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Introduction: The number of babies delivered between 37 weeks to 38 weeks and 6 days has been on the rise with increase in lower segment caesarian section (LSCS). These early term neonates have increased risk of developing respiratory distress syndrome, neonatal hyperbilirubinemia, transient tachypnoea, prolonged hospital stays, hypothermia, and feeding difficulty, when compared to a term neonate. An audit of early term neonatal short-term outcomes was undertaken at our institute. Methodology: A retrospective descriptive cross- sectional study was carried out between July 2020 and December 2020 at a private medical college Neonatal Intensive Care Unit. Neonates with a gestation age of 37 weeks and 0 days to 38 weeks and 6 days born were included. Results: A total of 137 early term delivery data were obtained. Hypothyroidism (23%) and gestational diabetes (23%) were found to be the most common associated antenatal problems. The most common morbidity out of 137 early term neonates was neonatal jaundice 91(66.4%) followed by respiratory distress which affected 38 (28%) neonates. Conclusion: This study establishes the high incidence of neonatal jaundice and respiratory morbidities in early term neonates. Hence it is better to avoid elective LSCS before 39 weeks of gestation provided there are no medical indications for the same.

Breastfeeding involves signaling between mother and offspring through biological (breast milk) and behavioral pathways. This study tested this by examining the effects of a relaxation intervention in an understudied infant population. Breastfeeding mothers of late preterm (340/7–366/7 weeks) and early term (370/7–386/7 weeks) infants were randomized to the relaxation group (RG, n = 35), where they were asked to listen to a meditation recording while breastfeeding from 3 weeks post-delivery, or the control group (CG, n = 37) where no intervention was given. Primary outcomes-maternal stress and infant weight-were assessed at 2–3 (baseline) and 6–8 weeks post-delivery. Secondary outcomes included infant length, infant behavior, maternal verbal memory, salivary cortisol, and breast milk composition. Infants in the RG had significantly higher change in weight-for-age Z-score compared to those in CG (effect size: 0.4; 95% CI: 0.09, 0.71; p = 0.01), and shorter crying duration [RG: 5.0 min, 0.0–120.0 vs. CG: 30.0 min, 0.0–142.0; p = 0.03]. RG mothers had greater reduction in cortisol (effect size: −0.08 ug/dL, 95% CI −0.15, −0.01; p = 0.03) and better maternal verbal learning score (effect size: 1.1 words, 95% CI 0.04, 2.1; p = 0.04) than CG mothers, but did not differ in stress scores. A simple relaxation intervention during breastfeeding could be beneficial in promoting growth of late preterm and early term infants. Further investigation of other potential biological and behavioral mediators is warranted.

