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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Perinatal and Neonatal Medicine".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 34564

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Special Issue Editors

Prof. Dr. Claude Billeaud

E-Mail Website1 Website2
Guest Editor

Hôpital des Enfants, CHU Pellegrin, 33076 Bordeaux, France
Interests: disciplines; pediatrics; nutrition and dietetics; skills and expertise; pregnant nutrition; transfattyacids; human; milk; neonatology; neonatal medicine; prenatal diagnosis; neonatal resuscitation; infant; nutrition-materna
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Dr. Virginie Rigourd

E-Mail Website
Guest Editor

1. Neonatology Necker Enfants Malades, 75015 Paris, France
2. Milk Bank Necker Enfants Malades, 75015 Paris, France
Interests: breastfed; human milk; human milk bank; breastfeeding; COVID-19
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is my pleasure to announce the launch of a new Special Issue of Healthcare on “Pregnancy and Perinatal Health”. This is of course a particularly broad subject which covers all the pathologies of pregnancy that have an impact on the fetus, as well as all the diseases of the fetus and the newborn. Some examples of pathologies of pregnancy and perinatal health include:

1. Perinatal Hematology

Point on rhesus anemia

Point on neonatal thrombocytopenia

Point on leukemia and oncology in pregnant women

Point on leukemia and oncology in neonate

Point on neonatal hemophilia

2. Donation in Perinatology

Donation—a philosopher's perspective

Donation of human milk

Cord blood donation and use

Oocyte, embryo, and sperm donation

Loan of uterus

3. Diseases in pregnancy that affect the newborn

Diabetes in pregnant women and newborns

Maternal myopathies and newborns

Myasthenia gravis and newborn

Maternal metabolic diseases and newborns

COVID-19 in pregnant mothers and neonatal care

Congenital malformations (with antenatal diagnostic)

The deadline of submission is 28 February 2022.

I look forward to receiving your abstracts on these topics; the authors of the most outstanding abstracts will be invited to give an oral presentation to the next congress of AEEP in Paris on 17–18 November 2021. Whether AEEP will be in person or virtual is yet to be determined and will be decided based on the situation around the COVID-19 pandemic at that time. Speakers must be members of AEEP/EAPE (do note that registration is EUR 60/year).

Kind Regards
Prof. Dr. Claude Billeaud
Dr. Virginie Rigourd
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

pregnancy
fetus
neonatal health
nutrition
lipids
protein
human milk
infections: virus, bacterial, congenital malformations (with antenatal diagnostic)
diseases of nutrition during pregnancy and/or neonatal diseases
human milk
human milk banking
human milk donation
cord blood donation

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Published Papers (11 papers)

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9 pages, 273 KiB

Open AccessArticle

Disability during Early Pregnancy: Using the Sheehan Disability Scale during the First Trimester in Japan

by Ayako Hada, Mariko Minatani, Mikiyo Wakamatsu and Toshinori Kitamura

Healthcare 2022, 10(12), 2514; https://doi.org/10.3390/healthcare10122514 - 12 Dec 2022

Cited by 4 | Viewed by 2133

Abstract

Background: Many pregnant women experience impairments in social, occupational, or other important functioning. Aim: This study aimed to confirm measurement and structural invariance of the Sheehan Disability Scale (SDS) and its validity during early pregnancy. Design: Longitudinal study with two observations. Methods: Questionnaires were distributed to pregnant women attending antenatal clinics at gestational weeks 10–13. Of 382 respondents, 129 responded to the SDS again 1 week later. Results: Confirmatory factor analysis shows good fit with the data: χ²/df = 0, comparative fit index (CFI) = 1.000, standardized root mean square residual (SRMR) = 0, and root mean square error of approximation (RMSEA) = 0.718. There is acceptable configural, measurement, and structural invariance of the factor structure between primiparas and multiparas as well as between two observation occasions. The Pregnancy–Unique Quantification of Emesis and Nausea, Patient Health Questionnaire-9, and Insomnia Severity Index subscales explain 47% of the variance in SDS scores. Conclusion: Perinatal health care professionals should pay more attention to the difficulties and disabilities that pregnant women face. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

