The second European Perinatal Health Report: documenting changes over 6 years in the health of mothers and babies in Europe

Zeitlin, Jennifer; Mohangoo, Ashna D.; Delnord, Marie; Cuttini, Marina

doi:10.1136/jech-2013-203291

Cited by 88 publications

(72 citation statements)

References 3 publications

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“…Information about previous caesarean delivery and multiple births was obtained for each study and, when listed as the indication for caesarean delivery, were regarded as highly likely to have resulted in prelabour caesarean delivery for all countries and years of birth represented in our dataset. Specifically, the data suggest that for mothers who have a repeat caesarean delivery, more than 80% of these are prelabour in both France 67 and Greece 68 (appendix p 7). Although some women in the prelabour caesarean delivery group might have undergone a trial of labour and were therefore misclassified, available data suggest that most of these births were correctly classified as prelabour caesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

Caesarean delivery and risk of childhood leukaemia: a pooled analysis from the Childhood Leukemia International Consortium (CLIC)

Marcotte

Thomopoulos

Infante‐Rivard

et al. 2016

The Lancet Haematology

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SummaryBackground-Results from case-control studies have shown an increased risk of acute lymphoblastic leukaemia (ALL) in young children born by caesarean delivery, and prelabour caesarean delivery in particular; however, an association of method of delivery with childhood leukaemia subtypes has yet to be established. We therefore did a pooled analysis of data to investigate the association between childhood leukaemia and caesarean delivery.

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Section: Discussionmentioning

confidence: 99%

Caesarean delivery and risk of childhood leukaemia: a pooled analysis from the Childhood Leukemia International Consortium (CLIC)

Marcotte

Thomopoulos

Infante‐Rivard

et al. 2016

The Lancet Haematology

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“…Rates of preterm birth in the UK are among the highest in the developed world 94 and are rising; 95 therefore, preterm birth represents a major public health issue and the challenge to find interventions to prevent NEC and late-onset sepsis is urgent. We are aware that there is currently a rise in the use of probiotics on UK neonatal units given to prevent NEC.…”

Section: Implications For Health Carementioning

confidence: 99%

A randomised controlled trial of the probiotic Bifidobacterium breve BBG-001 in preterm babies to prevent sepsis, necrotising enterocolitis and death: the Probiotics in Preterm infantS (PiPS) trial

Costeloe

Bowler

Brocklehurst

et al. 2016

Health Technol Assess

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BackgroundNecrotising enterocolitis (NEC) and late-onset sepsis remain important causes of death and morbidity in preterm babies. Probiotic administration might strengthen intestinal barrier function and provide protection; this is supported by published meta-analyses, but there is a lack of large well-designed trials.ObjectiveTo test the use of the probioticBifidobacterium brevestrain BBG-001 to prevent NEC, late-onset sepsis and death in preterm babies while monitoring probiotic colonisation of participants.DesignDouble-blind, randomised, placebo-controlled trial.SettingRecruitment was carried out in 24 hospitals, and the randomisation programme used a minimisation algorithm. Parents, clinicians and outcome assessors were blinded to the allocation.ParticipantsBabies born between 23 and 30 weeks’ gestation and randomised within 48 hours of birth. Exclusions included life-threatening or any gastrointestinal malformation detected within 48 hours of birth and no realistic chance of survival.InterventionsActive intervention: 1 ml ofB. breveBBG-001 in one-eighth-strength infant formula Neocate®(Nutricia Ltd, Trowbridge, UK), (6.7 × 107to 6.7 × 109colony-forming units) per dose administered enterally. Placebo: 1 ml of one-eighth-strength infant formula Neocate. Started as soon as practicable and continued daily until 36 weeks’ postmenstrual age.Main outcome measuresPrimary outcomes were an episode of bloodstream infection, with any organism other than a skin commensal, in any baby between 72 hours and 46 weeks’ postmenstrual age; an episode of NEC Bell stage ≥ 2 in any baby; and death before discharge from hospital. Secondary outcomes included stool colonisation withB. breve.ResultsIn total, 654 babies were allocated to receive probiotic and 661 to receive placebo over 37 months from July 2010. Five babies were withdrawn; 650 babies from the probiotic group and 660 from the placebo group were included in the primary analysis. Baseline characteristics were well balanced. There was no evidence of benefit for the primary outcomes {sepsis: 11.2% vs. 11.7% [adjusted relative risk (RR) 0.97, 95% confidence interval (CI) 0.73 to 1.29]; NEC Bell stage ≥ 2: 9.4% vs. 10.0% [adjusted RR 0.93, 95% CI 0.68 to 1.27]; and death: 8.3% vs. 8.5% [adjusted RR 0.93, 95% CI 0.67 to 1.30]}.B. brevecolonisation status was available for 1186 (94%) survivors at 2 weeks’ postnatal age, of whom 724 (61%) were positive: 85% of the probiotic group and 37% of the placebo group. There were no differences for subgroup analyses by minimisation criteria and by stool colonisation withB. breveat 2 weeks. No harms associated with the interventions were reported.LimitationsCross-colonisation of the placebo arm could have reduced statistical power and confounded results; analyses suggest that this did not happen.ConclusionsThis is the largest trial to date of a probiotic intervention. It shows no evidence of benefit and does not support routine use of probiotics for preterm infants.Future work recommendationsThe increasing understanding of the pathogenesis of NEC and sepsis will inform the choice of probiotics for testing and better define the target population. Future Phase III trials should incorporate monitoring of the quality and viability of the intervention and colonisation rates of participants; cluster design should be considered.Trial registrationCurrent Controlled Trials ISRCTN05511098 and EudraCT 2006-003445-17.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 66. See the NIHR Journals Library website for further project information.

