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Current Challenges and Advances in Preterm Birth
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Current Challenges and Advances in Preterm Birth

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 12905

Special Issue Editor

Prof. Dr. Alex Farr

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Division of Fetomaternal Medicine, Medical University of Vienna, Vienna, Austria
Interests: candidosis; vulvovaginal; obstetric labor; premature; premature birth; vaginal discharge; vaginosis; bacterial

Special Issue Information

Dear Colleagues,

Preterm birth at less than 37 gestational weeks is still among the leading causes of neonatal morbidity and mortality worldwide. Progress in perinatal and neonatal care has led to a substantial reduction in infant deaths and disability rates, but preterm birth itself remains an ongoing challenge. In general, it is a multifactorial event with a broad variety of causal factors, which potentially involve multiple disciplines during antenatal and postnatal care. The present Special Issue aims to summarize the current understanding of the mechanisms that are involved in preterm birth, as well as to present and review advances that are relevant to its different aspects. The multidisciplinary approach that is needed to adequately address preterm birth, and which should be presented herein, will offer healthcare professionals an insight into its complexity, provide understanding, and promote strategies. Submissions for this Special Issue should therefore involve original articles and systematic and nonsystematic reviews on the different aspects of preterm birth, including its etiology, screening, prevention, and perinatal and postnatal care, from the fields of basic, translational and clinical research, regardless of the medical discipline. Contributing to the understanding of preterm birth, which compromises the health of our future generations, is a challenge worth investing.

Prof. Alex Farr
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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. Journal of Clinical Medicine 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 2600 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

  • Preterm birth
  • Prematurity
  • Antenatal care
  • Screening measures
  • Multidisciplinary care
  • Neonatology

Published Papers (6 papers)

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Editorial

Jump to: Research, Review

2 pages, 148 KiB  
Editorial
Current Challenges and Advances in Preterm Birth
by Alex Farr
J. Clin. Med. 2021, 10(22), 5257; https://doi.org/10.3390/jcm10225257 (registering DOI) - 12 Nov 2021
Viewed by 1221
Abstract
As the Guest Editor of this Special Issue, I would like to express my gratitude to all the authors who have contributed [...] Full article
(This article belongs to the Special Issue Current Challenges and Advances in Preterm Birth)