10 pages, 833 KiB

Open AccessFeature PaperArticle

Systemic Inflammation Is Associated with Pulmonary Hypertension in Isolated Giant Omphalocele: A Population-Based Study

by Baptiste Teillet, Mohamed Riadh Boukhris, Rony Sfeir, Sébastien Mur, Emeline Cailliau, Dyuti Sharma, Pascal Vaast, Laurent Storme and Kévin Le Duc

Healthcare 2022, 10(10), 1998; https://doi.org/10.3390/healthcare10101998 - 11 Oct 2022

Cited by 1 | Viewed by 1581

Abstract

Our objective is to determine perinatal factors contributing to the development of pulmonary hypertension (PH) in patients with isolated giant omphaloceles (GO). All cases of omphaloceles that underwent prenatal and postnatal care at the University Hospital of Lille between 1996 and 2021 were reviewed. We included all infants with isolated GO, including at least a part of the liver, who were treated by delayed surgical closure. Prenatal and postnatal data were recorded and correlated with postnatal morbidities. We compared outcomes between a group of infants with GO who developed PH and infants with GO with no PH. We identified 120 infants with omphalocele. Fifty isolated GO cases fulfilled the inclusion criteria of our study. The incidence of PH was 30%. We highlighted a prolonged inflammatory state, defined as a CRP superior to 15 mg/L, platelets higher than 500 G/L, and white blood cells higher than 15 G/l for more than 14 days in patients who developed PH. This event occurred in 73% of patients with PH versus 21% of patients without PH (p < 0.05). Late-onset infection was not different between the two groups. We speculate that prolonged inflammatory syndrome promotes PH in infants with GO treated with delayed surgical closure. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

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7 pages, 3069 KiB

Open AccessArticle

Preliminary Outcomes of Cervical Cerclage for Shortened Cervix with Decidual Polyp

by Takuya Misugi, Kohei Kitada, Megumi Fudaba, Sayaka Tanaka, Yasushi Kurihara, Mie Tahara, Akihiro Hamuro, Akemi Nakano, Masayasu Koyama and Daisuke Tachibana

Healthcare 2022, 10(7), 1312; https://doi.org/10.3390/healthcare10071312 - 14 Jul 2022

Cited by 2 | Viewed by 4506

Abstract

The aim of this study was to elucidate the nature of decidual polyp (DP) and to compare DP outcomes treated with cervical cerclage for a shortened cervix with the outcomes of cases treated with cervical cerclage without DP. The medical records of pregnant women who were complicated with cervical polyps were retrospectively reviewed. Cervical cerclage was considered for those cases with a shortened cervical length of under 25 mm and before 25 gestational weeks. We also reviewed pregnant women who had no cervical polyps, and who underwent cervical cerclage during the same study period, and defined them as the control group. A total of 56 pregnant women with cervical polyps were identified. All of the polyps in the 14 cases that had undergone cervical cerclage migrated into the cervical canal. Of the thirty seven cases with cervical polyps that did not necessitate cervical cerclage, eight women delivered preterm and six of these cases were diagnosed as DP. In all of the women studied, polyp migration was observed in 68.6 %. Cervical cerclage was performed significantly earlier in the DP group than in the control group of 46 cases (p < 0.001; 18.4 weeks vs. 21.4 weeks, respectively). Cervical cerclage is effective in DP cases with a shortened cervical length and polypectomy should not be performed during pregnancy because of the risk of miscarriage. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

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10 pages, 3375 KiB

Open AccessArticle

Comparison of the Injury Mechanism between Pregnant and Non-Pregnant Women Vehicle Passengers Using Car Crash Test Dummies

by Ayumu Kuwahara, Masahito Hitosugi, Arisa Takeda, Seiji Tsujimura and Yasuhito Miyata

Healthcare 2022, 10(5), 884; https://doi.org/10.3390/healthcare10050884 - 11 May 2022

Cited by 2 | Viewed by 2272

Abstract

This paper analyzes the kinematics and applied forces of pregnant and non-pregnant women dummies sitting in the rear seat during a frontal vehicle collision to determine differences in the features of abdominal injuries. Sled tests were conducted at 29 and 48 km/h with pregnant and non-pregnant dummies (i.e., MAMA IIB and Hybrid III). The overall kinematics of the dummy, resultant acceleration at the chest, transrational acceleration along each axis at the pelvis, and loads of the lap belt and shoulder belt were examined. The belt loads were higher for the MAMA IIB than for the Hybrid III because the MAMA IIB had a higher body mass than the Hybrid III. The differences in the lap belt loads were 1119 N at 29 km/h and 1981–2365 N at 48 km/h. Therefore, for restrained pregnant women sitting in the rear seat, stronger forces may apply to the lower abdomen during a high-velocity frontal collision. Our results suggest that for restrained pregnant women sitting in the rear seat, the severity of abdominal injuries and the risk of a negative fetal outcome depend on the collision velocity. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