Introduction: Newborns having a gestational age between 37 to 416/7 weeks are defined as term newborn. The aim of the study was to investigate the rates and causes of hospitalization, and the differences in neonatal morbidities between early-term and full-term infants as a single-center experience in our hospital. Materials and Methods: This retrospective study was carried out in a tertiary neonatal intensive care unit between January 2013 and December 2014. Maternal characteristics and comorbidities; neonatal characteristics, length of hospital stay, and neonatal morbidities were recorded. Primary outcome measure was need for neonatal intensive care unit (NICU) admission. Results: Maternal comorbidities, ceserean delivery, low birth weight, SGA and multiple gestations were found to be higher in early-term infants and earlyterm infants were at higher risk for respiratory morbidities, respiratory support requirement, hypoglycemia and intravenous antibiotic therapy. After multivariate logistic regression analyses, only higher risk for respiratory morbidity persisted (OR:1.28 [1.02-1.59]; p=0.02). In contrast to that, full-term infants was found to be at higher risk for hypernatremia compared to early-term infants. Conclusions: Early term birth is associated with a higher neonatal morbidity and NICU admissions, and gestational age is known to be the most important determinant of this situation. With advanced maternal care and better understanding of the factors causing early term birth will lead to prevention and successfull management of this risk group. Giriş: Gestasyonel yaşı 37 ile 416/7 hafta arasında olan bebekler term yenidoğan olarak tanımlanır. Bu çalışmada, hastanemizde doğan ve izlenen erken term ve tam zamanlı term yenidoğanların neonatal morbiditeler, hastaneye yatış oranları ve nedenleri açısından karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Retrospektif olarak yürütülen bu çalışmada Ocak 2013 ile Aralık 2014 tarihleri arasında 3. basamak yenidoğan yoğun bakım (YDYB) servisinde yatırılarak izlenen term yenidoğanlar değerlendirilmiştir. Anneye ait özellikler, eşlik eden hastalıklar, yenidoğanların demografik özellikleri, hastane yatış süresi ve neonatal morbiditeler kayıt altına alınmış olup, çalışmanın birincil sonucu yenidoğan yoğun bakım ünitesine yatış gereksinimidir. Bulgular: Maternal eşlik eden hastalıklar, sezaryen doğum, düşük doğum ağırlığı, gestasyon yaşına göre küçük yenidoğanlar ve çoğul gebelikler erken term grubunda daha yüksek saptanmış olup, solunumsal morbiditeler, solunum desteği gereksinimi, hipoglisemi ve intravenöz antibiyotik gereksinimi açısından erken term grubunda daha yüksek saptanmıştır. Çoklu regresyon analizi sonrası sadece solunumsal morbiditeler açısından yüksek riskin devam ettiği görüldü (RR:1.28 [1.02-1.59]; p=0.02). Buna karşın, hipernatremi tam zamanlı term grubunda erken term grubuna göre daha yüksek saptandı. Sonuç: Erken termde doğum daha yüksek oranda neonatal morbidite ve YDYB yatışı ile ilişkili olup gestasyonel yaş bu durumu belirleyen en önemli faktördür. Daha iyi maternal bakım ve erken doğuma yol açabilecek faktörlerin belirlenmesi bu riskli grupta olası sorunların önlenmesini ve başarılı şekilde yönetilmesini sağlayacaktır.

Objectives: Jaundice is a physiological condition caused by hyperbilirubinemia, which is common in neonatal period. However, severe hyperbilirubinemia can cause kernicterus, which is a serious condition that leads to neurological problems. In this study, we aimed to investigate whether it is safe to use transcutaneous bilirubin (TcB) instead of blood for the evaluation of jaundice by comparing TcB measurement with standard total serum bilirubin (TSB) measurement values. Methods: A total of 105 term and early term infants with gestational ages between 37 and 42 weeks were included in the study. MBJ20 TcB measuring device was used for TcB measurement. TcB was measured from the forehead and sternum. To evaluate the relationship between TcB measurements and TSB measurements, we performed Pearson correlation, Spearman correlation, linear regression analysis, and Bland-Altman analysis in which we evaluated the scatter plot of the differences between the average values of the measurements. Results: There was a positive and statistically significant correlation between TcB forehead and TSB measurements and TcB sternum and TSB measurements (p

