Gotowe bibliografie tematyczne / Neonatal outcomes

Gotowa bibliografia na temat „Neonatal outcomes”

Autor: Grafiati
Data publikacji: 4 czerwca 2021
Data aktualizacji: 20 lutego 2023

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Artykuły w czasopismach na temat "Neonatal outcomes"

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Rashed, Ghader M., Areej A. Al-Omrani, Zahoor A. Mohmmed i AbdulKarem J. Al-Bahadle. "NEONATAL OUTCOMES IN GESTATIONAL DIABETES MELLITUS". Iraqi Journal of Medical Sciences 20, nr 1 (30.06.2022): 59–67. http://dx.doi.org/10.22578/ijms.20.1.8.

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Background: Gestational diabetes mellitus (GDM) is a common and serious maternal complication, in which hyperglycemia develops at any time during pregnancy due to progressive insulin resistance. It affects about 14% of pregnancies worldwide. There are many adverse effects of GDM that compromise the fetus and neonate. Objective: To compare neonatal outcomes according to type of treatment for GDM. Methods: A prospective study conducted at the Department of Pediatrics, (Neonatal Intensive Care Unit; NICU) and Obstetric in Al-Imamein Al-Kadhimein Medical City in Baghdad during a period from 1st of march 2019 to 1st of January 2020. The study included 100 neonates delivered by mothers with GDM, divided in to four groups according to their mothers' therapy; (diet group: 18 neonates, metformin group: 36, insulin group: 26, mixed group: 20). Results: Neonates in metformin group had a higher chance of having normal birth weight comparing with others, but neonates in insulin group have higher percent of prematurity, macrosomia, large for gestational age or small for gestational age, hypoglycemia and jaundice among others. No significant statistical difference between metformin and insulin, in mode of delivery, Apgar score, respiratory distress syndrome, hypocalcaemia, anomalies, and NICU admission but can occur more in insulin group. Conclusion: Metformin was able to reduce the risk of neonatal complications, therefore, it can be a good alternative for insulin in the treatment of GDM. Keywords: Gestational diabetes mellitus, macrosomia, metformin, insulin Citation: Rashed GM, Al-Omrani AA, Mohmmed ZA, Al-Bahadle AJ. Neonatal outcomes in gestational diabetes mellitus. Iraqi JMS. 2022; 20(1): 59-67. doi: 10.22578/IJMS.20.1.8
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Saboohi, Erum, Nighat Seema i Abdulah Hadi Hassan. "Maternal and fetal factors contributing to neonatal outcome in Al-Tibri Medical College and Hospital". Journal of Fatima Jinnah Medical University 15, nr 1 (15.03.2021): 18–22. http://dx.doi.org/10.37018/qbhp7754.

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Background: The study was done to identify the maternal and fetal factors contributing to neonatal outcome and to evaluate the correlation between risk factors and adverse neonatal outcome. Subjects and methods: This prospective observational study was conducted on 126 mothers and their neonates fulfilling the selection criteria at Al-Tibri Medical College and Hospital. A self-designed Performa was used to enter data of subjects. Sick neonates were referred to neonatal intensive care unit for admission and management. The results were analyzed by using SPSS version 22. A p-values <0.05 was considered as significant. Results: Out of 126 enrolled subjects, 81% mothers were multigravidas, 31% were unbooked, 13.5% had gestational comorbidities, 15% were drug addict, 2% were Hepatitis B positive. 22.2% underwent emergency LSCS while 31.7% delivered babies by elective LSCS. Regarding fetal factors contributing to sick babies, IUGR (20%), twin fetuses (15.4%), prematurity (47.7%) were significant. 65 were sick babies. Adverse neonatal outcomes observed were prematurity in 25.4%, IUGR in 11.1%, NICU admission in 33.3%, and neonatal death in 2%. Risk factors associated with adverse neonatal outcomes were positive maternal drug addiction (p-value = 0.028), preterm delivery (p-value<0.001), NICU admission (p-value<0.001) and low birth weight (p-value <0.001). Conclusion: Compromised maternal antenatal care has profound deleterious effect on fetus and neonate. Obstetricians, perinatologists and neonatologists need to work in concord to improve maternal antenatal care hence improving neonatal outcome. In our study adverse neonatal outcome was associated with unbooked cases, delivery by EmLSCS, addicted mother, preterm delivery, LBW and neonates requiring NICU admission.
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Siddiqui, Muhammad Asif, Sehrish Masood, Tayyaba Khawar Butt i Shahla Tariq. "Neonatal outcomes of birth asphyxia in tertiary care hospital of low-income country". Journal of Fatima Jinnah Medical University 15, nr 1 (15.03.2021): 23–26. http://dx.doi.org/10.37018/unkh2664.

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Background: Pakistan has highest neonatal mortality in the region and birth asphyxia is one of the main preventable contributors to this. Objective of this study is to determine the frequency of different neonatal outcomes in neonates with birth asphyxia. Subjects & Methods: It was descriptive case series study conducted in Department of Pediatrics Medicine, Services Hospital, Lahore in 6 months period during 6th Dec 2016 to 5th June 2017. 150 cases were included using non probability, consecutive sampling with 95% confidence level, 6% margin of error taking an expected percentage of neonate mortality as 15%. Data was analyzed with SPSS version 23. Categorical variables i.e., gender and neonatal outcomes in terms of neonatal mortality, discharge and neurological complications were expressed by frequency and percentage. Post stratification chi square test was applied. A p-value of <0.05 was taken as significant. Results: The mean age of neonates was 3.09±0.8 hours. Outcomes of these neonates was seen in terms of mortality, discharge and neurological problems. Out of total 150 patients, 51 (34%) neonates expired and 99 (66%) neonates were survived. And neonates 69 (46%) neonates were diagnosed with neurological complications. Conclusion: We found, birth asphyxia has significant association with neonatal mortality and neurological complications. Prevention of birth asphyxia with appropriate resuscitation at birth may be helpful in reduction of morbidity and mortality due to birth asphyxia.Neonates
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Rasamoelison, Rina J., Setra H. Rambeloson, Hanitriniaina S. C. Samena i Annick L. Robinson. "Impact of extreme maternal age on neonatal outcomes". International Journal of Contemporary Pediatrics 9, nr 11 (27.10.2022): 1016. http://dx.doi.org/10.18203/2349-3291.ijcp20222760.