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9 pages, 288 KiB

Open AccessArticle

Anxiety, Stress, and Social Support in Pregnant Women in the Province of Leon during COVID-19 Disease

by Rubén García-Fernández, Cristina Liébana-Presa, Pilar Marqués-Sánchez, María Cristina Martínez-Fernández, Natalia Calvo-Ayuso and Pedro Hidalgo-Lopezosa

Healthcare 2022, 10(5), 791; https://doi.org/10.3390/healthcare10050791 - 24 Apr 2022

Cited by 5 | Viewed by 2542

Abstract

The COVID-19 pandemic has posed a high risk to the mental health of the entire population. Pregnant women are strongly affected by the consequences of COVID-19, resulting in increased anxiety and stress. Social support can be a protective factor when it comes to mental health disturbances such as anxiety, fear, or stress in pregnant women. This research aims to describe the anxiety and stress of women in the first trimester of pregnancy in times of pandemic and its relationship with social support. A quantitative, descriptive, cross-sectional study was conducted. A total of 115 women in the first trimester of pregnancy participated. Anxiety was found in 78.3% of the women. Self-perceived stress correlated significantly with the dimensions “concern for changes in oneself”, “feelings about oneself”, “concern about the future”, and very weakly with social support. In addition, a negative correlation was observed between “feelings about oneself” and social support. During the COVID-19 pandemic, anxiety levels of women in our population are elevated. Pregnant women during the first trimester of pregnancy showed higher levels of fear of childbirth and concern about the future than multiparous women. Increased social support and decreased stress seem to influence “feeling about oneself”. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

9 pages, 222 KiB

Open AccessArticle

The Roles of Obstetrics Training Skills and Utilisation of Maternity Unit Protocols in Reducing Perinatal Mortality in Limpopo Province, South Africa

by Langanani C. Makhado, Mutshinyalo L. Mangena-Netshikweta, Seani A. Mulondo and Foluke C. Olaniyi

Healthcare 2022, 10(4), 662; https://doi.org/10.3390/healthcare10040662 - 1 Apr 2022

Cited by 2 | Viewed by 2258

Abstract

Perinatal mortality has been associated with poor maternal health during pregnancy and intrapartum periods. This study was conducted to determine the effects of obstetrics training programmes and the utilization of maternal unit protocols in the management of obstetric complications in reducing neonatal mortality rate in selected public hospitals in the Vhembe district of Limpopo province, South Africa. A quantitative, descriptive design was used and a non-probability purposive sampling method was used to select midwives with a minimum of two (2) years of working experience in maternity wards of selected public hospitals. A total of 105 completed questionnaires were analysed using SPSS version 23. Most of the respondents were within the age group of 40–59 years (74.3%) and with professional experience of more than 10 years (76.8%). More than half (63.8%) had qualified as midwives at a diploma level. Only 44.8% indicated that the protocols were always utilised, even though the majority (70.5%) believed that the protocols are helpful in managing obstetrics complications. The obstetric skills are helpful in reducing neonatal mortality, however, utilisation of the protocols is not encouraging in the studied health facilities. We recommend that efforts should be geared towards the enforcement of the protocol’s use, and all midwives should be encouraged to undergo the trainings. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

11 pages, 837 KiB

Open AccessEditor’s ChoiceArticle

Preventable Adverse Events in Obstetrics—Systemic Assessment of Their Incidence and Linked Risk Factors

by Beate Hüner, Christina Derksen, Martina Schmiedhofer, Sonia Lippke, Wolfgang Janni and Christoph Scholz

Healthcare 2022, 10(1), 97; https://doi.org/10.3390/healthcare10010097 - 4 Jan 2022