Objectives: describe mothers, pregnancies and newborns’ characteristics according to the type of childbirth history and to analyze repeated cesarean section (RCS) and vaginal delivery after cesarean section (VBACS), in São Paulo State in 2012. Methods: data are from the Sistema de Informações sobre Nascidos Vivos (Live Birth Information Systems). To find the RCS’s group, the current type of childbirth equal to cesarean section was selected and from these all the previous cesareans. To identify the VBACS’s group all live birth with current vaginal delivery were selected and from these all previous cesareans. Mothers with a history of RCS and VBACS were analyzed according to the characteristics of the pregnancy, newborn and the childbirth hospital. Results: 273,329 mothers of live birth with at least one previous child were studied. 43% of these were born of RCS and 7.4% of VBACS. Mothers who underwent RCS are older and higher educated and their newborns presented a lower incidence of low birth weight. Early term was the most frequent rating for gestational age born of RCS. Live births were of VBACS and had greater proportions of late term. The RCS was more common in hospitals not affiliated with the Sistema Único de Saúde (SUS) (Public Health System) (44.1%). Conclusion: the high RCS’s rates, especially in the private sector, highlight the necessity of improvements in childbirth care model in São Paulo. Resumo Objetivos: descrever características das mães, da gestação e do recém-nascido, segundo histórico de tipo de parto, analisando repetição de cesárea (RC) e parto vaginal após cesárea (PVAC), no Estado de São Paulo, em 2012. Métodos: os dados são provenientes do Sistema de Informações sobre Nascidos Vivos. Para encontrar o conjunto RC, selecionou-se o tipo de parto atual igual a cesárea e destes buscou-se todos com cesárea anterior. Para identificar o grupo PVAC, selecionou-se os recém-nascido com parto atual vaginal e destes buscou-se todos com cesárea anterior. Foram analisadas mães com história de RC e PVAC, segundo características da gestação, do recémnascido e hospital do parto. Resultados: estudou-se 273.329 nascidos vivos de mães com pelo menos um filho anterior. Destes, 43% nasceram por RC e 7,4% por PVAC. As mães que realizaram RC são mais velhas e mais escolarizadas, seus recém-nascidos apresentaram menor proporção de baixo peso ao nascer. Termo precoce foi a mais frequente idade gestacional dos que nasceram por RC. Os recém-nascidos por PVAC apresentaram maiores proporções de termo tardio. RC foi mais frequente nos hospitais sem vínculo com o Sistema Único de Saúde (44,1%). Conclusão: as altas taxas de RC, principalmente no setor privado, evidenciam necessidade de melhoras no modelo de atenção ao parto em São Paulo.

The aim of this study was to determine the effects of resveratrol (RES) treatment on corneal wound healing. Randomly divided into 2 groups were 26-week-old male Wistar albino rats. Group 1 was the control group (C) and group 2 was the RES group. A 2–3-mm-long vertical incision was made centrally in the right cornea of each rat to the descemet membrane using loupe magnification (2.5X) and the wounds were sutured using 10/0 nylon material. In the RES group, the rats were fed 30 mg/kg/day RES via oral gavage; the C and RES groups were provided food and water ad libitum for only 11 days. The matrix metalloproteinase-9 (MMP-9), nitric oxide, and malondialdehyde (MDA) levels, and antioxidant status (AOS) were measured. On day 11, the rats were euthanized and examined histologically. The score of 3 for connective tissue proliferation, in both the C and RES groups, indicated rates of 11.1% and 0.0%, respectively (P < 0.05). The score of 3 for inflammatory cell reaction, in both the C and RES groups, indicated rates of 11.1% and 0.0%, respectively (P < 0.05). The MDA results were as follows: days 0 and 11, 1.61 ± 0.316 and 2.854 ± 0.572 for the C and RES groups, respectively. The increase in group C was statistically significant (P < 0.001). The MMP-9 level was 1.115 ± 0.197 and 2.842 ± 0.368, respectively, in the 2 groups. The increase in the RES group was statistically significant (P < 0.01). According to the AOS, the intergroup difference was statistically significant (P < 0.05). As a result, RES inhibited vascularization of the corneal wound and retained the transparency of the corneal tissue. It is therefore suggested that extended studies and follow-up times are needed to better evaluate the outcomes of RES on the healing corneal wounds.

Objective The aim of this study is to model the association between gestational age at birth and early child development through 3 years of age. Study Design Development of 5,868 children in Upstate KIDS (New York State; 2008–2014) was assessed at 7 time points using the Ages and Stages Questionnaire (ASQ). The ASQ was implemented using gestational age corrected dates of birth at 4, 8, 12, 18, 24, 30, and 36 months. Whether children were eligible for developmental services from the Early Intervention Program was determined through linkage. Gestational age was based on vital records. Statistical models adjusted for covariates including sociodemographic factors, maternal smoking, and plurality. Results Compared with gestational age of 39 weeks, adjusted odds ratios (aOR) and 95% confidence intervals of failing the ASQ for children delivered at Conclusion Gestational age was inversely associated with developmental delays for all gestational ages. Evidence from our study is potentially informative for low-risk deliveries at 39 weeks, but it is notable that deliveries at 40 weeks exhibited further lower risk.