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Background: Pregnancies at extreme ages of reproductive life are considered to be at high risk for mother and neonate. The aim of the study was to determine neonatal risks associated with extreme maternal age.Methods: A retrospective cohort study was conducted at Befelatanana Maternity covering the period from 1 January to 31 December 2018. Data was collected from neonate’s medical files.Results: Of 789 neonates from mothers with extreme age included, 64.7% were from mothers under the age of 18, and 35.3% from mothers aged 40 and over. They were compared to 519 neonates from mothers aged 20-30. Maternal age under 18 was a risk factor for Apgar index below 7 at the 5th minute RR 1.69 (95% CI 1.17, 2.44), preterm birth RR 2.19 (95% CI 1.70, 2.80), low birthweight RR 2.03 (95% CI 1.53, 2.53) and admission to neonatalogy RR 2.64 (95% CI 2.20, 3.16). Also, the neonatal risks of pregnancy after 40 years were fetal death in utero RR 2.97 (95% CI 1.51, 5.85), low birthweight RR 2.47 (95% CI 1.97, 3.10), preterm birth RR 2.85 (95% CI 2.21, 3.68), and admission to Neonatalogy RR 3.06 (95% CI 2.54, 3.68).Conclusions: The extreme age of the mother is therefore a risk of neonatal adverse outcomes. Rigorous prenatal follow-up is needed for these high-risk pregnancies.
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Darcha, Rosina, i Margaret Wekem Kukeba. "Neonatal outcomes of obstetric complications". African Journal of Midwifery and Women's Health 15, nr 3 (2.10.2021): 1–10. http://dx.doi.org/10.12968/ajmw.2020.0030.

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Background/Aims Neonatal mortality remains a global challenge. In Ghana, neonatal mortality accounts for up to 50% of child mortality. A better understanding of the neonatal outcomes of obstetrics complications could contribute to context-specific evidence-based care to prevent neonatal deaths. This study aimed to describe the relationship between poor neonatal outcomes and obstetric complications in a tertiary health facility in the north of Ghana. Methods This was a cross-sectional quantitative study conducted at a tertiary health facility in northern Ghana. Purposive convenience sampling was used to select 384 mothers who experienced obstetric complications. A structured questionnaire was used to collect data on the participants' neonatal health outcomes. The chi-square test was performed to determine the relationship between neonatal health outcomes and obstetric complications, with significance set at P<0.05. Results A total of 20 obstetric complications were recorded. Overall, 327 participants had a single complication. The three most common obstetric complications resulting in adverse neonatal outcomes were obstructed labour (56.0%), pregnancy-induced hypertension (14.6%) and postpartum haemorrhage (11.6%). The majority (66.7%) of the neonates were healthy at birth, with 21.9% and 11.5% being sick or stillborn respectively. Obstetric complications were significantly associated with both neonatal morbidities and mortalities at P<0.000. Conclusions Preventable maternal obstetric complications continue to cause adverse neonatal outcomes in health facilities in Ghana. Appraisal of maternal and newborn care practices may be necessary to understand context-specific factors.
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McPherson, Christopher C. "Neonatal Herpes Simplex Virus: The Long Road to Improved Outcomes". Neonatal Network 39, nr 2 (1.03.2020): 92–98. http://dx.doi.org/10.1891/0730-0832.39.2.92.

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Herpes simplex virus (HSV) acquired during delivery places the neonate at risk for mortality or long-term neurodevelopmental disability. Exposure generally occurs from recurrent genital herpes infection, although primary infections result in the highest risk of neonatal disease. Neonates generally present in the second or third week of life with lesions. Encephalitis with seizures indicates the presence of central nervous system involvement, and other end organs may also be impacted. Clinical suspicion for neonatal HSV infection warrants immediate initiation of appropriate antiviral therapy. In the last 50 years, antiviral therapy has progressed from agents with prohibitive toxicity or cumbersome administration to herpes virus–specific agents that dramatically improve clinical outcomes with manageable toxicity. Multicenter clinical trials have demonstrated the superiority of high-dose intravenous acyclovir for acute therapy, followed by long-term oral suppressive therapy. This work has dramatically reduced morbidity and mortality from neonatal HSV, representing the benchmark for future clinical trials in neonatal pharmacotherapy.
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liston, Poonguzhali, Gomathy E i Sudha Reddy V. "Neonatal Outcomes in Women with Isolated Oligohydramnios". Indian Journal of Obstetrics and Gynecology 7, nr 2 (2019): 267–72. http://dx.doi.org/10.21088/ijog.2321.1636.7219.25.

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Gunawardane, Damitha Asanga, Samath D. Dharmaratne i Dhammica S. Rowel. "Neonatal outcome of term deliveries in Sri Lanka". South East Asia Journal of Public Health 7, nr 2 (28.11.2018): 34–39. http://dx.doi.org/10.3329/seajph.v7i2.38854.

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Major proportion (40-70%) of neonatal mortality is among ‘term neonates’. Even though, information on neonatal outcomes of term neonates is scarce. The high volume of term neonatal admissions to neonatal care units signify the importance of studying the neonatal outcomes among term neonates. The aim of this study is to describe the neonatal outcomes, of term neonates following term deliveries (37 completed weeks - 41 completed weeks and 6 days) at Teaching Hospital (TH) Kandy, Sri Lanka. A descriptive cross-sectional study was conducted to describe neonatal outcomes of term neonates before the initial hospital discharge point. A sample of 1,105 neonates, delivered at term were studied during the study period. Mean gestational age at delivery is 38.85 weeks and 41% of term neonates are delivered before completion of 39 weeks of Period of Amenorrhoea (POA). The mean birth weight of the term neo-nates is 2925.24 grams. Out of all term neonates, 15.84% (n=175) were admitted to Neonatal Care Unit (NCU) and 23.3% (n=257) had at least one diagnosed neonatal condition. The commonest neonatal condition was bacterial sepsis of newborn (n=138, 12.48%), followed by neonatal jaundice from other and unspecified causes (n=84, 7.6%), and respiratory distress of newborn (n=44, 3.94%). Median hospital stay of term neonates is 3 days. Majority of term neo-nates admitted to NCU are normal weight term neonates. Nearly one-fourth of term neonates had at least one diag-nosed neonatal condition. Prevention and control of infection from the time of birth to the time of discharge from the hospital should be given due attention to reducing bacterial sepsis among term neonates.South East Asia Journal of Public Health Vol.7(2) 2017: 34-39
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Webbe, James, Nicholas Longford, Sabita Uthaya, Neena Modi i Chris Gale. "Outcomes following early parenteral nutrition use in preterm neonates: protocol for an observational study". BMJ Open 9, nr 7 (lipiec 2019): e029065. http://dx.doi.org/10.1136/bmjopen-2019-029065.

