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1. Implications of a Reduced Length of Postpartum Hospital Stay on Maternal and Neonatal Readmissions, an Observational Study

Author

Stas, Amber, Breugelmans, Maria, Geerinck, Lynn, Laats, Julie, Spinnoy, An, Van Laere, Sven, and Gucciardo, Leonardo

Subjects
Medical care, Cost of -- Evaluation, Maternal health services -- Evaluation, Hospitals -- Admission and discharge, Health care industry
Abstract

Introduction Reducing the Length Of postpartum Stay (LOS) is associated with lower hospital costs, a major reason for initiating federal projects in Belgium. Disadvantages following the reduction of LOS are the risks of maternal and neonatal readmissions. This study compares readmissions with or without reduced LOS, by introducing the KOZI&Home program in the university hospital Brussels. Methods This is an observational study comparing the readmission rates of the length of postpartum hospital stay between two groups: the non-KOZI&Home group (> 2 days for vaginal birth and > 4 days for caesarean section) and KOZI&Home group ([less than or equal to] 2 days for vaginal birth and [less than or equal to] 4 days for caesarean section). A follow-up period of 16 weeks was set up. Results The maternal readmission rate was 4,8% for the non-KOZI&Home group (n = 332) and 3.3% for the KOZI&Home group (n = 253). Neonatal readmission rates were 7.2% and 15.9% respectively. After controlling influencing factors in a multivariate model for maternal and neonatal readmissions, there were no statistical significant differences. Factors negatively affecting neonatal readmissions are (1) dismissal period October-January (OR:3.22;95% CI 1.10-9.42) and (2) low education level (OR:3.44;95% CI 1.54-7.67), for maternal readmissions it concerns whether or not LOS is known (OR:3.26;95% CI 1.21-8.81). Discussion There is no effect of the KOZI&Home program on maternal nor neonatal readmission rates. Systematically informing about postpartum LOS antenatally will enforce preparation and is important to reduce maternal readmissions. Personalized information should be given to women discharged in the period October-January and to those with a lower education level, in order to reduce neonatal readmissions., Author(s): Amber Stas [sup.1] , Maria Breugelmans [sup.2] , Lynn Geerinck [sup.3] , Julie Laats [sup.4] , An Spinnoy [sup.3] , Sven Van Laere [sup.5] , Leonardo Gucciardo [sup.2] , [...]

Published
2023
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20. Changes in maternal and paternal body composition during the transition to parenthood (TRANSPARENTS).

Author

Versele, Vickà, Stas, Lara, Aerenhouts, Dirk, Deliens, Tom, Clarys, Peter, Gucciardo, Leonardo, Bogaerts, Annick, and Devlieger, Roland

Subjects
BODY composition, PARENTHOOD, CONFIRMATORY factor analysis, WAIST circumference, FAT
Abstract

Objective: The transition to parenthood might negatively influence health‐related behavior and can result in increased adiposity. The aim of this study was to investigate how body composition in mother–father dyads changes from pregnancy up to 6 months post partum. Methods: Anthropometrics were collected from 144 nulliparous couples at 12 weeks of gestation (PG12) and 6 weeks (PP6WK) and 6 months (PP6M) post partum. A longitudinal dyadic confirmatory factor analysis model was used to analyze changes in body composition. Body composition was treated as a latent variable using BMI, body fat percentage, and waist circumference as indicators. Results: For women, latent means increased at 6 weeks post partum (PP6WK − PG12: +1.115, SE: 0.117, p < 0.001), decreased again at 6 months post partum (PP6M − PP6WK: −0.368, SE: 0.107, p < 0.001), but remained above baseline levels (PP6M − PG12: +0.747; SE: 0.115, p < 0.001). For men, the latent means at follow‐up were higher than at baseline (PP6WK‐PG12: +0.370, SE: 0.075; PP6M‐PG12: +0.366, SE: 0.084, both p < 0.001). Conclusions: Increases in latent means correspond to unfavorable changes in BMI, body fat percentage, and waist circumference. These changes were observed from the beginning of pregnancy up to 6 months post partum. Weight management for both women and men during pregnancy and the early postpartum period is recommended and fathers should be included in pre‐ and postnatal standard care. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Effect of air temperature on human births, preterm births and births associated with maternal hypertension.