Cited by 7 | Viewed by 3861

Abstract

(1) Background: Adverse events (AEs) are an inherent part of all medical care. Obstetrics is special: it is characterized by a very high expectation regarding safety and has rare cases of harm, but extremely high individual consequences of harm. However, there is no standardized identification, documentation, or uniform terminology for the preventability of AEs in obstetrics. In this study, therefore, an obstetrics-specific matrix on the preventable factors of AEs is established based on existing literature to enable standardized reactive risk management in obstetrics. (2) Methods: AEs in obstetrics from one hospital from the year 2018 were retrospectively evaluated according to a criteria matrix regarding preventability. Risk factors for preventable AEs (pAEs) were identified. (3) Results: Out of 2865 births, adverse events were identified in 659 cases (23%). After detailed case analysis, 88 cases (13%) showed at least 1 pAE. A total of 19 risk factors could be identified in 6 categories of pAEs. (4) Conclusion: Preventable categories of error could be identified. Relevant obstetric risk factors related to the error categories were identified and categorized. If these can be modified in the future with targeted measures of proactive risk management, pAEs in obstetrics could also be reduced. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

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16 pages, 617 KiB

Open AccessArticle

Experience of Late Miscarriage and Practical Implications for Post-Natal Health Care: Qualitative Study

by Milda Kukulskienė and Nida Žemaitienė

Healthcare 2022, 10(1), 79; https://doi.org/10.3390/healthcare10010079 - 1 Jan 2022

Cited by 10 | Viewed by 4671

Abstract

Miscarriage is the most common reason for pregnancy loss, affecting around one in four pregnancies. It is classified as a traumatic event, associated with an increased risk for depression, anxiety, post-traumatic stress, alcohol dependence, somatic symptoms, sexual dysfunction, suicide, and complicated grief. This study aimed to analyse experiences of late miscarriage and to describe practical implications for post-natal health care based on characteristics of pregnancy loss revealed in a qualitative study. Seven women who had late miscarriages participated in in-depth biographical interviews. A phenomenological thematic analysis was applied. Experiential characteristics of late miscarriage were described by four themes and 13 subthemes: the initial splitting state (Dissociation, An Opened Void, An impaired Symbiosis, and The Body is Still Pregnant while the Psyche is Mourning); Betrayal of the body (Symbolic Experience of Internalised Death, Shocking Materiality of the Ongoing Miscarriage, Lost control of the Body, and Confusing Body Signals); Disconnecting (Depersonalising Medical Environment, Guilt Falsifies perception, and Retreat as a means of Self-Preservation); and Reconnecting (Collecting Shatters and Reinterpretation of Maternal Identity). Based on the results of the experiential analysis, another four themes represent practical recommendations for post-natal health care: Informing, Opportunity for Goodbye, Attention to Emotional Wellbeing, and Respectful Hospital Environment. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

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7 pages, 236 KiB

Open AccessArticle

The Pregnancy-Unique Quantification of Emesis and Nausea (PUQE-24): Configural, Measurement, and Structural Invariance between Nulliparas and Multiparas and across Two Measurement Time Points

by Ayako Hada, Mariko Minatani, Mikiyo Wakamatsu, Gideon Koren and Toshinori Kitamura

Healthcare 2021, 9(11), 1553; https://doi.org/10.3390/healthcare9111553 - 15 Nov 2021

Cited by 7 | Viewed by 3185

Abstract

Background: The severity of nausea and vomiting of pregnancy (NVP) correlates with pregnancy complications. This study aimed to confirm the measurement and structural invariance of the 24 h Pregnancy-Unique Quantification of Emesis and Nausea (PUQE-24) regarding parity and observation time among pregnant women during the first trimester. Methods: Questionnaires including the PUQE-24 and the Health-Related Quality of Life for Nausea and Vomiting during Pregnancy (NVP-QOL) questionnaire were distributed to pregnant women from 10 to 13 weeks of gestation who were attending antenatal clinics. There were 382 respondents, and of these, 129 responded to the PUQE-24 again one week later. Results: Confirmatory factor analysis of this single factor model showed a good fit with the data: CFI = 1.000. The PUQE-24 factor and NVP-QOL factor were strongly correlated (r = 82). Configural, measurement, and structural invariance of the factor structure of the PUQE items were confirmed between primiparas and multiparas as well as at the test and retest observation occasions. Conclusion: The findings suggested that using the PUQE-24 among pregnant women in the first trimester was robust in its factor structure. The PUQE-24 may be a promising tool as an easy and robust measure of the severity of nausea and vomiting among pregnant women. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

