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3 results on '"Kroon, M.L. de"'

1. Effectiveness of routine third trimester ultrasonography to reduce adverse perinatal outcomes in low risk pregnancy (the IRIS study)

Author

Henrichs, J., Verfaille, V., Jellema, P., Viester, L., Pajkrt, E., Wilschut, J., Horst, H.E. van der, Franx, A., Jonge, A. de, Baar, A.L. van, Bais, J.M.J., Bonsel, G.J., Bosmans, J.E., Dillen, J. van, Duijnhoven, N.T.L. van, Grobman, W.A., Groen, H., Hukkelhoven, C.W.P.M., Klomp, T., Kok, M., Kroon, M.L. de, Kruijt, M., Kwee, A., Ledda, S., Lafeber, H.N., Lith, J.M.M. van, Mol, B., Molewijk, B., Nieuwenhuijze, M., Oei, G., Oudejans, C., Paarlberg, K.M., Papageorghiou, A.T., Reddy, U.M., Reu, P. de, Rijnders, M., Roon-Immerzeel, A. de, Scheele, C., Scherjon, S.A., Snijders, R., Spaanderman, M.E., Teunissen, P.W., Torij, H.W., Vrijkotte, T.G., Westerneng, M., Zeeman, K.C., Zhang, J.J., IRIS Study Grp, Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, Obstetrics & Gynecology, Value, Affordability and Sustainability (VALUE), Reproductive Origins of Adult Health and Disease (ROAHD), Methods in Medicines evaluation & Outcomes research (M2O), Public Health Research (PHR), Obstetrics and Gynaecology, APH - Personalized Medicine, APH - Quality of Care, ARD - Amsterdam Reproduction and Development, Amsterdam Reproduction & Development (AR&D), Midwifery Science, Public and occupational health, Obstetrics and gynaecology, APH - Mental Health, General practice, and APH - Aging & Later Life

Subjects
PREDICTION, Psychological intervention, INFANTS, Infant, Newborn, Diseases, law.invention, 0302 clinical medicine, Randomized controlled trial, Pregnancy, law, Cluster Analysis, 030212 general & internal medicine, Cluster randomised controlled trial, ULTRASOUND, Netherlands, Fetal Growth Retardation, 030219 obstetrics & reproductive medicine, STILLBIRTH, Obstetrics, Incidence, Pregnancy Outcome, General Medicine, medicine.anatomical_structure, Infant, Small for Gestational Age, Pregnancy in Adolescence, Gestation, Female, Apgar score, Ultrasonography, medicine.medical_specialty, Adolescent, Pregnancy Trimester, Third, Birth weight, Midwifery, Third trimester, Ultrasonography, Prenatal, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, Low risk pregnancy, All institutes and research themes of the Radboud University Medical Center, medicine, MANAGEMENT, Humans, Stepped wedge, Fundal height, Iris (anatomy), Perinatal Mortality, business.industry, Research, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Infant, Newborn, NULLIPAROUS WOMEN, medicine.disease, BIRTH-WEIGHT, Apgar Score, Small for gestational age, business, FETAL-GROWTH RESTRICTION, CONSENSUS
Abstract

ObjectivesTo investigate the effectiveness of routine ultrasonography in the third trimester in reducing adverse perinatal outcomes in low risk pregnancies compared with usual care and the effect of this policy on maternal outcomes and obstetric interventions.DesignPragmatic, multicentre, stepped wedge cluster randomised trial.Setting60 midwifery practices in the Netherlands.Participants13 046 women aged 16 years or older with a low risk singleton pregnancy.Interventions60 midwifery practices offered usual care (serial fundal height measurements with clinically indicated ultrasonography). After 3, 7, and 10 months, a third of the practices were randomised to the intervention strategy. As well as receiving usual care, women in the intervention strategy were offered two routine biometry scans at 28-30 and 34-36 weeks’ gestation. The same multidisciplinary protocol for detecting and managing fetal growth restriction was used in both strategies.Main outcome measuresThe primary outcome measure was a composite of severe adverse perinatal outcomes: perinatal death, Apgar score ResultsBetween 1 February 2015 and 29 February 2016, 60 midwifery practices enrolled 13 520 women in mid-pregnancy (mean 22.8 (SD 2.4) weeks’ gestation). 13 046 women (intervention n=7067, usual care n=5979) with data based on the national Dutch perinatal registry or hospital records were included in the analyses. Small for gestational age at birth was significantly more often detected in the intervention group than in the usual care group (179 of 556 (32%) v 78 of 407 (19%), PConclusionIn low risk pregnancies, routine ultrasonography in the third trimester along with clinically indicated ultrasonography was associated with higher antenatal detection of small for gestational age fetuses but not with a reduced incidence of severe adverse perinatal outcomes compared with usual care alone. The findings do not support routine ultrasonography in the third trimester for low risk pregnancies.Trial registrationNetherlands Trial Register NTR4367.