Author

Blavier, Frédéric, Barbe, Kurt, Faron, Gilles, Doutreloup, Sébastien, Boukerrou, Malik, Fuchs, Florent, and Gucciardo, Leonardo

Subjects
CHILDBIRTH, PREMATURE labor, ATMOSPHERIC temperature, ATMOSPHERIC pressure, TEMPERATURE effect
Abstract

Objective We studied potential effects of outdoor air temperatures or barometric pressure on births, preterm births and births associated with maternal hypertension. Methods 12,269 births were retrospectively reviewed in Brussel and 25,880 in South Reunion Island. National Belgium and French weather reference centers provided outdoor air temperatures and barometric pressures from the nearest weather stations on the corresponding birthdays. Poisson regression models were used to assess if outdoor air temperatures or barometric pressure could be correlated, immediately and several days later, with the number of daily births, preterm births and births associated with hypertension. Results Outdoor air temperature was significantly correlated to the number of daily births in Brussels. For each additional degree Celsius, overall births increased by 0.4% during the same day. Four days later, overall births increased by 1.8%, preterm births by 2.6% and births associated with hypertension by 5.7%. Similar observations on numbers of daily births were reported in South Reunion Island, without reaching statistical significance (p = .08). Conclusion As previously demonstrated in recent studies, increased air temperature leads progressively to higher rates of births and preterm births. An even stronger delayed effect of air temperature was observed on births associated with hypertension. This would be worth further investigating. [ABSTRACT FROM AUTHOR]

Published
2022
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26. Enhancing the value of the sFlt-1/PlGF ratio for the prediction of preeclampsia: Cost analysis from the Belgian healthcare payers' perspective.

Author

UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Service de biochimie médicale, Chantraine, Frederic, Van Calsteren, Kristel, Devlieger, Roland, Gruson, Damien, Keirsbilck, Joachim Van, Dubon Garcia, Ana, Vandeweyer, Katleen, Gucciardo, Leonardo, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Service de biochimie médicale, Chantraine, Frederic, Van Calsteren, Kristel, Devlieger, Roland, Gruson, Damien, Keirsbilck, Joachim Van, Dubon Garcia, Ana, Vandeweyer, Katleen, and Gucciardo, Leonardo

Abstract

To evaluate the economic impact of introducing the soluble fms-like tyrosine kinase (sFlt-1) to placental growth factor (PlGF) ratio test into clinical practice in Belgium for the prediction of preeclampsia (PE). We developed a one-year time-horizon decision tree model to evaluate the short-term costs associated with the introduction of the sFlt-1/PlGF test for guiding the management of women with suspected PE from the Belgian public healthcare payers' perspective. The model estimated the costs associated with the diagnosis and management of PE in pregnant women managed in either a test scenario, in which the sFlt-1/PlGF test is used in addition to current clinical practice, or a no test scenario, in which clinical decisions are based on current practice alone. Test characteristics were derived from PROGNOSIS, a non-interventional study in women presenting with clinical suspicion of PE. Unit costs were obtained from Belgian-specific sources. The main model outcome was the total cost per patient. Introduction of the sFlt-1/PlGF ratio test is expected to result in a cost saving of €712 per patient compared with the no test scenario. These savings are generated mainly due to a reduction in unnecessary hospitalizations. The sFlt-1/PlGF test is projected to result in substantial cost savings for the Belgian public healthcare payers through reduction of unnecessary hospitalization of women with clinical suspicion of PE that ultimately do not develop the condition. The test also has the potential to ensure that women at high risk of developing PE are identified and appropriately managed.