This study aimed to find the optimal strategy for the application of salmon gonadotropin-releasing hormone analogue (sGnRHa) in outdoor-cultured pikeperch males in an exceptionally early term in early November. According to the histological examination, on the day of hormonal treatment, pikeperch testes were in the late stadium of spermatogenesis, with 78.7% of germ cells attributed to sperm cells. Five experimental groups were established varying on hormonal preparations and water temperature: (1) sGnRHa (25 μg kg−1) was applied to fish at pre-warming at water temperature of 11 °C (GnRH-LOW); (2) sGnRHa (25 μg kg−1) was applied to fish post-warming at water temperature of 15 °C (GnRH-HIGH); (3) priming group (5 μg kg−1 at 11 °C +25 μg kg−1 at 15 °C); (4) reference group – fish were injected with human chorionic gonadotropin; (5) control group - fish were injected with saline solution. Sperm was obtained from all fish in hormonally treated groups, whereas the fish treated with saline did not spermiate. The greatest values of the straight-line velocity (VSL), the curvilinear velocity (VCL), and the angular path velocity (VAP) of sperm cells, as well as the amounts of Mg2+, K+, and Na+ in the sperm seminal plasma, were obtained in GnRH-HIGH, whereas the GnRH-LOW group yielded the greatest sperm volume. Among the ions in seminal plasma, K+ and Na+ dominated and showed a relationship with sperm kinematic parameters. According to the obtained data, sGnRHa can be considered as an appropriate hormonal preparation to induce spermiation at an early preseason. Either before or after warming, sGnRHa application can yield sperm of proper quantity and quality as early as 5 months before the natural spawning season. A comprehensive study is recommended to evaluate the full period of sperm availability in outdoor-reared males, followed by direct evaluation of the fertilizing capacity.

OBJECTIVE: To assess the impact of a voluntary pledge policy and a mandatory nonpayment policy on reducing early‐term elective deliveries among privately insured and Medicaid‐enrolled individuals. DATA SOURCES/STUDY SETTING: Birth certificate data from 2009 to 2015, from South Carolina and 16 control states. STUDY DESIGN: We use a difference‐in‐differences approach to test the impact of two different policy types. Outcomes include the probability of an early elective delivery, gestation time, and birthweight. PRINCIPAL FINDINGS: The voluntary pledge and mandatory nonpayment policy reduced overall EED rates from 13.1 to 11.4 (−12.7 percent, [P

Purpose. To determine the features of the formation of biometric indicators of the corn hybrids yield at diffe­rent sowing dates in the conditions of the Forest-Steppe of Ukraine. Methods. Field experiments were laid on a plot of the experimental field of the research and production bree­ding enterprise LLC “Rasava” (Pustovarivka village, Skvyrskyi district, Kyiv region), located in the Right-Bank Forest-Steppe of Ukraine. Economically valuable and morpho-biological parameters of corn hybrids were studied according to a unified method for determining the indices of suitability for distribution in Ukraine. Results. The morphometric indices of the plant productivity formation and the yield of corn hybrids (plant height, length of the ear, number of grain rows, number of grains per row, grain yield from the ear) at the different dates of sowing (April 25, 10 and 25) were the most stable at the early term (April 25). The early-ripe hybrid ‘Richka SV’ provided the highest yield at sowing on April 25 – 11.6 t/ha, which is 1.5 t/ha more than at the traditionally accepted date of sowing – the first decade of May (May 10). The medium early hybrid ‘Richka S’, also at an early sowing date (April 25), produced yields of 11.3 t/ha, which is 0.6 t/ha more than during sowing on May 10. Conclusions. The morphometric indices of the formation of plant productivity and the timing of seeding affect the yield of corn hybrids in the conditions of the Forest-Steppe of Ukraine.

