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Premature Birth: Research, Intervention, and Results

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 14668

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Special Issue Editors

Prof. Dr. Juan Mozas-Moreno

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Guest Editor

Department of Obstetrics and Gynecology, University of Granada, 18010 Granada, Spain
Interests: reproductive medicine; fertility; sterility; pregnancy; gestational diabetes mellitus (GDM); maternal nutrition; Mediterranean diet (MD); lifestyles

Prof. Dr. José Antonio Castilla Alcalá

E-Mail Website
Guest Editor

1. Anatomy and Embryology Department, Medicine Faculty, Granada University, 18016 Granada, Spain
2. CEIFER Biobanco, 18004 Granada, Spain
Interests: biosafety and quality system in asssited reproductive technology; analytical quality specifications for seminal parameters; external and internal quality control for andrology and embryology laboratory; sperm cryopreservation

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue of Medicina entitled “Premature Birth: Research, Intervention, and Results”. For detailed information about the journal, we refer you to https://0-www-mdpi-com.brum.beds.ac.uk/journal/medicina.

As the World Health Organization has pointed out, preterm birth is recognized as a major public health problem, since prematurity is one of the main causes of death in children under 5 years of age and of impaired neurological development throughout the world. Preterm birth is a worldwide epidemic, with a global incidence of 15 million per year, and inequalities in survival rates and negative outcomes are described worldwide.

Current knowledge is limited about the epidemiology of preterm birth, in particular, about how it is defined and classified and what is known regarding its etiology, diagnosis, treatment, and outcomes. Despite reported associations between preterm birth and a wide range of sociodemographic, medical, obstetric, fetal, and environmental factors, approximately two-thirds of preterm births occur without an obvious risk factor, making their prevention more difficult. One of the greatest challenges in studying this outcome is that preterm birth is a complex condition that results from multiple etiological pathways. Preterm birth is, therefore, a critical event that not only affects the future of the newborn but also has an impact on families and society, with special reference to care and educational settings.

This Special Issue aims to document research on preterm birth and its outcomes. An interdisciplinary approach is appreciated, which is essential to addressing this syndrome. We warmly welcome your submissions to this Special Issue, which may include novel and interesting original articles or reviews.

Prof. Dr. Juan Mozas-Moreno
Prof. Dr. José Antonio Castilla Alcalá
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

preterm birth
prematurity
epidemiology
prediction
risk factors
public health implications
prevention
preterm labor
tocolysis
outcomes

Published Papers (4 papers)

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Research

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7 pages, 464 KiB

Open AccessArticle

The Influence of Oral Drotaverine Administration on Materno–Fetal Circulation during the Second and Third Trimester of Pregnancy

by Paweł Rzymski, Katarzyna Maria Tomczyk and Maciej Wilczak

Medicina 2022, 58(2), 235; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58020235 - 03 Feb 2022

Viewed by 3824

Abstract

Background and Objectives: The study aimed to evaluate the effect of the oral administration of drotaverine on maternal and fetal circulation as measured by Doppler sonography in women with a risk of preterm birth. Materials and Methods: The present prospective study was conducted on 34 women with singleton pregnancy at 26–36 weeks of gestation. Doppler flow and pulsatility index (PI) assessments of the umbilical artery, fetal middle cerebral artery, and uterine arteries were performed before and 90–120 min after oral drotaverine administration. Results: There were no statistically significant differences between the Doppler assessment (PI Uma—umbilical artery, MCA—middle cerebral artery, and ltUta—left uterine artery) before drotaverine administration and 90–120 min after oral intake, but there were statistically significant differences between the PI assessment of the rtUta (right uterine artery, 0.55 vs. 0.75, p = 0.05) and the mean of the Uta (0.66 vs. 0.74, p = 0.03). For changes in the CUR (cerebro–umbilical ratio) and % changes in the CUR and mean PI of the Uta, there was no correlation with obstetric history, AFI (amniotic fluid index), gestation week, infertility history, systolic pressure, or diastolic pressure. There was a statistically positive correlation between changes in the CUR and % change in the CUR and body weight and in height. Conclusions: Drotaverine has no statistically significant influence on the MCA and Uma PI. The oral administration of drotaverine has an impact on PI rtUta and the mean PI Uta. Full article

(This article belongs to the Special Issue Premature Birth: Research, Intervention, and Results)

