Preeclampsia and long-term health outcomes for mother and infant: An umbrella review. Preeclampsia (PE) is a pregnancy-associated condition with complex disease mechanisms and a risk factor for various long-term health outcomes for the mother and infant. The authors evaluated 21 articles for 90 associations. Seventy-nine associations were statistically significant; 9, including cerebrovascular disease, cerebrovascular disease, cardiac disease, dyslipidaemia, risk of death, fatal and non-fatal ischaemic heart disease, cardiovascular mortality, any diabetes or use of diabetic medication, attention deficit/hyperactivity disorder (ADHD) could be supported.
Comparison of Management Strategies for Neonates With Symptomatic Tetralogy of Fallot. Neonates with tetralogy of Fallot and symptomatic cyanosis (sTOF) require early intervention. This study compared 342 infants (2005-2017) who underwent staged repair (SR) (initial palliation [IP] and subsequent complete repair [CR]) versus 230 who received primary repair (PR). The primary outcome was death. Secondary outcomes included component (IP, CR, PR) and cumulative (SR): hospital stay; duration of cardiopulmonary bypass, anesthesia, ventilation, and inotrope use; and complication and re-intervention rates. Pre-procedural ventilation, prematurity, DiGeorge syndrome, and pulmonary atresia were more common in the SR group. The two groups showed similar mortality. In this multicenter comparison, early mortality and neonatal morbidity were lower in the SR group, but cumulative morbidity and re-interventions favored the PR group.
Factors Associated with Survival and Survival without Major Morbidity in Very Preterm Infants in Two Neonatal Networks: SEN1500 and NEOCOSUR. Very low-birth weight infants represent a high-risk population for morbidity and mortality in the neonatal period. The aim of the study was to determine the perinatal variables and interventions associated with survival and survival without major morbidity. This prospective study compared the Spanish SEN1500 [6,120 (57.9%)] and the South American NEOCOSUR [4,445 (42.1%)] networks, from January 2013 to December 2016. There were significant, but minor, differences between the networks. After adjusting for covariates, gestation, birth weight, small for gestation, female sex, multiple gestation, less invasive resuscitation, and the network of origin showed an independent effect on outcomes. Determining the causes of these differences deserves further study.
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