INTRODUCTION: Recent recommendations characterize deliveries at 37 weeks 0 days through 38 weeks 6 days as early term. We aimed to systematically review the literature on long-term cognition, school performance, and behavior in children born early term (37 weeks 0 days to 38 weeks 6 days) compared with full term (39 weeks 0 days to 40 weeks 6 days).MATERIAL AND METHODS: The review was performed according to the PRISMA Statement. The final literature search was performed on the 31st of January 2019. We located studies in PubMed, Embase, CINAHL, and Cochrane Library. Eligible studies were randomised controlled trials, cohort studies, and case-control studies, with outcome assessment performed at two to nineteen years. We collected information using a structured data form and evaluated study quality using the Newcastle-Ottawa Scale (NOS).RESULTS: We included 42 observational studies published between 2006 and 2018. No restriction to year of publication was made. The mean NOS score was 5.8 with a range from three to nine. Compared to children born full term, children born early term had a lower intelligence score in early adulthood and up to some 30% increased risk of attention-deficit/hyperactivity disorder. Furthermore, we found some 10-40% increased risk of cognitive problems, some 25% higher risk of language impairments, and 8-75% more with poorer overall school performance. No meta-analysis was conducted due to heterogeneity in the outcome measures. Only ten studies presented subgroup analyses in spontaneous deliveries or adjusted for type of labor onset/induction.CONCLUSIONS: Children born early term are at increased risk of cognitive deficits, poorer school performance, and behavioral problems compared to children born full term. This article is protected by copyright. All rights reserved.

Background/aim: The aim of the study was to determine the effects of robotic-assisted gait training on ambulation and functional capacity in patients with spinal cord injury.Materials and methods: In total, 88 patients were included and were randomly divided into two groups. The first group underwent 16 sessions of robotic therapy training for 8 weeks and conventional therapy for 5 days a week. The second group underwent conventional treatment. The Walking Index for Spinal Cord Injury II was used to evaluate functional ambulation, and the functional independence measure score was used to assess patients' functional independence levels in a blind manner.Results: A significant improvement was observed in both groups according to Walking Index for Spinal Cord Injury II and functional independence measure scores (P < 0.001). However, a significantly higher improvement according to the Walking Index for Spinal Cord Injury II (P = 0.011) and functional independence measure scores (P = 0.022) was seen in the robotic group than in the control group.Conclusions: Robotic-assisted gait training combined with conventional therapy was found to be superior to the conventional therapy in terms of gait function and level of disability.

For Lake Erie, it is already time to revise the phosphorus target loads set to address the problem of cyanobacterial blooms in theWestern Basin. Current targets were proposed by the Annex 4 task group in 2015, adopted by U.S. and Canadian governments in 2016, and set as objectives of domestic action plans in 2017. These targets, applicable to all spring discharges below the 90th percentile, set a maximumload for both total phosphorus (TP) and dissolved reactive phosphorus (DRP) equivalent to 60% of their 2008 spring loads. This essentiallymandates 40% reductions in both particulate phosphorus (PP) and DRP loading relative to 2008 loads. These targets do not explicitly incorporate the difference in bioavailability between DRP (~100% bioavailable) and PP (~25% bioavailable). From 2008 to 2017, DRP comprised 24% of the spring TP load and over half (~56%) of the total bioavailable phosphorus (TBAP) load, while PP comprised 76% of the TP load but only ~44% of the TBAP load. Subsequent deposition of PP in the estuarine and nearshore zones further reduces its significance in bloom development. By ignoring differences in bioavailability, the current targets provide no guidance for choosing among practices based on their relative effectiveness in reducing DRP or PP and their combined reductions in TBAP loading. Current targets place more emphasis on PP than needed to efficiently reach targeted cyanobacterial bloom reductions. To clarify appropriate management approaches and lead to greater success in reducing cyanobacterial blooms, target loads should be based on TBAP.

