Showing papers on "Gestational age published in 1987"
Journal Article•
TL;DR: There is a need for future research on the effect of maternal work, prenatal care, and certain vitamin and mineral deficiencies on intrauterine growth, and theeffect of genital tract infection, prenatal Care, maternal employment, stress and anxiety on prematurity.
Abstract: PIP: 43 determinants of low birth weight were analyzed from 895 published papers in the English and French literature from 1970-1984 The assessment was limited to singleton births of women living at sea level with no chronic illness; rare factors and complications of pregnancy were excluded The 43 factors were categorized as genetic and constitutional, demographic and psychosocial, obstetric, nutritional, maternal morbidity during pregnancy, toxic exposure and antenatal care The existence and magnitude of a causal effect on birth weight, gestational age, prematurity and intrauterine growth retardation were determined by a set of methodological standards In developed countries, the most important factor was cigarette smoking, followed by nutrition and pre-pregnancy weight In developing countries the major determinants were racial origin, nutrition, low pre-pregnancy weight, short maternal stature, and malaria Pre-pregnancy weight, prior premature birth or miscarriage, diethylstilbestrol exposure and smoking were major determinants of gestational duration, but the majority of prematurity was unexplained in both developed and developing countries There is a need for future research on the effect of maternal work, prenatal care, and certain vitamin and mineral deficiencies on intrauterine growth, and the effect of genital tract infection, prenatal care, maternal employment, stress and anxiety on prematurity
3,028 citations
TL;DR: Based on 20,713 singleton livebirths at the John Radcliffe Hospital, Oxford, in 1978-1984, new birthweight and head circumference values for males and females between 24 and 42 weeks of gestation are calculated.
454 citations
TL;DR: The severity of fetal hypoxia correlated significantly with fetal hypercapnia, acidosis, hyperlacticaemia, hypoglycaemia, and erythroblastosis, indicating that "birth asphyxia" is not necessarily due to the process of birth.
Abstract: The umbilical venous oxygen and carbon dioxide tensions, pH, lactate and glucose concentrations, nucleated red cell (erythroblast) count, and haemoglobin concentration were measured in 38 cases of intrauterine growth retardation in which fetal blood sampling was performed by cordocentesis. The oxygen tension was below the normal mean for gestational age in 33 cases; in 14 it was below the lower limit of the 95% confidence interval for normal pregnancies. The severity of fetal hypoxia correlated significantly with fetal hypercapnia, acidosis, hyperlacticaemia, hypoglycaemia, and erythroblastosis. These findings indicate that "birth asphyxia" is not necessarily due to the process of birth.
368 citations
TL;DR: It is concluded that, despite tight control of maternal diabetes, the development of behavioural states is disturbed in fetuses of nulliparous diabetic women.
366 citations
TL;DR: The use of cocaine during pregnancy was associated with lower gestational age at delivery, an increase in preterm labor and delivery, lower birth weights, and delivery of small for Gestational age infants.
360 citations
TL;DR: It was revealed that infants exposed to cocaine had significant depression of organizational response to environmental stimuli (state organization) when compared to methadone-exposed infants.
285 citations
TL;DR: Infants born to drug dependent women have a poorer general outcome than those born to non-drug dependent women, and infants born to cocaine abusing women had infants with decreased birth weight, head circumference, length and Apgar scores.
234 citations
TL;DR: It is concluded that, if left untreated, one abnormal value on an oral glucose tolerance test is strongly associated with adverse perinatal outcome.
224 citations
TL;DR: Absent end-diastolic velocity represents a unique and severe fetal condition that cannot be identified by present surveillance methods and requires a Doppler study for diagnosis.
216 citations
Journal Article•
TL;DR: It is concluded that maternal obesity should be considered a high risk factor for gestational diabetes, hypertension, therapeutic induction, prolonged second stage of labor, oxytocin stimulation of Labor, shoulder dystocia and delivery after 42 weeks gestation.
Abstract: We examined the risk of maternal obesity in 588 pregnant women weighing at least 113.6 kilograms (250 pounds) during pregnancy. Compared with a control group matched for age and parity, we found a significantly increased risk in the obese patient for gestational diabetes, hypertension, therapeutic induction, prolonged second stage of labor, oxytocin stimulation of labor, shoulder dystocia, infants weighing more than 4,000 grams and delivery after 42 weeks gestation. Certain operative complications were also more common in obese women undergoing cesarean section including estimated blood loss of more than 1,000 milliliters, operating time of more than two hours and wound infection postoperatively. These differences remained significant after controlling for appropriate confounding variables. We conclude that maternal obesity should be considered a high risk factor.
