A Worldwide Epidemic: The Problem and Challenges of Preterm Birth in Low- and Middle-Income Countries

Smid, Marcela C.; Stringer, Elizabeth M.; Stringer, Jeffrey S. A.

doi:10.1055/s-0035-1571199

Cited by 45 publications

(21 citation statements)

References 136 publications

(169 reference statements)

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“…We think that preterm birth might mainly influence the growth of HEU children in the first 3 months, but sustained nutritional support over 18 months was the major factor influencing growth in these HEU children. We did not find an obviously higher rate of preterm birth among HEU children compared with previously reported rates of the general population [16, 17]. We also showed that both adjusted and unadjusted weight-for-age Z scores were slightly above zero from age 6 to 18 months, but that both adjusted and unadjusted length-for-age Z scores showed a decreasing trend to less than zero at age 18 months, which suggests that health interventions among HEU children in Guangdong Province are effective for weight but not length, or that HIV exposure might have a greater impact on length than on weight in HEU children.…”

Section: Discussioncontrasting

confidence: 98%

Growth of HIV-uninfected children born to HIV-infected mothers in Guangdong, China: an 18-month longitudinal follow-up study

Tang

Wang

et al. 2019

BMC Pediatr

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BackgroundTo evaluate the early growth (weight and length) of HIV-exposed uninfected (HEU) children from the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) program in Guangdong Province, China.MethodsA total of 731 HEU children were longitudinally followed up at 7 time points, with anthropometric measurement conducted of weight and length (supine) in the first 18 months. Z scores were calculated, with and without adjustment for gestational age.ResultsA total of 708 HEU children were included in the final follow-up cohort, and 105 (14.83%) children completed all 7 follow-up visits. The mean of adjusted weight-for-age Z scores in these children was above zero and showed a decreasing trend in 18 months. The mean of adjusted length-for-age Z scores showed a decreasing trend and was above zero in the first 12 months; this declined to under zero at age 18 months. The proportion of underweight was 0.28–2.19% and that of stunting was 0.71–4.63% at each follow-up month-age. Slower growth in HEU children was associated with no sustained food subside after 6 month, mothers’ hemoglobin content less than 100 g/L during pregnancy, preterm birth, and low birth weight (p < 0.05).ConclusionsHEU children could catch up to WHO growth standards in first 18 months in Guangdong; however, growth declined after 12 months, and these children need sustained nutritional support.

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Section: Discussioncontrasting

confidence: 98%

Growth of HIV-uninfected children born to HIV-infected mothers in Guangdong, China: an 18-month longitudinal follow-up study

Tang

Wang

et al. 2019

BMC Pediatr

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“…Preterm birth, the birth of a baby at fewer than 37 weeks of gestational age (128), is the most common cause of death among infants worldwide (129). Inflammation has been considered to be associated with preterm birth (130).…”

Section: The Roles Of Macrophages In Pregnancy Complicationsmentioning

confidence: 99%

Macrophage Polarization in Physiological and Pathological Pregnancy

2019

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The immunology of pregnancy is complex and poorly defined. During the complex process of pregnancy, macrophages secrete many cytokines/chemokines and play pivotal roles in the maintenance of maternal-fetal tolerance. Here, we summarized the current knowledge of macrophage polarization and the mechanisms involved in physiological or pathological pregnancy processes, including miscarriage, preeclampsia, and preterm birth. Although current evidence provides a compelling argument that macrophages are important in pregnancy, our understanding of the roles and mechanisms of macrophages in pregnancy is still rudimentary. Since macrophages exhibit functional plasticity, they may be ideal targets for therapeutic manipulation during pathological pregnancy. Additional studies are needed to better define the functions and mechanisms of various macrophage subsets in both normal and pathological pregnancy.

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“…Accurate estimates of PTB rates are necessary for resource allocation and to design appropriate interventions for the prevention and treatment of prematurity and its sequelae. However, in some settings (especially those where early ultrasonography is scarce and women present late to prenatal care), data are inadequate and national estimates must be modeled [1,2]. Nearly all obstetric studies performed in Africa, such as those that describe the effects of HIV and antiretroviral therapy on adverse birth outcomes, use definitions of gestational age based only on last menstrual period (LMP), symphysis–fundal height, and/or neonatal assessment [3–6].…”

Section: Introductionmentioning

confidence: 99%

Quantifying bias between reported last menstrual period and ultrasonography estimates of gestational age in Lusaka, Zambia

Price

Winston

Vwalika

et al. 2018

Intl J Gynecology & Obste

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Objective: To quantify differences in assessing preterm delivery when calculating gestational age from last menstrual period (LMP) versus ultrasonography biometry. Methods: The Zambian Preterm Birth Prevention Study is an ongoing prospective cohort study that commenced enrolment in August 2015 at Women and Newborn Hospital of University Teaching Hospital in Lusaka, Zambia. Women at less than 20 weeks of pregnancy who were enrolled between August 17, 2015, and August 31, 2017, and underwent ultrasonography examination were included in the present analysis. The primary outcome was the difference between ultrasonography- and LMP-based estimated gestational age. Associations between baseline predictors and outcomes were assessed using simple regression. The proportion of preterm deliveries using LMP- and ultrasonography-derived gestational dating was calculated using Kaplan–Meier analysis. Results: The analysis included 942 women. The discrepancy between estimating gestational age using ultrasonography and LMP increased with greater gestational age at presentation and among patients with no history of preterm delivery. In a Kaplan–Meier analysis of 692 deliveries, 140 (20.2%, 95% confidence interval [CI] 17.7–23.0) and 79 (11.4%, 95% CI 9.6–13.6) deliveries were classified as preterm by LMP and ultrasonography estimates, respectively. Conclusion: Taking ultrasonography as a standard, a bias was observed in LMP-based gestational age estimates; these increased with advancing gestation at presentation. This resulted in misclassification of term deliveries as preterm.

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A Worldwide Epidemic: The Problem and Challenges of Preterm Birth in Low- and Middle-Income Countries

Cited by 45 publications

References 136 publications

Growth of HIV-uninfected children born to HIV-infected mothers in Guangdong, China: an 18-month longitudinal follow-up study

Growth of HIV-uninfected children born to HIV-infected mothers in Guangdong, China: an 18-month longitudinal follow-up study

Macrophage Polarization in Physiological and Pathological Pregnancy

Quantifying bias between reported last menstrual period and ultrasonography estimates of gestational age in Lusaka, Zambia

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