated preterm delivery without premature rupture of membranes (PROM) (34%), compared with spontaneous preterm delivery without PROM (17%) or preterm delivery with PROM (0%). Preeclampsia partially mediates the association between maternal short stature and preterm delivery.

  14. Trial of labour in twin pregnancies: a retrospective cohort study.

    Science.gov (United States)

    de Castro, H; Haas, J; Schiff, E; Sivan, E; Yinon, Y; Barzilay, E

    2016-05-01

    To assess the success rate of vaginal delivery among women with twin pregnancies; the Twin Birth Study has shown that vaginal delivery and caesarean section are equally safe for twin delivery but >40% of the planned vaginal delivery group delivered by caesarean section. A retrospective cohort study. A tertiary medical centre. A total of 2194 women with twin pregnancies not complicated with very low birthweight. Planned mode of delivery was documented in the woman's electronic record upon entering the delivery room. Information regarding maternal age at delivery, parity, gestational age, presentation, previous history of caesarean delivery, birthweight and Apgar score was collected from the obstetric electronic charts. Rate of vaginal twin delivery. Of the 2194 women included, 1311 twin pregnancies had planned caesarean delivery and 883 underwent a trial of labour. Of the 883 women who underwent a trial of labour, the rate of vaginal delivery was 86.9%, whereas the rates of caesarean delivery and combined vaginal-caesarean delivery were 11.1% and 2.0%, respectively. Presentation of second twin, gestational age and maternal age did affect the chances of success. Nulliparity [odds ratio (OR) 2.38, 95% confidence interval (95% CI) 1.4-4.05], Foley induction of labour (OR 2.33, 95% CI 1.38-3.91) and body mass index >30 kg/m(2) (OR 1.76, 95% CI 1.03-3) were independent risk factors for caesarean delivery. The rate of vaginal delivery among women with twin pregnancies who undergo labour can be high, especially in women who laboured spontaneously and have delivered before. The rate of vaginal delivery of twins can be high, especially in women who have delivered before. © 2015 Royal College of Obstetricians and Gynaecologists.

  15. Progesterone for the prevention of preterm birth in women with multiple pregnancies: the AMPHIA trial

    Directory of Open Access Journals (Sweden)

    Scheepers Hubertina CJ

    2007-06-01

    Full Text Available Abstract Background 15% of multiple pregnancies ends in a preterm delivery, which can lead to mortality and severe long term neonatal morbidity. At present, no generally accepted strategy for the prevention of preterm birth in multiple pregnancies exists. Prophylactic administration of 17-alpha hydroxyprogesterone caproate (17OHPC has proven to be effective in the prevention of preterm birth in women with singleton pregnancies with a previous preterm delivery. At present, there are no data on the effectiveness of progesterone in the prevention of preterm birth in multiple pregnancies. Methods/Design We aim to investigate the hypothesis that 17OHPC will reduce the incidence of the composite neonatal morbidity of neonates by reducing the early preterm birth rate in multiple pregnancies. Women with a multiple pregnancy at a gestational age between 15 and 20 weeks of gestation will be entered in a placebo-controlled, double blinded randomised study comparing weekly 250 mg 17OHPC intramuscular injections from 16–20 weeks up to 36 weeks of gestation versus placebo. At study entry, cervical length will be measured. The primary outcome is composite bad neonatal condition (perinatal death or severe morbidity. Secondary outcome measures are time to delivery, preterm birth rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal morbidity, maternal admission days for preterm labour and costs. We need to include 660 women to indicate a reduction in bad neonatal outcome from 15% to 8%. Analysis will be by intention to treat. We will also analyse whether the treatment effect is dependent on cervical length. Discussion This trial will provide evidence as to whether or not 17OHPC-treatment is an effective means of preventing bad neonatal outcome due to preterm birth in multiple pregnancies. Trial registration Current Controlled Trials ISRCTN40512715

  16. Induction of labour and scheduled cesarean deliveries in twin pregnancies at the Port-Royal Maternity Hospital in Paris France.

    Science.gov (United States)

    Papiernik, E; Hessabi, M; Dubourdieu, C; Zeitlin, J

    2001-06-01

    The study is a critical analysis of the decisions to induce labour or schedule cesareans in the practice of a third level referral centre, with as outcome criterion the reduction of fetal death. 783 women pregnant with twins were included from 1.1.1993 to 31.12.1998, in three groups: originally booked, referred for care during pregnancy, or transferred from another institution. The results show that an important proportion of preterm deliveries result from a medical decision to induce labour or from a scheduled cesarean in the originally booked group with even higher proportions in groups of referred and transferred women. These results are discussed in relation to fetal death rates and causes. Deaths related to fetal growth restriction were not observed in women originally booked for care. The hospital bias has been discussed. The conclusion is that decisions to minimize fetal deaths in twin pregnancies increased preterm deliveries by medical decision.

  17. Narratives about labour market transitions

    DEFF Research Database (Denmark)

    Cort, Pia; Thomsen, Rie

    2014-01-01

    on flexicurity and its implications for labour market transitions, little attention has been paid to the views and experiences of the individuals concerned. The aim of this article is to connect the grand narrative with individual narratives about labour market transitions in the Danish flexicurity system....... On the basis of narrative interviews with skilled workers, this article explores how labour market transitions are experienced by the individual and the role played by national support structures in the individual narratives. The article shows how, for the individual, a transition may prove to be a valuable...... learning experience during which radical career decisions are taken, and how support structures may work to the detriment of such learning and of the principles behind flexicurity. The article points to a reconceptualisation of transitions as important learning opportunities during which (more) adequate...

  18. Do labour market institutions matter?

    DEFF Research Database (Denmark)

    Geischecker, Ingo; Görg, Holger; Munch, Jakob Roland

    2010-01-01

    This paper studies the impact of outsourcing on individual wages in three European countries with markedly different labour market institutions: Germany, the UK and Denmark. To do so we use individual-level data sets for the three countries and construct comparable measures of outsourcing...... European countries with markedly different labour market institutions: Germany, the UK and Denmark. To do so we use individual-level data sets for the three countries and construct comparable measures of outsourcing at the industry level, distinguishing outsourcing by broad region. We discuss some possible...... at the industry level, distinguishing outsourcing by broad region. We discuss some possible intuitive reasons for why there may be differences in the impact of outsourcing across the three countries, based on labour market institutions. This paper studies the impact of outsourcing on individual wages in three...

  19. Labour in Global Value Chains

    DEFF Research Database (Denmark)

    Lund-Thomsen, Peter; Nadvi, Khalid; Chan, Anita

    2012-01-01

    A critical challenge facing developing country producers is to meet international labour standards and codes of conduct in order to engage in global value chains. Evidence of gains for workers from compliance with such standards and codes remains limited and patchy. This article focuses...... on the global football industry, a sector dominated by leading global brands that manage dispersed global value chains. It assesses the working conditions for football stitchers engaged in different forms of work organization, factories, stitching centres and home-based settings in Pakistan, India and China...... production contexts that influence work conditions. In doing so, it argues that current debates on the role of labour in global value chains have to go beyond a narrow focus on labour standards and corporate social responsibility compliance and engage with economic, technological and social upgrading...

  20. 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 ...

  1. 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

  2. A sociological analysis of labour unions and labour union elites in Developing countries: Turkish labour union elites

    OpenAIRE

    Ali Arslan

    2016-01-01

    This study will concern itself with Turkish labour unions and social portrait of contemporary Turkish labour union elites: firstly, brief information on theoretical and historical background of labour (trade) unions is given, then major findings about contemporary Turkish labour union elites are presented. Multiple methodological approaches were used to define the research subject, to outline the research universe. Extensive field researches comprise the major data sources of the study. V...

  3. Romanian Tourism Facing Labour Shortage

    Directory of Open Access Journals (Sweden)

    Iulia Chivu

    2008-10-01

    Full Text Available The purpose of this paper is to present the main tendencies in the Romanian tourism and their impact on the labour market. The first partof the paper presents the main tendencies in travel and tourism sector. The second part of the paper focuses on the challenges of the labour market inthe hotel sector, highlighting essential aspect related to the declining of population, shortage of the workforce, emigration, financial compensations.The final part exposes few ideas and possible suggestions that can be applied into the travel and tourism sector in order to better manage the multipledimensions of growth.

  4. ROMANIAN TOURISM FACING LABOUR SHORTAGE

    Directory of Open Access Journals (Sweden)

    Cristina Simon

    2008-05-01

    Full Text Available The purpose of this paper is to present the main trends în the Romanian tourism sector andtheir impact on the labour market. The first part of the paper presents the main trends în the travel and tourismsector. The second part of the paper focuses on the challenges of the labour market în the hotel sector,highlighting essential aspect related to the declining of population, shortage of the workforce, emigration,financial compensations. The final part exposes few ideas and possible suggestions that can be applied into thetravel and tourism sector în order to better manage the multiple dimensions of growth.

  5. Do Labour Market Institutions Matter?

    DEFF Research Database (Denmark)

    Geishecker, Ingo; Görg, Holger; Munch, Jakob Roland

    This paper studies the impact of outsourcing on individual wages in three European countries with markedly different labour market institutions: Germany, the UK and Denmark. To do so we use individual level data sets for the three countries and construct comparable measures of outsourcing...... at the industry level, distinguishing outsourcing by broad region. Estimating the same specification on different data show that there are some interesting differences in the effect of outsourcing across countries. We discuss some possible reasons for these differences based on labour market institutions...

  6. Contract & agency labour: beyond self-regulation?

    OpenAIRE

    Cotton, Elizabeth

    2010-01-01

    A paper about the regulation of contract labour. Academic and legal aspects as well as case studies of global union federation work to organise and regulate contract labour in Thailand, Pakistan, Colombia, South Korea and at international level.

  7. Factors Affecting Labour Productivity in Manufacturing Enterprises

    Directory of Open Access Journals (Sweden)

    Zbigniew Gołaś

    2011-07-01

    Full Text Available The article presents the results of the analysis of the factors influencing labour productivity in the manufacturing business sector in 20042008. Labour productivity was analyzed in the context of the assets productivity, technical equipment of work, labour intensity of production, wages, value added and depreciation costs, and using linear stepwise regression. The study shows that despite significant progress, the level of labour productivity in domestic manufacturing significantly lower than the average in the European Union. Lower than in Poland, the level of labour productivity gain only companies in Romania, Bulgaria, Lithuania, Latvia and Estonia. Estimated parameters of the regression function showed that the most important determinants of labour productivity in manufacturing are technical equipment of work, labour intensity of production, assets productivity, level of added value in relation to revenues. These factors explain the variability of labour productivity in 20042008 in a high degree.

  8. Women on the European Labour Market

    OpenAIRE

    Jan Baran; Atilla Bartha; Agnieszka Chlon-Dominczak; Olena Fedyuk; Agnieszka Kaminska; Piotr Lewandowski; Maciej Lis; Iga Magda; Monika Potoczna; Violetta Zentai

    2014-01-01

    This policy brief looks at the major developments in women's position on the European labour market over the past two decades, identifying several pathways to increased female labour market activity and obstacles to overcome.

  9. Health Consequences of Child Labour in Bangladesh

    OpenAIRE

    Ahmed, Salma; Ray, Ranjan

    2012-01-01

    Background: The paper examines the effect of child labour on child health outcomes in Bangladesh, advancing the methodologies and the results of papers published in different journals. Objective: We examine the effect of child labour on child health outcomes. Methods: We used Bangladesh National Child Labour Survey data for 2002-2003 for our analysis. Results: The main finding of the paper suggests that child labour is positively and significantly associated with the probability of b...

  10. A Reappraisal of Jevons's Thought on Labour

    OpenAIRE

    Motohiro, Okada; Faculty of Economics, Konan University

    2012-01-01

    This paper re-examines W. S. Jevons's thought on labour and elucidates its uniqueness and limitations. Jevons's subjectivist approach penetrated his theory of labour, and he regarded pain as the measure of labour. In the first edition of The Theory of Political Economy, Jevons provided insights that could lead to the negation of the market determination of wages and other work conditions, thus offering a rationalisation of the intervention of socio-political factors in labour exchange. In doi...

  11. Consumer boycott, household heterogeneity and child labour

    OpenAIRE

    Di Maio, Michele; Fabbri, Giorgio

    2010-01-01

    Consumer boycott campaigns against goods produced using child labour are becoming increasingly popular. Notwithstanding, there is no consensus on which are the effects of such type of activism on child labour. If some agreement is to be found in the recent economic literature, it is that the boycott does not reduce child labour. We contribute to this debate presenting a simple model which shows, instead, that there are conditions under which a consumer product boycott does reduce child labour...

  12. 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

    Full Text Available Chukwuemeka Anthony Iyoke,1 Osaheni Lucky Lawani,2 Euzebus Chinonye Ezugwu,1 Gideon Ilechukwu,3 Peter Onubiwe Nkwo,1 Sunday Gabriel Mba,1 Isaac Nwabueze Asinobi41Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria; 2Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria; 3Department of Paediatrics, Whiston Hospital, St Helen's and Knowsley Teaching Hospitals NHS Trust, Prescot, Lancashire, UK; 4Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, NigeriaBackground: Preterm birth is a high risk condition associated with significant mortality and morbidity in the perinatal, neonatal, and childhood periods, and even in adulthood. Knowledge of the epidemiology of preterm births is necessary for planning appropriate maternal and fetal care.Objective: The objective of this study was to determine the prevalence, pattern, and perinatal mortality associated with preterm births at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria.Methods: This was a review of prospectively collected routine delivery data involving preterm deliveries that occurred between 1 January 2009 and 31 December 2013. Data analysis involved descriptive and inferential statistics at 95% level of confidence using SPSS version 17.0 for Windows.Results: There were 3,760 live births over the 5-year study period out of which 636 were preterm births, giving a prevalence rate of 16.9%. Spontaneous preterm births occurred in approximately 57% of preterm births while provider-initiated births occurred in 43%. The mean gestational age at preterm deliveries was 32.6±3.2 weeks while the mean birth weight was 2.0±0.8 kilograms. Approximately 89% of preterm births involved singleton pregnancies. Sixty-eight percent of preterm births were moderate to late preterm. The male:female ratio of preterm babies born during the period was 1.2:1. The adjusted

  13. The Mismeasure of Academic Labour

    Science.gov (United States)

    Papadopoulos, Angelika

    2017-01-01

    In quantifying and qualifying the scope of academic labour, workload models serve multiple ends. They are intended to facilitate equitable and transparent divisions of academic work, to provide academics with a sense of whether their workload is reasonable relative to their colleagues, and universities with a mechanism for rationalising the…

  14. Narratives about Labour Market Transitions

    Science.gov (United States)

    Cort, Pia; Thomsen, Rie

    2014-01-01

    In European Union policy, Denmark is often referred to as a model country in terms of its flexicurity model and provision of financial support and access to education and training during periods of unemployment, i.e. during transitional phases in a working life. However, in the research on flexicurity and its implications for labour market…

  15. Theorising and Analysing Academic Labour

    Directory of Open Access Journals (Sweden)

    Thomas Allmer

    2018-01-01

    Full Text Available The aim of this article is to contextualise universities historically within capitalism and to analyse academic labour and the deployment of digital media theoretically and critically. It argues that the post-war expansion of the university can be considered as medium and outcome of informational capitalism and as a dialectical development of social achievement and advanced commodification. The article strives to identify the class position of academic workers, introduces the distinction between academic work and labour, discusses the connection between academic, information and cultural work, and suggests a broad definition of university labour. It presents a theoretical model of working conditions that helps to systematically analyse the academic labour process and to provide an overview of working conditions at universities. The paper furthermore argues for the need to consider the development of education technologies as a dialectics of continuity and discontinuity, discusses the changing nature of the forces and relations of production, and the impact on the working conditions of academics in the digital university. Based on Erik Olin Wright’s inclusive approach of social transformation, the article concludes with the need to bring together anarchist, social democratic and revolutionary strategies for establishing a socialist university in a commons-based information society.

  16. Aid and Sectoral Labour Productivity

    DEFF Research Database (Denmark)

    Selaya, Pablo; Thiele, Rainer

    2008-01-01

    The paper examines empirically the proposition that aid to poor countries is detrimental for external competitiveness, giving rise to Dutch disease type effects. At the aggregate level, aid is found to have a positive effect on growth of labour productivity. A sectoral decomposition shows...

  17. Manual Health and Labour Questionnaire

    NARCIS (Netherlands)

    L. van Hakkaart-van Roijen (Leona); M.L.E. Essink-Bot (Marie-Louise)

    2000-01-01

    textabstractWhen the indirect costs form a part of an economical evaluation, a standardised method for measuring production losses, as a result of illness, is required. Standardisation will increase the comparability and transparency of the results. The Health and Labour Questionnaire (HLQ) is

  18. Forecasting Macroeconomic Labour Market Flows

    DEFF Research Database (Denmark)

    Wilke, Ralf

    2017-01-01

    Forecasting labour market flows is important for budgeting and decision-making in government departments and public administration. Macroeconomic forecasts are normally obtained from time series data. In this article, we follow another approach that uses individual-level statistical analysis...

  19. Fracture of maternal sternum during spontaneous delivery.

    Science.gov (United States)

    Stubert, J; Gerber, B

    2009-12-01

    We report of a maternal sternal fracture during a spontaneous delivery in a 31-year-old primipara without a suitable trauma. The putative mechanism of fracture was strong hyperflexion of the thoracic spine and additional cervical flexion with pushing the chin to the thorax due to active management of labour. The history of the healthy woman was free of related risk factors. A possible promoting factor might be pregnancy-induced bone loss. Although there were clear symptoms, the diagnosis of the fracture was delayed by a week because nobody took account of such a possibility.

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

    Science.gov (United States)

    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

  1. Urinary ascites in a preterm female neonate: a rare case report ...

    African Journals Online (AJOL)

    Here we report a rare case of urinary ascites due to spontaneous bladder rupture in a preterm female neonate. The baby presented with respiratory distress, abdominal distension, anuria, and renal insufficiency. The diagnosis of bladder rupture was confirmed by peritoneal fluid aspiration with biochemical analysis and ...

  2. 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.

  3. Conceptualising primary labour relationship quality

    Directory of Open Access Journals (Sweden)

    Lukas I. Ehlers

    2017-05-01

    Full Text Available Background: A typology of desirable social conditions in supervisory relationships suggested that such conditions may also be desirable in other forms of labour relationships. A literature review confirmed that trust, compliance, fairness and good faith can be confidently regarded as universally desirable social conditions in all forms of individual or collective labour relationships between employers and employees. Aim: The purpose of this study was to determine if primary labour relationship quality (PLQ can be confidently conceptualised as a social construct that strongly relates to the perceived levels of compliance, fairness and good faith in supervisory or primary labour relationships. Setting: A combination of random and convenience sampling approaches was implemented to collect PLQ related data from 454 voluntary respondents, who were subordinate employees in the Tshwane region. Methods: A quantitative research methodology was adopted. This included conceptual definition of the PLQ construct, objective measurement of PLQ levels of voluntary respondents in an adequately sized sample, factor analysis and testing for relationships and differences in means between variables. Results: Data analysis results confirmed that it can be confidently concluded that the conceptual definition of PLQ was valid, and that positive PLQ perceptions of subordinate employees were significantly related to at least two other forms of desirable organisational outcomes. Conclusion: PLQ perceptions can be confidently defined as a distinct subjective quality estimate that is assimilated from unique expectations and perceptions of the levels of compliance, fairness, good faith and trust that a supervisor displays in a labour relationship with an immediate subordinate.