Published
2021

37. PRENATAL INTERVENTION FOR CONGENITAL DIAPHRAGMATIC HERNIA

Author

Deprest, Jan, primary, Jani, Jacques, additional, Van Schoubroeck, Dominique, additional, Cannie, Mieke, additional, Debeer, Anne, additional, Rayyan, Maissa, additional, Sbragia, Lourenço, additional, Van Mieghem, Tim, additional, Van de Velde, Marc, additional, Doné, Elise, additional, Gucciardo, Leonardo, additional, and Lerut, Toni E.M.R., additional

Published
2008
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38. Contributors

Author

Abbas, Ghulam, primary, Adelstein, David J., additional, Aigner, Clemens, additional, Alifano, Marco, additional, Allen, Mark S., additional, Altorki, Nasser K., additional, Andrade, Rafael S., additional, Andritsos, Michael J., additional, Arruda, M. Janine, additional, Ashiku, Simon K., additional, Ashrafi, Ahmad S., additional, Backer, Carl Lewis, additional, Bains, Majit S., additional, Baker, Mark E., additional, Banki, Farzaneh, additional, Bartlett, Nancy L., additional, Battafarano, Richard J., additional, Beauchamp, Gilles, additional, Bello, Ricardo A., additional, Bennett, W. Fred, additional, Bergeron, Michel G., additional, Bergeron, Yves, additional, Bhalla, Sanjeev, additional, Bizekis, Costas, additional, Boland, Brendan J., additional, Bousamra, Michael, additional, Bradley, Jeffrey D., additional, Brandolino, Mario, additional, Bredenberg, Carl E., additional, Bremner, Ross M., additional, Bronner, Mary P., additional, Bryant, Ayesha, additional, Burack, Joshua H., additional, Burgos, Raul, additional, Bussières, Jean S., additional, Campos, Javier H., additional, Cannie, Mieke, additional, Cassivi, Stephen D., additional, Casson, Alan G., additional, Castedo, Evaristo, additional, Cerfolio, Robert James, additional, Cetindag, Ibrahim Bulent, additional, Chelly, Jacques E., additional, Chiu, Priscilla, additional, Christie, Neil A., additional, Chung, Andy T.A., additional, Claytor, R. Brannon, additional, Cooper, Joel D., additional, Costantini, Mario, additional, Courcoulas, Anita P., additional, D'Amico, Thomas A., additional, Darling, Gail, additional, Dartevelle, Philippe, additional, de Hoyos, Alberto, additional, de Perrot, Marc, additional, De Wet, Charl J., additional, Debeer, Anne, additional, DeCamp, Malcolm M., additional, Dehdashti, Farrokh, additional, DeMeester, Steven R., additional, DeMeester, Tom R., additional, Deprest, Jan, additional, Deschamps, Claude, additional, Deslauriers, Jean, additional, Detterbeck, Frank C., additional, Díaz, Ismael A. Conti, additional, Doné, Elise, additional, Doody, Daniel P., additional, Downey, Gregory P., additional, Downey, Robert J., additional, Ducko, Christopher T., additional, Dumot, John A., additional, Duncan, Brian W., additional, Duranceau, André, additional, Edmundowicz, Steven A., additional, Einstein, David M., additional, Ellis, F. Henry, additional, Fadel, Elie, additional, Fell, Stanley C., additional, Fenske, Timothy S., additional, Ferguson, Mark K., additional, Fernandez, Felix G., additional, Fernando, Hiran C., additional, Ferraro, Pasquale, additional, Ferri, Lorenzo E., additional, Ferson, Peter F., additional, Finks, Jonathan F., additional, Finley, Richard J., additional, Flores, Raja M., additional, Fokin, Alexander A., additional, Fortin, Dalilah, additional, Fréchette, Éric, additional, Gaissert, Henning A., additional, Gamliel, Ziv, additional, Gandhi, Sanjiv K., additional, Ghefter, Mario