Published
2019

2. Effectiveness and cost-effectiveness of routine third trimester ultrasound screening for intrauterine growth restriction: study protocol of a nationwide stepped wedge cluster-randomized trial in The Netherlands (The IRIS Study)

Author

Henrichs, J., Verfaille, V., Viester, L., Westerneng, M., Molewijk, B., Franx, A., Horst, H ter, Bosmans, J.E., Jonge, A de, Jellema, P., Baar, A.L. van, Bais, J., Bonsel, G.J., Dillen, J. van, Duijnhoven, N.T.L. van, Grobman, W.A., Groen, H., Hukkelhoven, C.W.P.M., Klomp, T., Kok, M., Kroon, M.L. De, Kruijt, M., Kwee, A., Ledda, S., Lafeber, H.N., Lith, J.M. van, Mol, B.W., Nieuwenhuijze, M.J., Oei, G., Oudejans, C.B., Paarlberg, K.M., Pajkrt, E., Papageorghiou, A.T., Reddy, U.M., Reu, P.A.O.M. de, Rijnders, M., Roon-Immerzeel, A. de, Scheele, C., Scherjon, S.A., Snijders, R., Spaanderman, M.E.A., Teunissen, P.W., Torij, H.W., Vrijkotte, T.G., Twisk, J.W.R., Zeeman, K.C., Zhang, J., Henrichs, J., Verfaille, V., Viester, L., Westerneng, M., Molewijk, B., Franx, A., Horst, H ter, Bosmans, J.E., Jonge, A de, Jellema, P., Baar, A.L. van, Bais, J., Bonsel, G.J., Dillen, J. van, Duijnhoven, N.T.L. van, Grobman, W.A., Groen, H., Hukkelhoven, C.W.P.M., Klomp, T., Kok, M., Kroon, M.L. De, Kruijt, M., Kwee, A., Ledda, S., Lafeber, H.N., Lith, J.M. van, Mol, B.W., Nieuwenhuijze, M.J., Oei, G., Oudejans, C.B., Paarlberg, K.M., Pajkrt, E., Papageorghiou, A.T., Reddy, U.M., Reu, P.A.O.M. de, Rijnders, M., Roon-Immerzeel, A. de, Scheele, C., Scherjon, S.A., Snijders, R., Spaanderman, M.E.A., Teunissen, P.W., Torij, H.W., Vrijkotte, T.G., Twisk, J.W.R., Zeeman, K.C., and Zhang, J.

Abstract

Contains fulltext : 172417.pdf (publisher's version ) (Open Access), BACKGROUND: Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management. METHODS: For this trial, 15,000 women with a singleton pregnancy receiving care in 60 participating primary care midwifery practices will be included at 22 weeks of gestation. In the intervention (n = 7,500) and control group (n = 7,500) fetal growth will be monitored by serial fundal height assessments. All practices will start offering the control condition (ultrasonography based on medical indication). Every three months, 20 practices will be randomized to the intervention condition, i.e. apart from ultrasonography if indicated, two routine ultrasound examinations will be performed (at 28-30 weeks and 34-36 weeks). If IUGR is suspected, both groups will receive subsequent clinical management as described in the IRIS study protocol that will be developed before the start of the trial. The primary dichotomous clinical composite outcome is 'severe adverse perinatal outcome' up to 7 days after birth, including: perinatal death; Apgar score <4 at 5 minutes after birth; impaired consciousness; need for assisted ventilation for more than 24 h; asphyxia; septicemia; meningitis; bronchopulmonary dysplasia; intraventricular hemorrhage; cystic periventricular leukomalacia; neonatal seizures or necrotizing enterocolitis. For the economic evaluation, costs will be measured from a societal perspective. Quality of life wi

Published
2016

3. Among perinatal factors, only the Apgar score is associated with specific language impairment

Author

Diepeveen, F.B., Kroon, M.L. De, Dusseldorp, E., Snik, A.F.M., Diepeveen, F.B., Kroon, M.L. De, Dusseldorp, E., and Snik, A.F.M.

Abstract

Item does not contain fulltext, AIM: The purpose of this study was to assess the relation of perinatal risk factors with later development of specific language impairment (SLI). METHOD: In a case-control study, 179 children attending special needs schools for SLI were matched with non-affected children attending mainstream schools. Both groups consisted of 134 males and 45 females (age range 4-13y; mean age 9y, SD 2y 4mo). Data on duration of pregnancy, birthweight, delivery complications, birth characteristics, and Apgar scores were collected from the Preventive Child Health Care files of the Municipal Health Service. RESULTS: The gestational age of the children with SLI (mean 39.6wks, SD 0.1wk) and for the comparison group (mean 39.4wks, SD 0.1wk) and the birthweight of children with SLI (mean 3330.4g; SD 41.4g) and for the comparison group (mean 3388.1g; SD 39.8g) were not statistically different; neither were other pregnancy and birth characteristics, with the exception of the Apgar scores (effect of group for Apgar score after 1min p=0.045; after 5min p=0.001). The difference in Apgar scores was larger for females than for males (effect of group x sex for Apgar score after 1min p=0.049; after 5min p=0.043). INTERPRETATION: The relation between Apgar scores and SLI together with the influence of sex may be meaningful for predicting modelling and for understanding the causal pathway for SLI.

Published
2013

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