  4. 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.

  5. First-time mothers' experiences of early labour in Italian maternity care services.

    Science.gov (United States)

    Cappelletti, Giulia; Nespoli, Antonella; Fumagalli, Simona; Borrelli, Sara E

    2016-03-01

    The aim of this study is to explore first-time mothers' experiences of early labour in Italian maternity care services when admitted to hospital or advised to return home after maternity triage assessment. The study was conducted in a second-level maternity hospital in northern Italy with an obstetric unit for both low- and high-risk women. The participants included 15 first-time mothers in good general health with spontaneous labour at term of a low-risk pregnancy who accessed maternity triage during early labour, and were either admitted to hospital or advised to return home. A qualitative interpretive phenomenological study was conducted. A face-to-face recorded semi-structured interview was conducted with each participant 48-72h after birth. Four key themes emerged from the interviews: (a) recognising signs of early labour; (b) coping with pain at home; (c) seeking reassurance from healthcare professionals; and (d) being admitted to hospital versus returning home. Uncertainty about the progression of labour and the need for reassurance were cited by women as the main reasons for hospital visit in early labour. An ambivalent feeling was reported by the participants when admitted to hospital in early labour. In fact, while the women felt reassured in the first instance, some women subsequently felt dissatisfied due to the absence of one-to-one dedicated care during early labour. When advised to return home, a number of women reported feelings of disappointment, anger, fear, discouragement and anxiety about not being admitted to hospital; however, some of these women reported a subsequent feeling of comfort due to being at home and putting in place the suggestions made by the midwives during the maternity triage assessment. The guidance provided by midwives during triage assessment seemed to be the key factor influencing women׳s satisfaction when advised either to return home or to stay at the hospital during early labour. During antenatal classes and clinics

  6. Division of labour in the yeast

    DEFF Research Database (Denmark)

    Wloch-Salamon, Dominika M.; Fisher, Roberta May; Regenberg, Birgitte

    2017-01-01

    Division of labour between different specialized cell types is a central part of how we describe complexity in multicellular organisms. However, it is increasingly being recognized that division of labour also plays an important role in the lives of predominantly unicellular organisms....... Saccharomyces cerevisiae displays several phenotypes that could be considered a division of labour, including quiescence, apoptosis and biofilm formation, but they have not been explicitly treated as such. We discuss each of these examples, using a definition of division of labour that involves phenotypic...... mechanisms and selective pressures that can lead to the evolution of the very first stages of a division of labour....

  7. The baby has not come: obstructed labour

    Directory of Open Access Journals (Sweden)

    Nancy MacKeith

    2013-02-01

    Full Text Available This article is about how to recognize obstructed labour and deal with it in a way that preserves the life and health of mother and child. It is for midwives and others who work in maternity care and is based on our experiences in Yei, South Sudan. Obstructed labour means that the baby is too big to pass through the birth canal. It can be associated with prolonged labour. Prolonged labour can sometimes be treated, resulting in a normal delivery but a woman in true obstructed labour should be delivered by Caesarean section.

  8. Free Movement of Labour in Europe

    DEFF Research Database (Denmark)

    Galgóczi, Béla; Leschke, Janine

    to capitalise on these fears. So, is free movement of labour in Europe a problem or is it a solution in terms of contributing to better labour allocation? Using empirical evidence, this Working Paper describes the main trends in post-enlargement east/west intra-EU labour mobility. It looks at how different...... population groups, nationals, EU8 and EU21 migrants have been affected by the turbulent processes of opening up national labour markets and subsequently by the crisis. The authors conclude with policy recommendations to minimise the negative side effects of cross-border labour mobility...

  9. Born Too Soon: The global epidemiology of 15 million preterm births

    Science.gov (United States)

    2013-01-01

    This second paper in the Born Too Soon supplement presents a review of the epidemiology of preterm birth, and its burden globally, including priorities for action to improve the data. Worldwide an estimated 11.1% of all livebirths in 2010 were born preterm (14.9 million babies born before 37 weeks of gestation), with preterm birth rates increasing in most countries with reliable trend data. Direct complications of preterm birth account for one million deaths each year, and preterm birth is a risk factor in over 50% of all neonatal deaths. In addition, preterm birth can result in a range of long-term complications in survivors, with the frequency and severity of adverse outcomes rising with decreasing gestational age and decreasing quality of care. The economic costs of preterm birth are large in terms of immediate neonatal intensive care, ongoing long-term complex health needs, as well as lost economic productivity. Preterm birth is a syndrome with a variety of causes and underlying factors usually divided into spontaneous and provider-initiated preterm births. Consistent recording of all pregnancy outcomes, including stillbirths, and standard application of preterm definitions is important in all settings to advance both the understanding and the monitoring of trends. Context specific innovative solutions to prevent preterm birth and hence reduce preterm birth rates all around the world are urgently needed. Strengthened data systems are required to adequately track trends in preterm birth rates and program effectiveness. These efforts must be coupled with action now to implement improved antenatal, obstetric and newborn care to increase survival and reduce disability amongst those born too soon. Declaration This article is part of a supplement jointly funded by Save the Children's Saving Newborn Lives programme through a grant from The Bill & Melinda Gates Foundation and March of Dimes Foundation and published in collaboration with the Partnership for Maternal

  10. The interaction between maternal race/ethnicity and chronic hypertension on preterm birth.

    Science.gov (United States)

    Premkumar, Ashish; Henry, Dana E; Moghadassi, Michelle; Nakagawa, Sanae; Norton, Mary E

    2016-12-01

    In both the biomedical and public health literature, the risk for preterm birth has been linked to maternal racial/ethnic background, in particular African-American heritage. Despite this well-documented health disparity, the relationship of comorbid conditions, such as chronic hypertension, to maternal race/ethnicity and preterm birth has received relatively limited attention in the literature. The objective of the study was to evaluate the interaction between chronic hypertension and maternal racial/ethnic background on preterm birth. This is a retrospective cohort study of singleton pregnancies among women who delivered between 2002 and 2015 at the University of California, San Francisco. The associations of chronic hypertension with both spontaneous and medically indicated preterm birth were examined by univariate and multivariate logistical regression, adjusting for confounders including for maternal age, history of preterm birth, maternal body mass index, insurance type (public vs private), smoking, substance abuse, history of pregestational diabetes mellitus, and use of assisted reproductive technologies. The interaction effect of chronic hypertension and racial/ethnicity was also evaluated. All values are reported as odds ratios, with 95% confidence intervals and significance set at P = .05. In this cohort of 23,425 singleton pregnancies, 8.8% had preterm deliveries (3% were medically indicated preterm birth, whereas 5.5% were spontaneous preterm births), and 3.8% of women carried the diagnosis of chronic hypertension. Chronic hypertension was significantly associated with preterm birth in general (adjusted odds ratio, 2.74, P American women (adjusted odds ratio, 3.91, P Asian-American/Pacific Islander women (adjusted odds ratio, 3.51, P American women (adjusted odds ratio, 6.85, P Asian-American/Pacific Islander women (adjusted odds ratio, 9.87, P American and Asian/Pacific Islander women on medically indicated and total preterm birth rates raises the

  11. Intracervical procedures and the risk of subsequent very preterm birth: a case-control study.

    Science.gov (United States)

    Watson, Lyndsey F; Rayner, Jo-Anne; King, James; Jolley, Damien; Forster, Della

    2012-02-01

    To investigate the relation of prior intracervical procedures with very preterm birth. A population-based case-control study. The study was conducted in Australia between 2002 and 2004. Three hundred and forty-five women having a medically indicated and 236 having a spontaneous singleton birth between 20 and 31 weeks of gestation and 796 women selected randomly from all those giving birth at ≥37 weeks of gestation. Interview data were analysed using logistic regression. Very preterm birth. Very preterm birth was significantly associated with having any intracervical procedure [adjusted odds ratio (AOR) 2.07; 95% confidence interval (CI) 1.6-2.7], in particular curettage associated with abortion (AOR 1.80; 95% CI 1.2-2.6). Assisted reproductive technology procedures were significantly associated with medically indicated very preterm birth (AOR 3.07; 95% CI 1.8-5.3) and treatments for precancerous cervical changes were significantly associated with spontaneous very preterm birth, as follows: conization/cone biopsy (AOR 3.33; 95% CI 1.8-6.2) and cauterization/ablation (AOR 2.27; 95% CI 1.4-3.8). Suction aspiration for abortion, abnormal Pap smear without treatment and abortion without instrumentation were not associated with very preterm birth. Intracervical procedures are associated with very preterm birth. Notably, curettage rather than any other procedure associated with abortion appears to be implicated in the risk. The introduction of infection during cervical procedures may be the common link with risks found. Changing clinical practice in the management of abortion and human papillomavirus vaccination may lead to lowering the risks of very preterm birth. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. International migration and New Zealand labour markets.

    Science.gov (United States)

    Farmer, R S

    1986-06-01

    "This paper seeks to assess the value of the overseas-born members of the labour force in ensuring a flexible labour supply in New Zealand since the beginning of the 1970s. Three main issues are considered: first, the role of the labour market in New Zealand's immigration policy; second, international migration trends and the labour market; and third, the evidence on migration and labour market segmentation in New Zealand." Data used are from official external migration statistics, quinquennial censuses, and recent research. The author notes that "in New Zealand immigration measures are currently being taken that emphasize that immigration continues to add to the flexibility of the labour market while uncontrolled emigration is a major cause of labour market instability." (SUMMARY IN FRE AND SPA) excerpt

  13. 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.

  14. Distal skin vasodilation promotes rapid sleep onset in preterm neonates.

    Science.gov (United States)

    Barcat, Lucile; Decima, Pauline; Bodin, Emilie; Delanaud, Stephane; Stephan-Blanchard, Erwan; Leke, Andre; Libert, Jean-Pierre; Tourneux, Pierre; Bach, Veronique

    2017-10-01

    Although sleep is of paramount importance for preterm neonates, care of the latter in a neonatal intensive care unit does not favour sleep. Given that several studies in adults have described a 'vegetative preparedness to sleep' (in which distal skin vasodilation before lights-out promotes rapid sleep onset), we looked at whether or not this process operates in preterm neonates. Sleep propensity was assessed in terms of the duration of a spontaneous episode of wakefulness (W). Skin temperatures at six body sites (the abdomen, pectoral region, eye, hand, thigh and foot) were measured (using infrared thermography) during nocturnal polysomnography in 29 9-day-old preterm neonates (postmenstrual age: 209 ± 9 days). We then determined whether the duration of the W episode depended upon the local skin temperatures measured at the start, during and end of the episode. The W episode was shorter when distal skin temperatures (thigh, hand and foot) and the pectoral temperature were higher at the end of the episode (i.e. at sleep onset). The relationship with the duration of the W episode was not significant for temperatures measured at the start of the W episode. We observed gradual distal vasodilation at the pectoral region, the thigh, hand and foot (i.e. affecting most of the body's skin surface) during W episodes. Our results constitute initial evidence to show that distal vasodilation may have a key role in facilitating sleep onset in very preterm neonates. © 2017 European Sleep Research Society.

  15. Obstructive sleep apnea and the risk of preterm delivery.

    Science.gov (United States)

    Na-Rungsri, Kunyalak; Lertmaharit, Somrat; Lohsoonthorn, Vitool; Totienchai, Surachart; Jaimchariyatam, Nattapong

    2016-09-01

    The aim of this study was to evaluate the risk of obstructive sleep apnea (OSA) to preterm delivery (PTD), using the Berlin Questionnaire (BQ). This was a large, prospective cohort study among pregnant Thai women. The BQ was employed for symptom-based OSA screening during the second trimester, and PTD was recorded in 1345 pregnant women. Multivariate models were applied in controlling for potential confounders. The overall prevalence of the high risk of OSA was 10.1 %, and it was significantly associated with pre-pregnancy body mass index and score on the Perceived Stress Scale. An adjusted odds ratio for PTD in women with a high risk of OSA was 2.00 (95 % confidence intervals (CIs) = 1.20, 3.34). Stratified analyses, after adjusting for confounding factors, indicated that a high risk of OSA was associated with an increased risk of spontaneous preterm delivery (odds ratio (OR) = 2.45, 95 % CI = 1.20, 5.02), but not with preterm premature rupture of membranes (OR = 1.61, 95 % CI = 0.61, 4.26), and medically indicated preterm delivery (OR = 1.83, 95 % CI = 0.72, 4.64). Pregnant women with a high risk of OSA are at an increased risk of having PTD, compared with pregnant women with a low risk of OSA.

  16. 1 Prevalence of bacterial vaginosis and associated factors among ...

    African Journals Online (AJOL)

    Abstract: Bacterial vaginosis (BV) is an extremely common reproductive tract condition worldwide with reported high prevalence among African population. Factors associated with this condition include preterm labour, premature rupture of membranes, preterm delivery and possibly spontaneous abortion. Nevertheless ...

  17. Protocol for the immediate delivery versus expectant care of women with preterm prelabour rupture of the membranes close to term (PPROMT Trial [ISRCTN44485060

    Directory of Open Access Journals (Sweden)

    Buchanan Sarah L

    2006-03-01

    Full Text Available Abstract Background Preterm prelabour rupture of membranes (PPROM complicates up to 2% of all pregnancies and is the cause of 40% of all preterm births. The optimal management of women with PPROM prior to 37 weeks, is not known. Furthermore, diversity in current clinical practice suggests uncertainty about the appropriate clinical management. There are two options for managing PPROM, expectant management (a wait and see approach or early planned birth. Infection is the main risk for women in which management is expectant. This risk need to be balanced against the risk of iatrogenic prematurity if early delivery is planned. The different treatment options may also have different health care costs. Expectant management results in prolonged antenatal hospitalisation while planned early delivery may necessitate intensive care of the neonate for problems associated with prematurity. Methods/Design We aim to evaluate the effectiveness of early planned birth compared with expectant management for women with PPROM between 34 weeks and 366 weeks gestation, in a randomised controlled trial. A secondary aim is a cost analysis to establish the economic impact of the two treatment options and establish the treatment preferences of women with PPROM close to term. The early planned birth group will be delivered within 24 hours according to local management protocols. In the expectant management group birth will occur after spontaneous labour, at term or when the attending clinician feels that birth is indicated according to usual care. Approximately 1812 women with PPROM at 34–366 weeks gestation will be recruited for the trial. The primary outcome of the study is neonatal sepsis. Secondary infant outcomes include respiratory distress, perinatal mortality, neonatal intensive care unit admission, assisted ventilation and early infant development. Secondary maternal outcomes include chorioamnionitis, postpartum infection treated with antibiotics, antepartum

  18. The History of Labour Hire in Namibia: A Lesson for South Africa ...

    African Journals Online (AJOL)

    KEYWORDS: Labour hire; Namibia; temporary employees; exploitation of contract labour system; SWANLA; Namibian Labour Act; labour hire banned; regulation of Africa Personnel Services; Labour Amendment Act; Employment Services Act; labour brokers; South Africa; precarious; collective bargaining; triangular ...

  19. Investigating the variations in survival rates for very preterm infants in ten European regions: the MOSAIC birth cohort

    DEFF Research Database (Denmark)

    Draper, Elizabeth S; Zeitlin, Jennifer; Fenton, Alan C

    2008-01-01

    OBJECTIVE: To investigate the variation in the survival rate and the mortality rates for very preterm infants across Europe. DESIGN: A prospective birth cohort of very preterm infants for ten geographically defined European regions during 2003 followed to discharge home from hospital. PARTICIPANTS...... of the infants from 24 to 27 weeks gestation survived to discharge home from NIC. However large variations were seen in the timing of the deaths by region. Among all fetuses alive at onset of labour of 24-27 weeks gestation, between 84.0% and 98.9% were born alive and between 64.6% and 97.8% were admitted...

  20. Labour in Global Production Networks

    DEFF Research Database (Denmark)

    Lund-Thomsen, Peter; Nadvi, Khalid; Chan, Anita

    on the global football industry, a sector dominated by leading global brands who manage dispersed global production networks. It assesses the work conditions for football stitchers engaged in different forms of work organisation, factories, stitching centres, and home-based settings, in Pakistan, India......, and China. It draws on detailed qualitative primary field research with football stitching workers and producers in these three countries. The paper explains how, and why, work conditions of football stitchers differ across these locations through an analytical framework that interweaves both global...... and local production contexts that influence work condition. In doing so, it argues that current debates on the role of labour in global production networks have to go beyond a narrow focus on labour standards and CSR compliance and engage with economic, technological and social upgrading as factors...

  1. 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)

  2. 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...

  3. 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…

  4. Productive force and labour productivity

    Directory of Open Access Journals (Sweden)

    Kulik V.I.

    2017-09-01

    Full Text Available the authors discuss productive forces of a society – work and capital, as well as two intermediaries: the intermediary between the world of the nature and the person – means of work or “fixed capital” of a society, as productive force of social activities, and the intermediary inside a society – cost in the form of money that allows to define labour productivity and structural transformations in a society.

  5. Chlamydia trachomatis C-complex serovars are a risk factor for preterm birth

    DEFF Research Database (Denmark)

    Hollegaard, Stine; Vogel, Ida; Thorsen, Poul

    2007-01-01

    BACKGROUND: Potential associations between current or previous C. trachomatis infections (general IgG and serovars) and spontaneous preterm birth (PTB) were examined and associations between C. trachomatis infections and previous fertility problems were explored. PATIENTS AND METHODS: At week 17......, Chlamydia antigen, Chlamydia IgG, Chlamydia complex B, C and GF levels were measured. Spontaneous preterm birth (...) and odds ratios (OR) were estimated by logistic regression. RESULTS: C. trachomatis C-complex positivity was associated with spontaneous PTB [RR 2.6 (1.1-6.29)] and additionally with a prior history of subfertility [OR 4.4 [2.5-7.7]), infertility treatment [OR 7.2 (4.0-12.8)] and ectopic pregnancy [5.2 (2...

  6. [Correlation between the myometrial thickness in the second trimester and preterm delivery in a prospective study].