C., additional, Gierada, David S., additional, Gilbert, Sebastien, additional, Goldstein, Allan M., additional, Govindan, Ramaswamy, additional, Graeber, Geoffrey M., additional, Grégoire, Jocelyn, additional, Griffin, Noreen, additional, Grillo, Hermes C., additional, Grunenwald, Dominique, additional, Gucciardo, Leonardo, additional, Gullane, Patrick J., additional, Hagen, Jeffrey A., additional, Lee Hall, Bruce, additional, Hantler, Charles, additional, Harpole, David H., additional, Harrison-Phipps, Karen, additional, Haughey, Bruce H., additional, Haustermans, Karin, additional, Hazelrigg, Stephen R., additional, Henschke, Claudia I., additional, Herridge, Margaret S., additional, Hiebert, Clement A., additional, Holinger, Lauren, additional, Hölscher, Arnulf H., additional, Hoover, Susan J., additional, Huang, Jasmine, additional, Huddleston, Charles B., additional, Hunter, John G., additional, Iannettoni, Mark D., additional, Ilson, David H., additional, Inculet, Richard I., additional, Irshad, Kashif, additional, Jacobsohn, Eric, additional, Jani, Jacques, additional, Javidan-Nejad, Cylen, additional, Jones, David R., additional, Jones, William G., additional, Jurkovich, Gregory, additional, Kaiser, Larry R., additional, Karmy-Jones, Riyad, additional, Keller, Steven M., additional, Kent, Michael S., additional, Keshavjee, Shaf, additional, Kesler, Kenneth A., additional, Klepetko, Walter, additional, Konstantakos, Anastasios, additional, Korst, Robert J., additional, Kozower, Benjamin D., additional, Krakovitz, Paul, additional, Krasna, Mark J., additional, Kreisel, Daniel, additional, Krishna, Priya D., additional, Krupnick, Alexander S., additional, Kucharczuk, John C., additional, Kwong, King F., additional, Landreneau, Rodney J., additional, Lang, Florian, additional, Langer, Jacob C., additional, Lara-Guerra, Humberto, additional, Lardinois, Didier, additional, Law, Simon, additional, Lefrak, Stephen S., additional, Leighl, Natasha B., additional, Leo, Francesco, additional, Lerut, Antoon (Toni) E.M.R., additional, Liebermann-Meffert, Dorothea, additional, Linden, Philip A., additional, Litle, Virginia R., additional, Little, Sherard, additional, Locadia, Mirjam, additional, Losso, Luis C., additional, Louie, Brian E., additional, Low, Donald E., additional, Luketich, James D., additional, Lundell, Lars, additional, Lutey, Barbara A., additional, Macchiarini, Paolo, additional, Mackinnon, Susan E., additional, Maddaus, Michael A., additional, Malthaner, Richard A., additional, Mason, David P., additional, Mathisen, Douglas J., additional, Mattioli, Sandro, additional, Mavroudis, Constantine, additional, Maziak, Donna E., additional, Mazur, Paul, additional, McLoud, Theresa, additional, McRae, Karen M., additional, Mehran, Reza John, additional, Mekhail, Tarek, additional, Merritt, Robert E., additional, Meyers, Bryan F., additional, Meyerson, Shari L., additional, Miller, Daniel L., additional, Miller, Joseph I., additional, Mineo, Tommaso C., additional, Minsky, Bruce D., additional, Moley, Jeffrey, additional, Monnier, Philippe, additional, Montano, Rachel, additional, Moreira, Andre L., additional, Morse, Christopher R., additional, Mouroux, Jérôme, additional, Müller, Nestor L., additional, Mulligan, Michael, additional, Murthy, Sudish C., additional, Naunheim, Keith, additional, Nelems, Bill, additional, Ng, Calvin S.H., additional, Nguyen, Ninh T., additional, Nichols, Francis C., additional, Novak, Christine