Search

IntroductionRecently, researchers have introduced the concept of ‘early term’ infants, defined as infants born at 37 or 38 weeks of gestation, and their outcome has been discussed. Although the complications experienced by early term are less severe than those in preterm infants, this group accounts for a much larger proportion of newborns, making the assessment of outcomes important in clinical practice.MethodsThis observational study of term infants born at Tokyo Metropolitan Toshima Hospital aimed to understand the short-term outcomes in early term infants. Data extracted from the medical records were analyzed.ResultsAmong 4,669 eligible participants, 463 (9.9%) were born at 37 weeks and 1,270 (27.2%) were born at 38 weeks. The remaining 2,936 infants were born after 39 weeks of gestation. Logistic regression analysis showed higher odds ratio of hospitalization (1.56, 95% CI: 1.37–1.79, p

In this study, we examined the pharmacokinetics of nifedipine and investigated the maternal and foetal background factors that prolong pregnancy in pregnant women undergoing long‐term tocolysis. This prospective observational study included 38 pregnant women hospitalised for threatened preterm labour and treated with nifedipine extended‐release tablets in combination with an intravenous ritodrine infusion. Maternal plasma nifedipine concentrations were determined using high‐performance liquid chromatography. All patients were administered 20 or 40 mg/dose of nifedipine every 6 h at the time of blood sampling. The plasma trough concentration (Ctrough) was 22.6 ± 17.3 ng/mL, the maximum plasma concentration (Cmax) was 30.9 ± 15.3 ng/mL and the time to maximum concentration (Tmax) was 1.70 ± 1.10 h, as determined using noncompartmental analysis (NCA). The area under the curve for drug concentration (AUCtau) was 152.3 ± 91.8 mg/L・h, and oral clearance (CL/F) was 0.17 ± 0.08 L/h. Using logistic regression analyses, we identified the factors that predicted term delivery from 37 weeks to <42 weeks of gestation. Gestational age at admission and the AUCtau of nifedipine can predict term delivery. The AUCtau of nifedipine is a valuable regulatory predictor of term delivery in pregnant women undergoing long‐term tocolysis. [ABSTRACT FROM AUTHOR]

Preterm birth a common and severe pregnancy complications, causing significant health, development, and economic problems. Accurate diagnosis of imminent labor for women with threatened preterm labor (TPL) is crucial. Electrohysterography (EHG), which represents uterine myometrial electrical activity, is a potential tool for predicting preterm birth. Increased cell synchronization is fundamental to generating high-intensity and coordinated uterine myometrial electrical activity as labor approaches. The present work aimed to evaluate the synchronization measures from multichannel EHG signals to predict labor in less than 24 h (time to delivery, TTD <24 h vs. TTD≥24 h), and between imminent labor (TTD <1 week) and non-imminent labor (TTD≥1 week) in women with TPL. We computed three synchronization measures: the imaginary component of coherence, phase lag index, and weighted phase lag index (wPLI) within three specific frequency bandwidths (fast wave low (FWL): 0.1-0.34 Hz, fast wave high (FWH): 0.34-1 Hz, and whole bandwidth: 0.1-1 Hz) from 115 pregnant women (26-41 weeks of gestation). Our results revealed that multichannel EHG synchronization measures significantly increased closer to delivery (labor > non-labor, imminent > non-imminent). Indeed, wPLI in the FWH bandwidth exhibited a positive correlation with gestational age (p < 0.001，correlation coefficient = 0.35) and an inverse relationship with time to delivery (p < 0.001，correlation coefficient = -0.33). wPLI allows for better distinguishing imminent from non-imminent in women with TPL, especially for those electrode pairs in the vertical direction, which has been reported as the predominant direction of uterine activity propagation. The three synchronization measures computed in FWL and FWH bandwidth provided complementary information for predicting labor in less than 24 h and also imminent labor in women with TPL, achieving an F1-score of 93 % (84.2-93 %) and 99.5 % (85.2-99.5 %) respectively. Our results suggest that EHG synchronization analysis constitutes a new sensitive metrics to discriminate imminent labor which can be potentially used for improving preterm birth prediction and understand uterine electrical activity dynamics., Competing Interests: Declaration of competing interest All authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Environmental pollution and exposure to heavy metals such as lead can lead to adverse pregnancy complications such as preterm delivery. Due to the fact that the findings and evidence in this regard are still contradictory, this study was performed with aim to compare serum levels of lead in pregnant women with term and preterm delivery.Methods: This case-control study was performed in 2017-2019 on 108 pregnant women referred to Imam Reza Hospital affiliated to Kermanshah University of Medical Sciences in two groups of case (preterm delivery) and control group (term delivery). 2 cc of blood sample was taken from each term and preterm mothers in the hospital (where the mothers were hospitalized). After preparing the laboratory results of serum levels of lead and completing the questionnaires, data were analyzed by SPSS software (version 24) and T-test, Chi-square and Fisher's exact tests. P

