Search

Objective To investigate the effect of kangaroo mother care for low-birth-weight and preterm infants on parents' mental and physical health. Methods The Cochrane Central Register of Controlled Trials, Cochrane Register of Studies Online, PubMed[R], Web of Science, Scopus and EMBASE[R] databases were searched on 16 January 2023 for randomized and quasi-randomized trials on kangaroo mother care. Records identified were screened independently by two reviewers. Pooled relative risks (RRs) are reported for categorical variables, and standardized mean differences (SMDs) or mean differences are reported for continuous variables. Evidence quality was assessed using the GRADE approach. Findings The search identified 30 studies involving 7719 preterm or low-birth-weight infants. There was high- certainty evidence that kangaroo mother care substantially reduced the risk of moderate-to-severe postpartum maternal depressive symptoms compared with no kangaroo mother care (RR: 0.76; 95% confidence interval, CI: 0.59 to 0.96). In addition, there was low-certainty evidence that kangaroo mother care reduced scores for maternal stress (SMD: -0.82; 95% CI: -1.32 to -0.32) and anxiety (SMD: -0.62; 95% CI: -1.01 to -0.23) and increased mother-infant attachment and bonding scores (SMD: 1.19; 95% CI: 0.27 to 2.10). Limited evidence indicated father-infant interactions may be improved, though no marked effect on paternal depression or stress was observed. No trial reported parental physical health outcomes. Conclusion Kangaroo mother care for preterm and low-birth-weight infants was associated with less postpartum maternal depression, stress and anxiety and better mother-infant attachment and bonding. More research is required to evaluate effects on paternal health. Objectif Etudier les effets, sur la sante mentale et physique des parents, de la methode <> appliquee aux nouveau-nes prematures ou de faible poids de naissance. Methodes Nous avons parcouru les bases de donnees du Registre central Cochrane des essais controles, du Registre Cochrane des etudes en ligne, de PubMed[R], de Web of Science, de Scopus et d'EMBASE[R] le 16 janvier 2023, a la recherche d'essais randomises et quasi-randomises sur la methode <>. Les documents retenus ont ete passes en revue separement par deux reviseurs. Les risques relatifs combines (RR) ont ete signales pour les variables nominales, tandis que les differences moyennes standardisees (DMS) ou differences moyennes l'ont ete pour les variables continues. Enfin, la qualite des donnees probantes a ete evaluee selon l'approche GRADE. Resultats La recherche a permis d'identifier 30 etudes impliquant 7719 nouveau-nes prematures ou de faible poids de naissance. Nous pouvons affirmer avec un degre eleve de certitude que le risque d'apparition des symptomes d'une depression post-partum moderee a severe est nettement plus faible chez les meres ayant adopte la methode <> que chez celles ne l'ayant pas adoptee (RR: 0,76; intervalle de confiance de 95%, IC: 0,59 a 0,96). En outre, il existe des preuves de faible certitude selon lesquelles la methode <> ferait baisser le niveau de stress maternel (DMS: -0,82; IC de 95%: -1,32 a -0,32) et d'anxiete (DMS: -0,62; IC de 95%: -1,01 a -0,23), tout en renforcant les relations mere-enfant et la formation de liens affectifs (DMS: 1,19; IC de 95%: 0,27 a 2,10). Des donnees limitees indiquent que les interactions pere-enfant pourraient s'en trouver ameliorees, meme si aucun impact significatif n'a ete constate sur le stress ou la depression paternelle. Aucun essai n'a fait etat d'une influence sur la sante physique des parents. Conclusion La methode <> appliquee aux nouveaunes prematures ou de faible poids de naissance etait associee a une diminution du stress, de l'anxiete et de la depression post-partum du cote maternel, ainsi qu'a un attachement et des liens plus forts entre la mere et l'enfant. D'autres recherches sont necessaires pour evaluer ses effets sur la sante paternelle. Objetivo Investigar los efectos del metodo madre canguro para recien nacidos prematuros y de bajo peso al nacer sobre la salud mental y fisica de los padres. Metodos Se realizaron busquedas en las bases de datos del Registro Cochrane Central de Ensayos Controlados, del Registro Cochrane de Estudios en Linea, de PubMed[R], de Web of Science, de Scopus y de EMBASE[R] el 16 de enero de 2023 para obtener ensayos aleatorizados y cuasialeatorizados sobre el metodo madre canguro. Dos revisores analizaron de forma independiente los registros identificados. Se informan los riesgos relativos (RR) agrupados para las variables categoricas y las diferencias de medias estandarizadas (DME) o las diferencias de medias para las variables continuas. La calidad de la evidencia se evaluo mediante el enfoque GRADE. Resultados La busqueda identifico 30 estudios con 7719 recien nacidos prematuros o de bajo peso al nacer. Hubo pruebas de alta certeza de que el metodo madre canguro redujo significativamente el riesgo de sintomas depresivos posparto de moderados a graves en comparacion con ningun metodo madre canguro (RR: 0,76; intervalo de confianza del 95%, IC: 0,59 a 0,96). Ademas, hubo pruebas de baja certeza de que el metodo madre canguro redujo las puntuaciones de estres materno (DME: -0,82; IC del 95%: -1,32 a -0,32) y ansiedad (DME: -0,62; IC del 95%: -1,01 a -0,23) y aumento las puntuaciones de apego y vinculacion madre-hijo (DME: 1,19; IC del 95%: 0,27 a 2,10). Las pruebas limitadas indicaron que las interacciones padre-hijo pueden mejorar, aunque no se observo un efecto marcado sobre la depresion o el estres paterno. Ningun ensayo informo desenlaces de salud fisica de los padres. Conclusion El metodo madre canguro para recien nacidos prematuros y de bajo peso al nacer se asocio con menos depresion, estres y ansiedad maternos, posparto y mejor apego y vinculacion madre-hijo. Se necesitan mas investigaciones para evaluar los efectos sobre la salud paternal., Introduction Pregnancy and childbirth are critical periods in women's lives involving major physiological, psychological, domestic and sociodemographic changes. During the first 6 months postpartum, (1) an estimated 15% to 33% [...]