16 pages, 270 KiB

Open AccessArticle

Perceptions and Practice of Preconception Care by Healthcare Workers and High-Risk Women in South Africa: A Qualitative Study

by Winifred Chinyere Ukoha and Ntombifikile Gloria Mtshali

Healthcare 2021, 9(11), 1552; https://doi.org/10.3390/healthcare9111552 - 15 Nov 2021

Cited by 7 | Viewed by 3586

Abstract

Preconception care is biomedical, behavioural, and social health interventions provided to women and couples before conception. This service is sometimes prioritised for women at high risk for adverse pregnancy outcomes. Evidence revealed that only very few women in Africa with severe chronic conditions receive or seek preconception care advice and assessment for future pregnancy. Thus, this study aimed to explore the perceptions and practice of preconception care by healthcare workers and high-risk women in Kwa-Zulu-Natal, South Africa. This exploratory, descriptive qualitative study utilised individual in-depth interviews to collect data from 24 women at high risk of adverse pregnancy outcomes and five healthcare workers. Thematic analysis was conducted using Nvivo version 12. Five main themes that emerged from the study include participants’ views, patients’ access to information, practices, and perceived benefits of preconception care. The healthcare workers were well acquainted with the preconception care concept, but the women had inconsistent acquaintance. Both groups acknowledge the role preconception care can play in the reduction of maternal and child mortality. A recommendation is made for the healthcare workers to use the ‘One key’ reproductive life plan question as an entry point for the provision of preconception care. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

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8 pages, 250 KiB

Open AccessCommentary

Antenatal Assessment of the Prognosis of Congenital Diaphragmatic Hernia: Ethical Considerations and Impact for the Management

by Kévin Le Duc, Sébastien Mur, Dyuti Sharma, Rony Sfeir, Pascal Vaast, Mohamed Riadh Boukhris, Alexandra Benachi and Laurent Storme

Healthcare 2022, 10(8), 1433; https://doi.org/10.3390/healthcare10081433 - 30 Jul 2022

Cited by 4 | Viewed by 1802

Abstract

Congenital diaphragmatic hernia (CDH) is associated with abnormal pulmonary development, which is responsible for pulmonary hypoplasia with structural and functional abnormalities in pulmonary circulation, leading to the failure of the cardiorespiratory adaptation at birth. Despite improvement in treatment options and advances in neonatal care, mortality remains high, at close to 15 to 30%. Several risk factors of mortality and morbidities have been validated in fetuses with CDH. Antenatal assessment of lung volume is a reliable way to predict the severity of CDH. The two most commonly used measurements are the observed/expected lung to head ratio (LHRo/e) and the total pulmonary volume (TPV) on MRI. The estimation of total pulmonary volume (TPVo/e) by means of prenatal MRI remains the gold standard. In addition to LHR and TPV measurements, the position of the liver (up, in the thorax or down, in the abdomen) also plays a role in the prognostic evaluation. This prenatal prognostic evaluation can be used to select fetuses for antenatal surgery, consisting of fetoscopic endoluminal tracheal occlusion (FETO). The antenatal criteria of severe CDH with an ascended liver (LHRo/e or TPVo/e < 25%) are undoubtedly associated with a high risk of death or significant morbidity. However, despite the possibility of estimating the risk in antenatal care, it is difficult to determine what is in the child’s best interest, as there still are many uncertainties: (1) uncertainty about individual short-term prognosis; (2) uncertainty about long-term prognosis; and (3) uncertainty about the subsequent quality of life, especially when it is known that, with a similar degree of disability, a child’s quality of life varies from poor to good depending on multiple factors, including family support. Nevertheless, as the LHR decreases, the foreseeable “burden” becomes increasingly significant, and the expected benefit is increasingly unlikely. The legal and moral principle of the proportionality of medical procedures, as well as the prohibition of “unreasonable obstinacy” in all investigations or treatments undertaken, is necessary in these situations. However, the scientific and rational basis for assessing the long-term individual prognosis is limited to statistical data that do not adequately reflect individual risk. The risk of self-fulfilling prophecies should be kept in mind. The information given to parents must take this uncertainty into account when deciding on the treatment plan after birth. Full article

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