Objectives: To determine the risk of spontaneous preterm birth (sPTB) associated with the length of second stage of labour in the first term delivery. Design Retrospective cohort study. Setting: University hospital. Population Women with first two consecutive singleton births and the first birth at term. Those who did not reach the second stage of labour in the first delivery were excluded. Methods: Charts from 2007 to 2019 were reviewed. Main outcome measures: Rate of sPTB (<37 weeks of gestation) in the second delivery. Results: Of 13 958 women who met study inclusion criteria, 1464 (10.5%) parturients had a prolonged second stage (≥180 min) in their first term delivery. The rate of sPTB in the second delivery was similar in those with and without a prolonged second stage in first delivery (2.8% versus 2.8%; adjusted odds ratio [aOR] 1.35, 95% CI 0.96–1.90). After adjustment for mode of delivery, prolonged second stage was also not associated with subsequent sPTB in those who delivered by spontaneous and operative vaginal delivery. Those delivered by second‐stage caesarean section in the first delivery had a higher risk of sPTB in the second delivery (25/526, 4.8%; aOR 2.66, 95% CI 1.71–4.12; p < 0.001), with a more pronounced risk in those with second‐stage caesarean following a prolonged second stage of labour (15/259, 5.8%; aOR 3.40, 95% CI 1.94–5.94; p < 0.001). Conclusion: Second‐stage duration in a first term vaginal delivery is not associated with subsequent sPTB. The risk of sPTB is increased following second‐stage caesarean section, particularly if performed after a prolonged second stage. Second‐stage caesarean delivery, particularly after prolonged second stage, increases the risk of preterm birth. Second‐stage caesarean delivery, particularly after prolonged second stage, increases the risk of preterm birth. [ABSTRACT FROM AUTHOR]

Human milk (HM) provides essential nutrition for ensuring optimal infant growth and development postpartum. Metabolomics offers insight into the dynamic composition of HM. Studies have reported the impact of lactation stage, maternal genotype, and gestational age on HM metabolome. However, the majority of the studies have considered changes within the first month of lactation or sampled with large intervals. This leaves a gap in the knowledge of progressing variation in HM composition beyond the first month of lactation. The objective of this study was to investigate whether the HM metabolome from mothers with term deliveries varies beyond 1 month of lactation, during the period in which HM is considered fully mature. Human milk samples (n = 101) from 59 mothers were collected at weeks 1–2, 3–5, 7–9, and 20–25 postpartum and analyzed using 1H nuclear magnetic resonance spectroscopy. Several metabolites varied over lactation and exhibited dynamic changes between multiple time points. Higher levels of HM oligosaccharides, cis-aconitate, O-phosphocholine, O-acetylcarnitine, gluconate, and citric acid were observed in early lactation, whereas later in lactation, levels of lactose, 3-fucosyllactose, glutamine, glutamate, and short- and medium-chain fatty acids were increased. Notably, we demonstrate that the HM metabolome is dynamic during the period of maturity.

