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Research papers

The following research papers have provided the basis of some of the information found in this website.

Walsh JM et al: Moderate and Late Preterm Birth: Effect on Brain Size and Maturation at Term-Equivalent Age

Purpose: To compare the size of multiple brain structures, maturation in terms of both brain myelination and gyral development, and evidence of brain injury between moderate and late preterm (MLPT) and term-born infants at term equivalent age.

Conclusion: MLPT birth is associated with smaller brain size, less developed myelination of the posterior limb of the internal capsule, and more immature gyral folding than those associated with full-term birth. These brain changes may form the basis of some of the long-term neurodevelopmental deficits observed in MLPT children.

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Lain SJ et al: Incidence of Severe Adverse Neonatal Outcomes: Use of a Composite Indicator in a Population Cohort

Purpose: To develop a composite outcome indicator to identify infants with severe adverse outcomes in routinely collected population health datasets and assess the indicator’s association with readmission and infant mortality rates. Relevant diagnoses and procedures indicative of severe morbidity that are reliably reported were analysed and reviewed, and the neonatal adverse outcome indicator (NAOI) was refined. Data were obtained from linked birth and hospital data for 516,843 liveborn infants ≥24 weeks gestation, in New South Wales, Australia from 2001 to 2006

Conclusion: Face validity of the indicator was examined by calculating the relative risks (and 95% CI) of hospital readmission or death in the first year of life of those infants identified by the NAOI. Overall 4.6% of all infants had one or more conditions included in the NAOI; 35.4% of preterm infants and 2.4% of term infants. Infants identified by the composite indicator were 10 times more likely to die in the first year of life and twice as likely to be readmitted to hospital in the first year of life compared to infants not identified by the NAOI. The NAOI can reliably identify infants with a severe adverse neonatal outcome and can be used to monitor trends, assess obstetric and neonatal interventions and the quality of perinatal care in a uniform and cost-effective way.

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Bentley et al: Planned Birth Before 39 Weeks and Child Development: A Population-Based Study

Purpose: To investigate the association of gestational age and mode of birth with early child development.

Conclusion: Early (at <39 weeks) planned birth is associated with an elevated risk of poor child development at school age. The timing of planned birth is modifiable, and strategies to inform more judicious decision-making are needed to ensure optimal child health and development.

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K.S Joseph et al: The fetuses‐at‐risk approach: survival analysis from a fetal perspective

Conclusion: The fetuses‐at‐risk approach provides a survival analysis perspective for pregnancy outcomes. The approach involves a shift in emphasis from a births‐based approach to a fetuses‐based perspective. Some aspects of the approach, especially its extension to postnatal phenomena that have their origins in pregnancy, remain controversial. Yet this formulation is supported by biomedical studies (both animal and human), accounts for the fetus–infant continuum, addresses several puzzling paradoxes and provides insight into clinical phenomena that have otherwise defied explanation.

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