B., additional, Odell, Michael J., additional, Ollyo, Jean-Baptiste, additional, Onaitis, Mark W., additional, Onders, Raymond P., additional, Ong, Sharon, additional, Orringer, Mark B., additional, Ouellette, Denise, additional, Pairolero, Peter C., additional, Papsin, Blake C., additional, Park, Bernard J., additional, Parsons, Alden M., additional, Partrick, David A., additional, Pasche, Philippe, additional, Pastorino, Ugo, additional, Patel, Amit N., additional, Patterson, G. Alexander, additional, Pearson, F. Griffith, additional, Peitzman, Andrew B., additional, Pennathur, Arjun, additional, Pera, Manuel, additional, Peracchia, Alberto, additional, Pereira, Sérgio Tadeu L.F., additional, Peters, Jeffrey H., additional, Pettiford, Brian, additional, Phillips, Kacy, additional, Pierre, Andrew F., additional, Pompeo, Eugenio, additional, Pop, Daniel, additional, Poylin, Vitaliy, additional, Propst, Evan J., additional, Putnam, Joe B., additional, Qadeer, Mohammed A., additional, Raghu, Ganesh, additional, Rayyan, Maissa, additional, Razzuk, Linda M., additional, Razzuk, Maruf A., additional, Rendina, Erino A., additional, Rice, Thomas W., additional, Richter, Joel E., additional, Ritter, Jon H., additional, Rizk, Nabil P., additional, Robicsek, Francis, additional, Rocco, Gaetano, additional, Rosati, Riccardo, additional, Rosen, Clark A., additional, Rusch, Valerie W., additional, Salzman, Steve H., additional, Sampliner, Richard E., additional, Savary, Marcel, additional, Sbragia, Lourenço, additional, Schipper, Paul H., additional, Schrump, David S., additional, Sciurba, Frank C., additional, Shepherd, Frances A., additional, Shrager, Joseph B., additional, Siegel, Barry A., additional, Sihoe, Alan D.L., additional, Singhal, Sunil, additional, Slinger, Peter D., additional, Smith, Philip W., additional, Soper, Nathaniel J., additional, Souza, Carolina A., additional, Sprangers, Mirjam A.G., additional, Stewart, Robert D., additional, Stroobants, Sigrid G., additional, Sugarbaker, David J., additional, Sullivan, Erin A., additional, Sundaresan, Sudhir R., additional, Swanström, Lee L., additional, Temes, R. Thomas, additional, Tronc, François, additional, Ugalde, Paula A., additional, Urschel, Harold C., additional, Vaezi, Michael F., additional, Vallières, Eric, additional, van Berge Henegouwen, Mark I., additional, Van de Velde, Marc, additional, van Lanschot, Jan J.B., additional, Van Mieghem, Tim, additional, Van Natta, Timothy L., additional, Van Schoubroeck, Dominique, additional, Varela, Andrés, additional, Veeramachaneni, Nirmal K., additional, Venissac, Nicolas, additional, Venuta, Federico, additional, Videtic, Gregory M.M., additional, Vivó, Jorge Nin, additional, Waddell, Thomas K., additional, Walsh, Garrett L., additional, Warren, William H., additional, Waters, Paul F., additional, Watson, Thomas J., additional, Watts, Larry T., additional, Weder, Walter, additional, Wick, Mark R., additional, Wigle, Dennis A., additional, Wildes, Troy S., additional, Wilkins, Earl Wayne, additional, Withers, H. Rodney, additional, Witterick, Ian, additional, Wizorek, Joseph J., additional, Wong, John, additional, Wood, Douglas E., additional, Wright, Cameron D., additional, Wrightson, William, additional, Ximenes-Netto, Manoel, additional, Yang, Steve, additional, Yankelevitz, David F., additional, Yazbeck, Salam, additional, Yim, Anthony P.C., additional, Zakowski, Maureen, additional, and Zuccaro, Gregory, additional