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IntroductionPreterm babies are among the highest users of parenteral nutrition (PN) of any patient group, but there is wide variation in commencement, duration, and composition of PN and uncertainty around which groups will benefit from early introduction. Recent studies in critically unwell adults and children suggest that harms, specifically increased rates of nosocomial infection, outweigh the benefits of early administration of PN. In this study, we will describe early PN use in neonatal units in England, Wales and Scotland. We will also evaluate if this is associated with differences in important neonatal outcomes in neonates born between 30+0and 32+6weeks+daysgestation.Methods and analysisWe will use routinely collected data from all neonatal units in England, Wales and Scotland, available in the National Neonatal Research Database (NNRD). We will describe clinical practice in relation to any use of PN during the first 7 postnatal days among neonates admitted to neonatal care between 1 January 2012 and 31 December 2017. We will compare outcomes in neonates born between 30+0and 32+6weeks+daysgestation who did or did not receive PN in the first week after birth using a propensity score-matched approach. The primary outcome will be survival to discharge home. Secondary outcomes will include components of the neonatal core outcome set: outcomes identified as important by former patients, parents, clinicians and researchers.Ethics and disseminationWe have obtained UK National Research Ethics Committee approval for this study (Ref: 18/NI/0214). The results of this study will be presented at academic conferences; the UK charity Bliss will aid dissemination to former patients and parents.Trial registration numberNCT03767634
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Dwa, Yam Prasad, Sunita Bhandari, Devendra Shrestha i Ajaya Kumar Dhakal. "Perinatal outcomes in adolescent pregnancy". Journal of Chitwan Medical College 8, nr 2 (30.06.2018): 27–31. http://dx.doi.org/10.3126/jcmc.v8i2.23734.

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Introduction: Adolescent pregnancy is prevalent in Nepal and bears significant consequences to both mother and newborn. Methods: All pregnant women aged 19 years or less who were admitted for delivery at KIST Medical College during 14th April 2017 to 15th July 2018 were included in this study. Maternal and immediate neonatal outcomes were analyzed retrospectively from their medical records. Results: There were 135 pregnant adolescent women out of 1300 deliveries. Preeclampsia was observed in 2 pregnancies. Vaginal delivery (99; 73.3%) was the predominant mode of delivery. Emergency LS CS was performed in 35 (25.9%) deliveries and most frequent indications for LS CS were nonprogress of labor (8/35), breech presentation (8/35) and fetal distress (6/35). 10 (7.4%) babies were born preterm. 23 (17%) babies were born low birth weight. 37 (27.4%) neonates were symptomatic and required neonatal admission. Respiratory distress was the most frequent neonatal problem (29; 21.5%), followed by neonatal sepsis (18; 13.3%) and perinatal asphyxia (9; 6.7%). There were 3 (2.2%) still birth and 2 (1.5%) early neonatal deaths. Conclusion: Adolescent pregnancy was common and associated with increased early neonatal problems.
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Rozprawy doktorskie na temat "Neonatal outcomes"

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Hefley, Erin. "Interpregnancy Interval and Neonatal Outcomes". Thesis, The University of Arizona, 2014. http://hdl.handle.net/10150/315902.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
Objectives: Interpregnancy interval (IPI), the time period between the end of one pregnancy and the conception of the next, can have a significant impact on maternal and infant outcomes. This study examines the relationship between interpregnancy interval and neonatal outcomes of low birth weight, preterm birth, and specific neonatal morbidities. Study Design: Retrospective cohort study comparing neonatal outcomes across 6 categories of IPI using data on 202,600 cases identified from Arizona birth certificates and the Newborn Intensive Care Program data. Comparisons between groups were made using odds ratios and 95% confidence intervals, and multivariable logisitic regression analysis. Results: Interpregnancy intervals of < 12 months and ≥ 60 months were associated with low birth weight, preterm birth, and small for gestational age births. The shortest and longest IPI categories were also associated with specific neonatal morbidities, including periventricular leukomalacia, bronchopulmonary dysplasia, intraventricular hemorrhage, apnea bradycardia, respiratory distress syndrome, transient tachypnea of the newborn, and suspected sepsis. Relationships between interpregnancy interval and specific neonatal morbidities did not remain significant when adjusted for birth weight and gestational age. Conclusions: Significant differences in neonatal outcomes (preterm birth, low birth weight, and small for gestational age) were observed between IPI categories. Consistent with previous research, interpregnancy intervals < 12 months and ≥ 60 months appear to be associated with increased risk of poor neonatal outcomes. Any difference in specific neonatal morbidities between IPI groups appears to be mediated through increased risk of low birth weight and preterm birth by IPI.
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Johnson, Courtney Denning. "Postterm pregnancy risk factors and neonatal outcomes /". Available to US Hopkins community, 2003. http://wwwlib.umi.com/dissertations/dlnow/3080692.

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Tong, Yanling. "Developing ANN approaches to estimate neonatal ICU outcomes". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape3/PQDD_0020/MQ57165.pdf.

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Chen, Wenxiong. "Neonatal hyperbilirubinemia long-term neurophysiological and neurodevelopmental outcomes /". Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B37489380.

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Chen, Wenxiong, i 陈文雄. "Neonatal hyperbilirubinemia: long-term neurophysiological and neurodevelopmental outcomes". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B37489380.

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Proctor-Williams, Kerry. "Neurodevelopmental Outcomes for Infants with Neonatal Abstinence Syndrome". Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1827.

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Kvale, Janice Keller. "Maternal and neonatal outcomes associated with selected intrapartum interventions". Case Western Reserve University School of Graduate Studies / OhioLINK, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=case1061988693.

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Ankolekar, Kamini. "Hyperglycaemia, ethnicity and neonatal outcome study : a study conducted to review the influence of ethnicity on neonatal outcomes in pregnancies complicated with diabetes". Thesis, University of Leicester, 2016. http://hdl.handle.net/2381/37834.