    Science.gov (United States)

    Guo, Yeqing; Long, Xiangdang; Yao, Sui

    2015-02-01

    To investigate the relationship between preterm delivery and anterior myometrial (MA) thickness measured by ultrasound in the second trimester. The general information and pregnancy outcome of singleton pregnant women who had antenatal visit in the Hunan Provincial People's Hospital between Oct 2010 and Sep 2013 were collected prospectively. The MA thickness was measured at 20-27(+6) gestational weeks. The cases were divided into preterm delivery group and term delivery group. (1) A total of 1 031 pregnant women were recruited in this study. 147 pregnant women were in the preterm delivery group (14.26%, 147/1 031) and 884 women were in the term delivery group (85.74% , 884/1 031). The gestation age at delivery of the preterm delivery group was significantly earlier than the term delivery group [(34.57 ± 2.39) vs (39.23 ± 0.92) weeks, P history of preterm delivery, cesarean delivery rate and gestational age at the time of MA measurement between the two groups (P > 0.05). The incidence of premature rupture of membrane (PROM) in the preterm delivery group and in the term delivery group were 49.0% (72/147) and 15.8% (140/884), respectively, with statistically significant difference (P delivery group was (5.49 ± 1.39) mm, while in the preterm delivery group it was (5.60 ± 0.87) mm. There was no statistically significant difference between the two groups(P > 0.05). The mean value of MA thickness in the spontaneous preterm delivery group was(5.15 ± 0.75) mm, and was (5.61 ± 1.38 ) mm in the term delivery group, with statistically significant difference (P delivery group with PROM it was (5.38 ± 1.12) mm. The difference between the two groups were statistically significant (P 0.05). No correlation was found among PROM and MA thickness(r = 0.058, P > 0.05). However, in the preterm delivery group, the mean value of MA in PPROM was significantly thicker than the spontaneous preterm delivery cases (P delivery and PPROM, while the MA thickness should not be considered as

  7. Is there an association between subclinical hypothyroidism and preterm uterine contractions? A prospective observational study.

    Science.gov (United States)

    Nassie, Daniel I; Ashwal, Eran; Raban, Oded; Ben-Haroush, Avi; Wiznitzer, Arnon; Yogev, Yariv; Aviram, Amir

    2017-04-01

    To investigate the association between subclinical hypothyroidism and preterm contractions. Prospective observational study among women at 23 + 0/7 and 34 + 6/7 weeks of gestation, with no known thyroid function abnormality, and preterm uterine contractions (PTC). All patients underwent laboratory evaluation of Thyroid Stimulating Hormone (TSH) and Free Thyroxin (FT4). Patients with and without PTC were compared. No association was found between PTC and subclinical hypothyroidism. Rate of spontaneous preterm delivery (PTD) was comparable between women with abnormal and normal thyroid function tests. Excluding indicated PTD, patients in the study group had a higher rate of spontaneous PTD (24.7% versus 9.6%, p = 0.03). Patients with past PTD and preterm contractions had higher rates of hypothyroxinemia compared with patients without past PTD (54.6% versus 19.0% and 31.2%, p = 0.001), and patients with past PTD (regardless of the presence or absence of PTC) had higher rate of subclinical hypothyroidism compared with patients with PTC and without PTD (59.1% and 66.7% versus 31.6%, p = 0.017). No association was found between PTC and subclinical hypothyroidism in the entire cohort, except for patients with preterm contractions and a history of past PTD. This specific group of patients might benefit from thyroid function evaluation.

  8. Psychosocial Stress and Preterm Birth: The Impact of Parity and Race.

    Science.gov (United States)

    Wheeler, Sarahn; Maxson, Pamela; Truong, Tracy; Swamy, Geeta

    2018-03-29

    Objectives Studies examining risk factors for preterm birth (PTB) such as psychosocial stress are often focused on women with a history of PTB; however, most preterm babies are born to women with no history of preterm birth. Our objective was to determine if the relationship between psychosocial stress and PTB is altered by parity. Non-Hispanic black (NHB) women have increased psychosocial stress and PTB; therefore, we further aimed to determine if race alters the relationship between psychosocial stress, parity, and PTB. Methods We performed a secondary analysis of the Healthy Pregnancy, Healthy Baby Study comparing pregnant women who were primiparous (first pregnancy), multiparous with history of preterm birth, or multiparous with history of term birth. Perceived stress, perceived racism, interpersonal support, John Henryism and self-efficacy were measured using validated instruments. Logistic regression was used to model the effect of psychosocial stress on PTB stratified by parity and race. Results The analysis entire cohort included 1606 subjects, 426 were primiparous, 268 had a history of presterm birth, and 912 had a history of term birth. In women with a history of term birth, higher self-efficacy was associated with lower odds of spontaneous PTB, and this association was amplified in NHB women. In women with a history of spontaneous PTB, John Henryism Active Coping was associated with lower odds of spontaneous PTB in the index pregnancy. Conclusions for Practice The relationship between psychosocial stress and PTB may be mediated by parity and race.

  9. Child labour, human capital and life expectancy

    OpenAIRE

    Giam Pietro Cipriani

    2015-01-01

    This paper studies new mechanisms through which human capital and longevity interact with child labour and endogenous fertility. When children provide old age support in the form of care and companionship, the economy may display multiple development regimes: a development trap with low human capital and large use of child labour or a high steady state with high longevity and human capital and low child labour. A situation with indeterminacy of equilibrium outcomes may also occur if child mor...

  10. Efficiency Wages in Heterogenous Labour Markets

    OpenAIRE

    Pavel Ryska; Jan Prùša

    2011-01-01

    In this paper we tackle two shortcomings of present efficiency wage models. Firstly, they do not fully account for labour heterogeneity, thus implying that high-effort and low-effort units of labour are interchangeable. Secondly, building on this assumed homogeneity of labour, the models derive involuntary unemployment from effort decisions of workers, which are patently voluntary. We offer a consistent reformulation of the theory: Each of the effort or quality levels is regarded as a separat...

  11. International spillovers of labour market policies

    OpenAIRE

    Mai Chi Dao

    2013-01-01

    This paper uses a dynamic open-economy model to analyse the domestic and international spillover effects of policies aiming at reducing domestic labour costs, e.g., through cuts in labour taxes and unemployment benefits, when labour markets are unionized. Domestically, unionization dampens the downward wage adjustment due to unions' strategic rent-seeking and leads to a more muted expansion relative to a frictionless setting. Externally, the rent-sharing mechanism ensures that the terms of tr...

  12. Labour market policies, poverty and insecurity

    OpenAIRE

    Standing, Guy

    2008-01-01

    The paper sets out to evaluate the performance in terms of poverty alleviation of conventional labour market and social policies and arrangements in the era of globalised labour markets. To this end, it develops a framework based on five policy evaluation principles, centred on the normative notion of social justice, whereby the expansion of full freedom requires basic economic security for all.\\ud \\ud It concludes that most of the labour market interventions reviewed have suffered from commo...

  13. Regulation distance, labour segmentation and gender gaps

    OpenAIRE

    David Peetz

    2015-01-01

    Existing theories on human capital, labour market segmentation and discrimination fail to fully explain gender gaps—for example, the large gender gap in elite occupations where women apparently possess high labour market power. This article seeks to extend our understanding, through the interaction between labour segmentation, regulation content and regulation distance, the last referring to the extent to which employment of particular workers is (un)regulated, including by collective agreeme...

  14. Influence of timing of admission in labour and management of labour on method of birth: results from a randomised controlled trial of caseload midwifery (COSMOS trial).

    Science.gov (United States)

    Davey, Mary-Ann; McLachlan, Helen L; Forster, Della; Flood, Margaret

    2013-12-01

    to explore the relationship between the degree to which labour is established on admission to hospital and method of birth. a recent randomised controlled trial found fewer caesarean sections (CS) in women allocated to caseload midwifery (19.4%) compared with standard care (24.9%). There is interest in exploring what specific aspects of the care might have resulted in this reduction. a large tertiary-level maternity service in Melbourne, Australia. English-speaking women with no previous caesarean section at low risk of complications in pregnancy were recruited to a randomised controlled trial. Trial participants whose management did not include a planned caesarean and who were admitted to hospital in spontaneous labour were included in this secondary analysis of trial data (n=1532). this secondary analysis included women admitted to hospital in spontaneous labour who were randomised to caseload midwifery compared with those randomised to standard care with regard to timing of admission in labour, augmentation of labour and use of epidural analgesia. In a further analysis randomised groups were pooled to examine predictors of caesarean section for first births only using multiple logistic regression. nulliparous women randomised to standard care were more likely to have labour augmented than those having caseload care (54.2% and 45.5% respectively, p=0.008), but were no more likely to use epidural analgesia. They were admitted earlier in labour, spending 1.1 hours longer than those in the caseload arm in hospital before the birth (p=0.003). Parous women allocated to standard care were more likely than those in the caseload arm to use epidural analgesia (10.0% and 5.3% respectively, p=0.047), but were no more likely to have labour augmented. They were also admitted earlier in labour, with a median cervical dilatation of 4 cm compared with 5 cm in the caseload arm (p=0.012). Pooling the two randomised groups of nulliparous women, and after adjusting for randomised

  15. Spontaneous pneumothorax in weightlifters.

    Science.gov (United States)

    Marnejon, T; Sarac, S; Cropp, A J

    1995-06-01

    Spontaneous pneumothorax is infrequently caused by strenuous exertion. To our knowledge there has only been one case of spontaneous pneumothorax associated with weightlifting reported in the medical literature. We describe three consecutive cases of spontaneous pneumothorax associated with weightlifting. We postulate that spontaneous pneumothorax in these patients may be secondary to improper breathing techniques. It is important that physicians and weight trainers be aware of the association between weight lifting and spontaneous pneumothorax and assure that proper instruction is given to athletes who work with weights.

  16. Association of 308G/A TNF-α gene polymorphism and spontaneous ...

    African Journals Online (AJOL)

    Background: Single nucleotide polymorphism (SNP) within tumor necrosis factor alpha (TNF-α) gene promoter (308G/A TNFA) is associated with higher gene expression. The role of this SNP as a risk factor for spontaneous preterm birth has been assessed in some regions and the findings were significantly different ...

  17. Panamanian women׳s experience of vaginal examination in labour: A questionnaire validation.

    Science.gov (United States)

    Bonilla-Escobar, Francisco J; Ortega-Lenis, Delia; Rojas-Mirquez, Johanna C; Ortega-Loubon, Christian

    2016-05-01

    to validate a tool that allows healthcare providers to obtain accurate information regarding Panamanian women׳s thoughts and feelings about vaginal examination during labour that can be used in other Latin-American countries. validation study based on a database from a cross-sectional study carried out in two tertiary care hospitals in Panama City, Panama. Women in the immediate postpartum period who had spontaneous labour onset and uncomplicated deliveries were included in the study from April to August 2008. Researchers used a survey designed by Lewin et al. that included 20 questions related to a patient׳s experience during a vaginal examination. five constructs (factors) related to a patient׳s experience of vaginal examination during labour were identified: Approval (Alpha Cronbach׳s 0.72), Perception (0.67), Rejection (0.40), Consent (0.51), and Stress (0.20). it was demonstrated the validity of the scale and its constructs used to obtain information related to vaginal examination during labour, including patients' experiences with examination and healthcare staff performance. utilisation of the scale will allow institutions to identify items that need improvement and address these areas in order to promote the best care for patients in labour. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Socioeconomic position and the risk of spontaneous abortion: a study within the Danish National Birth Cohort

    OpenAIRE

    Norsker, Filippa Nyboe; Espenhain, Laura; á Rogvi, Sofie; Morgen, Camilla Schmidt; Andersen, Per Kragh; Nybo Andersen, Anne-Marie

    2012-01-01

    Objectives To investigate the relationship between different indicators of socioeconomic position and the risk of spontaneous abortion. Design Cohort study. Setting 1996–2002, Denmark. Participants All first time participants, a total of 89 829 pregnant women, enrolled in the Danish National Birth Cohort were included in the present study. Overall, 4062 pregnancies ended in spontaneous abortion. Information on education, income and labour market attachment in the year before pregnancy was dra...

  19. The Structure Of Labour Market And Demand For Hired Labour For ...

    African Journals Online (AJOL)

    The estimated hired labour de-mand elasticities for farm size, value of other inputs, village wage rate and distance are inelastic. It is noted that issues on labour requirement of farmers should be based on economic considera-tions such as the structure of labour of the farmers, farm size, village wage rate and cost of other ...

  20. 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.

  1. Employers’ Openness to Labour Immigrants

    Directory of Open Access Journals (Sweden)

    Asta Mikalauskiene

    2017-10-01

    Full Text Available The paper presents the elucidation of the concept of migration and theories describing the process of migration, determines the issue of openness to immigration and presents its theoretical explanation.. The analysis of the empirical studies conducted in Lithuania assessing the openness of employers to labour immigrants was performed including the analysis of immigration trends in this country. The factors determining the attitudes towards immigration and immigrants are presented being divided into the main groups of economic and social-cultural factors.

  2. Caring Labours as Decolonizing Resistance

    Directory of Open Access Journals (Sweden)

    Rebecca Hall

    2016-12-01

    Full Text Available This article brings feminist theories of social reproduction in conversation with decolonizing feminisms. It takes up Indigenous women's social reproductive labour as enactments of creative expansion. In approaching social reproduction as a site of struggle, it identifies three processes of expansion and resistance at this site: the expansion of care and intimacy into subsistence production; the expansion of the “family” beyond the nuclear through community and kin networks; and the expansion of relations of care to include the land.

  3. Disruptions to the cerebellar GABAergic system in juvenile guinea pigs following preterm birth.

    Science.gov (United States)

    Shaw, Julia C; Palliser, Hannah K; Dyson, Rebecca M; Berry, Mary J; Hirst, Jonathan J

    2018-04-01

    Children that are born preterm are at an increased risk of developing cognitive problems and behavioural disorders, such as attention deficit hyperactivity disorder (ADHD). There is increasing interest in the role of the cerebellum in these processes and the potential involvement of GABAergic pathways in neurodevelopmental disorders. We propose that preterm birth, and the associated loss of the trophic intrauterine environment, alters the development of the cerebellum, contributing to ongoing neurobehavioral disorders. Guinea pigs were delivered preterm (GA62) or spontaneously at term (GA69), and tissues collected at corrected postnatal day (PND) 28. Neurodevelopmental and GABAergic markers myelin basic protein (MBP), neuronal nuclei (NeuN), calbindin (Purkinje cells), and GAD67 (GABA synthesis enzyme) were analysed in cerebellar lobules IX and X by immunohistochemistry. Protein expression of GAD67 and GAT1 (GABA transporter enzyme) were quantified by western blot, whilst neurosteroid-sensitive GABA A receptor subunits were measured by RT-PCR. MBP immunostaining was increased in lobule IX of preterm males, and reduced in lobule X of preterm females when compared to their term counterparts. GAD67 staining was decreased in lobule IX and X of the preterm males, but only in lobule X of the preterm females compared to term cohorts for each sex. Internal granule cell layer width of lobule X was decreased in preterm cohorts of both sexes compared to terms. There were no differences between gestational age groups for NeuN staining, GAD67 and GAT1 protein expression as measured by western blotting, or GABA A receptor subunits as measured by RT-PCR between preterm and term for either sex. The present findings suggest that components of the cerebellar GABAergic system of the ex-preterm cerebellum are disrupted. The higher expression of myelin in the preterm males may be due to a deficit in axonal pruning, whereas females have a deficit in myelination at 28 corrected days of

  4. Maternal obesity and its effect on labour duration in nulliparous women: a retrospective observational cohort study.

    Science.gov (United States)

    Ellekjaer, Karen Louise; Bergholt, Thomas; Løkkegaard, Ellen

    2017-07-12

    Obesity is increasing among primipara women. We aimed to describe the association between body mass index (BMI) during early-pregnancy and duration of labour in nulliparous women. Retrospective observational cohort study of 1885 nulliparous women with a single cephalic presentation from 37 0/7 to 42 6/7 weeks of completed gestation and spontaneous or induced labour at Nordsjællands Hospital, University of Copenhagen, Denmark, in 2011 and 2012. Total duration of labour and the first and second stages of labour were compared between early-pregnancy normal-weight (BMI <25 kg/m 2 ), overweight (BMI 25-29.9 kg/m 2 ), and obese (BMI ≥30 kg/m 2 ) women. Proportional hazards and multiple logistic regression models were applied. Early pregnancy BMI classified 1246 (66.1%) women as normal weight, 350 (18.6%) as overweight and 203 (10.8%) as obese. No difference in the duration of total or first stage of active labour was found for overweight (adjusted HR = 1.01, 95% CI 0.88-1.16) or obese (adjusted HR = 1.07, 95% CI 0.90-1.28) compared to normal weight women. Median active labour duration was 5.83 h for normal weight, 6.08 h for overweight and 5.90 h for obese women. The risk of caesarean delivery increased significantly for overweight and obese compared to normal weight women (odds ratios (OR) 1.62; 95%CI 1.18-2.22 and 1.76; 95%CI 1.20-2.58, respectively). Caesarean deliveries were performed earlier in labour in obese than normal-weight women (HR = 1.80, 95%CI 1.28-2.54). BMI had no significant effect on total duration of active labour. Risk of caesarean delivery increased with increasing BMI. Caesarean deliveries are undertaken earlier in obese women compared to normal weight women following the onset of active labour, shortening the total duration of active labour.

  5. Maternal biomarkers of endothelial dysfunction and preterm delivery.

    Directory of Open Access Journals (Sweden)

    Xinhua Chen

    Full Text Available Endothelial dysfunction is key to the development of atherosclerosis. Preterm delivery foreshadows later maternal cardiovascular disease (CVD, but it is not known if endothelial dysfunction also occurs. We prospectively measured circulating biomarkers of endothelial dysfunction in pregnant women with preterm or term delivery.We conducted a case-control study nested within a large prospective epidemiological study of young, generally healthy pregnant women. Women who delivered preterm (<37 completed weeks gestation, n = 240 and controls who delivered at term (n = 439 were included. Pregnancies complicated by preeclampsia were analyzed separately. Circulating endothelial dysfunction biomarkers included soluble intercellular adhesion molecule-1 (sICAM-1, vascular cell adhesion molecule-1 (sVCAM-1 and soluble E-selectin (sE-selectin.Elevated levels of sICAM-1 and sVCAM-1 were positively associated with preterm delivery independent of usual risk factors. At entry (∼16 wks, the adjusted odds ratio (AOR was 1.73 (95% confidence interval (CI 1.09-2.74 for the highest quartile of sICAM-1 versus the lowest quartile and for sVCAM-1 the AOR was 2.17 (95% CI 1.36-3.46. When analysis was limited to cases with a spontaneous preterm delivery, the results were unchanged. Similar results were obtained for the 3rd trimester (∼30 wks. Elevated sE-selectin was increased only in preterm delivery complicated by preeclampsia; risk was increased at entry (AOR 2.32, 95% CI 1.22-4.40 and in the 3rd trimester (AOR 3.37, 95% CI 1.78-6.39.Impaired endothelial function as indicated by increased levels of soluble molecules commonly secreted by endothelial cells is a pathogenic precursor to CVD that is also present in women with preterm delivery. Our findings underscore the need for follow-up studies to determine if improving endothelial function prevents later CVD risk in women.