Published
2008
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40. Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19

Author

Di Mascio, Daniele, primary, Sen, Cihat, additional, Saccone, Gabriele, additional, Galindo, Alberto, additional, Grünebaum, Amos, additional, Yoshimatsu, Jun, additional, Stanojevic, Milan, additional, Kurjak, Asım, additional, Chervenak, Frank, additional, Rodríguez Suárez, María José, additional, Gambacorti-Passerini, Zita Maria, additional, Baz, María de los Angeles Anaya, additional, Aguilar Galán, Esther Vanessa, additional, López, Yolanda Cuñarro, additional, De León Luis, Juan Antonio, additional, Hernández, Ignacio Cueto, additional, Herraiz, Ignacio, additional, Villalain, Cecilia, additional, Venturella, Roberta, additional, Rizzo, Giuseppe, additional, Mappa, Ilenia, additional, Gerosolima, Giovanni, additional, Hellmeyer, Lars, additional, Königbauer, Josefine, additional, Ameli, Giada, additional, Frusca, Tiziana, additional, Volpe, Nicola, additional, Luca Schera, Giovanni Battista, additional, Fieni, Stefania, additional, Esposito, Eutalia, additional, Simonazzi, Giuliana, additional, Di Donna, Gaetana, additional, Youssef, Aly, additional, Della Gatta, Anna Nunzia, additional, Di Donna, Mariano Catello, additional, Chiantera, Vito, additional, Buono, Natalina, additional, Sozzi, Giulio, additional, Greco, Pantaleo, additional, Morano, Danila, additional, Bianchi, Beatrice, additional, Lombana Marino, Maria Giulia, additional, Laraud, Federica, additional, Ramone, Arianna, additional, Cagnacci, Angelo, additional, Barra, Fabio, additional, Gustavino, Claudio, additional, Ferrero, Simone, additional, Ghezzi, Fabio, additional, Cromi, Antonella, additional, Laganà, Antonio Simone, additional, Laurita Longo, Valentina, additional, Stollagli, Francesca, additional, Sirico, Angelo, additional, Lanzone, Antonio, additional, Driul, Lorenza, additional, Cecchini D, Fabiana, additional, Xodo, Serena, additional, Rodriguez, Brian, additional, Mercado-Olivares, Felipe, additional, Elkafrawi, Deena, additional, Sisti, Giovanni, additional, Esposito, Rosanna, additional, Coviello, Antonio, additional, Cerbone, Marco, additional, Morlando, Maddalena, additional, Schiattarella, Antonio, additional, Colacurci, Nicola, additional, De Franciscis, Pasquale, additional, Cataneo, Ilaria, additional, Lenzi, Marinella, additional, Sandri, Fabrizio, additional, Buscemi, Riccardo, additional, Gattei, Giorgia, additional, Sala, Francesca della, additional, Valori, Eleonora, additional, Rovellotti, Maria Cristina, additional, Done, Elisa, additional, Faron, Gilles, additional, Gucciardo, Leonardo, additional, Esposito, Valentina, additional, Vena, Flaminia, additional, Giancotti, Antonella, additional, Brunelli, Roberto, additional, Muzii, Ludovico, additional, Nappi, Luigi, additional, Sorrentino, Felice, additional, Vasciaveo, Lorenzo, additional, Liberati, Marco, additional, Buca, Danilo, additional, Leombroni, Martina, additional, Di Sebastiano, Francesca, additional, Di Tizio, Luciano, additional, Gazzolo, Diego, additional, Franchi, Massimo, additional, Ianniciello, Quintino Cesare, additional, Garzon, Simone, additional, Petriglia, Giuliano, additional, Borrello, Leonardo, additional, Nieto-Calvache, Albaro Josè, additional, Burgos-Luna, Juan