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12 pages, 2270 KiB

Open AccessArticle

Obstetric and Perinatal Outcomes after Very Early Preterm Premature Rupture of Membranes (PPROM)-A Retrospective Analysis over the Period 2000–2020

by Ernesto González-Mesa, Marta Blasco-Alonso, María José Benítez, Cristina Gómez-Muñoz, Lorena Sabonet-Morente, Manuel Gómez-Castellanos, Osmayda Ulloa, Ernesto González-Cazorla, Alberto Puertas-Prieto, Juan Mozas-Moreno, Jesús Jiménez-López and Daniel Lubián-López

Medicina 2021, 57(5), 469; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57050469 - 11 May 2021

Cited by 6 | Viewed by 2971

Abstract

Background and Objectives: Pre-term premature rupture of membranes (PPROM) responds for one third of preterm births, and it is associated with other complications that increase the risk of maternal or fetal poor outcome. To reduce uncertainty and provide accurate information to patients, the analysis of the large series is of great importance. In order to learn about the evolution over the time of the obstetric and perinatal outcomes in cases of PPROM at, or before, 28 weeks (very early PPROM) managed with an expectant/conservative protocol, we have designed the present study. Materials and Methods: We retrospectively studied all cases of very early PPROM attended in Malaga University Regional Hospital from 2000 to 2020. Results: Among 119,888 deliveries assisted, 592 cases of PPROM occurred in pregnancies at or before 28 weeks (0.49% of all deliveries, 3.9% of all preterm births and 12.9% of all cases of PPROM). The mean duration of the latency period between PPROM and delivery was 13.5 days (range 0 to 88 days), enlarging over the years. The mean gestational age at delivery was 27 weeks (SD 2.9; range 17–34). The proportion of cesarean deliveries was 52.5%. The overall perinatal mortality rate was 26.5%, decreasing over the period with a significant correlation Pearson’s coefficient −0.128 (p < 0.05). Conclusions: In the period 2000–2020, there was an improvement in the outcomes of very early PPROM cases and perinatal mortality showed a clear trend to decrease. Full article

(This article belongs to the Special Issue Premature Birth: Research, Intervention, and Results)

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11 pages, 883 KiB

Open AccessArticle

Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants

by Claudia Ioana Borțea, Florina Stoica, Marioara Boia, Emil Radu Iacob, Mihai Dinu, Roxana Iacob and Daniela Iacob

Medicina 2021, 57(5), 420; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57050420 - 27 Apr 2021

Cited by 13 | Viewed by 3622

Abstract

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models. Full article

(This article belongs to the Special Issue Premature Birth: Research, Intervention, and Results)

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Review

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9 pages, 1133 KiB

Open AccessReview

Characteristics of Heart Rate Tracings in Preterm Fetus

by Maria F. Hurtado-Sánchez, David Pérez-Melero, Andrea Pinto-Ibáñez, Ernesto González-Mesa, Juan Mozas-Moreno and Alberto Puertas-Prieto

Medicina 2021, 57(6), 528; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060528 - 25 May 2021

Cited by 6 | Viewed by 3575

Abstract

Background and Objectives: Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. One tool frequently used to determine the degree of fetal wellbeing is cardiotocography (CTG). A review of the available literature on fetal heart rate (FHR) monitoring in preterm fetuses shows that studies are scarce, and the evidence thus far is unclear. The lack of reference standards for CTG patterns in preterm fetuses can lead to misinterpretation of the changes observed in electronic fetal monitoring (EFM). The aims of this narrative review were to summarize the most relevant concepts in the field of CTG interpretation in preterm fetuses, and to provide a practical approach that can be useful in clinical practice. Materials and Methods: A MEDLINE search was carried out, and the published articles thus identified were reviewed. Results: Compared to term fetuses, preterm fetuses have a slightly higher baseline FHR. Heart rate is faster in more immature fetuses, and variability is lower and increases in more mature fetuses. Transitory, low-amplitude decelerations are more frequent during the second trimester. Transitory increases in FHR are less frequent and become more frequent and increase in amplitude as gestational age increases. Conclusions: The main characteristics of FHR tracings changes as gestation proceeds, and it is of fundamental importance to be aware of these changes in order to correctly interpret CTG patterns in preterm fetuses. Full article

(This article belongs to the Special Issue Premature Birth: Research, Intervention, and Results)

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