Pregnancy is a time of alternating states of inflammation. The establishment of pregnancy is marked by controlled inflammation and transition toward an anti-inflammatory state for much of the gestational period before returning to an inflammatory state at the onset of labor. Stress and depression trigger the HPA Axis to produce cortisol and levels are maintained in a state of elevation during pregnancy and continue to rise before parturition. The aim of this research was to explore the relationship of gestational age at delivery with mid-pregnancy levels of cytokines, stress and depression. Participant samples (N = 122) were collected between 16 and 26 weeks gestation and analyzed for 14 cytokines using a bead-based multiplex assay. Plasma cortisol was also measured along with demographic variables and measures of perceived stress and dysphoric mood. Results of Pearson's correlations showed that gestational age at delivery was significantly inversely correlated with pro-inflammatory cytokine IFN-ã and anti-inflammatory IL-13. A significant positive correlation was noted with the number of pregnancies in the obstetric history and pregnancy length. Both cortisol and stress were not correlated with gestational age at delivery.

There are increasing concerns about the excessive use of cesarean delivery in the United States, as cesarean deliveries have been associated with adverse maternal and infant health outcomes. Currently, the cesarean section (C/S) rate for Florida is the second highest in the nation. Furthermore, preliminary reports from the Florida Department of Health (FDOH) have implicated the increasing rate of cesarean delivery to an increase in the rate of late preterm births (PTB) in Florida (births at 34 to 36 weeks gestational age). Information on the impact of late PTB associated with cesarean delivery on the rate of maternal and infant morbidity in Florida as well as corresponding utilization of health care services is scarce. Information on the validity of data sources used to investigate infant and maternal health outcomes in Florida is also scarce. Therefore, the objectives of this research project were: (1) to determine the validity of data sources used to investigate low documented risk C/S and late PTB, and (2) to assess the impact of low documented risk C/S on maternal and infant morbidity and subsequent healthcare utilization. To determine the accuracy of data elements reported on the Florida birth certificate and hospital discharge data, sensitivity, specificity, positive predictive value, negative predictive value, kappa statistics and likelihood ratios were calculated. To assess differences in morbidity by route of delivery, generalized estimating equations and survival analyses were employed. Markov Chain Monte Carlo methods were used to determine appropriate morbidities for inclusion in all analyses. Differences in accuracy of data by data source was observed, with linked birth certificate and hospital discharge data demonstrating improved accuracy compared to birth certificate and discharge data alone. Further, significant differences in the rate of maternal and infant morbidity by route of delivery were observed, with cesarean delivery increasing the risk of adverse health outcomes, and intensive use of healthcare services.

Preterm birth continues to be an important public health concern globally. Born only 3 to 6 weeks premature, findings increasingly demonstrate that the late preterm population (34-36 weeks gestational age) is not exempt from long-term risk, as the last few weeks of gestation are important for both physical and cognitive development. This study examined whether late preterm birth was associated with poorer health, development and educational outcomes in the early childhood period, after controlling for a range of medical and social factors. / February 2016

Analysis of the genomic sequences of Streptococcus mutans UA159 and Group B Streptococcus (GBS) strains Streptococcus agalactiae NEM316 and S. agalactiae 2603V/R indicated the presence of two putative collagenase genes in each organism. smcol1 from S. mutans was previously cloned and analyzed and the results indicated that the enzyme belonged to the U32 family of collagenases/peptidases. This enzyme shares homology with the prtC of Porphyromonas gingivalis, one of the principal examples of the U32 family of peptidases. Considering the potential role of these enzymes in the pathogenicity of P. gingivalis (periodontitis or gum disease), GBS (premature rupture of the amniochorionic membrane) and S. mutans (dental root decay), it is necessary to study these enzymes and establish their role in the virulence of these organisms. Toward this goal the present study has focused on cloning collagenase 2 (smcol2) from S. mutans and cloning collagenase 1 (gbscol1), and collagenase 2 (gbscol2), from GBS. The information obtained will contribute to a further understanding of the U32 peptidase family.