212 citations
TL;DR: In this paper, 300 patients at high fetal risk (mean gestational age 34 wk) were randomised to a group for antenatal doppler umbilical artery waveform studies and a control group.
TL;DR: The results suggest that in twins with vertex-breech or vertex-transverse presentations after the thirty-fifth week of gestational age the neonatal outcome of the second twin was not significantly influenced by the route of delivery.
TL;DR: Data support an important role for home nasal cannula oxygen in promoting weight gain in selected infants with BPD and parents discontinued oxygen therapy inappropriately in seven infants, and all seven experienced significant deceleration in weight gain.
Abstract: • To study the effect of oxygen therapy on weight gain in bronchopulmonary dysplasia (BPD), the growth of 22 infants with BPD enrolled in a premature follow-up clinic and home oxygen program was examined retrospectively. Mean gestational age was 28 weeks (range, 26 to 33 weeks) and mean birth weight was 1110 g (range, 680 to 2000 g). After discharge, infants were monitored monthly to maintain transcutaneous oxygen tension over 55 mm Hg and/or pulse oximeter oxygen saturation over 92%. With appropriate home oxygen, all 22 infants grew as well as healthy, full-term infants (mean, 40th percentile; range, tenth to 80th percentile) when ages were corrected for prematurity. Parents discontinued oxygen therapy inappropriately in seven infants, and all seven experienced significant deceleration in weight gain. When home oxygen therapy was resumed, their weight gain improved, but the infants never regained their original percentiles during the study period. The 15 infants who continued home oxygen therapy maintained their original weight percentiles throughout the study period. These data support an important role for home nasal cannula oxygen in promoting weight gain in selected infants with BPD. (AJDC1987;141:992-995)
TL;DR: Throughout pregnancy the establishment of normative cerebellar measurements allows for the estimation of gestational age that is independent of the shape of the fetal head and offers potential for evaluation of abnormal fetal growth and anomalous development of the central nervous system.
TL;DR: Low ponderal index and midarm circumference to head circumference ratio are more sensitive predictors of outcome than is birth weight and are more appropriate end points for antenatal diagnostic studies than is Birth weight.
TL;DR: It is concluded that within defined limitations, maternal recall of birthweight and gestational age of previous children is sufficiently accurate for clinical and even for epidemiological use.
TL;DR: The data suggest that the small for gestational age fetus with normal umbilical artery velocimetry is at significantly lower risk than are those with abnormal ratios, which implies that management of theSmall for gestations age fetus may now be aided by a functional classification based on the umbilICAL artery velocity waveform.
Journal Article•
TL;DR: Serum levels of relaxin in normal and special-interest pregnancies using an homologous radioimmunoassay for human relaxin were higher than those reported in studies using heterologous assays, but the trend in serum levels was similar.
TL;DR: Investigation of possible associations of social and psychiatric factors with both low birth weight and preterm delivery found low income was found to be an independent predictor of birth weight when birth weight was treated both as a dichotomous and a continuous variable.
Abstract: A prospective study of 483 pregnant women was undertaken to examine possible associations of social and psychiatric factors with both low birth weight (less than 2500 g) and preterm delivery (less than 37 weeks' gestation). As few babies were born before term (n = 14) or with a low birth weight (n = 14) further analyses were conducted to investigate predictors of absolute birth weight and gestational age. Low income was found to be an independent predictor of birth weight when birth weight was treated both as a dichotomous and as a continuous variable. Unemployment was found to be associated with absolute birth weight. Although this effect was statistically accounted for by low income, a low income was frequently caused by unemployment. Smoking independently predicted absolute birth weight and tended to be associated with preterm delivery. None of the factors investigated was associated with gestational age. In contrast with previous findings, factors such as social class, adverse life events, and psychiatric state were not associated with birth outcome. The mechanism underlying the association between low income and low birth weight requires further investigation.
TL;DR: Findings indicate that growth of the transverse cerebellar diameter is unaffected by intrauterine growth retardation; thus this sonographic measurement may serve as an independent and reliable correlate of gestational age against which potential deviations of growth may be compared.
TL;DR: Results show that Doppler-derived vascular patterns correlate well with normal and adverse perinatal outcome and a description of the uterine and umbilical systolic/diastolic ratios should be part of the clinical evaluation of all pregnant women with hypertension.
TL;DR: The data suggest that maternal birth weight exerts a stronger influence on intrauterine growth than on the duration of gestation, and women who were smaller than average at birth should be considered at high risk for delivery of an SGA infant.