Manuel, additional, Kadji, Caroline, additional, Carlin, Andrew, additional, Bevilacqua, Elisa, additional, Moucho, Marina, additional, Pinto, Pedro Viana, additional, Figueiredo, Rita, additional, Morales Roselló, José, additional, Loscalzo, Gabriela, additional, Martinez-Varea, Alicia, additional, Diago, Vincente, additional, Jimenez Lopez, Jesús S, additional, Aykanat, Alicia Yeliz, additional, Cosma, Stefano, additional, Carosso, Andrea, additional, Benedetto, Chiara, additional, Bermejo, Amanda, additional, May Feuerschuette, Otto Henrique, additional, Uyaniklar, Ozlem, additional, Ocakouglu, Sakine Rahimli, additional, Atak, Zeliha, additional, Gündüz, Reyhan, additional, Haberal, Esra Tustas, additional, Froessler, Bernd, additional, Parange, Anupam, additional, Palm, Peter, additional, Samardjiski, Igor, additional, Taccaliti, Chiara, additional, Okuyan, Erhan, additional, Daskalakis, George, additional, Moreira de Sa, Renato Augusto, additional, Pittaro, Alejandro, additional, Gonzalez-Duran, Maria Luisa, additional, Guisan, Ana Concheiro, additional, Genç, Şerife Özlem, additional, Zlatohlávková, Blanka, additional, Piqueras, Anna Luengo, additional, Oliva, Dolores Esteban, additional, Cil, Aylin Pelin, additional, Api, Olus, additional, Antsaklis, Panos, additional, Ples, Liana, additional, Kyvernitakis, Ioannis, additional, Maul, Holger, additional, Malan, Marcel, additional, Lila, Albert, additional, Granese, Roberta, additional, Ercoli, Alfredo, additional, Zoccali, Giuseppe, additional, Villasco, Andrea, additional, Biglia, Nicoletta, additional, Madalina, Ciuhodaru, additional, Costa, Elena, additional, Daelemans, Caroline, additional, Pintiaux, Axelle, additional, Cueto, Elisa, additional, Hadar, Eran, additional, Dollinger, Sarah, additional, Brzezinski Sinai, Noa A., additional, Huertas, Erasmo, additional, Arango, Pedro, additional, Sanchez, Amadeo, additional, Schvartzman, Javier Alfonso, additional, Cojocaru, Liviu, additional, Turan, Sifa, additional, Turan, Ozhan, additional, Di Dedda, Maria Carmela, additional, Molpeceres, Rebeca Garrote, additional, Zdjelar, Snezana, additional, Premru-Srsen, Tanja, additional, Cerar, Lilijana Kornhauser, additional, Druškovič, Mirjam, additional, De Robertis, Valentina, additional, Stefanovic, Vedran, additional, Nupponen, Irmeli, additional, Nelskylä, Kaisa, additional, Khodjaeva, Zulfiya, additional, Gorina, Ksenia A., additional, Sukhikh, Gennady T., additional, Maruotti, Giuseppe Maria, additional, Visentin, Silvia, additional, Cosmi, Erich, additional, Ferrari, Jacopo, additional, Gatti, Alessandra, additional, Luvero, Daniela, additional, Angioli, Roberto, additional, Puri, Ludovica, additional, Palumbo, Marco, additional, D’Urso, Giusella, additional, Colaleo, Francesco, additional, Chiara Rapisarda, Agnese Maria, additional, Carbone, Ilma Floriana, additional, Mollo, Antonio, additional, Nazzaro, Giovanni, additional, Locci, Mariavittoria, additional, Guida, Maurizio, additional, Di Spiezio Sardo, Attilio, additional, Panici, Pierluigi Benedetti, additional, Berghella, Vincenzo, additional, Flacco, Maria Elena, additional, Manzoli, Lamberto, additional, Bifulco, Giuseppe, additional, Scambia, Giovanni, additional, Zullo, Fulvio, additional, and D’Antonio, Francesco, additional