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In England and Wales, about 2-5% of pregnancies are complicated with diabetes each year. Diabetes is a particular problem in the South Asian (SA) ethnic group with the prevalence of Type 2 Diabetes and GDM being about 6 times and 11 times higher respectively as compared to White British (WB) women. My PhD project was undertaken to study the influence of ethnicity and maternal hyperglycaemia during pregnancy on neonatal outcomes. This project consists of two retrospective studies and one prospective pilot study. The first retrospective study was undertaken to compare the neonatal outcomes in WB and SA infants born to mothers with gestational or pre-gestational diabetes (Type 1 and Type 2 diabetes). The second retrospective study was undertaken to compare the risk of morbidity and mortality between large for gestational age infants with a birthweight ≥ 97th centile and appropriate for gestational age infants with birthweight between 10th – 90th centile, both born to mothers without diabetes. Maternal hyperglycaemia during pregnancy leads fetal exposure to high blood glucose levels, which in turn leads to fetal hyperinsulinism. The neonatal complications seen in infants of diabetic mothers are due to persistent fetal hyperinsulinism after birth. Currently there is no clinical or biochemical test to identify, at birth, the infants who are at risk of neonatal complications. A prospective pilot study was undertaken to evaluate the feasibility of using cord blood C-peptide (surrogate marker of insulin) to identify infants born to mothers with diabetes and LGA infants of non-diabetic mothers at risk of postnatal complications. Such a test would enable early implementation of interventions to avoid complications and at the same time free the vast majority of infants from unnecessary medicalisation of their postnatal care.
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Poon, Chuen. "Cardiovascular outcomes of neonatal respiratory disease in infants and children". Thesis, Cardiff University, 2015. http://orca.cf.ac.uk/91302/.

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The aim of this thesis is to compare effects of respiratory distress syndrome (RDS) on the myocardial function of newborn preterm infants and the later effects of chronic lung disease of prematurity on pulmonary artery stiffness in school age children. The first study in this thesis compared global and regional myocardial function in preterm infants with respiratory distress syndrome (RDS) with preterm and term-born controls (30 with RDS, 30 preterm control ≤34 weeks, 60 term control) using conventional and tissue Doppler echocardiography at birth, at term, one month, and one year of age. The second study compared the pulmonary artery stiffness, an early preclinical marker of pulmonary hypertension, in children (aged 8-12 years) who had chronic lung disease of prematurity (CLD) with preterm and term-born controls. Pulmonary artery pulse wave velocity (PA PWV) was assessed in 59 children: 13 with CLD, 21 preterm (≤ 32 weeks gestation) and 25 term controls) using velocity encoded MRI technique while breathing room air and after 20 minutes of breathing 12% oxygen. At birth, infants with RDS had lower pulmonary artery AT:ET (p < 0.001), long axis shortening (p < 0.01), RV systolic velocity (p < 0.001) and higher TR (p < 0.01) compared to preterm and term control groups. The preterm groups was also noted to have diastolic dysfunction (lower mitral E:A) at birth (p < 0.001). At term corrected age, pulmonary artery AT:ET was still lower in the RDS group but no differences detected in TR between the groups. There were no differences in all parameters measured between the groups at one month and one year. 2 PA PWV was similar in all three groups at baseline when assessed at school age. However, following hypoxic challenge, PA PWV in children who had CLD increased significantly compared to preterm (p=0.025) and term controls (p=0.042). The findings in this thesis suggest that infants with RDS had mildly elevated pulmonary arterial pressure as a result of milder respiratory disease with improvement in antenatal and neonatal care. The RV global dysfunction in infants with RDS resolved with resolution of the respiratory condition. Both preterm groups underwent postnatal maturation of myocardial function and caught up with the term control group by one month corrected age. At school age, children who had CLD displayed increased pulmonary vascular reactivity to hypoxia and are at greater risk of developing pulmonary hypertension earlier.
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Srihari-Bhat, Prashanth. "Optimisation of neonatal ventilation from birth using physiological measurements as outcomes". Thesis, King's College London (University of London), 2017. https://kclpure.kcl.ac.uk/portal/en/theses/optimisation-of-neonatal-ventilation-from-birth-using-physiological-measurements-as-outcomes(79c78673-4c09-4f33-bdde-19d8e93b95cd).html.

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Aim: To optimize mechanical ventilation in the labour suite and on the neonatal unit using the results of physiological measurements as outcomes. A series of studies was undertaken to test the following hypotheses. 1. During the resuscitation of prematurely born infants, inflation pressures of 25/5 cmH2O would increase the expired tidal volume and end tidal carbon dioxide levels. In addition, maintenance of the first five inflations for two to three seconds would lead to higher tidal volumes. 2. In infants born at or near term, volume targeted ventilation (VTV) when compared to pressure limited ventilation (PLV) would be associated with shorter time to extubation, reduced work of breathing and better respiratory muscle strength. 3. In a dynamic lung model representing bronchopulmonary dysplasia, resistive unloading during proportional assist ventilation (PAV) would reduce the inspiratory load. 4. In infants with evolving bronchopulmonary dysplasia, PAV when compared to assist control ventilation (ACV) would be associated with reduced work of breathing, increased respiratory muscle strength and be associated with less ventilator-infant asynchrony and improved oxygenation as indicated by the oxygenation index (OI). 5. Extubation failure would be predicted by the tension time index of diaphragm (TTdi) and the tension time index of respiratory muscles (TTmus). Results: 1. The resuscitation study demonstrated that higher inflation pressures, but not longer inflation times produced significantly higher expired tidal volumes. 2. There were no significant differences in the time to successful extubation in at or near term-born infants supported by VTV or PLV; however, VTV was associated with significantly fewer episodes of hypocarbia. 3. The in-vitro study of PAV showed that the resistive unloading was relatively ineffective and hence as currently delivered is unlikely to be of clinical benefit to infants with a high resistance load. 4. PAV compared with ACV in prematurely born infants ventilated beyond the first week after birth resulted in a reduced work of breathing and a lower OI. 5. The TTdi study demonstrated that the TTdi and TTmus results significantly differed according to extubation outcome in ventilated infants. Overall TTdi ≥0.08 had 83% sensitivity and 81% specificity (90% sensitivity and 60% specificity in the preterm infants) in predicting extubation failure. Overall TTmus ≥0.19 had 50% sensitivity and 100% specificity (54% sensitivity and 100% specificity in the preterm infants) in predicting extubation failure.
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Książki na temat "Neonatal outcomes"

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Su, Min. Factors affecting adverse fetal, neonatal, and maternal outcomes in the Term Breech Trial. Ottawa: National Library of Canada, 2003.

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Ball, Hazel E. A literature review focusing on the outcomes of surviving infants from the neonatal intensive care unit. Leicester: De Montfort University, 2004.