  6. Reserves of labour content reduction in NPP construction

    International Nuclear Information System (INIS)

    Bekerman, R.E.

    1986-01-01

    Specific labour contents when constructing NPP with RBMK-1000 and WWER-1000 type reactors are presented. Factors affecting labour content of NPP construction are shown. Measures aimed at labour content decrease are suggested

  7. Frequency of Preterm Delivery in Proteinuric Verses Non Proteinuric Pregnancy Induced Hypertension

    International Nuclear Information System (INIS)

    Sheikh, S.; Haq, G.; Kazi, S.

    2015-01-01

    Objective: To compare the frequency of preterm labour associated with gestational proteinuric hypertension versus gestational non-proteinuric hypertension. Methods: The prospective cohort study was conducted at the Department of Obstetrics and Gynaecology, Dow University of Health Sciences and Civil Hospital Karachi, from April 1 to September 30, 2012, and comprised primigravidas of more than or equal to 20th weeks of gestation having blood pressure >140/90 mm Hg. Those with gestational hypertension with proteinuria represented the exposed group, while the non-exposed group had primigravidas with gestational hypertension without proteinuria. SPSS 10 was used to analyse data. Results: There were 112 subjects, with 56(50 percent) in each of the two groups. Mean maternal age in exposed group was 28.3±4.49 years and in the non-exposed group 26.08±0.04 years. Mean gestational age in the exposed group was 36.89±4.04 weeks and in the non-exposed group 37.75±3.428 weeks. Women with gestational hypertension with proteinuria were more likely to deliver preterm infants compared to women with gestational hypertension without proteinuria (p=0.009). Conclusion: Gestational proteinuric hypertension increased the risk of preterm labour, therefore vigilant monitoring of gestational proteinuric hypertension is important. (author)

  8. Partnerships: Labour/management approaches

    International Nuclear Information System (INIS)

    Thompson, T.

    1995-01-01

    Changes in the workplace that can be expected in light of the changes occurring in the electric utility industry and the private sector in general, were discussed. Increased pressure to be productive due to competition, continuous technological changes, the changing labour force and regulatory environments were identified as some of the forces responsible for the changes.. The old labour relations practices were reviewed and criticized for having been too confrontational and not focusing on common interests. Sharing of information was emphasized as a means to build a foundation of trust between unions and management. Worker participation in the direction of the company was said to be necessary for good relations. It was suggested that this should occur in the early stages of program/policy development so that the workers don't feel by-passed. Examples of initiatives and benefits resulting from cooperation of the union and management were described. It was concluded that while there would always be issues that union and management would not agree on, focusing on common interests will act as a strong motivator to resolving contentious issues to protect the mutually beneficial relationship between the two sides

  9. Maternal dietary patterns and preterm delivery: results from large prospective cohort study.

    Science.gov (United States)

    Englund-Ögge, Linda; Brantsæter, Anne Lise; Sengpiel, Verena; Haugen, Margareta; Birgisdottir, Bryndis Eva; Myhre, Ronny; Meltzer, Helle Margrete; Jacobsson, Bo

    2014-03-04

    To examine whether an association exists between maternal dietary patterns and risk of preterm delivery. Prospective cohort study. Norway, between 2002 and 2008. 66 000 pregnant women (singletons, answered food frequency questionnaire, no missing information about parity or previously preterm delivery, pregnancy duration between 22+0 and 41+6 gestational weeks, no diabetes, first enrolment pregnancy). Hazard ratio for preterm delivery according to level of adherence to three distinct dietary patterns interpreted as "prudent" (for example, vegetables, fruits, oils, water as beverage, whole grain cereals, fibre rich bread), "Western" (salty and sweet snacks, white bread, desserts, processed meat products), and "traditional" (potatoes, fish). After adjustment for covariates, high scores on the "prudent" pattern were associated with significantly reduced risk of preterm delivery hazard ratio for the highest versus the lowest third (0.88, 95% confidence interval 0.80 to 0.97). The prudent pattern was also associated with a significantly lower risk of late and spontaneous preterm delivery. No independent association with preterm delivery was found for the "Western" pattern. The "traditional" pattern was associated with reduced risk of preterm delivery for the highest versus the lowest third (hazard ratio 0.91, 0.83 to 0.99). This study showed that women adhering to a "prudent" or a "traditional" dietary pattern during pregnancy were at lower risk of preterm delivery compared with other women. Although these findings cannot establish causality, they support dietary advice to pregnant women to eat a balanced diet including vegetables, fruit, whole grains, and fish and to drink water. Our results indicate that increasing the intake of foods associated with a prudent dietary pattern is more important than totally excluding processed food, fast food, junk food, and snacks.

  10. another dimension to child labour: counselling implications

    African Journals Online (AJOL)

    Elizabeth Egbochuku

    industrial revolution, Charles Dickens (1812-1870) the author of “Oliver. Twist” had the issue of child labour as his main theme. Today, the problem is still prevailing. Bequel and Boyden (1998) opine that all over the world, children are incorporated into a range of different employment relations either as wage labourers in ...

  11. Economic independence, labour law and social security

    NARCIS (Netherlands)

    Holtmaat, H.M.T.; Kravaritou, Y.

    2015-01-01

    This work is based on papers presented at a conference entitled "The Sex of Labour Law in Europe/Le Sexe du droit du travail en Europe", which was held at the European University Institute in Florence. The contributors argue that law in general, and especially social and labour law, is not asexual,

  12. Essays on labour markets and pensions

    NARCIS (Netherlands)

    Bonthuis, B.N.

    2016-01-01

    In this dissertation we study labour markets, pension systems, and the interaction between the two. In the second chapter after the introduction we study the effects of fiscal changes in an overlapping-generations model. A labour tax increase reduces welfare more than a consumption tax increase and

  13. Labour opposes performance-related pay.

    Science.gov (United States)

    Bhinkett, David

    1994-10-13

    According to a recent Gallup Poll for UNISON, 8 July 1994, only 1% of nursing and midwifery staff believe that the Conservative Party has the best policies for the NHS, as against 64% who back Labour's approach. A total of 78% of nurses and midwives would vote Labour in a general election tomorrow, while only 5% would vote Tory.

  14. Plantation labour and economic crisis in Cameroon

    NARCIS (Netherlands)

    Konings, P.J.J.

    1995-01-01

    The few existing studies on the response of labour to the economic crisis and structural adjustment in African countries tend to focus on the (oppositional) relations between the State and central labour organizations. They largely ignore the response of workers and unions at the workplace. This

  15. The amendment of the Labour Code

    Directory of Open Access Journals (Sweden)

    Jana Mervartová

    2012-01-01

    Full Text Available The amendment of the Labour Code, No. 365/2011 Coll., effective as from 1st January 2012, brings some of fundamental changes in labour law. The amendment regulates relation between the Labour Code and the Civil Code; and is also formulates principles of labour law relations newly. The basic period by fixed-term contract of employment is extended and also frequency its conclusion is limited. The length of trial period and the amount of redundancy payment are graduated. An earlier legislative regulation which an employee is temporarily assign to work for different employer has been returned. The number of hours by agreement to perform work is increased. The monetary compensation by competitive clause is reduced. The other changes are realised in part of collective labour law. The authoress of article notifies of the most important changes. She compares new changes of the Labour Code and former legal system and she also evaluates their advantages and disadvantages. The main objective of changes ensures labour law relations to be more flexible. And it should motivate creation of new jobs opening by employers. Amended provisions are aimed to reduction expenses of employers under the reform of the public finances. Also changes are expected in the Labour Code in connection with the further new Civil Code.

  16. Labour costs and queueing theory in retailing

    NARCIS (Netherlands)

    J.B.G. Frenk (Hans); A.R. Thurik (Roy); C.A. Bout

    1991-01-01

    textabstractIn this paper approximation results for the M/G/s queueing model are used to derive an empirically verified shop type dependent non-homogeneous relation between labour volume and sales in retail trade. Moreover, we formulate the retailer's labour management as a formal minimization

  17. Beyond Social Protection: Labour Markets, Entrepreneurship, and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    However, speculations about potential labour disincentives and a "culture of dependency" abound. ... Martinez-Restrepo, a young Colombian researcher finishing her PhD studies, was invited to join and coordinate a regional project titled: Beyond Social Protection: Labour Markets, Entrepreneurship, and Gender Equality.

  18. CONTRACT LABOUR SYSTEM AND LESSONS FOR POST ...

    African Journals Online (AJOL)

    Shiweda

    2017-02-02

    Feb 2, 2017 ... Various historians have written on contract labour system in. Namibia and have analysed the origins of the institutionalized structure of labour exploitation, central to colonial power and profit (see Clarence-Smith & Moorsom 1975;. Katjavivi 1988; Emmett 1999; Stals 1967). The literature highlights the ...

  19. The experience of labour with epidural analgesia

    DEFF Research Database (Denmark)

    Jepsen, Ingrid; Keller, Kurt Dauer

    2014-01-01

    of the epidural analgesia as high, in general, their satisfaction with labour is unchanged or even lower when epidural analgesia is used. Question: How do women experience being in labour with epidural analgesia, and what kind of midwifery care do they, consequently, need? Methods: A field study and semi...

  20. The baby has not come: obstructed labour

    African Journals Online (AJOL)

    Introduction. This article is about how to recognize obstructed labour and deal with it in a way that preserves the life and health of mother and child. It is for midwives and others who work in maternity care and is based on our experiences in Yei, South Sudan. Obstructed labour means that the baby is too big to pass through ...

  1. 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

  2. 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.

  3. Selected maternal, fetal and placental trace element and heavy metal and maternal vitamin levels in preterm deliveries with or without preterm premature rupture of membranes.

    Science.gov (United States)

    Kucukaydin, Zehra; Kurdoglu, Mertihan; Kurdoglu, Zehra; Demir, Halit; Yoruk, Ibrahim H

    2018-01-25

    To compare maternal, fetal and placental trace element (magnesium, zinc and copper) and heavy metal (cadmium and lead) and maternal vitamin (retinol, α [alpha]-tocopherol, vitamin D 3 , 25-hydroxyvitamin D 3 and 1,25-dihydroxyvitamin D 3 ) levels in preterm deliveries with and without preterm premature rupture of membranes (PPROM). Sixty-eight patients giving birth preterm were grouped into preterm deliveries with PPROM (n = 35) and without PPROM (n = 33). Following delivery, maternal and umbilical cord blood sera and placental tissue samples were obtained. While magnesium, zinc, copper, cadmium and lead levels were measured in all samples, the levels of retinol, α-tocopherol, vitamin D 3 , 25-hydroxyvitamin D 3 and 1,25-dihydroxyvitamin D 3 were measured only in maternal serum. While magnesium level in maternal serum and zinc levels in both maternal and umbilical cord sera were lower, placental magnesium level was higher in preterm deliveries with PPROM (P 0.05). In preterm deliveries with PPROM, 25-hydroxyvitamin D 3 and retinol levels were higher, while vitamin D 3 and 1,25-dihydroxyvitamin D 3 levels were lower in maternal serum (P < 0.05). Maternal serum α-tocopherol levels were similar between the groups. Compared to spontaneous preterm births, PPROM is associated with low maternal serum together with high placental tissue magnesium and low maternal and umbilical cord sera zinc levels. Higher retinol and 25-hydroxyvitamin D 3 and lower vitamin D 3 and 1,25-dihydroxyvitamin D 3 maternal serum levels are also evident in these patients. © 2018 Japan Society of Obstetrics and Gynecology.

  4. Health consequences of child labour in Bangladesh

    Directory of Open Access Journals (Sweden)

    Salma Ahmed

    2014-01-01

    Full Text Available Background: The paper examines the effect of child labour on child health outcomes in Bangladesh, advancing the methodologies and the results of papers published in different journals. Objective: We examine the effect of child labour on child health outcomes. Methods: We used Bangladesh National Child Labour Survey data for 2002-2003 for our analysis. Results: The main finding of the paper suggests that child labour is positively and significantly associated with the probability of being injured or becoming ill. Intensity of injury or illness is significantly higher in construction and manufacturing sectors than in other sectors. Health disadvantages for different age groups are not essentially parallel. Conclusions: The results obtained in this paper strengthen the need for stronger enforcement of laws that regulate child labour, especially given its adverse consequences on health. Although the paper focuses on Bangladesh, much of the evidence presented has implications that are relevant to policymakers in other developing countries.

  5. Universal cervical length screening for singleton pregnancies with no history of preterm delivery, or the inverse of the Pareto principle.

    Science.gov (United States)

    Rozenberg, P

    2017-06-01

    Ultrasound measurement of cervical length in the general population enables the identification of women at risk for spontaneous preterm delivery. Vaginal progesterone is effective in reducing the risk of preterm delivery in this population. This screening associated with treatment by vaginal progesterone is cost-effective. Universal screening of cervical length can therefore be considered justified. Nonetheless, this screening will not appreciably reduce the preterm birth prevalence: in France or UK, where the preterm delivery rate is around 7.4%, this strategy would make it possible to reduce it only to 7.0%. This small benefit must be set against the considerable effort required in terms of screening ultrasound scans. Universal ultrasound screening of cervical length is the inverse of Pareto's principle: a small benefit against a considerable effort. © 2016 Royal College of Obstetricians and Gynaecologists.

  6. Trends in family labour, hired labour and contract work on french fieldcrop farms: the role of agricultural policies

    OpenAIRE

    Dupraz, Pierre; Latruffe, Laure

    2010-01-01

    This article analyses the factors driving the evolution of on-farm labour use, including own family labour, hired labour and contract work, in French fieldcrop farms during 1990-2007. Particular attention is given to the level and type of agricultural support. The increase in the farm labour force over the years is due to increases in hired labour and contract work which are complements for each other rather than substitutes, and complement for family labour. Crop area payments and Single Far...

  7. The Czech Labour Market and Flexicurity

    Directory of Open Access Journals (Sweden)

    Potužáková Zuzana

    2009-12-01

    Full Text Available Flexicurity reflects the current basic trend within the EU in guaranteeing high employment levels and attainability of national fiscal systems. It was introduced in Denmark in 90ties and helped to reduce the (long-term unemployment levels significantly. The Czech labour market, despite the transformation process, has still a space for further improvement, especially in the time of economic slow-down. The aim of the paper is to describe the flexicurity elements in the Czech Republic. First of all, we describe the general economical background and compare it with other Central European economies and with situation in Denmark where the concept comes from. In other parts of the paper we analyze the particular elements of the so called golden triangle of flexicurity – flexible labour market, generous welfare system and active labour market policies. We also focus on the components of the flexicurity, which the Czech labour market still lacks and would be useful to implement them. Despite the fact that the previous period (years 2005-2008 was very successful, the period was not used effectively to reform the labour market deeper. The Czech labour market faces nowadays several crucial problems such as too high employment protection of the regular workers or small incentives for the long-term unemployed to re-enter the labour market. As a result of these features we can speak without doubt about dual labour market protecting part of labour force too generously and leaving too many people outside the market. Further the construction of the social system does not motivate the long-term unemployed to enter the labour market again or to get further qualification to boost their chances to get a job again. All these facts lead to the ineffective operation with the human capital in the Czech Republic and deepen the costs on social and relating policies.

  8. 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

  9. Hypnosis for pain management during labour and childbirth.

    Science.gov (United States)

    Madden, Kelly; Middleton, Philippa; Cyna, Allan M; Matthewson, Mandy; Jones, Leanne

    2016-05-19

    women in the hypnosis group and those in the control groups for most of the other primary outcomes. There were no clear differences for sense of coping with labour (MD 0.22, 95% CI -0.14 to 0.58, one study, 420 women; low-quality evidence) or spontaneous vaginal birth (average RR 1.12, 95% CI 0.96 to 1.32, six studies, 2361 women; low-quality evidence; random-effects model). There were no clear differences for satisfaction with pain relief (measured on a seven-point scale two weeks postnatally) for women in the hypnosis group who also received pethidine (MD 0.41, 95% CI -0.45 to 1.27; one study, 72 women), Entonox (MD 0.19, 95% CI -0.19 to 0.57; one study, 357 women), self-hypnosis (MD 0.28, 95% CI -0.32 to 0.88; one study, 160 women), or epidural (MD -0.03, 95% CI -0.40 to 0.34; one study, 127 women), but a slight benefit in favour of hypnosis was seen for women who received water immersion (MD 0.52, 95% CI 0.04 to 1.00; one study, 174 women (all low-quality evidence). There were no clear differences for satisfaction with pain relief when it was measured as the number of women who reported they had adequate pain relief (risk ratio (RR) 1.06, 95% confidence interval (CI) 0.94 to 1.20, one study, 264 women; low-quality evidence). It should be noted that for pharmacological pain relief and spontaneous vaginal birth, there was evidence of considerable statistical heterogeneity, which could not be fully explained by subgroup analysis.For this review's secondary outcomes, no clear differences were found between women in the hypnosis group and women in the control groups for most outcomes where data were available. There was mixed evidence regarding benefits for women in the hypnosis group compared with all control groups for pain intensity, satisfaction with childbirth experience and postnatal depression. For each of these outcomes, data from more than one trial were available for analysis but could not be combined due to differences in measurement methods. There was

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

    Directory of Open Access Journals (Sweden)

    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

  11. Induction of labour for improving birth outcomes for women at or beyond term

    Science.gov (United States)

    Gülmezoglu, A Metin; Crowther, Caroline A; Middleton, Philippa; Heatley, Emer

    2014-01-01

    Background As a pregnancy continues beyond term the risks of babies dying inside the womb or in the immediate newborn period increase. Whether a policy of labour induction at a predetermined gestational age can reduce this increased risk is the subject of this review. Objectives To evaluate the benefits and harms of a policy of labour induction at term or post-term compared with awaiting spontaneous labour or later induction of labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (31 March 2012). Selection criteria Randomised controlled trials conducted in women at or beyond term. The eligible trials were those comparing a policy of labour induction with a policy of awaiting spontaneous onset of labour. Cluster-randomised trials and cross-over trials are not included. Quasi-random allocation schemes such as alternation, case record numbers or open random-number lists were not eligible. Data collection and analysis Two review authors independently assessed trials for inclusion. Two review authors independently assessed trial quality and extracted data. Data were checked for accuracy. Outcomes are analysed in two main categories: gestational age and cervix status. Main results We included 22 trials reporting on 9383 women. The trials were generally at moderate risk of bias. Compared with a policy of expectant management, a policy of labour induction was associated with fewer (all-cause) perinatal deaths: risk ratio (RR) 0.31, 95% confidence interval (CI) 0.12 to 0.88; 17 trials, 7407 women. There was one perinatal death in the labour induction policy group compared with 13 perinatal deaths in the expectant management group. The number needed to treat to benefit (NNTB) with induction of labour in order to prevent one perinatal death was 410 (95% CI 322 to 1492). For the primary outcome of perinatal death and most other outcomes, no differences between timing of induction subgroups were seen; the majority of trials adopted

  12. Spontaneous uterine rupture

    African Journals Online (AJOL)

    ABSTRACT. Rupture of a gravid uterus is a surgical emergency. Predisposing factors include a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present the case of a spontaneous complete uterine rupture at a gestational age of 34 weeks in a 35 year old patient ...