ObjectiveAlthough the randomized controlled trial (RCT) of the efficacy of hysteroscopic resection in women with uterine septum has not shown any significant correlation in recent research, motivation for deeper study remains insufficient. In this study, the objective was to determine pregnancy-related outcomes, along with adverse obstetric outcomes, following hysteroscopic resection and also to determine whether women with hysteroscopic resection bear the same outcomes as women with normal uterine cavities.Search MethodsFrom January 1995 to February 2022, a systematic literature review was conducted to identify all studies published concerning the gestation outcomes of women with and without hysteroscopic resection while comparing the gestation outcomes of women after hysteroscopic resection and with a normal uterine cavity. Our primary outcome was the live birth rate (LBR). The secondary outcomes were term delivery, preterm delivery, spontaneous miscarriage, malpresentation, cesarean section, and other adverse obstetric outcomes.Results22 studies were included in this meta-analysis. The control groups of 14 studies were treated women, and the control groups of the other 8 studies were patients bearing a normal uterine cavity. Hysteroscopic resection was related to a higher rate of term delivery (OR = 2.26, 95% CI, 1.26–4.05), and a lower rate of spontaneous abortion (OR = 0.50, 95% CI, 0.27–0.93), and a lower rate of malpresentation (OR = 0.31, 95% CI, 0.19–0.50). Nevertheless, in comparison with the normal uterus group, the rates of preterm birth, cesarean section, and postpartum hemorrhage after resection did not return to normal levels.ConclusionHysteroscopic resection can effectively reduce the risk of abortion and malpresentation in patients possessing a uterine septum while increasing the term delivery rate. Although well-designed RCTs should confirm our meta-analysis, it still bears recommending to patients

Electrohysterogram (EHG) is a promising method for noninvasive monitoring of uterine electrical activity. The main purpose of this study was to characterize the multichannel EHG signals to distinguish between term delivery and preterm birth, as well as deliveries within and beyond 24 h. A total of 219 pregnant women were grouped in two ways: (1) term delivery (TD), threatened preterm labor (TPL) with the outcome of preterm birth (TPL_PB), and TPL with the outcome of term delivery (TPL_TD); (2) EHG recording time to delivery (TTD) ≤ 24 h and TTD > 24 h. Three bipolar EHG signals were analyzed for the 30 min recording. Six EHG features between multiple channels, including multivariate sample entropy, mutual information, correlation coefficient, coherence, direct partial Granger causality, and direct transfer entropy, were extracted to characterize the coupling and information flow between channels. Significant differences were found for these six features between TPL and TD, and between TTD ≤ 24 h and TTD > 24 h. No significant difference was found between TPL_PB and TPL_TD. The results indicated that EHG signals of TD were more regular and synchronized than TPL, and stronger coupling between multichannel EHG signals was exhibited as delivery approaches. In addition, EHG signals propagate downward for the majority of pregnant women regardless of different labors. In conclusion, the coupling and propagation features extracted from multichannel EHG signals could be used to differentiate term delivery and preterm birth and may predict delivery within and beyond 24 h. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Preterm birth is associated with lower neurocognitive performance. However, whether children's neurodevelopment improves with longer gestations within the full-term range (37-41 weeks) is unclear. Given the high rate of obstetric intervention in the USA, it is critical to determine whether long-term outcomes differ for children delivered at each week of term.Methods: This secondary analysis included 39 199 live-born singleton children of women who were admitted to the hospital in spontaneous labour from the US Collaborative Perinatal Project (1959-76). At each week of term gestation, we evaluated development at 8 months using the Bayley Scales of Infant Development, 4 years using the Stanford-Binet IQ (SBIQ) domains and 7 years using the Wechsler Intelligence Scales for Children (WISC) and Wide-Range Achievement Tests (WRAT).Results: Children's neurocognitive performance improved with each week of gestation from 37 weeks, peaking at 40 or 41 weeks. Relative to those delivered at 40 weeks, children had lower neurocognitive scores at 37 and 38 weeks for all assessments except SBIQ and WISC Performance IQ. Children delivered at 39 weeks had lower Bayley Mental (β = -1.18; confidence interval -1.77, -0.58) and Psychomotor (β = -1.18; confidence interval -1.90, -0.46) scores. Results were similar for within-family analyses comparing siblings, with the addition of lower WRAT scores at 39 weeks.Conclusions: The improvement in development scores across assessment periods indicates that each week up to 40 or 41 weeks of gestation is important for short- and long-term cognitive development, suggesting 40-41 weeks may be the ideal delivery window for optimal neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence and risk of adverse perinatal outcomes in early-term (37+0-38+6 weeks), full-term (39+0-40+6 weeks), late-term (41+0-41+6 weeks), and post-term (>42+0 weeks) deliveries with spontaneous labor onset.Study Design: A population-based cohort with data from the Medical Birth Registry Norway (MBRN) and Statistics Norway (SSB) was conducted. The study population consisted of 665,244 women with cephalic singleton live births at term or post-term with spontaneous labor onset during the period of 1999-2014 in Norway. Maternal, obstetric, and fetal characteristics were obtained from the MBRN. Maternal education data were obtained from the SSB. The prevalence rates of adverse perinatal outcomes for each gestational age (GA) group were estimated. Inter-group differences were detected with Chi square tests. Multivariable regression analysis adjusted for maternal age, educational level, smoking, parity, maternal diabetes, and preeclampsia was used to assess adverse outcome prevalence for early- late-, and post-term births compared to full-term births.Results: Deliveries at early-term were associated with an increased prevalence of neonatal jaundice, polyhydramnios, small for gestational age (SGA) status, respiratory support, and neonatal intensive care unit (NICU) admission compared with deliveries at GAs of 39-43 weeks (p < 0.001). Low 5-min Apgar scores and newborn antibiotic treatment occurred at an increased prevalence in both early-term and post-term infants, relative to the full-term group (p < 0.001). The prevalence of oligohydramnios, meconium-stained amniotic fluid, and newborn birth injuries increased with increasing GA.Conclusions: More perinatal morbidity was observed among early-term infants compared to infants with later term deliveries, underscoring the need for cautious management of low-risk early-term deliveries. [ABSTRACT FROM AUTHOR]