Background To investigate the influence of duration of bilateral acute limb ischemia (BALI) due to acute aortic occlusion (AAO) on the amputation-free survival in the early- and mid-term follow-ups (FUs). Methods A retrospective analysis of patients treated due to primary occlusion of the infrarenal aorta and BALI was performed. Univariate analysis was used to determine the risk factors of adverse outcomes and to compare the duration of BALI between amputation-free survival and the non-amputation-free survival group. The log-rank test was used to compare amputation-free survival in the FU. Results The data of 16 patients, with a mean age of 70 ± 11 years, were analyzed. Predominantly females (56.3%, 9/16) were included in the study. The median FU was 32 months (range, 26–108 months). The mean ischemia time was significantly shorter in the amputation-free survival group compared to that in the non-amputation-free survival group (7.4 ± 3.5 hours vs. 22.4 ± 16.3 hours, p = .01). The time frame for successful bilateral lower limb revascularization was at Conclusions The duration of BALI due to AAO < 11 hours was shown to be associated with improved amputation-free survival in the early- and mid-term FUs. Trial registration: The study was retrospectively registered in TCTR international registry (identification no. TCTR20210609002).

INTRODUCTION: The purpose of this study was to evaluate the two year clinical and radiographic outcomes of patients undergoing a primary total hip arthroplasty (THA) using the Trident Tritanium primary Cup. METHODS: 197 patients who underwent a direct anterior THA using a Tritanium acetabular component between 2011 and 2015 were retrospectively reviewed by two surgeons from a single institution. The investigators, along with an independent physician, separately reviewed radiographs blinded to clinical data looking for radiolucent lines adjacent to the acetabular cup using the Charnley-DeLee zones. Clinical results were measured using acetabular revision surgery as an end point for failure. According to the American Academy of Orthopaedic Surgeons Levels of Evidence, this study was consistent with a Level III Therapeutic study. RESULTS: 101 (48.73%) subjects did not exhibit any radiolucent lines around the acetabular component. 53 (26.90%) subjects displayed radiolucency in only one zone. 27 (13.71%) subjects displayed radiolucency in two zones, and 16 (8.12%) displayed radiolucency in all three zones. Radiolucency was most prevalent in zone 1 at 2 years with 83 (42.13%) subjects displaying radiolucency. There were five (2.54%) acetabular failures within two years of the index surgery. Of those 5 subjects, 3 displayed radiolucency in 1 zone, 2 displayed radiolucency in >1 zone, and 2 displayed radiolucencies >1 mm. CONCLUSION: In our study, the Tritanium Cup demonstrated a 2.54% failure rate for aseptic loosening at 2 year follow-up. In addition, 48.73% of patients displayed a radiolucent line in at least one Charnley-DeLee zone. We also observed a progression of radiolucencies between the 6 month radiographs and the 2 year radiographs.

Studies have reported a dose-dependent relationship between gestational age and poorer school readiness. The study objective was to quantify the risk of developmental vulnerability for children at school entry, associated with gestational age at birth and to understand the impact of sociodemographic and other modifiable risk factors on these relationships. Linkage of population-level birth registration, hospital, and perinatal datasets to the Australian Early Development Census (AEDC), enabled follow-up of a cohort of 64,810 singleton children, from birth to school entry in either 2009, 2012, or 2015. The study outcome was teacher-reported child development on the AEDC with developmental vulnerability defined as domain scores th percentile of the 2009 AEDC cohort. We used modified Poisson Regression to estimate relative risks (RR) and risk differences (RD) of developmental vulnerability between; (i) preterm birth and term-born children, and (ii) across gestational age categories. Compared to term-born children, adjustment for sociodemographic characteristics attenuated RR for all preterm birth categories. Further adjustment for modifiable risk factors such as preschool attendance and reading status at home had some additional impact across all gestational age groups, except for children born extremely preterm. The RR and RD for developmental vulnerability followed a reverse J-shaped relationship with gestational age. The RR of being classified as developmentally vulnerable was highest for children born extremely preterm and lowest for children born late-term. Adjustment for sociodemographic characteristics attenuated RR and RD for all gestational age categories, except for early-term born children. Children born prior to full-term are at a greater risk for developmental vulnerabilities at school entry. Elevated developmental vulnerability was largely explained by sociodemographic disadvantage. Elevated vulnerability in children born post-term is not explained by sociodemographic disadvantage to the same extent as in children born prior to full-term.