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Rowland, Lisa E. Patient outcomes in maternal-infant nursing. Springhouse, Pa: Springhouse Corp., 1994.

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Evaluating the processes of neonatal intensive care: Thinking upstream to improve downstream processes. London: BMJ, 2004.

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Margaret, Redshaw, i English National Board for Nursing, Midwifery and Health Visiting., red. Evaluating the outcomes of Advanced Neonatal Nurse Practitioner Programmes. London: English National Board for Nursing, Midwifery and Health Visiting, 1999.

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Schulman, Joseph. Evaluating the Processes of Neonatal Intensive Care: Thinking Upstream to Improve Downstream Outcomes. Wiley & Sons, Incorporated, John, 2009.

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Schulman, Joseph. Evaluating the Processes of Neonatal Intensive Care: Thinking Upstream to Improve Downstream Outcomes. Wiley & Sons, Incorporated, John, 2008.

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Moore, David L., i Kenneth R. Goldschneider. Neonatal Epidural. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0058.

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Over the past couple of decades there has been increased awareness that opioid use for postoperative pain in neonates may not result in the best outcomes for these patients. Concurrently, there has been an increased use of regional techniques for postoperative pain in the neonate, in particular epidural anesthesia. The most common technique has been an epidural block via a caudal catheter. Caudal catheters can be used for lumbar and thoracic epidural blocks. The caudal catheter technique allows for a theoretically safer means of placement than the classic, at-level, loss-of-resistance technique.
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Moharir, Mahendranath D. Neonatal and childhood cerebral sinovenous thrombosis: Recanalization rates and outcomes. 2006.

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Jackson, Barbara J., i Howard Needelman. Follow-Up for NICU Graduates: Promoting Positive Developmental and Behavioral Outcomes for At-Risk Infants. Springer, 2018.

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Części książek na temat "Neonatal outcomes"

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Rintala, Risto J., i Mikko P. Pakarinen. "Long-Term Outcomes in Neonatal Surgery". W Rickham's Neonatal Surgery, 1255–68. London: Springer London, 2018. http://dx.doi.org/10.1007/978-1-4471-4721-3_70.

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Cazares, Joel, i Atsuyuki Yamataka. "Long Term Outcomes in Pediatric Urology". W Rickham's Neonatal Surgery, 1269–80. London: Springer London, 2018. http://dx.doi.org/10.1007/978-1-4471-4721-3_71.

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Morewitz, Stephen J. "Maternal, Fetal, and Neonatal Outcomes". W Domestic Violence and Maternal and Child Health, 97–106. Boston, MA: Springer US, 2004. http://dx.doi.org/10.1007/978-0-306-48530-5_7.

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Eklund, Wakako. "Global Research to Advance Neonatal Nursing and Neonatal Outcomes". W Neonatal Nursing: A Global Perspective, 171–79. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-91339-7_18.

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Spitzer, Alan R. "Data Collection and Assessment of Respiratory Outcomes". W Manual of Neonatal Respiratory Care, 769–75. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-39839-6_97.

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Zupancic, John A. F. "Data Collection and Assessment of Respiratory Outcomes". W Manual of Neonatal Respiratory Care, 889–93. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-93997-7_97.

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Gibson, Anne-Marie, Doug F. Hacking, Colin R. Robertson i Lex W. Doyle. "Long-Term Outcomes After Mechanical Ventilation in Neonates". W Pediatric and Neonatal Mechanical Ventilation, 1475–88. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-01219-8_63.

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Valentine, Stacey L., i Adrienne G. Randolph. "Long-Term Outcomes After Mechanical Ventilation in Children". W Pediatric and Neonatal Mechanical Ventilation, 1489–99. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-01219-8_64.

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Thomas, Sumesh, Prashanth Murthy i Saroj Saigal. "Long-Term Outcomes of Newborns with Bronchopulmonary Dysplasia". W Manual of Neonatal Respiratory Care, 657–61. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-39839-6_81.

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Thomas, Sumesh, i Prashanth Murthy. "Long-Term Outcomes of Newborns with Bronchopulmonary Dysplasia". W Manual of Neonatal Respiratory Care, 749–54. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-93997-7_80.

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Streszczenia konferencji na temat "Neonatal outcomes"

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Sbrollini, Agnese, Sofia Romagnoli, Ilaria Marcantoni, Luca Burattini, Micaela Morettini i Laura Burattini. "Neonatal Clinical Outcomes: a Comparative Analysis". W 2022 IEEE International Symposium on Medical Measurements and Applications (MeMeA). IEEE, 2022. http://dx.doi.org/10.1109/memea54994.2022.9856584.

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Nijjar, Isha, Tarak Desai i Shree Vishna Rasiah. "GP241 Neonatal outcomes for babies with ebstein’s anomaly". W Faculty of Paediatrics of the Royal College of Physicians of Ireland, 9th Europaediatrics Congress, 13–15 June, Dublin, Ireland 2019. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2019. http://dx.doi.org/10.1136/archdischild-2019-epa.300.

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Adam, R., M. Temmerman, R. Ochieng, M. Carvahlo, P. Okiro, MC Quek, E. Gulavi i D. Atandi. "G555 The maternal and neonatal microbiota correlates of preterm birth and adverse neonatal outcomes". W Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference–Online, 25 September 2020–13 November 2020. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2020. http://dx.doi.org/10.1136/archdischild-2020-rcpch.473.

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Armstrong, Caitlin, Yvonne Yui, Victoria Nakibuuka-Kirabira, Patrick Bainghana, Ronald Kyambadde, K. Onwona-Agyeman, Medge Owen, Yvonne Vaucher, Billie Lou Short i Leah Greenspan Hodor. "Designated Neonatal Resuscitation and Transport Team Implementation Improves Neonatal Outcomes in Low Resource Settings". W AAP National Conference & Exhibition Meeting Abstracts. American Academy of Pediatrics, 2021. http://dx.doi.org/10.1542/peds.147.3_meetingabstract.691.

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Sukoco, Amin, Harsono Salimo i Yulia Lanti Retno Dewi. "Biological and Socio-Demographic Factors Associated with Neonatal Mortality: Evidence from Karanganyar District, Central Java". W The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.110.