Published
2020
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45. Body weight, body composition and energy balance related behaviour during the transition to parenthood: study protocol of a multi-centre observational follow-up study (TRANSPARENTS)

Author

Deliens, Tom, primary, Versele, Vickà, additional, Vanden Eynde, Hannelore, additional, Clarys, Peter, additional, Devlieger, Roland, additional, Bogaerts, Annick, additional, Gucciardo, Leonardo, additional, Schreurs, Annick, additional, Van Holsbeke, Caroline, additional, and Aerenhouts, Dirk, additional

Published
2019
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47. Primary maternal cytomegalovirus infections: accuracy of fetal ultrasound to predict sequelae in offspring Reply

Author

Leyder, Mina, Vorsselmans, Anniek, Gucciardo, Leonardo, Obstetrics, Surgical clinical sciences, and Mother and Child

Subjects
Medicine(all), Primary maternal cytomegalovirus infections, Children
Abstract

We thank Picone and Mandelbrot for their interesting comments. In Belgium, 3 prenatal ultrasound scans are refunded by the Federal Institute for Health Insurance (1st, 2nd, and 3rd trimester ultrasound examinations). As mentioned in our article, pregnant patients with primary cytomegalovirus infections were invited for targeted additional ultrasound scans to be performed every 4 weeks until delivery. Dates of the ultrasound scans and gestational ages for every included patient were registered (data not shown) as well as fetal and placental findings. We share the same opinion about correlations between autopsy findings and clinical postnatal cytomegalovirus impairments. Histopathologic observations should be interpretated with caution to avoid overestimation of adverse outcomes. On the other hand, underestimation of adverse outcomes should not be neglicted. A few patients in this study declined autopsy or were lost for follow-up. For several cases of pregnancy terminations, neuropathological examinations failed because of fetal brain tissue autolyse. Underestimation of adverse outcomes or missed falsely negative ultrasound assessments are therefore not excluded and could have led to overrated negative predictive values for fetal ultrasound. This study was initiated 20 years ago, the knowledge about cytomegalovirus infection, its natural history during pregnancy, and available tools for prenatal risk stratification were limited, compared with actual management options. In 1996, patients with first-trimester primary cytomegalovirus infection and proven fetal infection based on amniotic fluid analysis were considered to be at high risk for severe neurologic postnatal impairments. Therefore, management options that included pregnancy termination, even for cases with negative fetal ultrasound results, were discussed with patients. Important progress has been made. Risk for fetal neurologic impairments can be stratified with the use of noninvasive techniques like magnetic resonance imaging analysis with improved sensitivity and sensibility when compared with fetal ultrasound scanning.1 This was implemented in our clinical practice with fewer indications for terminations. Nevertheless, discussions about prognosis and cytomegalovirus-related postnatal sequelae remain difficult. Counseling should include a broader clinical approach with a more extended screening for adverse outcomes. Ophthalmologic cytomegalovirus complications are clearly underestimated2 as is long-term progressive hearing deterioration that has been noted in 18–62% of all children with sensorineural hearing loss at birth.3 Both could lead to cytomegalovirus-related neurodevelopmental impairments without adequate identification and management.

Published
2017

49. The fetal fibronectin test: 25 years after its development, what is the evidence regarding its clinical utility? A systematic review and meta-analysis.

Author

Faron, Gilles, Balepa, Lisa, Parra, José, Fils, Jean-François, and Gucciardo, Leonardo

Subjects
META-analysis, PREMATURE labor, MULTIPLE pregnancy, AMNION, BIOMARKERS, FIBRONECTINS, RESEARCH, RESEARCH methodology, SYSTEMATIC reviews, EVALUATION research, MEDICAL cooperation, COMPARATIVE studies
Abstract

Background: The identification of women at risk for preterm birth should allow interventions which could improve neonatal outcome. Fetal fibronectin, a glycoprotein which acts normally as glue between decidua and amniotic membranes could be a good marker of impending labour when its concentration in cervicovaginal secretions between 22 and 36 weeks of gestation is ≥50 ng/mL. Many authors worldwide have tested this marker with many different methodologies and clinical settings, but conclusions about its clinical use are mixed. It is time for a comprehensive update through a systematic review and meta-analysis.Methods: We searched PubMed, Cochrane Library, and Embase, supplemented by manual search of bibliographies of known primary and review articles, international conference papers, and contact with experts from 1-1990 to 2-2018. We have selected all type of studies involving fetal fibronectin test accuracy for preterm delivery. Two authors independently extracted data about study characteristics and quality from identified publications. Contingency tables were constructed. Reference standards were preterm delivery before 37, 36, 35, 34, and 32 weeks, within 28, 21, 14, or 7 d and within 48 h. Data were pooled to produce summary likelihood ratios for positive and negative tests results.Results: One hundred and ninety-three primary studies were identified allowing analysis of 53 subgroups. In all settings, none of the summary likelihood ratios were >10 or <0.1, thus indicating moderate prediction, particularly in asymptomatic women and in multiple gestations.Conclusions: The fetal fibronectin test should not be used as a screening test for asymptomatic women. For high-risk asymptomatic women, and especially for women with multiple pregnancies, the performance of the fetal fibronectin test was also too low to be clinically relevant. Consensual use as a diagnostic tool for women with suspected preterm labor, the best use policy probably still depends on local contingencies, future cost-effectiveness analysis, and comparison with other more recent available biochemical markers. [ABSTRACT FROM AUTHOR]

Published
2020
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