  13. Spontaneous intracranial hypotension.

    LENUS (Irish Health Repository)

    Fullam, L

    2012-01-31

    INTRODUCTION: Spontaneous\\/primary intracranial hypotension is characterised by orthostatic headache and is associated with characteristic magnetic resonance imaging findings. CASE REPORT: We present a case report of a patient with typical symptoms and classical radiological images. DISCUSSION: Spontaneous intracranial hypotension is an under-recognised cause of headache and can be diagnosed by history of typical orthostatic headache and findings on MRI brain.

  14. Maternal and neonatal epidemiological features in clinical subtypes of preterm-birth

    Science.gov (United States)

    Gimenez, Lucas G.; Krupitzki, Hugo B.; Momany, Allison M.; Gili, Juan A.; Poletta, Fernando A.; Campaña, Hebe; Cosentino, Viviana R.; Saleme, César; Pawluk, Mariela; Murray, Jeffrey C.; Castilla, Eduardo E.; Gadow, Enrique C.; Lopez-Camelo, Jorge S.

    2016-01-01

    Objective This study was designed to characterize and compare the maternal and newborn epidemiological characteristics through analysis of environmental factors, socio-demographic characteristics, and clinical characteristics between the different clinical subtypes of preterm birth (PTB): Idiopathic (PTB-I), premature rupture of the membranes (PTB-PPROM) and medically indicated (PTB-M). The two subtypes PTB-I and PTB-PPROM grouped are called spontaneous preterm births (PTB-S). Methods A retrospective, observational study was conducted in 1.291 preterm non-malformed singleton live-born children to nulliparous and multiparous mother’s in Tucumán-Argentina between 2005 and 2010. Over 50 maternal variables and ten newborn variables were compared between the different clinical subtypes. The comparisons were done to identify heterogeneity between subtypes of preterm birth: (PTB-S) vs. (PTB-M), and within spontaneous subtype: (PTB-I) vs. (PTB-PPROM). In the same way, two conditional logistic multivariate regressions were used to compare the odds ratio (OR) between PTB-S and PTB-M, as well as PTB-I and PTB-PPROM. We matched for maternal age when comparing maternal variables and gestational age when comparing infant variables. Results The PTB-I subtype was characterized by younger mothers of lower socioeconomic status, PTB-PPROM was characterized by environmental factors resulting from inflammatory processes, and PTB-M was characterized by increased maternal or fetal risk pregnancies. Conclusions The main risk factor for PTB-I and PTB-M was having had a prior preterm delivery, however previous spontaneous abortion was not a risk factor, suggesting a reproductive selection mechanism. PMID:26701680

  15. 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.

  16. Low-dose aspirin and preterm birth: a randomized controlled trial.

    Science.gov (United States)

    Silver, Robert M; Ahrens, Katherine; Wong, Luchin F; Perkins, Neil J; Galai, Noya; Lesher, Laurie L; Faraggi, David; Wactawski-Wende, Jean; Townsend, Janet M; Lynch, Anne M; Mumford, Sunni L; Sjaarda, Lindsey; Schisterman, Enrique F

    2015-04-01

    To evaluate the association between low-dose aspirin initiated before conception and the risk of preterm birth. This was a secondary analysis of the Effects of Aspirin in Gestation and Reproduction trial. Women with a history of pregnancy loss (original stratum: one loss less than 20 weeks of gestation during the previous year; expanded stratum: one or two losses with no restrictions on timing or gestational age of the losses) were randomized to either daily low-dose aspirin (81 mg, n=615) and folic acid or folic acid alone (placebo; n=613). Preterm birth was compared between groups using intent-to-treat analysis. Preterm birth rates were 4.1% (22/535 low-dose aspirin) and 5.7% (31/543 placebo) (relative risk [RR] 0.72, 95% confidence interval [CI] 0.42-1.23); spontaneous preterm birth rates were 1.1% (6/535 low-dose aspirin) and 2.2% (12/543 placebo) (RR 0.51, 95% CI 0.19-1.34); medically indicated preterm birth rates were 2.6% (14/535 low-dose aspirin) and 2.9% (16/543 placebo) (RR 0.89, 95% CI 0.44-1.80). After restriction to confirmed pregnancies using inverse probability weighting, preterm birth rates were 5.7% and 9.0% (RR 0.63, 95% CI 0.37-1.09) and spontaneous preterm birth rates were 1.4% and 3.2% (RR 0.44, 95% CI 0.17-1.18). In confirmed pregnancies in the original stratum, preterm birth occurred in 3.8% and 9.7% of the low-dose aspirin and placebo groups, respectively (RR 0.39, 95% CI 0.16-0.94). Preconception low-dose aspirin was not significantly associated with the overall rate of preterm birth. Although the study was underpowered for this secondary analysis, numeric trends in favor of benefit, particularly in the women with a recent, single early pregnancy loss, warrant further investigation. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00467363.

  17. FOETOMATERNAL AND NEONATAL OUTCOME OF PRETERM PREMATURE RUPTURE OF MEMBRANES

    Directory of Open Access Journals (Sweden)

    Kusumam Vilangot Nhalil

    2017-10-01

    Full Text Available BACKGROUND Preterm premature rupture of membrane is defined as rupture of foetal membrane before onset of labour at less than 37 completed weeks of gestation. Incidence of PPROM is around 3-10% of all deliveries. Primary complication for mother is infection and for foetus and neonate is prematurity, foetal distress, cord compression, deformation, pulmonary hypoplasia, necrotising enterocolitis and neurologic disorders. Most likely outcome is preterm delivery within 1 week. The aim of the study is to study the foetomaternal and neonatal outcome in PPROM patients and the common prevalent organism in PPROM. MATERIALS AND METHODS This is a cohort study of pregnant women from 24-37 weeks with PPROM admitted to IMCH for a period of 1 year, January 2016 to December 2016. 100 patients with PPROM were taken up for the study. The data was collected using the following inclusion and exclusion criteria. Inclusion criteria are gestational age 24-37 weeks confirmed by dates, clinical examination and ultrasound with lack of uterine contractions for at least 1 hour from PPROM; single live pregnancy in vertex presentation; PPROM confirmed by direct visualisation, neonates admitted in NICU soon after delivery. RESULTS 49% of patients with preterm premature rupture of membranes were from 18-24 years.68% of patients had a latency period of 3 weeks.15% of patients had maternal tachycardia, 4% had tenderness of uterus and 4% had leucocytosis and 14% had an elevated CRP. Thus, clinical chorioamnionitis was seen in 14% of patients, 38% of babies born had prematurity and 2% had sepsis and 19% had respiratory distress syndrome and hyperbilirubinaemia, 2% had perinatal asphyxia, 2% had anomalies, 1% had necrotising enterocolitis and 5% were NND. Common organisms were normal flora, E. coli, Streptococci and Enterococci. CONCLUSION PPROM increases the incidence of maternal morbidity with longer hospital stay due to chorioamnionitis. Neonatal morbidity is increased due to

  18. OUR EXPERIENCE WITH EPIDURAL LABOUR ANALGESIA

    Directory of Open Access Journals (Sweden)

    Uršula Reš Muravec

    2003-12-01

    Full Text Available Background. To evaluate the effects of regional labour analgesia used at the Hospital for Gynecology and Obstetrics in Postojna, Slovenia, in the year 2002.Patients and methods. In this retrospective study we enrolled 294 parturients who delivered in the year 2002 in the Postojna Maternity Hospital: in group 1 there were 147 parturients in whom three different regional analgesic techniques (study group were used at labour; in group 2 there were 147 parturients in whom regional analgesia was not used (control group. In the first step the two groups were compared in terms of maternal demographic data, duration and outcome of labour and 1' and 5' Apgar scores. In the second step the three regional analgesic groups were compared in terms of the course and outcome of labour, fetal condition, side and adverse effects of regional analgesic techniques, and patient satisfaction with a particular analgesic technique.Results. Regional labour analgesia was used in 147 (14% of the 1048 women who delivered in 2002: epidural analgesia (EPI was performed in 51.0%, combined spinal-epidural (CSE in 42.2% and spinal analgesia (SA in 6.8% of cases. The women in the regional analgesia group were significantly older, more educated, more often nulliparous and accompanied by their partner at labour than the women in the control group. Further, the duration of labour was significantly longer, oxytocin more frequently administered than in the control group. In terms of labour outcome there were no differences in the Cesarean section rates and 1- and 5-min Apgar scores minutes, but and the vacuum extraction rate was significantly higher in the regional analgesia group. Among the three regional analgesia techniques used, there were no statistically significant differences observed in terms of labour duration and outcome, and Apgar scores. The patient satisfaction was greatest with CSE. Adverse side effects such as weak muscles, reduced motion abilities, itching, nausea

  19. Male and Female Labour Supply in Denmark

    DEFF Research Database (Denmark)

    Graversen, Ebbe Krogh

    1996-01-01

    This paper estimates labour supply for married and single men and women in Denmark in 1990, using a double-hurdle model which allows involuntary unemployment due to for example demand restrictions, and fixed costs of work. A labour supply f unction based on a variant of the Stone-Geary utility...... function with a nonlinear wage rate is estimated. Elasticities of labour supply with respect to wage, income and tax rate are presented. Finally, the effects on the four groups of a few recently discussed tax and transfer reforms in Denmark are simulated....

  20. Migration in a segmented labour market.

    Science.gov (United States)

    Gordon, I

    1995-01-01

    "Current research in migration is moving on from neo-classical and behavioural perspectives to a more structural approach relating to wider processes, issues of power and the particular role of employers. Within this programme a key issue for investigation is the interaction between spatial mobility and the structuring of labour markets. This paper focuses on the significance of labour market segmentation--in terms both of job stability and gender--for migration, both theoretically and through an empirical analysis of data from the UK Labour Force Survey on sponsored and unsponsored moves." excerpt

  1. Optimal tax progressivity in imperfect labour markets

    DEFF Research Database (Denmark)

    Sørensen, Peter Birch

    1999-01-01

    All modern labour market theories capable of explaining involuntary unemployment as an equilibrium phenomenon imply that increased income tax progressivity reduces unemployment, but they also imply that higher progressivity tends to reduce work effort and labour productivity. This suggests...... that there may be an optimal degree of tax progressivity where the marginal welfare gain from reduced involuntary unemployment is just offset by the marginal welfare loss from lower productivity. This paper sets up four different models of an imperfect labour market in order to identify the degree of tax...

  2. Corporate Social Responsibility and Labour Agency

    DEFF Research Database (Denmark)

    Lund-Thomsen, Peter; Coe, Neil M.

    2015-01-01

    This article examines the circumstances under which corporate social responsibility (CSR) initiatives facilitate and/or constrain labour agency in global production networks (GPNs). Using a case study of Nike’s CSR approach in the football manufacturing industry of Pakistan, we explore the extent...... to which the measures advocated in a new, emerging policy paradigm on CSR in GPNs enabled labour agency at Nike’s main football supplier factory in Pakistan. We argue that while such CSR policies can create enhanced space for labour agency, that potential agency is also shaped (i) by wider economic forces...

  3. 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

  4. Exhaled Carbon Dioxide and Neonatal Breathing Patterns in Preterm Infants after Birth.

    Science.gov (United States)

    Nicoll, Jessica; Cheung, Po-Yin; Aziz, Khalid; Rajani, Vishaal; O'Reilly, Megan; Pichler, Gerhard; Schmölzer, Georg M

    2015-10-01

    To examine the amount of exhaled carbon dioxide (ECO2) with different breathing patterns in spontaneously breathing preterm infants after birth. Preterm infants had a facemask attached to a combined carbon dioxide/flow sensor placed over their mouth and nose to record ECO2 and gas flow. A breath-by-breath analysis of the first 5 minutes of the recording was performed. Thirty spontaneously breathing preterm infants, gestational age (mean ± SD) 30 ± 2 weeks and birth weight 1635 ± 499 g were studied. ECO2 from normal breaths and slow expirations was significantly larger than with other breathing patterns (P breath also increased with gestational age P breathing pattern both during the first minute of recording and overall. Breathing pattern proportions also varied by gestational age. Finally, ECO2 from the fifth minute of recording was significantly greater than that produced during the first 4 minutes of recording (P ≤ .029). ECO2 varies with different breathing patterns and increases with gestational age and over time. ECO2 may be an indicator of lung aeration and that postnatal ECO2 monitoring may be useful in preterm infants in the delivery room. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Chest physiotherapy in preterm infants with lung diseases

    Directory of Open Access Journals (Sweden)

    Cota Francesco

    2010-09-01

    Full Text Available Abstract Background In neonatology the role of chest physiotherapy is still uncertain because of the controversial outcomes. Methods The aim of this study was to test the applicability in preterm infants of 'reflex rolling', from the Vojta method, in preterm neonates with lung pathology, with particular attention to the effects on blood gases and oxygen saturation, on the spontaneous breathing, on the onset of stress or pain. The study included 34 preterm newborns with mean gestational age of 30.5 (1.6 weeks - mean (DS - and birth weight of 1430 (423 g - mean (DS -, who suffered from hyaline membrane disease, under treatment with nasal CPAP (continuous positive airways pressure, or from pneumonia, under treatment with oxygen-therapy. The neonates underwent phase 1 of 'reflex rolling' according to Vojta method three times daily. Respiratory rate, SatO2, transcutaneous PtcCO2 e PtcO2 were monitored; in order to evaluate the onset of stress or pain following the stimulations, the NIPS score and the PIPP score were recorded; cerebral ultrasound scans were performed on postnatal days 1-3-5-7, and then weekly. Results In this population the first phase of Vojta's 'reflex rolling' caused an increase of PtcO2 and SatO2 values. No negative effects on PtcCO2 and respiratory rate were observed, NIPS and PIPP stress scores remained unmodified during the treatment; in no patient the intraventricular haemorrhage worsened in time and none of the infants developed periventricular leucomalacia. Conclusions Our experience, using the Vojta method, allows to affirm that this method is safe for preterm neonates, but further investigations are necessary to confirm its positive effects and to evaluate long-term respiratory outcomes.

  6. pectations of the pain of labour, in urban Xhosa primigravidae

    African Journals Online (AJOL)

    Adele

    Qualitative study of the knowledge and ex- pectations of the pain of labour, in urban. Xhosa primigravidae. Introduction. Although various modes of analgesia for labour are well established in the black population of South Africa, there are few analyses of the knowledge and expectations of labour and labour pain. Consider-.

  7. The influence of technological changes on labour availability: A ...

    African Journals Online (AJOL)

    In developing countries (such as Nigeria), labour is an essential factor in farming. This is because most of the farming activities are carried out with the use of labour. However, the advent of technological development has had an influence on labour availability. In view of the importance of labour in Nigerian agriculture, this ...

  8. 55 Implications of Child Labour on Household Resource Management

    African Journals Online (AJOL)

    User

    2012-04-25

    Apr 25, 2012 ... Child Labour: A Briefing Manual;. International Labour Office, Geneva, pp71. Nkuly J. L. 2000. Child Labour: background paper. African Newsletter on. Occupational Health and Safety. 10(2), 36 – 39. Oloko S. B. A. 1997. Child Labour, in: The progress of Nigeria children. Nigeria. UNICEF/FOS Lagos, 48 – ...

  9. The Puzzle of Migrant Labour Shortage and Rural Labour Surplus in China

    OpenAIRE

    John Knight; Deng Quheng and Li Shi

    2010-01-01

    The paper examines the contentious issue of the extent of surplus labour that remains in China. China was an extreme example of a surplus labour economy, but the rapid economic growth during the period of economic reform requires a reassessment of whether the second stage of the Lewis model has been reached or is imminent. The literature is inconclusive. On the one hand, there are reports of migrant labour scarcity and rising migrant wages; on the other hand, estimates suggest that a consider...

  10. LABOUR FORCE PERCEPTIONS ABOUT THE RELATIONSHIP BETWEEN EDUCATION SYSTEM PERFORMANCES AND LABOUR MARKET REQUIREMENTS

    OpenAIRE

    Gina Cristina DIMIAN; Monica ROMAN; Laura MURESAN

    2012-01-01

    The purpose of this paper is to investigate some of the educational mismatches occurred in the Romanian labour market and to try to find solutions for a more rapid adaptation of the education system to labour market transformations. The analysis is based on a quantitative research aimed at studying employers’ opinions related to the relationship between education system performances and labour market requirements.The results show that even in a crisis period when unemployment is at high value...

  11. 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.

  12. Twitter, Journalism and Affective Labour

    Directory of Open Access Journals (Sweden)

    Eugenia Siapera

    2015-03-01

    Full Text Available The rise of the network aspects of journalism in the context of social mediasuch as Twitter, and the increased importance accorded to community building and maintenance as well as to reciprocity, point to the need to take into account the affective part of journalistic labour. This refers to these aspects of journalistic work that are linked to the creation of networks and communities, to interactions with readers and the forming of bonds between journalists and their readers. An analysis of the affective labour of journalists on Twitter, we argue, is necessary in order to understand the potential and ambiguities of this part of their labour. Based on a set of in-depth interviews with Twitter journalists, this article found three main repertoires of affective labour: the organic relations repertoire, which points to the increasing importance of authenticity as a means of establishing credibility on Twitter; the temporal repertoire; and the repertoire of responsibility. The importance of the affective labour of journalism is found in its biopolitical productivity. The development of an organic relationship with followers, the emergence of stronger bonds between core groups that then become communities, the extension of care and help to the network, are all evidence of the importance of this biopolitical productivity and point to the construction of a new and potentially more radical sociopolitical role for journalism. However, this potential is ambiguous insofar as these elements contain unresolved tensions and ambiguities. These include the trade in selves and the associated commodification; the re-formulation of time, especially its diachronic dimension, as accumulation of social capital; the role of reciprocity and responsibility in reproducing inequalities; and care as care for only those deemed deserving. These ambiguities severely undermine and limit the potentials of affective labour, pointing to the need to develop a purposeful political

  13. Manual and Electroacupuncture for Labour Pain: Study Design of a Longitudinal Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Linda Vixner

    2012-01-01

    Full Text Available Introduction. Results from previous studies on acupuncture for labour pain are contradictory and lack important information on methodology. However, studies indicate that acupuncture has a positive effect on women’s experiences of labour pain. The aim of the present study was to evaluate the efficacy of two different acupuncture stimulations, manual or electrical stimulation, compared with standard care in the relief of labour pain as the primary outcome. This paper will present in-depth information on the design of the study, following the CONSORT and STRICTA recommendations. Methods. The study was designed as a randomized controlled trial based on western medical theories. Nulliparous women with normal pregnancies admitted to the delivery ward after a spontaneous onset of labour were randomly allocated into one of three groups: manual acupuncture, electroacupuncture, or standard care. Sample size calculation gave 101 women in each group, including a total of 303 women. A Visual Analogue Scale was used for assessing pain every 30 minutes for five hours and thereafter every hour until birth. Questionnaires were distributed before treatment, directly after the birth, and at one day and two months postpartum. Blood samples were collected before and after the first treatment. This trial is registered at ClinicalTrials.gov: NCT01197950.