TL;DR: It is suggested that prostaglandin gel cervical ripening and induction of labor and delivery by 42 weeks' gestation may be the most appropriate management for patients with well-established gestational age and an unfavorable cervical examination.
TL;DR: This association between acquired CMV infection in premature infants and the development of chronic lung disease provides further evidence that vigorous efforts to prevent CMV infections in hospitalized neonates is warranted.
Abstract: • During a five-year period, 32 preterm infants weighing less than 2000 g were diagnosed as having postnatally acquired cytomegalovirus (CMV) infection in a neonatal intensive care unit. These CMV-infected infants were matched with 32 uninfected controls for gestational age, birth weight, and birth date; the two groups did not differ in Apgar scores or the incidence of respiratory distress syndrome and patent ductus arteriosus. Roentgenographic evidence of bronchopulmonary dysplasia (BPD) developed in 24 (75%) of 32 CMV-infected infants, an incidence significantly greater than that observed in control infants (12/32; 38%). Infants with acquired CMV infection required more respiratory support and longer hospitalization than uninfected controls. This association between acquired CMV infection in premature infants and the development of chronic lung disease provides further evidence that vigorous efforts to prevent CMV infection in hospitalized neonates is warranted. ( AJDC 1987;141:303-305)
TL;DR: It is concluded that genetic factors play only a small part in determining birth weight, after standardisation for fetal sex, maternal height, gestational age, and proteinuric pre-eclampsia.
Abstract: Birthweight correlations were analysed among 505 intergenerational pairs of first births to women aged 18-25 identified from a large obstetric data bank. After standardisation for fetal sex, maternal height, gestational age, and proteinuric pre-eclampsia residual correlations of between 0.1402 and 0.1725 were found, suggesting only a small genetic effect. It is concluded that genetic factors play only a small part in determining birth weight.
Journal Article•
TL;DR: Fetal stomach dimensions were measured sonographically in 152 fetuses with gestational ages ranging from nine to 40 weeks to offer potential prenatal diagnosis of a variety of gastrointestinal lesions and provide a method by which variations from the norm can be assessed.
TL;DR: It is suggested that indomethacin therapy is an effective way to manage pregnancy complicated by polyhydramnios and that adverse effects or intolerance to the drug was avoided by either a reduction in the dose or cessation of indomethin therapy.
TL;DR: Results support the use of physical criteria rather than neurologic or combined criteria for the clinical assessment of gestational age in low birth weight infants.
TL;DR: The pathologic anatomy of a prospectively collected series of 36 anencephalic infants provides an opportunity to investigate the epidemiology of organ system pathology in anencephaly as well as other facets of its natural history.
Abstract: This report presents the pathologic anatomy of a prospectively collected series of 36 anencephalic infants. This series provides an opportunity to investigate the epidemiology of organ system pathology in anencephaly (AN) as well as other facets of its natural history. AN infants had a mean gestational age 2.5 weeks younger than normal controls, though birthweight was normal for gestational age. Nearly 1/3 of the liveborn infants with AN died within 15 minutes, 2/3 within 3 hours; 3 AN infants survived to 48 hours. Details and discussions of the pathologic findings and their physiologic significance are presented. Regarding those AN infants who received detailed neurologic examinations, correlations are made between the brain pathology and neurologic function prior to death.
TL;DR: During a prospective national survey of mortality and morbidity in infants born before 32 weeks gestation in the Netherlands in 1983, the incidence of periventricular-intraventricular hemorrhage was studied with ultrasound and Gestational age appeared to be the strongest predictive factor for both incidence and severity of PIVH.
Abstract: During a prospective national survey of mortality and morbidity in infants born before 32 weeks gestation in the Netherlands in 1983, the incidence of periventricular-intraventricular hemorrhage (PIVH) was studied with ultrasound, in 484 of those infants Stepwise logistic regression analyses were used to examine the predictive value of several maternal, prenatal and postnatal factors for the development of neonatal PIVH PIVH was detected in 140 infants (289%); of these, 36 were grade I, 39 grade II, 22 grade III and 43 grade IV The mortality rate increased from 3 to 84% with increasing severity of PIVH Gestational age appeared to be the strongest predictive factor for both incidence and severity of PIVH, followed by idiopathic respiratory distress syndrome (IRDS), prolonged rupture of membranes and birth weight Of the maternal and prenatal factors studied, only prolonged rupture of membranes (greater than 24 hours) and preeclampsia appeared to influence the risk of developing PIVH Both were associated with a 50% reduction in the incidence of PIVH None of the intrapartum factors studied showed a significant association with subsequent development of PIVH Development of IRDS appeared to result in a twofold increase in the incidence of PIVH