https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)01024-7.pdf

Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60820-4.pdf

National regional and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications.

Hyperglycemia and Adverse Pregnancy Outcomes

Resumen Incidencia mundial de parto prematuro: revision sistematica de la morbilidad y mortalidad maternas Objetivo Analizar las tasas de prematuridad a nivel mundial para evaluar la incidencia de este problema de salud publica, determinar la distribucion regional de los partos prematuros y profundizar en el conocimiento de las actuales estrategias de evaluacion.Metodos Los datos utilizados sobre las tasas de prematuridad a nivel mundial se extrajeron a lo largo de una revision sistematica anterior de datos publicados e ineditos sobre la mortalidad y morbilidad maternas notificados entre 1997 y 2002. Esos datos se complementaron mediante una busqueda que abarco el periodo 2003–2007. Las tasas de prematuridad de los paises sin datos se estimaron mediante modelos de regresion multiple especificos para cada region.Resultados Estimamos que en 2005 se registraron 12,9 millones de partos prematuros, lo que representa el 9,6% de todos los nacimientos a nivel mundial. Aproximadamente 11 millones (85%) de ellos se concentraron en Africa y Asia, mientras que en Europa y America del Norte (excluido Mexico) se registraron 0,5 millones en cada caso, y en America Latina y el Caribe, 0,9 millones. Las tasas mas elevadas de prematuridad se dieron en Africa y America del Norte (11,9% y 10,6% de todos los nacimientos, respectivamente), y las mas bajas en Europa (6,2%).Conclusion El parto prematuro es un problema de salud perinatal importante en todo el mundo. Los paises en desarrollo, especialmente de Africa y Asia meridional, son los que sufren la carga mas alta en terminos absolutos, pero en America del Norte tambien se observa una tasa elevada. Es necesario comprender mejor las causas de la prematuridad y obtener estimaciones mas precisas de la incidencia de ese problema en cada pais si se desea mejorar el acceso a una atencion obstetrica y neonatal eficaz.

/pdf/the-worldwide-incidence-of-preterm-birth-a-systematic-review-210c5n0761.pdf

The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity

The aim of this study was to revise the 2003 Fenton Preterm Growth Chart, specifically to: a) harmonize the preterm growth chart with the new World Health Organization (WHO) Growth Standard, b) smooth the data between the preterm and WHO estimates, informed by the Preterm Multicentre Growth (PreM Growth) study while maintaining data integrity from 22 to 36 and at 50 weeks, and to c) re-scale the chart x-axis to actual age (rather than completed weeks) to support growth monitoring. Systematic review, meta-analysis, and growth chart development. We systematically searched published and unpublished literature to find population-based preterm size at birth measurement (weight, length, and/or head circumference) references, from developed countries with: Corrected gestational ages through infant assessment and/or statistical correction; Data percentiles as low as 24 weeks gestational age or lower; Sample with greater than 500 infants less than 30 weeks. Growth curves for males and females were produced using cubic splines to 50 weeks post menstrual age. LMS parameters (skew, median, and standard deviation) were calculated. Six large population-based surveys of size at preterm birth representing 3,986,456 births (34,639 births < 30 weeks) from countries Germany, United States, Italy, Australia, Scotland, and Canada were combined in meta-analyses. Smooth growth chart curves were developed, while ensuring close agreement with the data between 24 and 36 weeks and at 50 weeks. The revised sex-specific actual-age growth charts are based on the recommended growth goal for preterm infants, the fetus, followed by the term infant. These preterm growth charts, with the disjunction between these datasets smoothing informed by the international PreM Growth study, may support an improved transition of preterm infant growth monitoring to the WHO growth charts.

/pdf/a-systematic-review-and-meta-analysis-to-revise-the-fenton-1bkcp7xdca.pdf

A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants

Purpose of review
In countries with comparable levels of development and healthcare systems, preterm birth rates vary markedly – a range from 5 to 10% among live births in Europe. This review seeks to identify the most likely sources of heterogeneity in preterm birth rates, which could explain differences between European countries.

What contributes to disparities in the preterm birth rate in European countries

Des enquetes nationales perinatales sont realisees a intervalle regulier pour suivre l’evolution des principaux indicateurs de sante et de pratiques medicales, aider a l’evaluation et a la decision des actions de sante, et repondre a des questions qui se posent a un moment donne.

Enquête nationale périnatale 2003

Socio-demographic characteristics of mothers have been associated with exclusive breastfeeding duration, but little is known about the association with maternal full- and part-time employment and return to work in European countries. To study the associations between breastfeeding, any and almost exclusive (infants receiving breast milk as their only milk) breastfeeding, at 4 months of infant's age and the socio-demographic and occupational characteristics of mothers. We used the EDEN mother-child cohort, a prospective study of 2002 singleton pregnant women in two French university hospitals. We selected all mothers (n = 1,339) who were breastfeeding at discharge from the maternity unit. Data on feeding practices were collected at the maternity unit and by postal questionnaires at 4, 8 and 12 months after the birth. Among infants breastfed at discharge, 93% were still receiving any breastfeeding (83% almost exclusive breastfeeding) at the 3rd completed week of life, 78% (63%) at the 1st completed month, and 42% (20%) at the 4th completed month. Time of return to work was a major predictor for stopping breastfeeding: the sooner the mothers returned to work, the less they breastfed their babies at 4 months of infant's age, independently of full-time or part-time employment. The association was stronger for almost exclusive breastfeeding mothers than for any breastfeeding ones. In a society where breastfeeding is not the norm, women may have difficulties combining work and breastfeeding. Specific actions need to be developed and assessed among mothers who return to work and among employers.

/pdf/breastfeeding-duration-social-and-occupational-27dextu8qh.pdf

Breastfeeding Duration, Social and Occupational Characteristics of Mothers in the French ‘EDEN Mother–Child’ Cohort

The purpose of this study was to assess the psychological difficulties encountered by mothers 1 year after the birth of triplets. Twelve mothers entered the study having delivered triplets in a public hospital in Paris. Nine pregnancies had been initiated after in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT), two after ovarian stimulation and one was spontaneous. The method consisted of tape-recorded semi-structured interviews at the mothers' homes. At 1 year, a majority of mothers reported considerable fatigue and stress. In most cases, home help was no longer provided by social services or by relatives. A majority suffered from social isolation and had difficulties in going out because of a lack of help, and inquisitive looks and questions from other people. Most mothers said that having triplets placed a strain on the marital relationship. The relationship with the children was often disturbed. Mothers reported that it was difficult to give adequate attention to the three children at the same time. Most of them tended to become emotionally detached. Eight mothers expressed psychological difficulties and three of them were treated for depression. Families with triplets should be provided with increased help, special attention, counselling and support, either at home, in clubs or in special clinics.

Béatrice Blondel

Papers

What contributes to disparities in the preterm birth rate in European countries

Enquête nationale périnatale 2003

Breastfeeding Duration, Social and Occupational Characteristics of Mothers in the French ‘EDEN Mother–Child’ Cohort

Assessment at 1 year of the psychological consequences of having triplets

European indicators of health care during pregnancy, delivery and the postpartum period