  14. Prostaglandin E2 gel In ripening of cervix in induction of labour.

    Directory of Open Access Journals (Sweden)

    Warke H

    1999-10-01

    Full Text Available A study was done in 75 patients who underwent induction of labour with Prostaglandin E2 gel. All these patients had an unripe cervix. The commonest indications were post-datism, intrauterine growth retardation and pregnancy-induced hypertension. All patients were primigravidas with singleton pregnancy and beyond 35 weeks of pregnancy. The mean Bishop score at the time of instillation was less than three. The improvement of another 2-3 points within six hours and by 7-8 points within 12 hours was found after instillation of the gel. 92% of the patients went into spontaneous labour and 8% required reinstillation. The incidence of failed induction was 1.33%. The mean duration of latent phase was 10.34 hours. Induction delivery time was 16.43 hours. 68.1% patients required augmentation of labour and 31.9% did not require augmentation of labour with oxytocin drip. The incidence of vaginal delivery was 81.33% and that of caesarean section was 17.33%. The commonest indication of caesarean section was foetal distress.

  15. Progesterone for the prevention of preterm birth: indications, when to initiate, efficacy and safety

    Directory of Open Access Journals (Sweden)

    Helen Y How

    2008-12-01

    Full Text Available Helen Y How, Baha M SibaiDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, OH USAAbstract: Preterm birth is the leading cause of neonatal mortality and morbidity and long-term disability of non-anomalous infants. Previous studies have identified a prior early spontaneous preterm birth as the risk factor with the highest predictive value for recurrence. Two recent double blind randomized placebo controlled trials reported lower preterm birth rate with the use of either intramuscular 17 alpha-hydroxyprogesterone caproate (IM 17OHP-C or intravaginal micronized progesterone suppositories in women at risk for preterm delivery. However, it is still unclear which high-risk women would truly benefit from this treatment in a general clinical setting and whether socio-cultural, racial and genetic differences play a role in patient’s response to supplemental progesterone. In addition the patient’s acceptance of such recommendation is also in question. More research is still required on identification of at risk group, the optimal gestational age at initiation, mode of administration, dose of progesterone and long-term safety.Keywords: preterm birth prevention, 17-alpha-hydroxyprogesterone caproate

  16. Intracluster correlation coefficients for the Brazilian Multicenter Study on Preterm Birth (EMIP): methodological and practical implications

    Science.gov (United States)

    2014-01-01

    Background Cluster-based studies in health research are increasing. An important characteristic of such studies is the presence of intracluster correlation, typically quantified by the intracluster correlation coefficient (ICC), that indicate the proportion of data variability that is explained by the way of clustering. The purpose of this manuscript was to evaluate ICC of variables studied in the Brazilian Multicenter Study on Preterm Birth. Methods This was a multicenter cross-sectional study on preterm births involving 20 referral hospitals in different regions of Brazil plus a nested case–control study to assess associated factors with spontaneous preterm births. Estimated prevalence rates or means, ICC with 95% confidence intervals, design effects and mean cluster sizes were presented for more than 250 maternal and newborn variables. Results Overall, 5296 cases were included in the study (4,150 preterm births and 1,146 term births). ICC ranged from 0.3 was found in some clinical management aspects well defined in literature such as use of corticosteroids, indicating there was homogeneity in clusters for these variables. Conclusions Clusters selected for Brazilian Multicenter Study on Preterm Birth had mainly heterogeneous findings and these results can help researchers estimate the required sample size for future studies on maternal and perinatal health. PMID:24755392

  17. Mechanical methods for induction of labour

    NARCIS (Netherlands)

    Jozwiak, Marta; Bloemenkamp, Kitty W. M.; Kelly, Anthony J.; Mol, Ben Willem J.; Irion, Olivier; Boulvain, Michel

    2012-01-01

    Background Mechanical methods were the first methods developed to ripen the cervix and induce labour. During recent decades they have been substituted by pharmacological methods. Potential advantages of mechanical methods, compared with pharmacological methods, may include simplicity of

  18. Online Resistance to Precarious Archaeological Labour

    Directory of Open Access Journals (Sweden)

    Sam Hardy

    2015-05-01

    Full Text Available The international cultural heritage economy has long been underpinned by a reserve army of unemployed/underemployed labour. The entry-level workforce is being further undermined and unpaid/underpaid labour is additionally being consolidated through the crisis and austerity measures. Independently and under different pressures, archaeologists across Europe have begun to use blogging, micro-blogging and other social media in concerted national efforts to document, analyse and resist exploitative and exclusive employment practices. This article focuses on the development of movements against unpaid labour (free archaeology in the UK, against unpaid and underpaid internship (volontariato and stage in Italy, and for employment (istihdam in Turkey. Using insights gained through observing and participating in these movements, and through running a research blog on precarious labour in the cultural heritage industry, this article examines the benefits and limits of blogging/micro-blogging as a tool for debate within the profession, communication with the public, and activism.

  19. Labour market transitions and job satisfaction

    NARCIS (Netherlands)

    G.E. Bijwaard (Govert); A. van Dijk (Bram); J. de Koning (Jaap)

    2003-01-01

    textabstractThe paper investigates the relationship between job satisfaction and labour market transitions. Using a multinomial logit model, a model is estimated on the basis of individual data in which transitions are explained from individual characteristics, job characteristics, dissatisfaction

  20. Trade Unions, Forced Labour and Human Trafficking

    Directory of Open Access Journals (Sweden)

    Michele Ford

    2015-09-01

    Full Text Available This article examines the dilemmas facing trade unions seeking to engage on questions of forced labour and human trafficking. The International Labour Organization and elements of the international trade union movement have succeeded in getting forced labour on the policy agenda globally and within many national settings. However, trade unions have limited capacity to effect real change in relation to these issues because of limitations on their influence, determined largely by membership density and the limited number of sectors in which they are present, but also internal assessments of what constitutes ‘core business’. As a consequence, while trade unions may advocate for legislative or policy change, partner with non-governmental organisations to deal with particular cases, or even engage directly with vulnerable populations, the integration of those populations into the day to day concerns of trade unions necessarily remains elusive—particularly in the global south, where forced labour is most prevalent.

  1. Child labour: a public health issue.

    Science.gov (United States)

    Gulzar, Saleema Aziz; Vertejee, Samina; Pirani, Laila

    2009-11-01

    Child labour is a global practice and has many negative outcomes. According to International Labour Organization, child labour is the important source of child exploitation and child abuse in the world today. The Human Rights Commission of Pakistan has estimated the number of Pakistani working children to be around 11-12 millions, out of which, at least, half the children are under the age of ten years. It portrays the society's attitude towards child care. It is therefore, essential to break this vicious cycle and hence, enable the society to produce healthy citizens. This article analyzes the determinants of child labour in the Pakistani context and its implications for child's life, in specific, and for the nation, in general, utilizing the model developed by Clemen-stone & McGuire (1991). Since this practice has complex web of causation, a multidisciplinary approach is required to combat this issue through proposed recommendations.

  2. Racial and ethnic disparities in use of 17-alpha hydroxyprogesterone caproate for prevention of preterm birth.

    Science.gov (United States)

    Yee, Lynn M; Liu, Lilly Y; Sakowicz, Allie; Bolden, Janelle R; Miller, Emily S

    2016-03-01

    Racial/ethnic disparities in preterm birth remain a major public health challenge in the United States. While 17-alpha hydroxyprogesterone caproate (17OHP-C) is recommended for preterm birth prevention in women with a prior preterm birth, non-Hispanic black women continue to experience higher rates of recurrent preterm birth than white women receiving the same treatment. Further investigation of disparities in 17OHP-C use and adherence is warranted. We sought to evaluate whether racial and ethnic disparities exist in the use of and adherence to 17OHP-C within a population of eligible women. This was a retrospective cohort study of women with a prior spontaneous, singleton preterm birth who were eligible for 17OHP-C for preterm birth prevention and received care at a single institution from 2010 through 2014. Associations between self-identified race/ethnicity (non-Hispanic black vs women in all other racial/ethnic groups) and documented counseling about 17OHP-C, receipt of any 17OHP-C, and adherence to 17OHP-C administration were each estimated by bivariable analysis and multivariable logistic regression. Adherence to 17OHP-C was defined as not >1 missed dose, initiation racial/ethnic groups. After adjustment for potential confounders, non-Hispanic black women were significantly less likely to be adherent to 17OHP-C (adjusted odds ratio, 0.16; 95% confidence interval, 0.04-0.65). A significant interaction between non-Hispanic black race/ethnicity and public insurance was identified (adjusted odds ratio, 0.16; 95% confidence interval, 0.05-0.52). In a diverse cohort of women eligible for preterm birth prevention, non-Hispanic black women are at an increased risk of nonadherence to 17OHP-C. Non-Hispanic black women with public insurance are at a particularly increased risk of nonadherence. Copyright © 2016 Elsevier Inc. All rights reserved.

  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. Do labour market reforms reduce labour productivity growth? A panel data analysis of 20 OECD countries (1960–2004)

    NARCIS (Netherlands)

    Vergeer, R.; Kleinknecht, A.

    2014-01-01

    Based on comprehensive regression analysis, the authors find that weak wage growth and a smaller labour share of national income significantly reduce labour productivity growth. They conclude that supply-side labour market reforms have contributed to reducing labour productivity growth: this cannot

  6. Effect of body position on ventilation distribution in ventilated preterm infants.

    Science.gov (United States)

    Hough, Judith L; Johnston, Leanne; Brauer, Sandy; Woodgate, Paul; Schibler, Andreas

    2013-02-01

    Positioning is considered vital to the maintenance of good lung ventilation by optimizing oxygen transport and gas exchange in ventilated premature infants. Previous studies suggest that the prone position is advantageous; however, no data exist on regional ventilation distribution for this age group. To investigate the effect of body position on regional ventilation distribution in ventilated and nonventilated preterm infants using electrical impedance tomography. Randomized crossover study design. Neonatal ICU. A total of 24 ventilated preterm infants were compared with six spontaneously breathing preterm infants. Random assignment of the order of the positions supine, prone, and quarter prone. Ventilation distribution was measured with regional impedance amplitudes and global inhomogeneity indices using electrical impedance tomography. In the spontaneously breathing infants, regional impedance amplitudes were increased in the posterior compared with the anterior lung (p < 0.01) and in the right compared with the left lung (p = 0.03). No differences were found in the ventilated infants. Ventilation was more inhomogeneous in the ventilated compared with the healthy infants (p < 0.01). Assessment of temporal regional lung filling showed that the posterior lung filled earlier than the anterior lung in the spontaneously breathing infants (p < 0.02) whereas in the in the ventilated infants the right lung filled before the left lung (p < 0.01). In contrast to previous studies showing that ventilation is distributed to the nondependent lung in infants and children, this study shows that gravity has little effect on regional ventilation distribution.

  7. Factors affecting Child Labour in India

    OpenAIRE

    Maheshwari Mridul; Singh, Manjari

    2008-01-01

    Child labour in India is a critical socio-economic problem that needs special attention of policy makers. In order to make effective policies to reduce child labour it is important to understand the specific factors that affect it in different situations. The paper empirically examines these factors across 35 Indian states and union territories at three levels of aggregation: total population, rural/urban, and male/female. The results showed that education, fertility, and workforce participat...

  8. Indian women in subsistence and agricultural labour.

    OpenAIRE

    Mies M; Lalitha K; Kumari K

    1983-01-01

    Working paper comprising a case study on the economic role of low income rural women, especially as women workers employed in subsistence farming in Andra Pradesh, India. Covers labour force participation, sexual division of labour, sex discrimination in land tenure and occupational structure, the role of women's organizations, income generating activities, employment as agricultural workers and domestic workers, income and family budget. Discusses the effect of the milk credit scheme on pove...

  9. Illegal Immigration and Agrarian Labour Market

    Directory of Open Access Journals (Sweden)

    Venancio Salcines

    2003-03-01

    Full Text Available In this work we analyse the relation which exists between a landowner and the immigrant workers contracted illegally by this person. For this reason, a theoretical model is developed based on the interconnection between the illegal and legal labour market. The big landowner analysed exercises a monopolistic power in the contracting of illegal manual labour. The application of a tariff in two parts permits this big landowner to obtain a greater surplus from the worker.

  10. Wage Setting in Democratic Labour Unions

    DEFF Research Database (Denmark)

    Filges, Trine

    1999-01-01

    In this paper, we analyse the wage setting of a democratic labour union. The union members differ with respect to their employment probabilities. The union wage only changes if the parameters of the median member change. An exogenous shock to revenue may increase the wage, even if labour demand...... is iso-elastic and unemployment benefits may have only a small effect on wages if the median member differs from the average. These findings are in accordance with empirical results....

  11. Labour education in the information age

    OpenAIRE

    Baldacchino, Godfrey

    1991-01-01

    In the context of the managerial and economic restructuring currently underway, this article argues for a systematic policy of labour education meant to empower workers as active participants, critical members and knowledgeable negotiators at the workplace and in society at large. Such labour education is diagnosed firstly in terms of what it is not, by a critique of the dominant brand of "education for work" recently embarked upon by both state and private capital ...

  12. Labour Demand and Exchange Rate Volatility

    OpenAIRE

    Udo Broll; Sabine Hansen

    2004-01-01

    The purpose of this paper is to assess under what conditions exchange rate volatility exerts a positive effect on a firm's labour demand. As the exchange rate volatility increases, so does the value of the export option provided the firm under study is flexible. Flexibility is important because it gives the firm option value. Higher volatility increases the potential gains from trade and may increase the demand for labour. This may explain part of the mixed empirical findings regarding the ef...

  13. Labour Quality Model for Organic Farming Food Chains

    OpenAIRE

    Gassner, B.; Freyer, B.; Leitner, H.

    2008-01-01

    The debate on labour quality in science is controversial as well as in the organic agriculture community. Therefore, we reviewed literature on different labour quality models and definitions, and had key informant interviews on labour quality issues with stakeholders in a regional oriented organic agriculture bread food chain. We developed a labour quality model with nine quality categories and discussed linkages to labour satisfaction, ethical values and IFOAM principles.

  14. Labour-Related Structural Trends in South African Maize Production

    OpenAIRE

    Zyl, J. Van; Vink, Nick; Fenyes, T. I.

    1987-01-01

    The substitution of capital goods, including new technology, for land and labour has played an important role and has influenced the structure of Sout African agriculture. Farm labour-related trends in the summer rainfall grain-producing area of South Africa are considered. The amount of labour used, the remuneration of labour, the substitution of capital for labour and productivity trends are analyzed. Growth rates were obtained by fitting exponential functions with time as independent varia...

  15. Sectoral variation in consequences of intra-European labour migration

    DEFF Research Database (Denmark)

    Refslund, Bjarke

    2016-01-01

    Intra-European labour migration has divergent labour market consequences across institutional settings and economic sectors. Some sectors experience increasing pressure on industrial relations and labour market segmentation while others do not experience such effects, and it remains unclear how...... to explain this variation. Based on empirical findings from a comparative study of four economic sectors in Denmark, this article discusses the role of labour market institutions and structural conditions in shaping the consequences of labour migration at a sectoral level....

  16. 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

  17. [Introduction of emotional labour into oncology].

    Science.gov (United States)

    Lazányi, Kornélia; Molnár, Péter; Szluha, Kornélia

    2007-06-03

    Health care professionals do not have emotional labour obligations in their employment contract. However, in everyday work it is often inevitable for them to change their true feelings. This is critically true for professionals treating chronic or cancer patients. The suitable emotional state of the treatment staff does not only influence the practitioner-patient relationship but the process of recovery as well. Depending on the way one might get into the appropriate emotional state, the literature distinguishes between surface, deep and genuine acting. While surface and deep emotional labour has numerous negative psychological consequences genuine acting is usually accompanied by positive side effects. For those working in the field of oncology, emotional labour is a part of the role expectations of the professionals. This is how the appropriate attitude is a fundamental part of the professionals' essence. For the in depth analysis of subjects related to emotional labour, the authors adopted ideas from L. Festinger 's cognitive dissonance theory. The best way to alleviate cognitive dissonance and the negative side effects of emotional labour is to prevent the emergence of them. Oncology professionals should fit their role expectations genuinely, without particular efforts. If this was impossible, or the particular life situations did not allow genuine acting, it is the employer's and the workmates' common duty to help professionals, to ease the load of emotional labour, to diminish the occurring cognitive dissonance with the help of appropriate recompense.

  18. The conciliation of collective labour conflicts

    Directory of Open Access Journals (Sweden)

    Iulia BĂDOI

    2013-12-01

    Full Text Available The present article envisages presenting the conciliation as a resolution procedure for the conflicts of interests/collective labour conflicts. The conciliation was stipulated as a resolution procedure for the conflicts of interests/collective labour conflicts even from the first acts that regulated this domain, being foreseen as a mandatory phase within the process of solving this type of conflicts. The subject of conciliation was approached before within the doctrine, from this juridical institution development point of view, the used research methods being the observation and the comparative analysis. The legislator adapted the procedure for the resolution of conflicts of interests/ collective labour conflicts in accordance with the social and economic development of the labour relations and identified other means of resolution, such as the mediation, the arbitrage or the strike, when the conciliation didn’t lead to the end of the conflict. The present paper aims is to realize an assessment over the historical development of the labour conflicts conciliation and to draw up a study on the statistical data concerning these conflicts. The study may be used within the research activity, its contribution being set up by the updated presentation of the statistical data and on the legislation within the field of labour conflicts conciliation.