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ABSTRACT Background: The highest risk of childhood death occurs during the neonatal period. Risks of poor outcomes during pregnancy and childbirth are exacerbated by poverty, low status of women, lack of education, poor nutrition, heavy workloads, and violence. This study aimed to examine biological and socio-demographic factors associated with neonatal mortality. Subjects and Method: A case control study was conducted in Karanganyar, Central Java, Indonesia. Study population was infant neonates. A sample of 200 mothers and their neonates, including 50 dead neonates and 150 alive infants was selected by fixed disease sampling. The dependent variable was infant mortality. The independent variables were maternal mid-upper arm circumference (MUAC), maternal age, maternal occupation, family income, and number birth delivery. The data were obtained from medical record and questionnaire. The data were analyzed by a multiple logistic regression. Results: The risk of neonatal death increased with mother working outside the house (b= 0.95; 95% CI= 0.10 to 1.80; p= 0.028). The risk of neonatal death decreased with maternal MUAC ≥23.5 cm (b= -1.21; 95% CI= -2.03 to -0.38; p= 0.004), maternal age 20-35 years (b= -1.06; 95% CI= -1.83 to -0.29; p= 0.007), family income ≥Rp 1,833,000 (b= -1.37; 95% CI= -2.20 to -0.54; p= 0.001), and number of birth delivery 2 to 4 (b= -0.67; 95% CI= -1.39 to 0.05; p= 0.067). Conclusion: The risk of neonatal death increases with mother working outside the house. The risk of neonatal death decreases with maternal MUAC ≥23.5 cm, maternal age 20-35 years, high family income, and number of birth delivery 2 to 4. Keywords: neonatal death, biological factors, socio-demographic factors Correspondence: Amin Sukoco. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: soekotjo78@gmail.com. Mobile: +6281329387610. DOI: https://doi.org/10.26911/the7thicph.03.110
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Gray, P., A. Molnar i B. Firman. "Early High-Dose Caffeine Citrate: Neonatal and Neurodevelopmental Outcomes". W 7th International Conference on Clinical Neonatology—Selected Abstracts. Thieme Medical Publishers, 2018. http://dx.doi.org/10.1055/s-0038-1647088.

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Poole, Barish, Arlene Garingo, Philippe Friedlich, Ashwini Lakshmanan, Christopher Gayer i Jennifer Shepherd. "Mode of Delivery, Outcomes, and Resource Utilization in Neonatal Gastroschisis". W Selection of Abstracts From NCE 2016. American Academy of Pediatrics, 2018. http://dx.doi.org/10.1542/peds.141.1_meetingabstract.538.

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Tsai, Y. C., S. F. Luo, M. J. Chiou i C. F. Kuo. "OP0135 Foetal-neonatal and maternal outcomes in women with rheumatoid arthritis". W Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.6143.

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Kaplan, Ron L., Andrea T. Cruz, Kenneth Michelson, Constance McAneney, Mercedes M. Blackstone, Christopher M. Pruitt, Nipam Shah i in. "Neonatal Mastitis and Omphalitis: Presentation, Outcomes, and Concurrent Serious Bacterial Infection". W AAP National Conference & Exhibition Meeting Abstracts. American Academy of Pediatrics, 2021. http://dx.doi.org/10.1542/peds.147.3_meetingabstract.507.

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Horn, Delia, Danielle Ehret, Kristen DeStigter, Erika M. Edwards i Renny Ssembatya. "Association Between Antenatal Ultrasound Findings And Neonatal Outcomes In Rural Uganda". W AAP National Conference & Exhibition Meeting Abstracts. American Academy of Pediatrics, 2021. http://dx.doi.org/10.1542/peds.147.3_meetingabstract.683.

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Raporty organizacyjne na temat "Neonatal outcomes"

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Dudley, Lilian D. Do maternity waiting homes improve maternal and neonatal outcomes in low-resource settings? SUPPORT, 2011. http://dx.doi.org/10.30846/110509.

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The poor utilisation of maternal health services and antenatal care by women living in rural areas has been associated with high maternal and neonatal mortality. Maternity waiting homes have been advocated as a way of overcoming geographical barriers in such settings and improving access to care and maternal and neonatal outcomes.
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S. Lassi, Zohra, i Batool A. Haider. Community-based intervention packages for reducing maternal morbidity and mortality and improving neonatal outcomes. International Initiative for Impact Evaluation (3ie), maj 2012. http://dx.doi.org/10.23846/sr1014.

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Lassi, Zohra S., Batool A. Haider i Zulfiqar A. Bhutta. Community-based intervention packages for reducing maternal morbidity and mortality and improving neonatal outcomes. International Initiative for Impact Evaluation, maj 2012. http://dx.doi.org/10.23846/sr14.

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Brännström, Mats, Ylva Carlsson i Henrik Hagberg. Obstetric outcome after uterus transplantation. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, styczeń 2023. http://dx.doi.org/10.37766/inplasy2023.1.0052.

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Review question / Objective: Is delivery by elective cesarean section as safe for the mother and the neonate after uterus transplantation as after delivery by elective cesarean section for reasons such as breech and psychological indication regarding stillbirth/neonatal mortality, neonatal morbidity, maternal mortality, and morbidity? Rationale: To compare pregnancy, obstetrical and neonatal complications at delivery by cesarean section in patients that have undergone uterus transplantation and in a normal groups of women.
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Hyrink, Tabitha, Violet Barasa i Syed Abbas. Sexual and Reproductive Health and Rights (SRHR) and Maternal, Neonatal and Child Health (MNCH) in Bangladesh: Impacts of the Covid-19 Pandemic. Institute of Development Studies, maj 2022. http://dx.doi.org/10.19088/ids.2022.028.

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The Covid-19 pandemic has exacerbated and drawn fresh attention to long-standing systemic weaknesses in health and economic systems. The virus – and the public health response – has wrought significant disruption on sexual and reproductive health and rights (SRHR) and maternal, neonatal and child health (MNCH) in Bangladesh. Known negative health outcomes include increased domestic and gender-based violence, child marriage, negative mental health, and adverse child health outcomes. This scoping paper for the Covid-19 Learning, Evidence and Research Programme for Bangladesh (CLEAR) aims to inform future research and policy engagement to support response, recovery, progress, and future health system resilience for SRHR and MNCH in Bangladesh, following the Covid-19 crisis. We present what is known on disruptions and impacts, as well as evidence gaps and priority areas for future research and engagement.
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Grimes, Kathryn E. L., Adam J. Walter, Amanda A. Honeycutt, Cristina Bisson i Jennifer B. Griffin. Reach Health Assessing Cost-Effectiveness for Family Planning (RACE-FP) Methodology Report: Estimating the Impact of Family Planning Interventions in the Philippines. RTI Press, kwiecień 2022. http://dx.doi.org/10.3768/rtipress.2022.op.0072.2205.