Background: Preterm birth is a major determinant of adverse health consequences, and early term births are also associated with increased risk of various outcomes. In light of climate change, the effect of ambient temperature on earlier delivery is an important factor to consider. Several studies have focused on associations of ambient air temperature (Ta) on preterm birth, but few have examined associations with early term births. Aims: To investigate the association of prenatal exposure to Ta with preterm birth (

Introdução: Discute-se o uso da corticoterapia (CTC) antenatal em gestações de recém-nascidos (RNs) prematuros tardios e termo precoce, principalmente em gestantes diabéticas, que já apresentam gestações de alto risco e parto cesáreos eletivos. Objetivo: Analisar a relação entre a CTC antenatal, em partos eletivos de prematuro tardio e termo precoce em gestantes diabéticas, e desfechos maternos e perinatais. Material e métodos: Foi realizado um estudo retrospectivo no Complexo Hospital de Clínicas da Universidade Federal do Paraná, onde foram avaliados os níveis glicêmicos das gestantes antes e após a CTC, e dados dos RNs, como glicemia, necessidade de oxigênio complementar e outros. Resultados: Gestantes diabéticas que receberam CTC antenatal apresentaram mais picos de hiperglicemia do que as gestantes diabéticas que não receberam tal terapia. Tanto no grupo de gestantes diabéticas com CTC, quanto no grupo que não recebeu essa terapia, houve associação positiva entre o uso de oxigenoterapia neonatal, ocorrência de hipoglicemia neonatal e outras variáveis com diferentes desfechos maternos e perinatais. Conclusão: O uso de corticoide antenatal deve ser realizado intra-hospitalar com supervisão dos níveis glicêmicos maternos pelas equipes de Obstetrícia e Endocrinologia devido à possível ocorrência de alterações importantes nesses níveis. É necessário uma equipe multidisciplinar no cuidado à gestante diabética. Outros estudos com população de gestantes diabéticas e uso de CTC antenatal em gestações mais tardias são necessários.Palavras chave: Diabetes Mellitus, Corticosteroides, Gravidez de alto risco, PrematuroABSTRACT:Introduction: The use of antenatal corticotherapy (CTC) in late preterm and premature term newborn pregnancies is discussed, especially in diabetic pregnant women who already have high-risk pregnancies and will be forwarded elective C-section. Objective: To analyze the relationship between antenatal CTC in elective late preterm and premature term deliveries in diabetic pregnant women and maternal and perinatal outcomes. Material and methods: A retrospective study was performed at the Clinical Hospital Complex of the Federal University of Parana, where the glycemic levels of pregnant women before and after corticosteroid therapy were evaluated, as well as newborn data, such as blood glucose, supplemental oxygen requirement and others. Results: Diabetic pregnant women who received antenatal CTC had more peaks of hyperglycemia than diabetic pregnant women who did not receive such therapy. Both in the group of diabetic pregnant women with CTC, and in the group that did not receive this therapy, there was a positive association between the use of neonatal oxygen therapy, occurrence of neonatal hypoglycemia and other variables with different maternal and perinatal outcomes. Conclusion: The use of antenatal corticosteroids should be performed in-hospital with supervision of maternal glycemic levels by the Obstetrics and Endocrinology teams due to the possible occurrence of significant changes in these levels. A multidisciplinary team is needed in the care of diabetic pregnant women. Further studies with the diabetic pregnant population and antenatal CTC use in later pregnancies are needed.Keywords: Diabetes Mellitus, Corticosteroids, High risk pregnancy, Premature infant

Late preterm (LP) and early term (ET) infants can be considered the “great dissemblers”: they resemble healthy full-term infants in appearance, but their immaturity places them at increased risk of poor short- and long-term outcomes. Nutritional requirements are greater than for full-term babies, but there are few good data on the nutritional requirements for LP and ET babies, leading to substantial variation in practice. Recent data indicate that rapid growth may be beneficial for neurocognitive function but not for body composition and later metabolic health. Breastfeeding the LP or ET infant can be challenging, and mothers of these infants may need additional support to breastfeed successfully. Future research should investigate nutritional requirements of LP and ET infants for optimal growth, addressing both short- and long-term outcomes and the potential trade-off between neurocognitive and metabolic benefits.