Background Gut dysbiosis contributes to the high risk of bloodstream infection (BSI) among premature infants. Most prior studies of the premature infant gut microbiota were conducted in Western countries and prior to development of current tools for strain-resolved analysis. Methods We performed metagenomic sequencing of weekly fecal samples from 75 premature infants at a single hospital in Singapore. We evaluated associations between clinical factors and gut microbiota composition using PERMANOVA and mixed effects linear regression. We used inStrain to perform strain-level analyses evaluating for gut colonization by BSI-causing strains. Results Median (interquartile range) gestation was 27 (25, 29) weeks, and 63% of infants were born via Cesarean section. Antibiotic exposures (PERMANOVA; R.sup.2 = 0.017, p = 0.001) and postnatal age (R.sup.2 = 0.015, p = 0.001) accounted for the largest amount of variability in gut microbiota composition. Increasing postnatal age was associated with higher relative abundances of several common pathogens (Enterococcus faecalis: p < 0.0001; Escherichia coli: p < 0.0001; Klebsiella aerogenes: p < 0.0001; Klebsiella pneumoniae: p < 0.0001). Antibiotic exposures were generally associated with lower relative abundances of both frequently beneficial bacteria (e.g., Bifidobacterium species) and common enteric pathogens (e.g., Enterobacter, Klebsiella species). We identified strains identical to the blood culture isolate in fecal samples from 12 of 16 (75%) infants who developed BSI, including all infections caused by typical enteric bacteria. Conclusions Antibiotic exposures were the dominant modifiable factor affecting gut microbiota composition in a large cohort of premature infants from South-East Asia. Strain-resolved analyses indicate that the gut is an important reservoir for organisms causing BSI among premature infants. Keywords: Preterm neonates, Early-onset sepsis, Late-onset sepsis, Intestinal microbiome, inStrain, Author(s): Sarah M. Heston[sup.1], Charis Shu En Lim[sup.2], Chengsi Ong[sup.2,3,4], Mei Chien Chua[sup.2,3], Matthew S. Kelly[sup.1] and Kee Thai Yeo[sup.2,3] Background Sepsis remains a major cause of mortality and morbidity [...]

Background: Estrogens play a critical role in parturition, and poly- and perfluoroalkyl substances (PFAS), which have estrogenic effects, have been associated with preterm birth. However, the impact of estrogens on the association between PFAS and preterm birth is unknown. Objective: The objective of this study is to investigate if estrogens modified the association between PFAS and preterm birth, using a nested case-control study design. Methods: A total of 371 preterm births and 508 controls were selected from a birth cohort study in China between 2016 and 2018. Perfluorobutanoic acid (PFBA), perfluorohexanesulfonic acid (PFHxS) and its branched isomer, perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS) and its branched isomer, and perfluorononanoic acid (PFNA) were quantified in maternal serum (mean gestational age of 32 wk). Estradiol and estriol were quantified in cord serum. Preterm birth was defined as live delivery at Results: Overall, higher odds ratios (ORs) of preterm birth were associated with each 1 ln-unit PFAS increase: PFBA [1.20, 95% confidence interval (CI): 1.14, 1.26], PFNA (1.30, 95% CI: 1.21, 1.39), PFOA (1.98, 95% CI: 1.54, 2.55), and PFOS (1.91, 95% CI: 1.76, 2.07) and its branched isomer (1.91, 95% CI: 1.90, 1.92). We detected statistically significant interactions between cord estradiol and PFAS on preterm birth, while no mediation effects of cord estrogen were observed. The ORs of PFOS (4.29, 95% CI: 1.31, 8.25), its branched isomer (6.71, 95% CI: 1.06, 11.91), and preterm birth were greater for participants with high cord estrogen levels than for participants with low cord estrogen levels. Discussion: Our findings suggest that estrogen modified the association between maternal PFAS exposure and preterm birth. Further studies on maternal PFAS exposure and preterm birth, taking interaction effects of cord estrogens into account, are warranted. https://doi.org/10.1289/EHP11377, Introduction Poly- and perfluoroalkyl substances (PFAS) comprise more than 4,000 unique chemicals, some of which are ubiquitous in the environment. (1) Exposure to PFAS is a growing public health concern. [...]