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“…Within the framework of the Turkish Ministry of Health policy of the last several years, there is an effort to reduce the frequency of cesarean sections and increase that of vaginal deliveries [29]. According to data from the 2013 Turkish National Health Survey, the frequency of cesarean sections in Turkey is 48% [30], while in the European rates range from 14.8% in Iceland to 52.2% in Cyprus [31]. The mentioned new health policy may indirectly contribute to the prevention of Pre-Eclampsia considering our finding of a high incidence of anemia in women having concluded their last pregnancy with a cesarean section.…”

Section: Discussionmentioning

confidence: 99%

Evaluation the anemia status among preeclamptic pregnants in hospital inpatients from Sanliurfa, Turkey

Toker¹,

Kabalcioğlu²,

Sönmez³

et al. 2016

Med-Science

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Pre-eclampsia is common in the region who are underserved to antenatal care services and constitute risk of anemia.To evaluate the anemia status and its contributing factors in pregnant women a diagnosis of Pre-Eclampsia. This cross-sectional study was conducted from October 2012 to January 2013. This study involved 128 pregnant women hospitalized with a diagnosis of Pre-Eclampsia who consented to being study subjects were included. Statistical analysis was performed using descriptive statistics, Chi-square test, Student's t-test, ANOVA and Pearson's correlation, Binary logistic regression coefficient. Average (±1 SD) and percent frequency values were: Age, 31.53±6.43 years; parity 2.96±1.51; cesarean section at last birth, 40.6%; unplanned pregnancy, 28.1%; use of iron and vitamin pills, 100%; presence of anemia (i.e. blood hemoglobin (Hb) <11), 25%; average Hb, 11.93±1.49 g/dL; and hematocrit (Hct), 35.33±4.05%. No significant effect of the considered socio-demographic factors was observed. A significant difference was observed in the frequency of anemia between patients whose preceding delivery had been by cesarean section and those with regular delivery (32.7% vs. 11.6%, respectively, p=0.044). Statistically significant negative correlation could be detected between pregnancy intervals and anemia (OR, 0.74). Anemia is important factor in the etiology of PreEclampsia, despite access to sufficient prenatal care, these pregnant patients is common frequently. Previous delivery method appears to play a role in the development of anemia. These pregnant patients may be at increased risk due not only to Pre-Eclampsia but also to their anemia.

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The second European Perinatal Health Report: documenting changes over 6 years in the health of mothers and babies in Europe

Cited by 88 publications

References 3 publications

Caesarean delivery and risk of childhood leukaemia: a pooled analysis from the Childhood Leukemia International Consortium (CLIC)

Caesarean delivery and risk of childhood leukaemia: a pooled analysis from the Childhood Leukemia International Consortium (CLIC)

A randomised controlled trial of the probiotic Bifidobacterium breve BBG-001 in preterm babies to prevent sepsis, necrotising enterocolitis and death: the Probiotics in Preterm infantS (PiPS) trial

Evaluation the anemia status among preeclamptic pregnants in hospital inpatients from Sanliurfa, Turkey

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