Research

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10 pages, 4699 KiB  
Article
Comparison of Ultrasound Descriptors of Abnormally Invasive Placenta (AIP) over the Course of the Second and Third Trimester—Is an Increase Verifiable?
by Monika E. Gorczyca, Stephanie Springer, Petra Pateisky, Johannes Ott, Barbara Ulm and Kinga Chalubinski
J. Clin. Med. 2021, 10(21), 4960; https://doi.org/10.3390/jcm10214960 - 26 Oct 2021
Cited by 2 | Viewed by 1261
Abstract
Limited data exist regarding the course of abnormally invasive placentation (AIP) (=placenta accreta spectrum (PAS)) during the 2nd and 3rd trimester, although this knowledge would be important for optimal patient care. In this retrospective single-center longitudinal cohort study, potential aggravation of AIP was [...] Read more.
Limited data exist regarding the course of abnormally invasive placentation (AIP) (=placenta accreta spectrum (PAS)) during the 2nd and 3rd trimester, although this knowledge would be important for optimal patient care. In this retrospective single-center longitudinal cohort study, potential aggravation of AIP was evaluated in 37 patients with ultrasound (US) pictures stored on a minimum of two visits. Five raters, blinded to diagnosis and gestational age, judged the degree of AIP as recommended by the International Society for PAS. The probability of invasiveness was estimated as absent, low, intermediate, severe (0–3 points), the extent as absent, focal, diffuse (0–2 points), and the presence and appearance of each US-sign as absent, mild, severe (0–3 points). None of the 10 judged signs appeared more severe (p ≥ 0.41) with progressing pregnancy. Neither the number of positively scored US-signs (earlier scan; 6.14 ± 2.06, later scan; 5.94 ± 2.16; p = 0.28), nor the estimated probability & extent of AIP rose (3.69 ± 1.15 vs. 3.67 ± 1.22; p = 1.0). Test-retest reliability corroborated excellent agreement between visits (mean number of positive US-signs ICC (3,1) = 0.94, 95% CI 0.91–0.97; p < 0.0001). Overall, there was no clinically detectable increase in invasiveness over the course of the 2nd and 3rd trimester. This should be further evaluated in prospective studies. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Preterm Birth)
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11 pages, 2716 KiB  
Article
Periodontal Disease and Vitamin D Deficiency in Pregnant Women: Which Correlation with Preterm and Low-Weight Birth?
by Martina Ferrillo, Mario Migliario, Andrea Roccuzzo, Pedro Molinero-Mourelle, Giovanni Falcicchio, Giuseppina Rosaria Umano, Federica Pezzotti, Pier Luigi Foglio Bonda, Dario Calafiore and Alessandro de Sire
J. Clin. Med. 2021, 10(19), 4578; https://doi.org/10.3390/jcm10194578 - 2 Oct 2021
Cited by 33 | Viewed by 3982
Abstract
Periodontal disease seems to be correlated with low vitamin D serum levels, preterm birth (PTB) and low birth weight (LBW), although the literature still lacks a consensus. This study aimed to investigate this correlation in a cohort of pregnant women over 20 weeks [...] Read more.
Periodontal disease seems to be correlated with low vitamin D serum levels, preterm birth (PTB) and low birth weight (LBW), although the literature still lacks a consensus. This study aimed to investigate this correlation in a cohort of pregnant women over 20 weeks of gestation from the University Hospital “Maggiore della Carità”, Novara, Italy. We assessed serum levels of vitamin D and oral health status through the following indexes: Oral Hygiene Index (OHI), Plaque Control Record (PCR), Gingival Bleeding Index (GBI), and Community Periodontal Index of Treatment Needs (CPTIN). Moreover, we assessed the number of PTB and LBW among the newborns. Out of 121 pregnant women recruited, 72 (mean age 29.91 ± 3.64 years) were included. There was a statistically significant correlation between preterm and OHI > 3 (p = 0.033), and between LBW and OHI > 3 (p = 0.005) and CPITN = 3 (p = 0.027). Both pregnant women with vitamin D deficiency ((25-hydroxy-vitamin D) < 30 ng/mL) and PTB plus LBW newborns were significantly correlated (p < 0.05) with poor levels of all oral health status indexes during pregnancy. Furthermore, these conditions (women with hypovitaminosis D and combination of PTB and LBW) were shown to be significantly correlated (p < 0.001). Taken together, our findings reported a high prevalence of PTB and LBW with poor oral health and vitamin D deficiency in pregnant women. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Preterm Birth)
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7 pages, 231 KiB  
Article
Clinical Early-Onset Sepsis Is Equally Valid to Culture-Proven Sepsis in Predicting Outcome in Infants after Preterm Rupture of Membranes
by Agnes Grill, Monika Olischar, Michael Weber, Lukas Unterasinger, Angelika Berger and Harald Leitich
J. Clin. Med. 2021, 10(19), 4539; https://doi.org/10.3390/jcm10194539 - 30 Sep 2021
Cited by 1 | Viewed by 1348
Abstract
Background: Culture-proven sepsis is the gold standard in early-onset neonatal sepsis diagnosis. Infants born ≤29 weeks gestation after preterm rupture of membranes in the years 2009–2015 were included in a retrospective cohort study performed at a level III fetal-maternal unit. The study aimed [...] Read more.
Background: Culture-proven sepsis is the gold standard in early-onset neonatal sepsis diagnosis. Infants born ≤29 weeks gestation after preterm rupture of membranes in the years 2009–2015 were included in a retrospective cohort study performed at a level III fetal-maternal unit. The study aimed to compare culture-proven sepsis, clinical sepsis and positive laboratory biomarkers ≤72 h as predictors of mortality before discharge and the combined outcome of mortality or severe short-term morbidity (severe cerebral morbidity, bronchopulmonary dysplasia and retinopathy). Results: Of the 354 patients included, culture-proven sepsis, clinical sepsis and laboratory biomarkers were positive in 2.3%, 8.5% and 9.6%, respectively. The mortality rate was 37.5% for patients with culture-proven sepsis (3/8), 33.3% for patients with clinical sepsis (10/30) and 8.8% for patients with positive laboratory biomarkers (3/34), respectively. Mortality or severe morbidity occurred in 75.0% of patients with culture-proven sepsis (6/8), 80.0% of patients with clinical sepsis (24/30) and 44.1% of patients with positive laboratory biomarkers (15/34), respectively. Conclusion: In preterm infants after preterm rupture of membranes, clinical sepsis was almost four times more common and at least equally valuable in predicting mortality and mortality or severe morbidity compared to culture-proven sepsis. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Preterm Birth)
9 pages, 1630 KiB  
Article
Screening Pregnant Women for Bacterial Vaginosis Using a Point-of-Care Test: A Prospective Validation Study
by Philipp Foessleitner, Herbert Kiss, Julia Deinsberger, Julia Ott, Lorenz Zierhut, Klara Rosta, Veronica Falcone and Alex Farr
J. Clin. Med. 2021, 10(11), 2275; https://doi.org/10.3390/jcm10112275 - 24 May 2021
Cited by 9 | Viewed by 2515
Abstract
Bacterial vaginosis in early pregnancy is associated with an increased risk of preterm birth. The introduction of a simple screen-and-treat program into antenatal care was shown to significantly reduce the rate of preterm birth. The gold standard for diagnosing bacterial vaginosis is Gram [...] Read more.
Bacterial vaginosis in early pregnancy is associated with an increased risk of preterm birth. The introduction of a simple screen-and-treat program into antenatal care was shown to significantly reduce the rate of preterm birth. The gold standard for diagnosing bacterial vaginosis is Gram staining, which is, however, time-consuming and requires laboratory facilities. The objective of this prospective study was to validate a point-of-care sialidase activity detection test (OSOM® BVBLUE® Test) for asymptomatic pregnant women and evaluate its accuracy as a screening tool. We enrolled 200 pregnant participants, 100 with Gram staining-confirmed bacterial vaginosis and 100 healthy controls. Compared to Gram staining, the point-of-care test showed a sensitivity of 81%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 98.1%. In conclusion, we found that the OSOM® BVBLUE® Test was an accurate method for diagnosing bacterial vaginosis in asymptomatic pregnant women. This point-of-care test can therefore be considered a reliable and easy-to-use screening tool for bacterial vaginosis during pregnancy. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Preterm Birth)
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Review