Background: Infants lose some of their birth weight before hospital discharge. This loss, which is accepted as “physiological” up to a certain level (5-7%), is supplemented with food in early period for infants with over 7% of loss. While food supplementation does not have the benefits of mother’s milk, it may cause low breastfeeding success in the long run. In newborns, the identification of risk factors affecting weight loss in a few days following birth will increase exclusive breastfeeding success. The aim of this study is to evaluate the risk factors that cause weight loss in newborns before hospital discharge. Methods: Weight loss in infants born in a private trust hospital of Koc University American Hospital between 1 January 2011 and 31 December 2014 was evaluated. The hospital records of 3812 babies who completed the inclusion criteria were included in the study. The variables giving meaningful results in binary tables were evaluated with “Multivariate Logistic Regression”.Results: The increase in maternal age, Caesarean section birth, primiparity, female gender and being early term were statistically significant risk factors for early weight loss in newborns.

Introduction: The aim of the present study was to determine if the use of local anesthesia by different ways would reduce postoperative pain after laparoscopic total extraperitoneal inguinal hernia repair.Methods: Thirty patients were randomly divided into three groups. Upon completion of the prolene mesh repair, Group 1 (mean age: 45.8±8.6 years) received 5 cc levobupivacaine installed into the preperitoneal space every 6 h for 24 h via a catheter placed to the preperitoneal space. In Group 2 (mean age: 44.9±11.5 years), levobupivacaine-soaked spongostan was placed into the preperitoneal space after the placement of the prolene mesh. Group 3 (mean age: 45.4±10.7 years) was determined as the control group and received 75 mg diclofenac sodium after inguinal hernia repair. Pain was assessed by using a Visual Analog Scale of 1 (minimal pain) to 10 (worst pain) at fixed time intervals of 0, 6, 12, 18, and 24 h after surgery.Results: The trend of postoperative pain in 0, 6, and 18 h of Group 1 was significantly lower than that of Group 3 (p

Objective: There are a variety of maternal or fetal conditions that require late preterm or early term delivery. In cases where early delivery is indicated, optimal management is not always clear. Historically, obstetricians used amniocentesis to document fetal lung maturity, but recently, many have transitioned to administration of antenatal corticosteroids (ACS). The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving ACS prior to scheduled cesarean delivery (CD) less than 39 weeks. Methods: This was a retrospective cohort study of women undergoing scheduled CD by one maternal-fetal medicine practice between 36 and 38 6/7 weeks, from 2005 to 2017. We identified women who underwent amniocentesis or received ACS within 2 weeks prior to delivery. Neonatal outcomes were compared between the two groups, with the primary outcome being neonatal intensive care unit (NICU) admission. Results: A total of 502 women were included, of whom 313 (62.4%) underwent amniocentesis and 189 (37.6%) received ACS. Overall, 55 (11.0%) of neonates were admitted to the NICU. NICU admission was not significantly different between groups (11.8 versus 9.5%, p=.46). This held true after adjusting for gestational age and other differences in baseline characteristics. There were no significant differences between groups for all other neonatal outcomes, including NICU admission for respiratory indications, respiratory support, neonatal greater than maternal length of stay, low Apgar scores, and neonatal death. Rates of hypoglycemia were low and not significantly different between groups (2.2% in the amniocentesis group versus 0.5% in the ACS group, p=.27). Diabetes was the only covariate significantly associated with NICU admission (aOR 3.19, 95% CI 1.35, 7.54). Conclusions: In women undergoing scheduled CD between 36 and 38 6/7 weeks, administration of ACS is associated with similar neonatal outcomes compared to amniocentesis. This supports the current notion that outcomes are similar with ACS compared to amniocentesis for late preterm and early term deliveries. Brief rationale: The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving antenatal corticosteroids (ACS) prior to scheduled cesarean delivery (CD) less than 39 weeks. We found that in women undergoing scheduled cesarean delivery between 36 and 38 6/7 weeks, administration of antenatal corticosteroids is associated with similar neonatal outcomes compared to amniocentesis.