Background: Risk factors for maternal Vitamin D deficiency and preterm birth are convergence, but the distribution of 25- hydroxyvitamin D (25(OH) Vitamin D) levels among preterm infants is not known. We aimed to assess the association of 25(OH) Vitamin D levels in mothers with term and preterm delivery with their neonates. Materials and Methods: This case--control study was conducted on 62 mothers with spontaneous preterm delivery and their neonates as the case group and 124 mothers with term delivery and their neonates as the control group. From mothers and neonate's umbilical cord at birth, 10 cc blood was taken and immediately sent to the laboratory for measuring Vitamin D levels . Pearson correlation, independent samples t-test, and kappa concordance coefficient were used for data analysis. Results: In the term group, 102 cases (82.3%) had Vitamin D deficiency/insufficiency and 22 cases (17.7%) had normal Vitamin D level while in the preterm group, 56 cases (90.3%) had Vitamin D deficiency/insufficiency, and 6 cases (9.7%) had normal Vitamin D level (P > 0.05). The correlation between maternal and neonatal 25(OH) Vitamin D levels in the term and preterm group was statistically significant (term group: r = 0.874, P < 0.001 and preterm group: r = 0.733, P < 0.001). Conclusion: Our study did not show a significant difference between two groups in terms of Vitamin D status both in mothers and neonates while the significant association was found between Vitamin D levels of mothers and neonates in both groups. These findings confirmed the previous studies' findings that Vitamin D levels in neonates could be predicted from their mothers. As a result, successful Vitamin D and calcium supplementation for improving 25(OH) Vitamin D levels in the maternal and neonatal populations for protecting the harmful effects of Vitamin D insufficiency/deficiency are recommended. [ABSTRACT FROM AUTHOR]

Delayed cord clamping in the first minute in preterm infants born before 34 weeks of gestation improves neonatal hematologic measures and may reduce mortality without increasing any other morbidity. In term-born babies, it also seems to improve both the short- and long-term outcomes and shows favorable scores in fine motor and social domains. However, there is insufficient evidence to show what duration of delay is best. The current evidence supports not clamping the cord before 30 seconds for preterm births. Future trials could compare different lengths of delay. Until then, a period of 30 seconds to 3 minutes seems justified for term-born babies. [ABSTRACT FROM AUTHOR]

Imbalanced immune responses against fetus alloantigens can lead to abnormality in pregnancy. Interleukin-10(IL-10) plays key roles in regulation of immune responses against self and foreign antigens to induce tolerance to these antigens. Therefore, alteration in expression of IL-10 during pregnancy may result in several pathologic conditions such as preterm labor. IL-10 leads to a normal pregnancy via several molecular mechanisms including development of tolerogenic dendritic cells, T regulatory lymphocytes and activation of the JAK1/STAT3 pathway in the target cells. This review has collected recent data regarding the status of IL-10 expression during term and preterm deliveries and also its molecular mechanisms that lead to a normal pregnancy.