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9 pages, 609 KiB  
Review
The Effects of Preterm Birth on Musculoskeletal Health-Related Disorders
by Florian Schachinger and Sebastian Farr
J. Clin. Med. 2021, 10(21), 5082; https://doi.org/10.3390/jcm10215082 - 29 Oct 2021
Cited by 3 | Viewed by 1854
Abstract
Preterm birth is associated with various diseases and conditions which demand multidisciplinary medical care. Approximately 10% of all neonates are born prematurely with an increasing survival rate in almost all Western countries. This ongoing, yet desirable trend is creating new challenges for sufficient [...] Read more.
Preterm birth is associated with various diseases and conditions which demand multidisciplinary medical care. Approximately 10% of all neonates are born prematurely with an increasing survival rate in almost all Western countries. This ongoing, yet desirable trend is creating new challenges for sufficient medical treatment regimens, which should be upheld throughout the patients’ lives. Orthopedic surgeons are focused on musculoskeletal disorders and the improvement of patients’ ability to cope with the challenges of everyday life. The most common conditions associated with preterm birth are cerebral palsy and a dysregulation of the calcium/phosphorus metabolism, which may lead to fractures. These diseases may vary greatly in their organic manifestation and clinical presentation. This demands multidisciplinary cooperation and parental support. Clinical management is aimed on the early enhancement of a patient’s physical, as well as neurological condition, and to prevent the development of secondary musculoskeletal disorders. In this article, we give an overview of the current literature on the most common musculoskeletal disorders associated with preterm birth and critically discuss state of the art diagnostic standards and treatment algorithms. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Preterm Birth)
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