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In the Philippines, demand for family planning (FP) is high, and the government is committed to helping the population achieve universal access to quality FP information and services. Reach Health Assessing Cost-Effectiveness for Family Planning (RACE-FP) is a decision support tool designed to estimate the impact FP interventions have on averting unintended pregnancies and on downstream maternal and neonatal health (MNH) outcomes. This report provides technical details of the RACE-FP model. RACE-FP is organized by objectives: improve postpartum FP, improve public sector and private sector provision of FP, improve demand for FP, reduce contraceptive stockouts, and introduce a modern contraceptive method. Although other models have been developed to estimate the impact of contraceptive use on averting unintended pregnancy at the national level for the Philippines, RACE-FP is the only model to provide estimates at national and regional levels, include intervention and commodity costs, disaggregate outcomes by age group and setting (public, private, community), and estimate the broader impact of modern contraceptive prevalence on MNH outcomes. RACE-FP can be an important resource to determine the relative benefit of FP interventions in the Philippines and could support policy decisions globally.
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Patton, Amy, Kylie Dunavan, Kyla Key, Steffani Takahashi, Kathryn Tenner i Megan Wilson. Reducing Stress, Anxiety, and Depression for NICU Parents. University of Tennessee Health Science Center, maj 2021. http://dx.doi.org/10.21007/chp.mot2.2021.0012.

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This project aims to appraise evidence of the effectiveness of various practices on reducing stress, anxiety, and depression among parents of infants in the neonatal intensive care unit (NICU). The project contains six research articles from both national and international journals. Study designs include one meta-analysis, one randomized controlled trial, one small scale randomized controlled trial, one prospective phase lag cohort study, on pretest-posttest study, and one mixed-methods pretest-posttest study. Recommendations for effective interventions were based on best evidence discovered through quality appraisal and study outcomes. All interventions, except for educational programs and Kangaroo Care, resulted in a statistically significant reduction of either stress, anxiety, and/ or depression. Family centered care and mindfulness-based intervention reduced all barriers of interest. There is strong and high-quality evidence for the effect of Cognitive Behavioral Therapy on depression, moderate evidence for the effect of activity-based group therapy on anxiety, and promising evidence for the effect of HUG Your Baby on stress.
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Viswanathan, Meera, Jennifer Cook Middleton, Alison Stuebe, Nancy Berkman, Alison N. Goulding, Skyler McLaurin-Jiang, Andrea B. Dotson i in. Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions. Agency for Healthcare Research and Quality (AHRQ), kwiecień 2021. http://dx.doi.org/10.23970/ahrqepccer236.

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Background. Untreated maternal mental health disorders can have devastating sequelae for the mother and child. For women who are currently or planning to become pregnant or are breastfeeding, a critical question is whether the benefits of treating psychiatric illness with pharmacologic interventions outweigh the harms for mother and child. Methods. We conducted a systematic review to assess the benefits and harms of pharmacologic interventions compared with placebo, no treatment, or other pharmacologic interventions for pregnant and postpartum women with mental health disorders. We searched four databases and other sources for evidence available from inception through June 5, 2020 and surveilled the literature through March 2, 2021; dually screened the results; and analyzed eligible studies. We included studies of pregnant, postpartum, or reproductive-age women with a new or preexisting diagnosis of a mental health disorder treated with pharmacotherapy; we excluded psychotherapy. Eligible comparators included women with the disorder but no pharmacotherapy or women who discontinued the pharmacotherapy before pregnancy. Results. A total of 164 studies (168 articles) met eligibility criteria. Brexanolone for depression onset in the third trimester or in the postpartum period probably improves depressive symptoms at 30 days (least square mean difference in the Hamilton Rating Scale for Depression, -2.6; p=0.02; N=209) when compared with placebo. Sertraline for postpartum depression may improve response (calculated relative risk [RR], 2.24; 95% confidence interval [CI], 0.95 to 5.24; N=36), remission (calculated RR, 2.51; 95% CI, 0.94 to 6.70; N=36), and depressive symptoms (p-values ranging from 0.01 to 0.05) when compared with placebo. Discontinuing use of mood stabilizers during pregnancy may increase recurrence (adjusted hazard ratio [AHR], 2.2; 95% CI, 1.2 to 4.2; N=89) and reduce time to recurrence of mood disorders (2 vs. 28 weeks, AHR, 12.1; 95% CI, 1.6 to 91; N=26) for bipolar disorder when compared with continued use. Brexanolone for depression onset in the third trimester or in the postpartum period may increase the risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo (5% vs. 0%). More than 95 percent of studies reporting on harms were observational in design and unable to fully account for confounding. These studies suggested some associations between benzodiazepine exposure before conception and ectopic pregnancy; between specific antidepressants during pregnancy and adverse maternal outcomes such as postpartum hemorrhage, preeclampsia, and spontaneous abortion, and child outcomes such as respiratory issues, low Apgar scores, persistent pulmonary hypertension of the newborn, depression in children, and autism spectrum disorder; between quetiapine or olanzapine and gestational diabetes; and between benzodiazepine and neonatal intensive care admissions. Causality cannot be inferred from these studies. We found insufficient evidence on benefits and harms from comparative effectiveness studies, with one exception: one study suggested a higher risk of overall congenital anomalies (adjusted RR [ARR], 1.85; 95% CI, 1.23 to 2.78; N=2,608) and cardiac anomalies (ARR, 2.25; 95% CI, 1.17 to 4.34; N=2,608) for lithium compared with lamotrigine during first- trimester exposure. Conclusions. Few studies have been conducted in pregnant and postpartum women on the benefits of pharmacotherapy; many studies report on harms but are of low quality. The limited evidence available is consistent with some benefit, and some studies suggested increased adverse events. However, because these studies could not rule out underlying disease severity as the cause of the association, the causal link between the exposure and adverse events is unclear. Patients and clinicians need to make an informed, collaborative decision on treatment choices.
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McDonagh, Marian, Andrea C. Skelly, Amy Hermesch, Ellen Tilden, Erika D. Brodt, Tracy Dana, Shaun Ramirez i in. Cervical Ripening in the Outpatient Setting. Agency for Healthcare Research and Quality (AHRQ), marzec 2021. http://dx.doi.org/10.23970/ahrqepccer238.