Summary Background High dietary intakes of phytosterols (Phyto), such as those consumed by vegans and vegetarians, are not recommended for cholesterol-lowering in pregnant women (PW) because the safety of their use during pregnancy has not been fully established [1]. Information on Phyto in pregnancy is very limited. Objective To characterize the maternal-fetal gradient of free and esterified Phyto at the time of delivery in humans. Design PW who had a term delivery at the Obstetrics and Gynecology Unit of the University Hospital of Padua (Padua, Italy), between November 2016 and March 2017, participated in the study. Fatty acids (FA), cholesterol (Chol), Chol metabolites (7-dehydrocholesterol, 7-DHChol; lathosterol, Latho; 7α-hydroxycholesterol, 7α-OHChol), and Phyto (campesterol, Camp; stigmasterol, Stigma; sitosterol, Sito) were measured in both maternal (MB) and cord blood (CB) at the time of delivery. Non-pregnant adult volunteers (Ref-NA) served as a reference. Results Thirty-four term PW and 12 Ref-NA signed informed consent and were studied. Plasma total Phyto concentrations in CB were up to 20-fold lower than in MB (p < 0.05). Positive and significant correlations were found between total Phyto of MB-CB pairs (p < 0.01), and between total FA and Camp of MB (p < 0.05). Interestingly, free Chol to Chol ester ratio of CB did not differ from that of MB, and free Phyto to Phyto ester ratios were higher in CB than in MB (p < 0.001). No differences were found between Phyto concentrations of MB and Ref-NA. However, free Chol to Chol ester ratio, and free Phyto to Phyto ester ratios were higher in MB than in Ref-NA (p < 0.05). Chol synthesis, as indicated by 7-DHChol to 7α-OHChol, Latho to 7α-OHChol, and Latho to Sito ratios, was greatest in CB and lowest in Ref-NA. Conclusion Our data suggest that free Phyto cross the human placenta more easily than Phyto ester. An elevated Stigma to Chol ratio in CB than in MB was also described for the first time. The impact of these findings on the neonatal outcomes remains to be elucidated. [ABSTRACT FROM AUTHOR]

Objective: To examine whether different grades of placenta inflammation are associated with risk for spontaneous preterm birth, taking into consideration maternal and delivery factors. Placentas from spontaneous preterm births were compared with a control group from full-term deliveries.Methods: Placentas from 98 full-term, 71 late preterm (gestational week 34-37), and 65 early preterm (gestational week 22-33) singleton deliveries were analysed from the Karolinska University Hospital in Stockholm. The placentas were examined for histologic chorioamnionitis (HCA) grade 1 (low) and 2 (high). Mother, child, and delivery parameters were collected from maternity centre and delivery forms.Results: There was a relatively low incidence of HCA in the preterm groups (26.7% and 38.5% in the late and early preterm groups, respectively). HCA 2 was most common in the early preterm group and HCA 1 was most common in the full-term group. The odds of early preterm birth was lower for placentas with HCA 1 compared to HCA 2 (OR = 0.17) and higher for placentas with HCA 2 compared to no HCA (OR = 2.17).Conclusions: Despite a relatively low incidence of HCA in the preterm groups, HCA 2 seems to be associated with early preterm birth whereas HCA 1 seems to be part of the full-term delivery. [ABSTRACT FROM AUTHOR]