Bakgrund: Vården av för tidigt födda barn har utvecklats från att vara fokuserad på det sjuka barnet och personalen runt det till att vara familjecentrerat. I de flesta länder har olika vårdformer införts med fokus på hela familjen och personalen har till uppgift att stötta och hjälpa de att delta i vården av sitt barn. I hela världen föds det ungefär 15 miljoner för tidigt födda barn dit barn födda före vecka 37 räknas. Syfte: Att beskriva föräldrarnas upplevelser av att vårda sitt för tidigt födda barn på neonatalen. Metod: En litteraturöversikt över nio vetenskapliga studier utförda med kvalitativ metod. Studierna valdes ut från databaserna CINAHL Complete och Pubmed. Två studier hittades via två andra studiers referenslistor. Studierna lästes, sammanfattades och kategoriserades i olika teman och subteman. Resultat: Resultatet presenteras i två teman, Att vårda sitt barn med subteman Att vara med och få ta hand om sitt barn och Erfarenheter av känguruvård och hud-mot-hudvård och Olika vårdformers betydelse för föräldrarna. Nästa tema var Personalens betydelse med subteman Betydelsen av personalens stöd, uppmuntran och kompetens och Svårt med kommunikation och vikten av information. Denna litteraturöversikt visade att föräldrarna ville vara med och vårda sitt barn. Föräldrarna önskade att personalen stöttade dem att våga ta hand om sitt barn och visade och hjälpte dem bli den som tog hand om det mesta runt barnet. De önskade att personalen tog med dem i planeringen av vården och informerade dem fortlöpande om barnets hälsotillstånd. Diskussion: Resultatet visade att föräldrarna ville vårda sitt barn på neonatalen och hur viktigt det var att föräldrarna fick hjälp att lära sig vårda barnet. Neonatalen var en helt ny ofta skrämmande miljö för föräldrarna och barnet upplevdes som liten och känslig och föräldrarna var rädda att skada sitt barn. Resultatet visade att föräldrarna hade liknande upplevelser av att vårda sitt barn trots att de kom från många olika länder. Resultatet diskuterades utifrån konsensusbegreppet vårdandet med utgångspunkt från Katie Erikssons ansa, leka, lära. Ansandet handlar om den dagliga vården av barnet med tvätt, blöjbyten och omvårdnad. Lära syftar till att föräldrarna behöver hjälp att lära sig ta hand om barnet då det är väldigt litet och känsligt och omvårdnaden är uppbyggd på mycket forskning vad som är bäst för det för tidigt födda barnet. Leka syftar på att pröva sig fram och öva och hitta nya lösningar. Olika vårdformer har införts på många ställen i världen och dessa har som mål att hjälpa föräldrarna och personalen att vårda barnet på bästa sätt. I dessa studier har de olika vårdformernas betydelse inte undersökts specifikt utan bara nämnts övergripande. God kommunikation är viktig för alla föräldrar i studierna och när den fungerar så hjälper den föräldrarna att våga vara med sitt barn, vårda det och känna sig som barnets förälder. / Background: Initially the care of the preterm children was focused on the sick child and the care-givers. Nowadays, it focuses on the families around the children and many different forms of care are introduced in a lot of countries. The care-givers task is to help the parents to teach them to take care of their preterm child and to support the families. About 15 million children are born preterm (before 37 weeks) around the world each year. Aim: To describe parents´ experiences in taking care of their preterm child at a neonatal ward. Method: A literature review of nine scientific studies that where done in qualitative design. The studies where found in the databases CINAHL Complete and Pubmed. Two of the studies where found from two other studies´ references. The studies where red and summarized and divided into themes and subthemes. Results: The result are presented in two themes, To care for the child with subthemes To be with your child and allowed to take care of it and Experiences of kangaroo-care and skin to-skincare and Different forms of care. And the second theme was The importance of the care-givers with subthemes The significance of the caregivers support and encouragement and Difficulties with communication and the value of information and competence. This literature review showed that the parents wanted to take care of their preterm child. The parents wished to get support so that they dared to take care of the child. They wanted the care-givers to plan the day with them so they could be part of the care for their child. They also wanted to get information about the child’s health condition. Discussions: The result showed that the parents wanted to take care of their child at the neonatal ward and it was important that they were teached how to do it. The neonatal ward is a completely new world for the parents and they were afraid of hurting the child because it was so small and vulnerable. The result showed that parents all around the world had similar experiences regarding taking care of their preterm child. The result was discussed using Katie Erikssons´ nursing theory of caring with the concepts trim, play and learn. To trim means the daily care of the child. They care for another human being, to wash it, change diapers and to care for it. To learn means that the parents´ need help to learn to take care about the small vulnerable child. To play means that the parents try to find new solutions and practice by trial and error. Different forms of care are introduced in many countries in the world and their aim are to help parents and caregivers provide the best care for the premature children. These different forms of care are not studied specifically in this study. Good communication and information are very important for the parents. When it works it helps the parents to dare to be with their child and care for it and let them feel like they are the child’s parent.

No description available.

