Lockdown Impact on Spontaneous Premature Birth in a Level III NICU
Premature BirthPreterm LaborPreterm labor (PL) is the leading cause of hospitalization during pregnancy and premature birth the leading cause of fetal morbidity and mortality in France. PL is defined by regular and painful uterine contractions associated with a change in the cervix, between 22 and 36 weeks of gestation. It has been shown that the risk of spontaneous prematurity increases particularly in case of working over 40 hours per week, hard physically conditions, or prolonged daily transport time. Rest is one of the most efficient measure to prevent PL and should be proposed to all pregnant women, and combined with other therapies such as tocolysis or cerclage when needed. The very particular period of lockdown during the COVID-19 pandemic had pregnant women to drastically reduce their activity. They suspended their work and stayed home for various reasons such as pregnancy in progress, children at home, and also collective reasons such as teleworking or workplace closure. During the lockdown period from March 17th to May 11th 2020, fewer preterm labor and less spontaneous prematurity have been suspected by the neonatology and obstetrics teams throughout the Lorraine region. Our study aims to objectively confirm this observation. In this investigation we aim to find a relationship between lockdown, PL and spontaneous prematurity which would need to re-evaluate public health recommendations for pregnant women outside the lockdown.
Dynamics of the Microbiome in the Premature Infant
InfectionThe purpose of the study is to describe the dynamics of the microbiome in the premature infant as a means to adapt the premature infant gut to affect better health outcomes.
Motherhood and Microbiome
Preterm BirthThis is a prospective cohort, enriched with women with a prior term birth, of singleton pregnancies who will be followed for the outcome of preterm birth. The main exposure of interest is the characterization of the cervico-vaginal microbiota. Women will be recruited from a population seeking routine obstetrical care at obstetrical practices at Penn. They will have three research visits during pregnancy to complete questionnaires and collect samples of cervico-vaginal fluid and cervical cells. Outcome data will be collected about the prenatal events and timing of delivery.
Impact of Different Modes of Noninvasive Ventilation on Regional Oximetry and Hemodynamics in Premature...
Respiratory Distress SyndromeThe purpose of this study is to examine the blood flow and the delivery of oxygen to the brain and gut in preterm babies while they are supported with two modes of breathing machine and compare these two methods to see if one allows for better blood flow to the brain and gut.
Neonatal Outcome by Reason for Delivery
Preterm DeliveryTo determine the rate of Composite Neonatal Morbidity for very preterm babies delivered secondary to preterm labor (PTL) vs. prelabor rupture of membranes (PROM). Composite neonatal morbidity is defined as ≥ 1 of the following: Respiratory Distress Syndrome (RDS) (oxygen requirement, clinical diagnosis, and consistent chest radiograph), bronchopulmonary dysplasia (BPD) (requirement for oxygen support at 28 days of life), severe intraventricular hemorrhage (IVH) (grades III or IV), periventricular leukomalacia (PVL), blood culture-proven sepsis, necrotizing enterocolitis (NEC), or perinatal death (stillbirth or death before neonatal hospital discharge.
Skin Lipid Profiles in Term and Preterm Infants
Preterm InfantsThis study is designed to compare the skin lipid and protein composition between term and premature infants and determine how the skin composition changes over the first four weeks of life. The investigators hope to elucidate the unique characteristics of premature skin by measuring the lipid and protein content in skin, how it changes during the first month of life, and how it varies with formula feeding versus breast feeding. Additionally, the investigators will study the relationships among diet, skin composition and plasma lipids in premature infants over the first four weeks of life.
Fetal Thymus Involution as a Predictor of Adverse Neonatal Outcomes
Women Admitted to Labor and Delivery for the Management of Preterm Labor and/or Preterm Premature Rupture of Membranes (PPROM)The thymus gland is a specialized organ in the chest that plays a central role in the adaptive immune system throughout development until puberty. In response to stress, the fetal thymus gland may shrink, or involute. The investigators propose a prospective cohort study that will enroll pregnant women admitted to labor and delivery for the management of preterm labor and/or preterm premature rupture of membranes from 28-36 weeks gestation. Based on sonographic thymus measurements, the investigators will develop a clinical prediction tool to identify babies who are at increased risk for adverse neonatal outcomes. A reliable non-invasive predictor of adverse neonatal outcome using thymic ultrasound measurements has the potential to affect clinical management, improve outcomes for premature babies, and direct further research efforts.
An Observational Study to Assess Respiratory Syncytial Virus (RSV) Respiratory Events Among Premature...
HealthyThe primary objective is to assess the burden of respiratory disease in outpatient settings among 32 to 35 weeks' gestational age (wGA) infants in the USA who did not receive RSV prophylaxis during the infants' first RSV season.
Vaginal, Oral and Systemic Inflammation in Preterm Birth
Local or Systemic Signs for InfectionPreterm BirthThe prevalence of preterm birth is not decreasing in the last decades despite of improving health care. Intrauterine infections are important in the etiology of preterm birth but the interconnection of systemic inflammation and preterm birth is not clear. Mechanisms of preterm birth should be assessed as preterm birth is the major risk factor for morbidity and mortality during birth, thus being important for the individual and regarding health costs. No interventions will be carried out in this study. Hypotheses: There is a common etiology between oral and vaginal inflammation Bacterial species are similar in vagina and oral cavity There are similar oral and systemic immune reactions which provoke preterm birth Inflammatory markers are found in pregnant women at risk and get back to normal post partum In this matched case control study of pregnant women local, systemic and oral inflammation markers and bacterial load are assessed to find out interconnections between these body compartments to allow for explanation of the etiology of preterm birth.
Time Outside Target Oxygen Saturation Range in Preterm Infants and Long Term Outcomes and Preterm...
Retinopathy of PrematurityThe purpose of this study is to determine if there is a relationship between time spent out the targeted oxygen saturation range in preterm infants is associated with long-term outcomes such as Retinopathy of Prematurity.