Purpose: To compare maternal and neonatal outcomes in induced vs. expectant management of term PROM. Methods: This retrospective study included patients with term PROM. A total of 325 were enrolled: 213 managed expectantly and 112 induced at admission and matched according to gestational age. Expectant management group patients were allowed to defer labour induction up to 48 h. Primary outcome measures were maternal or foetal signs of infection (chorioamnionitis, early neonatal sepsis or postpartum endometritis) and prolonged maternal hospitalization. Secondary outcome was caesarean delivery rate. Results: All group characteristics were comparable except that expectant management included more nulliparous women. Women managed expectantly had a higher rate of prolonged hospitalization [15 (7 %) vs. 2 (1.8 %); P = 0.043] as an indication of maternal complications, compared to induction management. They also had a higher rate of caesarean delivery [34 (16.4 %) vs. 8 (7.1 %), respectively; P = 0.024]. Adjustment for parity did not change the results. Early neonatal outcomes were similar between groups. Conclusions: Expectant management increases the likelihood of caesarean delivery and prolonged maternal hospitalization. This should be considered when advising patients with term PROM regarding labour induction. [ABSTRACT FROM AUTHOR]

Objective: To apply the classification of term delivery of the American College of Obstetricians and Gynaecologists, describe the frequency of the various categories, and explore neonatal outcomes among groups. Materials and methods: A cross-sectional study including pregnant women considered initially healthy with a term pregnancy defined on the basis of the last reliable menstruation and ultrasound performed in the first half of the gestation period in a private, Level III clinic, in Cali, Colombia, in 2013. Deliveries were classified as early term, full term and late term. Social and demographic characteristics of the mothers and perinatal outcomes are described. The frequency of each category is described and group comparisons are performed using the variance analysis (ANOVA),and the Kruskal-Wallis or Chi-square test. Results: Of 502 births, 200 (39.8 %) were classified as early term, 354 (50.6 %) as full term, and 48 (9.6 %) as late term. There was a higher frequency of contributive insurance coverage and high risk pregnancies in the early term group. Statistically significant differences were observed in terms of low birth weight and average neonatal weight in the early term group, whereas neonatal asphyxia was higher in the late term group. There were no differences in terms of respiratory distress syndrome or length of stay. Conclusion: It is feasible to apply the new ACOG term pregnancy classification. The frequency of early term delivery is high in Colombia. There was no evidence of significant differences in neonatal outcomes between the three groups except for higher neonatal asphyxia in the late term group. [ABSTRACT FROM AUTHOR]

Background: We performed an epigenome-wide longitudinal DNA methylation study on an Indian cohort of pregnant women, GARBH-Ini, at three time points during pregnancy and at delivery. Aim & objective: Our aim was to identify temporal DNA methylation changes in maternal peripheral blood during the period of gestation and assess their impact on biological pathways critical for term delivery. Results: Significantly differentially methylated CpGs were identified by linear mixed model analysis (Bonferroni p < 0.01) and classified into two distinct temporal methylation trends: increasing and decreasing during gestation. Genes with upward methylation trend were enriched for T-cell activity, while those with a downward trend were enriched for solute transport and cell structure organization functions. Conclusion: Consistent trends of DNA methylation in maternal peripheral blood point to the sentinel function of T cells in the maintenance of pregnancy, and the importance of coordinated cellular remodeling to facilitate term delivery.