Infants born prior to the term of 36 gestation weeks and 6 days are considered preterm infants. The number of preterm infants in Lithuania amounts to 5 – 6% per year. The most significant health problems of such infants in the neonate period are caused by immaturity of the organs and their systems. Knowledge of a preterm infant’s psychomotoric development contributes to early notification of disorders, more effective composition of problem-orientated corrective programs and monitoring of development progress. According to the reference literature, early application of physical therapy enables recovery of as much as 50 percent of infants and improvement of the condition of the rest. The goal of this thesis is to determine within which group: in the preterm infants (extremely preterm (born within 25-30 gestation week) or very preterm infants (born within 31-36 gestation week)), physical therapy has major effect for the emergence time of motor function. The objectives of the thesis are as follows: 1. Comparison of emergence time of motor functions with regard to extremely preterm and very preterm infants within the same stage of corrected age. 2. Comparison of motor development of the extremely preterm and very preterm infant groups and within each separate group considering the gender aspect. 3. Comparison of motor development alternation of the extremely preterm and very preterm infant groups and within each separate group considering the aspect of applied surgical treatment... [to full text]

<p>Risk factors such as intrauterine and vaginal infection put pregnant women at risk for delivering preterm. Bacterial vaginosis (BV) is a polymicrobial clinical syndrome commonly diagnosed in women of reproductive age, with women of African descent with low socioeconomic status and previous preterm delivery at high risk. Although frequently isolated from healthy women,&nbsp / Gardnerella vaginalis has been most frequently associated with BV. There is limited data available on the prevalence of BV in Southern Africa / therefore, we embarked on a study to determine the&nbsp / prevalence of BV and G. vaginalis in predominantly black communities in the Western Cape, in order to establish the role of G. vaginalis in BV. Women attending various Maternity and Obstetrics&nbsp / units (MOU) in the Cape Peninsula with and without a history of pre-term delivery (PTD) were invited to participate in the study. Several factors were statistically associated with pregnancy history,&nbsp / including location of study population, parity, smoking and presence of clinical symptoms. The presence of G. vaginalis was determined by culture in 51.7% of the preterm delivery group (PTDG)&nbsp / and 44% of the full-term delivery group (FTDG) women. BV was detected in 31.13% of PTDG and 23.67% of FTDG by Gram stained analysis according to Nugent scoring criteria, with age and HIV&nbsp / status posing as risk factors. When comparing PTDG and FTDG for an association between the presence of G. vaginalis and BV, a stronger association was observed in the PTDG but it was not statistically significant. In both PTDG and FTDG, G. vaginalis was isolated significantly more often in women diagnosed with BV at 24.5% (p &lt / 0.05). Antibiogram studies revealed both Metronidazole and Clindamycin resistant strains of G. vaginalis. G. vaginalis Biotype 7 is specifically associated with BV, while Biotype 2 appears to be associated with BV in women with a history&nbsp / of PTD. Accuracy of diagnostic tools were tested and it was determined that Nugent scoring is more sensitive in diagnosing BV (76.04%), but culture for G. vaginalis is more specific (83.21%). Although this study was limited in that we were unable to follow-up pregnancy outcomes, we were able to confirm the perceived role of G. vaginalis in BV.&nbsp / </p>

Vitamin D status is assessed with circulating 25-hydroxyvitamin D [25(OH)D]. As some evidence suggests that low vitamin D status adversely affects neonatal health, this project aimed to determine the association between cord blood 25(OH)D levels and preterm birth (PTB; <37 weeks gestation), low birthweight (LBW; <2500 grams) and small for gestational age (SGA; <10th percentile) and to examine the relationship between maternal 25(OH)D levels during the first trimester of pregnancy and fetal 25(OH)D levels at birth in a Canadian population. This nested case-control study used serums, questionnaires and chart reviews collected in Quebec City. Compared to 25(OH)D concentrations ≥75 nmol/L, concentrations 37.5-<75, 50-<75, and <75 nmol/L were associated with lower odds of LBW, PTB and an adverse neonatal composite outcome, and PTB as well as LBW, respectively. Maternal and neonatal 25(OH)D were correlated (r=0.23, p<0.01; adjusted r=0.46, p<0.01). This study contributes to evidence for identifying further policy and research directions.

Feeding problems in preterm neonates stem from complications of early delivery. Attainment of independent feeding is a prerequisite for Neonatal Intensive Care Unit (NICU) discharges. Some quantitative studies of infant feeding involve excessive amounts of time for data processing. Multivariate spectral analysis was used to minimize time for investigation of variability in these rhythms. Auto and Cross-spectral parameters of the rhythms were correlated with Gestational Age (GA), Postmenstrual Age (PMA), Birthweight (BW), Days of Life (DOL), and Time Since First Nipple feeding (TSFN). Auto-spectral analysis showed 25.55% increase in Bandwidth of suck (bw-su) for a 2-week increase in GA (DOL fixed) and 8.99% increase in bw-su for a 10-day increase in DOL (GA fixed). Crossspectral analysis showed a decrease of 0.158Hz of Bandwidth of Suck-Swallow (bw-SS) for a 2-week increase in GA for GA later than 28 weeks. For GA earlier than 28 weeks, peak coherence decreased by 0.774 for a 2-week increase in GA (PMA fixed) and decreased by 0.126 for a 2-week increase in PMA (GA fixed). The method describes the progression of feeding rhythms through correlations with clinical indexes, thus providing clinicians with an understanding of the development of infant feeding and helps predict long-term developmental outcomes.