  19. Researching Informal Labour Migration: Russian Realities

    Directory of Open Access Journals (Sweden)

    Lev Perepelkin

    2006-09-01

    Full Text Available Modern Russian society is affected by “non-resident informal employment”: a regular productive activity that is not firmly and officially registered in accordance with Russian foreign labour regulations. A specific characteristic of this phenomenon in Russia is that the multimillion flow of CIS working age citizens enters Russia absolutely legally, but with the intention of working in the so-called shadow or semi-legal economy. The authors’ main aim is to present a complex and balanced evaluation of the situation. On one hand they argue that this labour migration was of some use to Russia, i.e. in the early 1990’s large groups of “informal” foreign workers filled an economic niche, unpopular among local labour force (construction and repair, small sized retail trade etc. and thus enabled to solve the deficit in many services and satisfy needs for basic products. On the other hand, a negative reflection of such shadow employment exceeded all of its conjuncture benefits from post-soviet “gastarbeiter” labour.. The permanency of these migration contingents undermines the Russian labour market, not only from the point of wages and working conditions. It provides and maintains not only unfair labour practices, but also the deterioration of common morals and ethics: the devaluation of positive values, the predominance of cynic pragmatism in Russian people and legislative nihilism.

  20. Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Magro-Malosso, E R; Saccone, G; Chen, M; Navathe, R; Di Tommaso, M; Berghella, V

    2017-02-01

    Several randomized controlled trials (RCTs) compared induction of labour with expectant management in non-diabetic women with suspected fetal macrosomia. To evaluate the effects of labour induction for suspected fetal macrosomia. Literature search in electronic databases. We included all RCTs of suspected fetal macrosomia comparing labour induction with expectant management in term pregnancy. The primary outcome was the incidence of caesarean delivery. Four RCTs, including 1190 non-diabetic women with suspected fetal macrosomia at term, were analysed. Pooled data did not show a significant difference in incidence of caesarean delivery [relative risk (RR) 0.91, 95% confidence interval (CI) 0.76-1.09], operative and spontaneous vaginal delivery, shoulder dystocia, intracranial haemorrhage, brachial plexus palsy, Apgar score macrosomia is associated with a significant decrease in fetal fractures, and therefore can be considered as a reasonable option. TWEETABLE ABSTRACT: #Induction of labour for #macrosomia improves neonatal outcome. © 2016 Royal College of Obstetricians and Gynaecologists.

  1. Re: What is the best treatment to reduce the need for caesarean section in nulliparous women at term with delayed first stage of labour?

    DEFF Research Database (Denmark)

    Boie, Sidsel; Glavind, Julie; Uldbjerg, Niels

    2017-01-01

    The authors pose the question - What is the best treatment to reduce the need for caesarean section in nulliparous women at term with delayed first stage of labour? and state in their paper that "There is no consensus on the optimal dose regimen of oxytocin for delay in the first stage of labour...... in nulliparous women at term (37-42 weeks’ gestation) to reduce unplanned caesarean section and increase vaginal birth with minimal adverse events". However, they describe only low and high dose oxytocin regimens and fail to acknowledge that no oxytocin at all is associated with a spontaneous delivery just...... implies that these are the only options for addressing an improvement in the mode of delivery in slow labour. Although oxytocin shortens labour, it does so at the expense of an increase in uterine hyperstimulation and abnormal fetal heart rate patterns, and this may not be to the advantage of either...

  2. Epidural analgesia during labour, routinely or on request: a cost-effectiveness analysis.

    Science.gov (United States)

    Bonouvrié, Kimberley; van den Bosch, Anouk; Roumen, Frans J M E; van Kuijk, Sander M; Nijhuis, Jan G; Evers, Silvia M A A; Wassen, Martine M L H

    2016-12-01

    To assess the cost-effectiveness of routine labour epidural analgesia (EA), from a societal perspective, as compared with labour analgesia on request. Women delivering of a singleton in cephalic presentation beyond 36+0 weeks' gestation were randomly allocated to routine labour EA or analgesia on request in one university and one non-university teaching hospital in the Netherlands. Costs included all medical, non-medical and indirect costs from randomisation to 6 weeks postpartum. Effectiveness was defined as a non-operative, spontaneous vaginal delivery without EA-related maternal adverse effects. Incremental cost-effectiveness ratio (ICER) was defined as the ratio of the difference in costs and the difference in effectiveness between both groups. Data were analysed according to intention to treat and divided into a base case analysis and a sensitivity analysis. Total delivery costs in the routine EA group (n=233) were higher than in the labour on request group (n=255) (difference -€ 322, 95% CI -€ 60 to € 355) due to more medication costs (including EA), a longer stay in the labour ward, and more operations including caesarean sections. Total postpartum hospital costs in the routine EA group were lower (difference -€ 344, 95% CI -€ 1338 to € 621) mainly due to less neonatal admissions (difference -€ 472, 95% CI -€ 1297 to € 331), whereas total postpartum home and others costs were comparable (difference -€ 20, 95% CI -€ 267 to € 248, and -€ 1, 95% CI -€ 67 to € 284, respectively). As a result, the overall mean costs per woman were comparable between the routine EA group and the analgesia on request group (€ 8.708 and € 8.710, respectively, mean difference -€ 2, 95% CI -€ 1.012 to € 916). Routine labour EA resulted in more deliveries with maternal adverse effects, nevertheless the ICER remained low (€ 8; bootstrap 95% CI -€ 6.120 to € 8.659). The cost-effectiveness acceptability curve indicated a low probability that

  3. Vaginal prostaglandin gel to induce labour in women with one previous caesarean section.

    LENUS (Irish Health Repository)

    Agnew, G

    2012-02-01

    This retrospective study reviewed the mode of delivery when vaginal prostaglandins were used to induce labour in women with a single previous lower segment caesarean section. Over a 4-year period, PGE 2 gel was used cautiously in low doses in 54 women. Induction with PGE 2 gel was associated with an overall vaginal birth after caesarean section (VBAC) rate of 74%, which compared favourably with the 74% VBAC rate in women who went into spontaneous labour (n = 1969). There were no adverse outcomes recorded after the prostaglandin inductions but the number reported are too small to draw any conclusions about the risks, such as uterine rupture. We report our results because they may be helpful in assessing the chances of a successful VBAC in the uncommon clinical circumstances where prostaglandin induction is being considered.

  4. Use of misoprostol for induction of labour in unvaorable cervix in eclampsia

    International Nuclear Information System (INIS)

    Nahar, S.; Begum, S.; Yansur, S.; Rasul, C.H.

    2004-01-01

    Objective: To find out safety and efficiency of Misoprostol in cervical ripening and induction of labour to achieve vaginal delivery. Results: From Misoprostol insertion to delivery time was 4-24 hours. Vaginal delivery was achieved in 80.2%, which included spontaneous, forceps and vacuum extraction. Caesarean section rate was 19.7%. Indications for C. Section included Misoprostol unresponsiveness 11% and fetal distress in 8.6%. Oxytocin augmentation was required in 32% of cases. Term babies were 58%. Intrauterine death and neonatal deaths were 9.8% and 8.6% respectively. Hyper stimulation and postpartum haemorrhage was seen in 2.4% and 3.7% of patients respectively. Conclusion: intravaginal Misoprostol is well tolerated and is very effective for the induction of labour in eclampsia. It helps vaginal delivery in toxemic patients, reduces maternal morbidity, mortality and hospital stay. (author)

  5. Midwifery dilemma: to fast or feed the labouring woman. Part 2: The case supporting oral intake in labour.

    Science.gov (United States)

    Parsons, Myra

    2004-03-01

    This article has, so far, explored the phenomenon of aspiration associated with obstetric general anaesthesia (see Part 1). Part 2 examines the literature pertaining to the history of dietary regimes for labour and the physiological and psychological effect of restricting or allowing food and fluids during labour. The increasing trend among some health professionals to allow food and fluids during labour and research conducted to investigate the effect of the labouring woman's oral intake on the labour and birth outcomes is also discussed.

  6. 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.

  7. 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

  8. VAGINAL PROGESTERONE VERSUS CERVICAL CERCLAGE FOR THE PREVENTION OF PRETERM BIRTH IN WOMEN WITH A SONOGRAPHIC SHORT CERVIX, SINGLETON GESTATION, AND PREVIOUS PRETERM BIRTH: A SYSTEMATIC REVIEW AND INDIRECT COMPARISON META-ANALYSIS

    Science.gov (United States)

    CONDE-AGUDELO, Agustin; ROMERO, Roberto; NICOLAIDES, Kypros; CHAIWORAPONGSA, Tinnakorn; O'BRIEN, John M.; CETINGOZ, Elcin; DA FONSECA, Eduardo; CREASY, George; SOMA-PILLAY, Priya; FUSEY, Shalini; CAM, Cetin; ALFIREVIC, Zarko; HASSAN, Sonia S.

    2012-01-01

    OBJECTIVE No randomized controlled trial has directly compared vaginal progesterone and cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous spontaneous preterm birth. We performed an indirect comparison of vaginal progesterone versus cerclage, using placebo/no cerclage as the common comparator. STUDY DESIGN Adjusted indirect meta-analysis of randomized controlled trials. RESULTS Four studies evaluating vaginal progesterone versus placebo (158 patients) and five evaluating cerclage versus no cerclage (504 patients) were included. Both interventions were associated with a statistically significant reduction in the risk of preterm birth <32 weeks of gestation and composite perinatal morbidity and mortality compared with placebo/no cerclage. Adjusted indirect meta-analyses did not show statistically significant differences between vaginal progesterone and cerclage in reducing preterm birth or adverse perinatal outcomes. CONCLUSION Based on state-of-the-art methodology for indirect comparisons, either vaginal progesterone or cerclage are equally efficacious in the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous preterm birth. The selection of the optimal treatment may depend upon adverse events, cost and patient/clinician preferences. PMID:23157855

  9. Socioeconomic position and the risk of spontaneous abortion: a study within the Danish National Birth Cohort.

    Science.gov (United States)

    Norsker, Filippa Nyboe; Espenhain, Laura; A Rogvi, Sofie; Morgen, Camilla Schmidt; Andersen, Per Kragh; Nybo Andersen, Anne-Marie

    2012-01-01

    To investigate the relationship between different indicators of socioeconomic position and the risk of spontaneous abortion. Cohort study. 1996-2002, Denmark. All first time participants, a total of 89 829 pregnant women, enrolled in the Danish National Birth Cohort were included in the present study. Overall, 4062 pregnancies ended in spontaneous abortion. Information on education, income and labour market attachment in the year before pregnancy was drawn from national registers. Spontaneous abortion, that is, fetal death within the first 22 weeks of pregnancy, was the outcome of interest. The authors estimated HRs of spontaneous abortion using Cox regression analysis with gestational age as the underlying time scale. Women with abortion when compared with women with >12 years of education (HR 1.19 (95% CI 1.05 to 1.34)). The HR estimates for the four lowest income quintiles were all increased (HRs between 1.09 and 1.15) as compared with the upper quintile but did not differ considerably from each other. In general, no statistically significant association was found between labour market attachment and the risk of spontaneous abortion; however, the group of women on disability pension had an increased HR of spontaneous abortion when compared with women who were employed (HR 1.32 (95% CI 0.82 to 2.13)). Educational level and income were inversely associated with the risk of spontaneous abortion. As these factors most likely are non-causally related to spontaneous abortion, the findings indicate that factors related to social position, probably of the environmental and behavioural type, may affect spontaneous abortion risk. The study highlights the need for studies addressing such exposures in order to prevent spontaneous abortions.

  10. [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

  11. 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...

  12. 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.

  13. 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) ...

  14. Labour productivity and innovation performance: the importance of internal labour flexibility practices

    NARCIS (Netherlands)

    Preenen, P.T.Y.; Vergeer, R.; Kraan, K.O.; Dhondt, S.

    2017-01-01

    This article develops and examines the idea that internal labour flexibility practices are beneficial for labour productivity and innovation performance of companies. This is tested in two studies using unique company level datasets. In Study 1, results obtained from 377 independent companies

  15. Determinants of Labour Force Participation for Selected Groups With Weak Labour Market Attachment

    DEFF Research Database (Denmark)

    Le Maire, Daniel; Scheuer, Christian

    2006-01-01

    In this paper we evaluate the eects of economic incentives on the labour market participation for selected groups with weak labour market attachment. We argue that the people most likely to be affected by economic incentives are recipients of socialassistance and home-working housewives. Partner...

  16. Off-Farm Labour Decision of Canadian Farm Operators: Urbanization Effects and Rural Labour Market Linkages

    Science.gov (United States)

    Alasia, Alessandro; Weersink, Alfons; Bollman, Ray D.; Cranfield, John

    2009-01-01

    Understanding the factors affecting off-farm labour decisions of census-farm operators has significant implications for rural development and farm income support policy. We examine the off-farm labour decisions of Canadian farm operators using micro-level data from the 2001 Census of Agriculture combined with community level data from the 2001…

  17. LABOUR TAXATION IN THE EUROPEAN UNION

    Directory of Open Access Journals (Sweden)

    Sabau-Popa Liviu Mihai

    2011-07-01

    Full Text Available This article proposes an analysis, which we consider extremely useful in the current economic context, of the evolution of labour income fiscality, more precisely, the effect of the public debt growth on the tax wedge for the labour income. The share of fiscal revenues from direct taxes, indirect taxes and social contributions is relatively close in the old member states of the European Union in comparison with the new member states, which register a lower level of income from direct taxes. The low level of income from direct taxes is compensated by more significant shares of the social contributions or indirect taxes. The main motivations of cross-border migration are: a successful career in a multinational corporation, high variations of the tax rate, of the salary income between states and, last but not least, the level of the net salary. To this day, there are no plans to harmonize across the European Union the legislation regarding the taxes wages and the social security contributions. Still, the European Union had in view the coordination of the national tax systems to make sure that the employees and the employers do not pay several times the social contributions in their movement across the community space. Despite the fact that some states tax the labour income at a low level, the labour fiscality remains high in the European Union in comparison with other industrialized economies, probably also due to the fact that the majority of the member states have social market economies. The increase of the fiscality level for the labour income determines the decrease of the employment rate and the raise of the unemployement rate. The solution to guarantee a higher employment rate, which is a target of the European Union Strategy Europe 2020 could be the relaxation of the labour income fiscality by transferring the tax wedge on the labour income towards property or energy taxation.

  18. Narratives of neoliberalism: 'clinical labour' in context.

    Science.gov (United States)

    Parry, Bronwyn

    2015-06-01

    Cross-border reproductive care has been thrust under the international spotlight by a series of recent scandals. These have prompted calls to develop more robust means of assessing the exploitative potential of such practices and the need for overarching and normative forms of national and international regulation. Allied theorisations of the emergence of forms of clinical labour have cast the outsourcing of reproductive services such as gamete donation and gestational surrogacy as artefacts of a wider neoliberalisation of service provision. These accounts share with many other narratives of neoliberalism a number of key assertions that relate to the presumed organisation of labour relations within this paradigm. This article critically engages with four assumptions implicit in these accounts: that clinical labourers constitute a largely homogeneous underclass of workers; that reproductive labour has been contractualised in ways that disembed it from wider social and communal relations; that contractualisation can provide protection for clinical labour lessening the need for formal regulatory oversight; and that the transnationalisation of reproductive service labour is largely unidirectional and characterised by a dynamic of provision in which 'the rest' services 'the West'. Drawing on the first findings of a large-scale ethnographic research project into assisted reproduction in India I provide evidence to refute these assertions. In so doing the article demonstrates that while the outsourcing and contractualisation of reproductive labour may be embedded in a wider neoliberal paradigm these practices cannot be understood nor their impacts be fully assessed in isolation from their social and cultural contexts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Immersion in water in labour and birth

    Directory of Open Access Journals (Sweden)

    Elizabeth R. Cluett

    Full Text Available BACKGROUND: Enthusiasts suggest that labouring in water and waterbirth increase maternal relaxation, reduce analgesia requirements and promote a midwifery model of care. Critics cite the risk of neonatal water inhalation and maternal/neonatal infection. OBJECTIVES: To assess the evidence from randomised controlled trials about immersion in water during labour and waterbirth on maternal, fetal, neonatal and caregiver outcomes. METHODS: Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2011 and reference lists of retrieved studies. Selection criteria: Randomised controlled trials comparing immersion in any bath tub/pool with no immersion, or other non-pharmacological forms of pain management during labour and/or birth, in women during labour who were considered to be at low risk of complications, as defined by the researchers. Data collection and analysis: We assessed trial eligibility and quality and extracted data independently. One review author entered data and the other checked for accuracy. MAIN RESULTS: This review includes 12 trials (3,243 women: 8 related to just the first stage of labour: one to early versus late immersion in the first stage of labour; two to the first and second stages; and another to the second stage only. We identified no trials evaluating different baths/pools, or the management of third stage of labour. Results for the first stage of labour showed there was a significant reduction in the epidural/spinal/paracervical analgesia/anaesthesia rate amongst women allocated to water immersion compared to controls (478/1,254 versus 529/1,245; risk ratio (RR 0.90; 95% confidence interval (CI 0.82 to 0.99, six trials. There was also a reduction in duration of the first stage of labour (mean difference -32.4 minutes; 95% CI -58.7 to -6.13. There was no difference in assisted vaginal deliveries (RR 0.86; 95% CI 0.71 to 1.05, seven trials, caesarean sections (RR 1.21; 95% CI 0

  20. Impending macrosomia: will induction of labour modify the risk of caesarean delivery?

    Science.gov (United States)

    Cheng, YW; Sparks, TN; Laros, RK; Nicholson, JM; Caughey, AB

    2012-01-01

    Objective To compare the annual incidence rates of caesarean delivery between induction of labour and expectant management in the setting of macrosomia. Design This is a retrospective cohort study. Setting Deliveries in the USA in 2003. Population Singleton births of macrosomic neonates to low-risk nulliparous women at 39 weeks of gestation and beyond. Methods Women who had induction of labour at 39 weeks of gestation with a neonatal birthweight of 4000 ± 125 g (3875–4125 g) were compared with women who delivered (either induced or spontaneous labour) at 40, 41 or 42 weeks (i.e. expectant management), assuming an intrauterine fetal weight gain of 200 g per additional week of gestation. Similar comparisons were made at 40 and 41 weeks of gestation. Chi-square test and multivariable logistic regression analysis were used for statistical comparison. Main outcome measures Method of delivery, 5-minute Apgar scores, neonatal injury. Results There were 132 112 women meeting the study criteria. In women whose labours were induced at 39 weeks and who delivered a neonate with a birthweight of 4000 ± 125 g, the frequency of caesarean was lower compared with women who delivered at a later gestational age (35.2% versus 40.9%; adjusted OR 1.25, 95% CI 1.17–1.33). This trend was maintained at both 40 weeks (36.1% versus 42.6%; adjusted OR 1.31, 95% CI 1.23–1.40) and 41 weeks (38.9% versus 41.8%; adjusted OR 1.16, 95% CI 1.06–1.28) of gestation. Conclusions In the setting of known birthweight, it appears that induction of labour may reduce the risk of caesarean delivery. Future research should concentrate on clinical and radiological methods to better estimate birthweight to facilitate improved clinical care. These findings deserve examination in a large, prospective, randomised trial. PMID:22251443

  1. The new Romanian regulation of undeclared labour

    Directory of Open Access Journals (Sweden)

    Raluca Dimitriu

    2017-12-01

    Full Text Available The “black” labour is an indicator of how efficient is the enforcement of the labour law. Irrespective of how progressive may the labour law system be in a society, the proliferation of work without employment contracts expresses the failure of the labour law system in the real market. In Romania, Labour Code has been dramatically changed in the summer of 2017, especially with the declared goal to better organize the fight against the undeclared work. This paper is an analysis of the impact of these changes in an attempt to highlight the consequences of the new regulation, which seems to be fighting undeclared work predominantly by punitive tools. Following a general approach to the vulnerability of the worker without an employment contract, as well as some of the reasons for such choice, the analysis starts from the identification of the practical difficulties raised by the new regulation. On the other hand, the paper highlights the benefits of returning to the consensual nature of the employment contract, as well as the disadvantages of the excessive widening of the definition of the concept of undeclared work.