Background: The "39-week rule," adopted by the American College of Obstetricians and Gynecologists circa 2009, discouraged routine elective induction of labor in early-term gestations (37 weeks 0 days-38 weeks 6 days) to decrease the risk of adverse neonatal outcomes. However, little research exists regarding any unintended adverse pregnancy outcomes associated with this policy shift., Objective: This study aimed to quantify the difference in incidence of adverse pregnancy outcomes before and after the implementation of the 39-week rule., Study Design: Deidentified data from all births in the state of South Carolina from 2000 to 2008 (before the 39-week rule) and from 2013 to 2017 (after statewide implementation and enforcement of the rule) were obtained from the South Carolina Revenue and Fiscal Affairs Office. Demographic data and International Classification of Diseases 9/10 codes were obtained for each birth. Our primary outcome was the incidence of any of the following adverse pregnancy outcomes: cesarean delivery, hypertensive disorders, chorioamnionitis, postpartum hemorrhage, high-degree lacerations, placental abruption, and intensive care unit admission. Propensity score analysis was used to control for age, body mass index, and race. After stratification by propensity score, the Cochran-Mantel-Haenszel test was used to compare the prerule and postrule groups., Results: A total of 633,985 births were eligible for inclusion-412,632 from 2000 to 2008, and 221,353 from 2013 to 2017. There was a significant increase in the primary outcome in the postrule period (39.94% pre vs 42.76% post; P<.01). The incidence of all hypertensive disorders was significantly increased in the postrule period compared with the prerule period (7.75% pre vs 10.1% post; P<.01). The incidence of chorioamnionitis and cesarean delivery also increased in the postrule period (1.45% pre vs 1.92% post; P<.01; 29.6% pre vs 31.82% post; P<.01; respectively)., Conclusion: There was a significant increase in the primary outcome following the implementation of the 39-week rule. Although the policy shift was driven by a desire to decrease adverse neonatal outcomes, aggregate benefit was not observed for pregnancy outcomes., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Imbalanced immune responses against fetus alloantigens can lead to abnormality in pregnancy. Interleukin-10 (IL-10) plays key roles in regulation of immune responses against self and foreign antigens to induce tolerance to these antigens. Therefore, alteration in expression of IL-10 during pregnancy may result in several pathologic conditions such as preterm labor. IL-10 leads to a normal pregnancy via several molecular mechanisms including development of tolerogenic dendritic cells, T regulatory lymphocytes and activation of the JAK1/STAT3 pathway in the target cells. This review has collected recent data regarding the status of IL-10 expression during term and preterm deliveries and also its molecular mechanisms that lead to a normal pregnancy. [ABSTRACT FROM AUTHOR]

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 is most at risk of developing severe medical conditions that can affect the respiratory, gastrointestinal, immune, central nervous, auditory and visual systems. There is a strong body of evidence emerging that suggests the analysis of uterine electrical signals, from the abdominal surface (Electrohysterography – EHG), could provide a viable way of diagnosing true labour and even predict preterm deliveries. This paper explores this idea further and presents a new dynamic self-organized network immune algorithm that classifies term and preterm records, using an open dataset containing 300 records (38 preterm and 262 term ). Using the dataset, oversampling and cross validation techniques are evaluated against other similar studies. The proposed approach shows an improvement on existing studies with 89% sensitivity , 91% specificity , 90% positive predicted value , 90% negative predicted value , and an overall accuracy of 90%. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study is to document the gender specific intrapartum and neonatal outcomes in term, singleton, appropriately grown babies. Study design De-identified, routinely collected data of all women meeting inclusion criteria between 2001 and 2011 were examined ( n = 9223). Inclusion criteria were public (non-insured), primiparous women who had delivered singleton, appropriately grown babies at term. In this retrospective cohort study, we estimated 95% confidence intervals. Outcomes measured were maternal demographics, mode of delivery, birthweight, APGAR score, cord blood acidemia, respiratory distress, any resuscitation requirement, nursery admission and stillbirth rates. Results The sex ratio of male babies was 1.05:1 (4718 males; 4505 females, p = 0.85). Male babies were more likely to be delivered by instrumental ( p = 0.004) or caesarean ( p < 0.001). Birthweight was found to be a significant influencing factor on mode of delivery. Even after adjusting for birthweight, male babies were more likely to be delivered by instrumental delivery (OR 1.24, p < 0.001), as well as by emergency caesarean for failure to progress (OR 1.24, p = 0.04) and fetal distress (OR 1.38, p < 0.001). Male babies, despite having greater birthweights than female babies ( p < 0.001), were more likely to have lower APGAR scores at 5 min ( p = 0.004), require neonatal resuscitation ( p < 0.001), develop respiratory distress ( p = 0.005) and require nursery admission ( p < 0.001). No statistical difference between male and female babies was found for cord blood acidemia ( p = 0.58) or stillbirth ( p = 0.49). Conclusion This large cohort study demonstrates that term, appropriately grown male babies in primiparous pregnancies fare more poorly in the intrapartum and neonatal periods than female babies. Even when birthweight was accounted for, male babies still required higher rates of intervention in the intrapartum and neonatal periods. This suggests gender may play an independent role in influencing pregnancy outcomes, although the underlying contributing physiology is not definitively established. The gender of the baby perhaps should be considered when counselling parents in the antepartum period. [ABSTRACT FROM AUTHOR]