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Objectives. To assess the comparative effectiveness and potential harms of cervical ripening in the outpatient setting (vs. inpatient, vs. other outpatient intervention) and of fetal surveillance when a prostaglandin is used for cervical ripening. Data sources. Electronic databases (Ovid® MEDLINE®, Embase®, CINAHL®, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews) to July 2020; reference lists; and a Federal Register notice. Review methods. Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) and cohort studies of cervical ripening comparing prostaglandins and mechanical methods in outpatient versus inpatient settings; one outpatient method versus another (including placebo or expectant management); and different methods/protocols for fetal surveillance in cervical ripening using prostaglandins. When data from similar study designs, populations, and outcomes were available, random effects using profile likelihood meta-analyses were conducted. Inconsistency (using I2) and small sample size bias (publication bias, if ≥10 studies) were assessed. Strength of evidence (SOE) was assessed. All review methods followed Agency for Healthcare Research and Quality Evidence-based Practice Center methods guidance. Results. We included 30 RCTs and 10 cohort studies (73% fair quality) involving 9,618 women. The evidence is most applicable to women aged 25 to 30 years with singleton, vertex presentation and low-risk pregnancies. No studies on fetal surveillance were found. The frequency of cesarean delivery (2 RCTs, 4 cohort studies) or suspected neonatal sepsis (2 RCTs) was not significantly different using outpatient versus inpatient dinoprostone for cervical ripening (SOE: low). In comparisons of outpatient versus inpatient single-balloon catheters (3 RCTs, 2 cohort studies), differences between groups on cesarean delivery, birth trauma (e.g., cephalohematoma), and uterine infection were small and not statistically significant (SOE: low), and while shoulder dystocia occurred less frequently in the outpatient group (1 RCT; 3% vs. 11%), the difference was not statistically significant (SOE: low). In comparing outpatient catheters and inpatient dinoprostone (1 double-balloon and 1 single-balloon RCT), the difference between groups for both cesarean delivery and postpartum hemorrhage was small and not statistically significant (SOE: low). Evidence on other outcomes in these comparisons and for misoprostol, double-balloon catheters, and hygroscopic dilators was insufficient to draw conclusions. In head to head comparisons in the outpatient setting, the frequency of cesarean delivery was not significantly different between 2.5 mg and 5 mg dinoprostone gel, or latex and silicone single-balloon catheters (1 RCT each, SOE: low). Differences between prostaglandins and placebo for cervical ripening were small and not significantly different for cesarean delivery (12 RCTs), shoulder dystocia (3 RCTs), or uterine infection (7 RCTs) (SOE: low). These findings did not change according to the specific prostaglandin, route of administration, study quality, or gestational age. Small, nonsignificant differences in the frequency of cesarean delivery (6 RCTs) and uterine infection (3 RCTs) were also found between dinoprostone and either membrane sweeping or expectant management (SOE: low). These findings did not change according to the specific prostaglandin or study quality. Evidence on other comparisons (e.g., single-balloon catheter vs. dinoprostone) or other outcomes was insufficient. For all comparisons, there was insufficient evidence on other important outcomes such as perinatal mortality and time from admission to vaginal birth. Limitations of the evidence include the quantity, quality, and sample sizes of trials for specific interventions, particularly rare harm outcomes. Conclusions. In women with low-risk pregnancies, the risk of cesarean delivery and fetal, neonatal, or maternal harms using either dinoprostone or single-balloon catheters was not significantly different for cervical ripening in the outpatient versus inpatient setting, and similar when compared with placebo, expectant management, or membrane sweeping in the outpatient setting. This evidence is low strength, and future studies are needed to confirm these findings.
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Balk, Ethan M., Kristin J. Konnyu, Wangnan Cao, Monika Reddy Bhuma, Valery A. Danilack, Gaelen P. Adam, Kristen A. Matteson i Alex Friedman Peahl. Schedule of Visits and Televisits for Routine Antenatal Care: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), czerwiec 2022. http://dx.doi.org/10.23970/ahrqepccer257.

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Background. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine plan a new evidence-based joint consensus statement to address the preferred visit schedule and the use of televisits for routine antenatal care. This systematic review will support the consensus statement. Methods. We searched PubMed®, Cochrane databases, Embase®, CINAHL®, ClinicalTrials.gov, PsycINFO®, and SocINDEX from inception through February 12, 2022. We included comparative studies from high-income countries that evaluated the frequency of scheduled routine antenatal visits or the inclusion of routine televisits, and qualitative studies addressing these two topics. We evaluated strength of evidence for 15 outcomes prioritized by stakeholders. Results. Ten studies evaluated scheduled number of routine visits and seven studies evaluated televisits. Nine qualitative studies also addressed these topics. Studies evaluated a wide range of reduced and traditional visit schedules and approaches to incorporating televisits. In comparisons of fewer to standard number of scheduled antenatal visits, moderate strength evidence did not find differences for gestational age at birth (4 studies), being small for gestational age (3 studies), Apgar score (5 studies), or neonatal intensive care unit (NICU) admissions (5 studies). Low strength evidence did not find differences in maternal anxiety (3 studies), preterm births (3 studies), and low birth weight (4 studies). Qualitative studies suggest that providers believe fewer routine visits may be more convenient for patients and may free up clinic time to provide additional care for patients with high-risk pregnancies, but both patients and providers had concerns about potential lesser care with fewer visits. In comparisons of hybrid (televisits and in-person) versus in-person only visits, low strength evidence did not find differences in preterm births (4 studies) or NICU admissions (3 studies), but did suggest greater satisfaction with hybrid visits (2 studies). Qualitative studies suggested patients and providers were open to reduced schedules and televisits for routine antenatal care, but importantly, patients and providers had concerns about quality of care, and providers and clinic leadership had suggestions on how to best implement practice changes. Conclusion. The evidence base is relatively sparse, with insufficient evidence for numerous prioritized outcomes. Studies were heterogeneous in the care models employed. Where there was sufficient evidence to make conclusions, studies did not find significant differences in harms to mother or baby between alternative models, but evidence suggested greater satisfaction with care with hybrid visits. Qualitative evidence suggests diverse barriers and facilitators to uptake of reduced visit schedules or televisits for routine antenatal care. Given the shortcomings of the evidence base, considerations other than proof of differences in outcomes may need to be considered regarding implications for clinical practice. New studies are needed to evaluate prioritized outcomes and potential differential effects among different populations or settings.
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