Background Intestinal dysbiosis is implicated in the origins of necrotising enterocolitis and late-onset sepsis in preterm babies. However, the effect of modulators of bacterial growth (e.g. antibiotics) upon the developing microbiome is not well-characterised. In this prospectively-recruited, retrospectively-classified, case-control study, high-throughput 16S rRNA gene sequencing was combined with contemporaneous clinical data collection, to assess the within-subject relationship between antibiotic administration and microbiome development, in comparison to preterm infants with minimal antibiotic exposure. Results During courses of antibiotics, diversity progression fell in comparison to that seen outside periods of antibiotic use (-0.71units/week vs. + 0.63units/week, p < 0.01); Enterobacteriaceae relative abundance progression conversely rose (+ 10.6%/week vs. -8.9%/week, p < 0.01). After antibiotic cessation, diversity progression remained suppressed (+ 0.2units/week, p = 0.02). Conclusions Antibiotic use has an acute and longer-lasting impact on the developing preterm intestinal microbiome. This has clinical implications with regard to the contribution of antibiotic use to evolving dysbiosis, and affects the interpretation of existing microbiome studies where this effect modulator is rarely accounted for., Author(s): R. A. Hutchinson[sup.1,2], K. L. Costeloe[sup.1], W. G. Wade[sup.1,3,4], M. R. Millar[sup.1], K. Ansbro[sup.1], F. Stacey[sup.2] and P. F. Fleming[sup.1,2] Introduction Intestinal dysbiosis is increasingly implicated in the pathophysiological [...]

Background/objectives Vitamin D deficiency during pregnancy may influence adverse outcomes in offspring. The aim of this systematic review and meta-analysis of observational studies was to assess the association between low prenatal concentrations of 25(OH)D (by using three different cut-off levels), preterm birth (PTB) and anthropometric and neurodevelopmental outcomes in offspring. Subjects/methods Studies reporting data on the association between maternal vitamin D concentrations and offspring outcomes identified through a systematic review of scientific literature published in PubMed/MEDLINE, Scopus and the Cochrane Library databases up to April 2017. Results We included 54 eligible studies. Vitamin D-deficient mothers ( Conclusion Maternal vitamin D deficiency is associated with offspring adverse anthropometric outcomes and PTB; insufficiency with a higher risk of SGA, PTB and adverse neurodevelopmental outcomes., Author(s): Monica Tous [sup.1] [sup.2], Marcela Villalobos [sup.1], Lucia Iglesias [sup.1] [sup.2], Sílvia Fernández-Barrés [sup.1] [sup.3], Victoria Arija [sup.1] [sup.2] [sup.4] Author Affiliations: (1) Research Group in Nutrition and Mental [...]

Objective To study the effect of intestinal microecology on postnatal weight gain of very preterm infants in neonatal intensive care unit (NICU). Methods Very preterm infants who met the inclusion criteria were enrolled. The subjects were divided into the extrauterine growth retardation (EUGR) group(defined as a body weight less than the 10th percentile of the corresponding gestational age or a weight loss between birth and a given time of > 2SD were considered EUGR) and normal growth group, and the growth was evaluated at 2 and 4 weeks after birth. Meanwhile, the stool samples were taken to perform16S ribosomal RNA (rRNA) high -throughput 16S rRNA sequencing of the intestinal microflora was performed on stool samples. Results A total of 22 infants were included. There was no significant difference in the alpha diversity indexes indices between the two groups at 2 weeks or 4 weeks after birth. The beta diversity analysis showed that the two groups had similar principal components of the intestinal microflora were similar between the two groups. Linear discriminant analysis (LDA) effect size (LEfSe) showed that 2 weeks after birth, the bacteria with an absolute LDA score (log10) higher than 4 included Streptococcaceae, Streptococcus, Bacteroidetes, Bacteroidales and Stenotrophomonas in the EUGR group and Enterococcaceae and Enterococcus in the control group. At the 4th week after birth, the bacteria with an absolute LDA score (log10) higher than 3 in the EUGR group includedwere Clostriaceae, Eubacteriaceae and Eubacterium. TheBy comparing the composition of the microbial community composition comparison showed, significant differences were found in the principal components of Enterococcus and Streptococcus on the family and genus levels at 2 weeks after birth. No Bifidobacterium was found in either group at 4 weeks after birth. Conclusion Intestinal microecology is different between infants with EUGR and those with normal growth. The diversity and richness of the intestinal microflora in preterm infants at the NICU are significantly insufficient and change dynamically with time, and the establishment of intestinal homeostasis is obviously delayed. Keywords: Very preterm infants, Extrauterine growth, Neonatal intensive care unit, Intestinal microflora, Author(s): Ying-Xue Ding[sup.1], Shou-Ni Wang[sup.2], Hong Cui[sup.1] and Li-Na Jiang[sup.1] Introduction Preterm infants can suffer from immature immune system and physiological characteristics. The establishment of the neonatal intensive care units [...]