  2. Maternal heart rate changes during labour.

    Science.gov (United States)

    Söhnchen, N; Melzer, K; Tejada, B Martinez de; Jastrow-Meyer, N; Othenin-Girard, V; Irion, O; Boulvain, M; Kayser, B

    2011-10-01

    Labour and delivery represent a considerable effort for pregnant women. Lack of aerobic fitness may limit pushing efforts during childbirth and represents increased cardiovascular strain and risk. Increasing prevalence of sedentary behaviour and lack of aerobic fitness may reduce heart rate reserve during labour. We quantified maternal heart rate reserve (maximum heart rate minus resting heart rate) of 30 healthy pregnant women during labour and delivery and related it to habitual daily physical activity levels quantified during the third pregnancy trimester by the Pregnancy Physical Activity Questionnaire. Heart rates during labour reached values similar to those observed during moderate to heavy physical exercise. During active pushing one out of five women reached heart rates more than 90% of their heart rate reserve (188 ± 7 beats per min). Half of the women reached more than 70% of heart rate reserve (172 ± 14 beats per min). Physically inactive women used more of their heart rate reserve as physically more active women (87 ± 20% vs. 65 ± 12%, upper and lower tertile respectively, plabour is increased in physically inactive women and may potentially limit the intensity and duration of pushing efforts. Such higher cardiovascular strain in physically less active women may represent increased cardiovascular risk during labour. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  3. 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

  4. (Mismanaging labour markets? The decline of the contemporary global labour market for British seafarers.

    Directory of Open Access Journals (Sweden)

    S. Ruggunan

    2010-12-01

    Full Text Available Purpose: The purpose of this article is to investigate the ways in which states are still significant actors in creating and shaping the nature and characteristics of global labour markets. My argument is demonstrated through an empirical case study of the global labour market for British seafarers. Problem Investigated: The last 30 years has witnessed a decimation of the number of employed British seafarers, particularly at lower rank levels, such as ratings. I contend that despite Britain's long and rich maritime history, the British state has not acted meaningfully to reverse the decline of British seafarers. The lack of meaningful action I contend is an attempt to crew British owned ships with cheaper seafaring labour from Asia, particularly south east Asia. In so doing the British state has contributed to the decline of a once thriving labour market. There has simultaneously been an upsurge in the employment of seafarers of other nationalities, and thus the creation of new labour markets in countries such as the Philippines. This paper is an attempt to understand some of the factors responsible for the decline of the British labour market for seafarers. Methodology and Approach: This paper is the outcome of a larger qualitative study undertaken for my doctoral thesis in industrial sociology which examined the transformation of the global labour market for South African, Filipino and British seafarers. The methodology consists of in depth interviews with maritime officials and trade union leaders. These were conducted in person in London, United Kingdom between 2005 and 2008. These interviews are supported by extensive literature and documentary research, to validate, support and test claims made by my interviewees. Implications and Value of the Research: The theoretical contribution of this paper is to reinsert the state more critically into the literature on labour markets. Empirically, seafaring labour markets are largely ignored by the

  5. [Premature twins: clinic comparison, reproductive assisted techniques versus spontaneous conception].

    Science.gov (United States)

    Noriega-Alvarez, Roxana; Iglesias-Leboreiro, José; Bernardez-Zapata, Isabel

    2014-01-01

    Twin pregnancies occur one out of every 800. Due to the increase in maternal age and infertility, the use of assisted reproductive technology (ART) has risen. Thirty five percent of pregnancies solved using ART are twin pregnancies. A RT consists of infertility treatments in which oocytes and sperm are manipulated. The objective of this study was to compare the clinical behavior of premature twins born through ART versus those born after spontaneous conception (SC). Retrolective cohort study. The data was obtained from the records of preterm twins born between August 2010 and August 2013. Preterm twins were categorized in two groups: the ones conceived using ART versus those conceived through SC. Demographic characteristics and neonatal outcomes were compared. The total was of 398 patients: 208 conceived in consequence of ART and 190 through SC. The primary outcome and neonatal morbidities showed no significant difference, only the incidence of necrotizing enterocolitis and the use of parenteral nutrition showed significant difference. The length of hospital stay between groups was similar. In our population of preterm twins, the mode of conception had no detectable effect on mortality or short term morbidities.

  6. [Usefulness assessment of selected proinflammatory cytokines' level in cervico-vaginal fluid of pregnant women as an early marker of preterm delivery].

    Science.gov (United States)

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

    2005-09-01

    Recent studies have suggested that proinflammatory cytokines might play a crucial role in the mechanism of preterm labour and delivery. The main aim of this prospective study was to evaluate the usefulness of selected proinflammatory cytokines' (IL-1 alpha, IL-1 beta, IL-6 and IL-8) levels in cervico-vaginal fluid of pregnant women as an early marker of preterm delivery. Cervico-vaginal fluids were obtained from 107 pregnant women at 22 to 34 weeks' gestation, including 61 women with threatened preterm labour (TPL) and 46 women with physiological course of pregnancy (reference group). Those samples were analyzed for the concentrations of selected cytokines using standard enzyme-linked immunosorbent assay technique (ELISA). Lower genital tract microbiology was diagnosed using Gram stain method according to Spiegel's criteria and by culture. Mean gestational age at the time of sampling was 28.6 weeks. Mean time between sampling and delivery was 8,24 weeks in TPL group and 10.2 weeks in reference group. BV was diagnosed in 25.2% of subjects under study. M. hominis and U. urealyticum were diagnosed more frequently among women from TPL group (25.9% vs 14.9% and 36.2% vs 17.0%, respectively). Out of 107 women 15 (14.0%) delivered before 37th week of gestation. The rate of preterem delivery was significantly higher in threatened preterm labour group--21.3% is comparison to reference group--4.3%. Median cervico-vaginal concentration of IL-1 alpha, IL-1 beta, IL-6 and IL-8 did not differ between preterm and term delivery group. Only women with lower genital tract infection and one cytokine's low concentration (below 25th percentile) presented a higher risk of preterm delivery--OR=2,91. If IL-1 alpha and IL-1 beta concentrations were below 25th percentile, the calculated risk of preterm delivery was OR = 4.65. The highest risk was noted for women with lower genital tract infection and low cervico-vaginal concentrations of IL-1 alpha and IL-8--OR = 8.0 (3.20-20.01). The early

  7. Labour and Segmentation in Value Chains

    DEFF Research Database (Denmark)

    Hammer, Nikolaus; Riisgaard, Lone

    2015-01-01

    . This process is based on new dynamics of segmentation and variegated relations between the formal and informal sectors. For example, informality has come to play an important role in factory regimes, although with important differences: we can distinguish industries that developed informal factory forms......, and opportunities for resistance. While this suggests that factory regimes need to be tuned more explicitly to the specific dynamics of work, employment and reproduction, we argue that labour process and GVC analyses have developed themes that allow fruitful linkages. We look at issues around the employment...... contract, living arrangements, and labour mobility, and the role they play for factory regimes and their insertion into GVCs. Arguably, the extension of hegemonic despotism constitutes a simultaneous development to processes of industrial upgrading. Linking labour process and GVC analyses underscores, both...

  8. Optimal tax progressivity in imperfect labour markets

    DEFF Research Database (Denmark)

    Sørensen, Peter Birch

    1999-01-01

    All modern labour market theories capable of explaining involuntary unemployment as an equilibrium phenomenon imply that increased income tax progressivity reduces unemployment, but they also imply that higher progressivity tends to reduce work effort and labour productivity. This suggests...... progressivity which would maximise the welfare of the representative wage earner. Simulations with these models suggest that the optimal degree of tax progressivity could be quite large, although the results are sensitive to the generosity of unemployment benefits and to the after-tax wage elasticity of work...... that there may be an optimal degree of tax progressivity where the marginal welfare gain from reduced involuntary unemployment is just offset by the marginal welfare loss from lower productivity. This paper sets up four different models of an imperfect labour market in order to identify the degree of tax...

  9. Homelessness in France: Labour market implications

    Directory of Open Access Journals (Sweden)

    Arup Mitra

    2011-01-01

    Full Text Available This paper analyses homelessness in France with regard to three major mutually interacting sets of factors: labour-market strains, illegal migration and institutional inadequacy. Macroeconomic challenges have resulted in the loss of jobs and subsequent labour-market hardships, and these have tended to affect those without adequate skills. As a result, labour-market problems together with a lack of social capital and adequate housing at affordable prices, accompanied by insufficient institutional support, has resulted in increased homelessness. All of this indicates that there should be active government intervention in the housing market in order to create space for the relatively weaker section of the population in the growth process, which is often unequal. Another important issue is how to create jobs with positive growth in real wages because, without adequate purchasing power, simply providing housing would mean transferring poverty from one space to another.

  10. Wage Change in the Lithuanian Labour Market

    Directory of Open Access Journals (Sweden)

    Laura Žiogelytė

    2011-03-01

    Full Text Available In a market, the labour force of the population can be sold and bought. The wage is the price or the monetary value of the labour force. The wage rate depends on the key internal and external factors. In a market economy, remuneration for work becomes the object of negotiation between the employer and the employee. In order to legally implement this negotiation, we need to describe the term of the wage, wage systems, wage structure, functions and other issues. The article deals with the theoretical issues relating to wages: the concept of the wage, the main function of wages, the factors influencing the wage rate are analysed and systematised. The article analyses net wages and gross wages and other factors influencing the Lithuanian labour market. Article in Lithuanian

  11. Piracetam for fetal distress in labour.

    Science.gov (United States)

    Hofmeyr, G Justus; Kulier, Regina

    2012-06-13

    Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress. The objective of this review was to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012). Randomised trials of piracetam compared with placebo or no treatment for suspected fetal distress in labour. Both review authors assessed eligibility and trial quality. One study of 96 women was included. Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03). There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score. There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

  12. 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...

  13. 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...

  14. 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

  15. Spontaneous Atraumatic Mediastinal Hemorrhage

    Directory of Open Access Journals (Sweden)

    Morkos Iskander BSc, BMBS, MRCS, PGCertMedEd

    2013-04-01

    Full Text Available Spontaneous atraumatic mediastinal hematomas are rare. We present a case of a previously fit and well middle-aged lady who presented with acute breathlessness and an increasing neck swelling and spontaneous neck bruising. On plain chest radiograph, widening of the mediastinum was noted. The bruising was later confirmed to be secondary to mediastinal hematoma. This life-threatening diagnostic conundrum was managed conservatively with a multidisciplinary team approach involving upper gastrointestinal and thoracic surgeons, gastroenterologists, radiologists, intensivists, and hematologists along with a variety of diagnostic modalities. A review of literature is also presented to help surgeons manage such challenging and complicated cases.

  16. Micro-evidence on day labourers and the thickness of labour markets in South Africa

    Directory of Open Access Journals (Sweden)

    Waldo Krugell

    2014-08-01

    The South African labour market is characterised by sharp segmentation, high unemployment and apparently limited informal sector employment. Recent work has focussed on the importance of the quality of education while others have argued that the rigidity of the labour market constrains employment growth. This paper considers the spatial aspects of the day labour market and argues that the size and proximity of economic activity found in agglomerations ensure a thick labour market that allows for better matching between workers and jobs. The results indicate that the day labourers who were hired by the same employer more often received higher earnings. Once workers have a matric qualification they receive earnings above the average, as do workers who have completed vocational training. Skills, as well as factors associated with a thicker labour market are positively associated with wages. The thicker metropolitan labour market allows workers to become more specialised and receive higher earnings. This has important policy implications and calls for the development of people and places.

  17. Concepts of Digital Labour: Schelling's Naturphilosophie

    Directory of Open Access Journals (Sweden)

    Kevin Michael Mitchell

    2014-09-01

    Full Text Available This paper uses F.W.J. Schelling’s Naturphilsophie as a point of departure to theorize the concept of digital labour. Beginning with Marx’s distinction between fulfilling and unfulfilling labour, it is argued that the former is labour that is immanent to, and in line with, the Schellingian notion of Nature as process and ungrounded ground, while the unfulfilling variant externalizes Nature and attempts to use it against itself in the service of capital, and the establishment of what I call a state-of-power. Schelling’s The Ages of the World is re-interpreted by exchanging his version of immaterial spirituality for digital virtuality, and as a result, digital labour is viewed as a consequence of previous forms of world historical developments. While digital virtuality is in fact materialist in terms of both the labour that activates it, and the substrate that sustains it, the materiality of the digital is often overlooked in favour of an anti-materialist stance that works to disconnect the digital labourer from their online activity, and preclude the critical self-awareness necessary for the acknowledgement of their online “playful” activity as work. It ends with an analysis of Mark Zuckerberg’s ideational attempt to “re-wire” the world via Facebook’s digital infrastructure, which begins to set the conditions of possibility for inter-personal interaction, and explores the possibilities for resistance available in Foucault’s notion of the care of the self.

  18. The new poverty in the labour market

    Directory of Open Access Journals (Sweden)

    Victor Climent

    2015-06-01

    Full Text Available Purpose: This paper aims to analize the new situation of labour different from the one of the eighties and nineties of the 20th century, that is configuring a new model of poverty within the labour market.Design/Methodology: The current research is based on a comparative analysis of governmental reports, proposals and plans aimed at reducing poverty through labour market. This analysis allows to detect the main actions developed by governmental institutions.Findings: Currently a growing number of workers (employees and self-employed is pushed towards poverty as a consequence of the deterioration of labour conditions in the framework of the economic globalisation. During the crisis of the 80s, becoming employed was a warranty to escape from poverty, but nowadays this is not enough. Unemployment it is not the only synonym of poverty and social exclusion is not solely found in marginal social groups. The new labour conditions, with low salaries, temporary contracts and long working times configure a new tipology of poverty directly linked with job market that affects more highly educated and professional groupsResearch limitations: This research collects different governmental reports and Action Plans at all levels. Even that, there can be other reports not included in this article.Originality/Value: Currently, poverty risk responds to multifactorial parameters determined by the relationship of the individual with the labour market, family structure, available social capital, level of family debt and existing social policies. The comparative study of these factors allow a better understanding and analysis of this phenomenon, increasingly global and affecting a higher number of social groups.

  19. An authentic animal model of the very preterm infant on nasal continuous positive airway pressure.

    Science.gov (United States)

    Dargaville, Peter A; Lavizzari, Anna; Padoin, Priscila; Black, Don; Zonneveld, Elroy; Perkins, Elizabeth; Sourial, Magdy; Rajapaksa, Anushi E; Davis, Peter G; Hooper, Stuart B; Moss, Timothy Jm; Polglase, Graeme R; Tingay, David G

    2015-12-01

    The surge in uptake of nasal continuous positive airway pressure (CPAP) for respiratory support in preterm infants has occurred in the absence of an authentic animal model. Such a model would allow investigation of research questions of physiological and therapeutic importance. We therefore aimed to develop a preterm lamb model of the non-intubated very preterm infant on CPAP. After staged exteriorisation and instrumentation, preterm lambs were delivered from anaesthetised ewes at 131 to 133 days gestation. Via a single nasal prong (4-mm internal diameter, 6- to 7-cm depth), positive pressure was delivered from the outset, with nasal intermittent positive pressure ventilation (NIPPV) used until transition to nasal CPAP was attempted, and periodically thereafter for hypoventilation. Caffeine and doxapram were used as respiratory stimulants. Gastric distension was prevented with an oesophageal balloon. Cardiorespiratory parameters and results of arterial blood gas analyses were monitored throughout the study period, which continued for 150 min after first transition to CPAP. Ten preterm lambs were studied, at gestation 132 ± 1 days (mean ± SD) and birth weight 3.6 ± 0.45 kg. After stabilisation on NIPPV, transition to nasal CPAP was first attempted at 28 ± 11 min. There was transient respiratory acidosis, with gradual resolution as spontaneous respiratory activity increased. In the final hour, 79% ± 33% of time was spent on CPAP alone, with typical respiratory rates around 60 breaths per minute. PaCO2 at end-experiment was 58 ± 36 mmHg. Non-intubated preterm lambs can be effectively transitioned to nasal CPAP soon after birth. This animal model will be valuable for further research.

  20. Trial of labour after caesarean section: Two-year analysis at a Portuguese centre.

    Science.gov (United States)

    Abreu-Silva, Joao; Castro, Jorge; Maia, Catarina; Pinho, Manuela; Carvalho, Claudina

    2017-08-01

    We conducted a retrospective study aimed at determining variables associated with a higher success rate for vaginal delivery after caesarean section, and assessing the impact of induction of labour. Secondarily, we aimed to describe our vaginal delivery and uterine rupture rates with the use of a controlled-release dinoprostone vaginal insert for cervical ripening. Of 292 women who met the inclusion criteria, induction of labour occurred in 48% (94% with dinoprostone). There was a non-significant difference between the vaginal delivery rate of spontaneous labour (57%) and induction of labour (33%), after adjusting for confounding variables. The success rate was influenced by a Bishop score ≥6, previous vaginal delivery and previous caesarean for dystocia or failed induction. There was only one case of uterine rupture, which was associated with dinoprostone use (overall rate 0.34%, 0.77% for dinoprostone). Impact statement Trial of labour after caesarean section is considered an alternative to elective repeat caesarean. Both present associated benefits and risks, the most fearsome of which is uterine rupture during labour (0.78% in term pregnancies). Induction is also possible but carries a higher risk of uterine rupture and lower success rate for vaginal birth. Prostaglandins have been of particular concern due to a higher risk of uterine scar rupture, estimated at 2% for dinoprostone; however, its use as a controlled-release vaginal insert has been under-reported. Our study confirms the reported impact of previous vaginal delivery, previous caesarean indication and Bishop score at admission on success rate for vaginal birth after caesarean. We were unable to prove a lower success rate for induction of labour after adjusting for other variables. Despite our study limitations, we report on the use of a controlled-release vaginal insert with 10mg of dinoprostone in 130 women with a uterine rupture rate of 0.77%, lower than previously reported and similar to the