ABSTRACT
To perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) that investigated the clinical benefits of 17-alpha hydroxyprogesterone caproate (17OHPC) in the prevention of recurrent preterm birth (PTB) among singleton pregnant women with a previous history of PTB. We searched four major databases up till April 2021 and assessed the risk of bias in the included studies. We meta-analyzed various maternal-neonatal endpoints (n=18) and pooled them as mean difference or risk ratio (RR) with 95% confidence interval (CI) using the random-effects model. Six RCTs met the inclusion criteria, comprising 2,573 patients (17OHPC=1,617, control=956). RCTs revealed an overall low risk of bias. The rates of PTB <35 weeks (n=5 RCTs; RR, 0.77; 95% CI, 0.63-0.93; P=0.008), PTB <32 weeks (n=3 RCTs; RR, 0.68; 95% CI, 0.51-0.91; P=0.009), neonates with low birth weight (<2.5 kg) at delivery (n=3 RCTs; RR, 0.63; 95% CI, 0.5-0.79; P<0.001), and neonatal death (n=4 RCTs; RR, 0.41; 95% CI, 0.20-0.84; P=0.02) were significantly reduced in the 17OHPC group compared with the control group. Moreover, 17OHPC treatment correlated with a significantly decreased rate of retinopathy (n=2 RCTs; RR, 0.42; 95% CI, 0.18-0.97; P=0.004). However, there were no significant differences in the rates of neonatal intensive care unit admission, cesarean delivery, and other pretermrelated complications between both the groups. Among singleton pregnant women with a prior history of PTB, 17OHPC may favorably decrease the risks of recurrent PTB and reduce the rate of neonatal death.
ABSTRACT
Objectives: To identify the incidence, clinical characteristics, predisposing factors, morbidity, and mortality among hospitalized neonates with pneumothorax
Methods: The records of 2 204 infants admitted to the neonatal intensive care unit at King Fahad Medical City, Saudi Arabia, between 2011 and 2014 were reviewed. All newborns hospitalized in the neonatal intensive care unit with pneumothorax were included in the study. Participants were evaluated for baseline characteristics, predisposing factors of neonatal pneumothorax [NP], accompanying disorders, and mortality
Results: Pneumothorax was diagnosed in 86 patients, with an incidence of 3.9%. The most common predisposing factors of NP were bag mask ventilation, followed by hypoplastic lung disease, and mechanical ventilation. Twenty-five [29.1%] newborns with pneumothorax died. The most common accompanying disorder was premature rupture of membrane. On multivariate analysis, pulmonary hemorrhage, a birth weight < 2 500 g, and low Apgar score [< 7] at one minute were independently associated with mortality
Conclusions: This study highlights the extent of NP problems among hospitalized neonates and the most common predisposing factors of NP
ABSTRACT
The objective of this study was to assess the perceived negative impact on mother-child attachment of raising children with the help of foreign maids, as practised in Arab Gulf countries. A descriptive cross-sectional study was conducted. A convenience sample was recruited from June 2010 to December 2010 from three tertiary hospitals and shopping centres. Five hundred questionnaires were distributed. Of these, 336 with complete data sets were analysed. The study was approved by the Institutional Review Board of the King Fahad Medical City. The analysed data were tabulated in the form of descriptive statistics. Eighty per cent of households had a maid, but only 50% of mothers had careers. The proportion of babies who were not bottle-fed was 31.6%, with 15.7% exclusively breast-fed. Of the 52.8% of babies who were both breast- and bottle-fed, most were usually bottle-fed. The proportions of participants who reported high and low levels of mother-child attachment were 61.9% and 15.6% respectively. Although 22.6% declined to comment on this, questioning revealed a low level of mother-child attachment in this group, and therefore low mother-child attachment totalled 38.2% 115.6%+22.6%. In 45.2% of cases, mothers stated that bonding was iot affected by the maid, whereas 30% stated that bonding was affected. Although 24.2% declined to express their view, further questioning confirmed their discomfort in answering this question; this suggested that they did perceive a lack of bonding, and therefore that this affected a total of 54.2% [24.2%+ 30%] of households. Although only half of the mothers had careers, a larger proportion of households had maids, indicating an overdependence of mothers on domestic aides. The very low proportion of babies who were exclusively breast-fed would suggest that mother-child bonding was affected in a large proportion of households that bottle-fed. However, about two-thirds of the mothers claimed high levels of mother-child bonding, whereas only one-sixth felt that bonding was adversely affected. The remainder were reluctant to discuss this point, suggesting that the problem of low levels of mother-child bonding exists. The study found that almost half of mother-child bonding relationships could be impaired by the presence of maids. This study indicates that mother-child attachment is adversely affected by the presence of maids, which could prove detrimental to the psychosocial development of affected children and the population of the Gulf Cooperation Council countries in the long term. Family-friendly work policies for mothers and education on responsible parenting are recommended