Data_Sheet_1_Mother's Own Milk and Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis.pdf

Background: Bronchopulmonary dysplasia (BPD) is the most common complication of very preterm birth and can lead to lifelong health consequences. Optimal nutrition is a cornerstone in the prevention and treatment of BPD. In very preterm infants, mother's own milk (MOM) feeding is associated with lower risks of necrotizing enterocolitis, retinopathy of prematurity, and sepsis. Although several studies have shown that MOM may protect against BPD, a systematic analysis of the evidence has not been performed to date.Methods: A comprehensive literature search was conducted using PubMed/MEDLINE and EMBASE, from their inception to 1 December 2017. Longitudinal studies comparing the incidence of BPD in preterm infants fed with exclusive MOM, MOM supplemented with preterm formula (PF), and/or exclusively fed with PF were selected. A random-effects model was used to calculate the Mantel Haenszel risk ratio (RR) and 95% confidence interval (CI).Results: Fifteen studies met the inclusion criteria (4,984 infants, 1,416 BPD cases). Use of exclusive MOM feedings was associated with a significant reduction in the risk of BPD (RR 0.74, 95% CI 0.57–0.96, 5 studies). In contrast, meta-analysis could not demonstrate a significant effect on BPD risk when infants fed with more than 50% MOM were compared with infants fed with Conclusion: To our knowledge, this is the first systematic review and meta-analysis that specifically evaluates the role of MOM on BPD. Our data indicate that MOM may reduce the incidence of BPD when used as an exclusive diet, but this result needs to be interpreted with caution. We did not find the same difference in analyses with other dosages of MOM. Further studies adequately powered to detect changes in BPD rates and that adjust for confounders are needed to confirm the beneficial effects of MOM on BPD.</p

MOESM1 of Adherence to a snacking dietary pattern is decreasing in Colombia among the youngest and the wealthiest: results of two representative national surveys

Additional file 1 : Table S1. Loading factors (L) of foods in each pattern Colombia, 2010–2015. Table S1 presents the factorial loads of the patterns established in each year. This information is of interest to the reader because it allows ensuring the comparability of the results and also guarantees the grouping in the period studied

Maternal body-mass index and odds ratios for meconium aspiration and neonatal seizures: live singleton term births in Sweden 1992–2010.

a<p>Both models are adjusted for maternal country of birth, smoking in early pregnancy, education, parity, height, maternal age, and infant year of birth. Number of births included in the analyses of meconium aspiration and neonatal seizures: crude models <i>n = </i>1,512,506 births, model 1 <i>n = </i>1,462,187 births, and model 2 <i>n = </i>1,374,148 births.</p>b<p>Women with any type of diabetes, chronic hypertension, preeclampsia, or having infants with malformations are excluded.</p

Child body mass index-for-age z-scores according to maternal anthropometry, DHS/Brazil, 2006.

<p>Note: ¹Overall F-test;</p>2<p>p for trend test;</p>3<p>mean differences adjusted for maternal age, maternal education, smoking status, maternal parity, household income and household food security.</p><p>The model for waist circumference was additionally adjusted for maternal height and maternal BMI. Sample sizes for adjusted models were 3,407, 3,404 and 3,325 for maternal height, BMI and WC, respectively. BAZ: body mass index-to-age z-score; WC: waist circumference; BMI: body mass index.</p

Datasheet1_Association between endotypes of prematurity and pharmacological closure of patent ductus arteriosus: A systematic review and meta-analysis.pdf

IntroductionEndotypes leading to very and extremely preterm birth are clustered into two groups: infection/inflammation and dysfunctional placentation. We conducted a systematic review of observational studies exploring the association between these two endotypes and the pharmacological closure of patent ductus arteriosus (PDA) induced by cyclooxygenase (COX) inhibitors. Chorioamnionitis represented the infectious-inflammatory endotype, while dysfunctional placentation proxies were hypertensive disorders of pregnancy (HDP) and small for gestational age (SGA) or intrauterine growth restriction.MethodsPubMed/Medline and Embase databases were searched. The random-effects odds ratio (OR) and 95% confidence interval (CI) were calculated for each association. We included 30 studies (12,639 infants).ResultsMeta-analysis showed a significant association between exposure to HDP and increased rate of pharmacological closure of PDA (17 studies, OR 1.41, 95% CI 1.10–1.81, p = 0.006). In contrast, neither chorioamnionitis (13 studies, OR 0.75, 95% CI 0.47–1.18, p = 0.211) nor SGA (17 studies, OR 1.20, 95% CI 0.96–1.50, p = 0.115) were significantly associated with the response to therapy. Subgroup analyses showed that the higher response to COX inhibitors in the HDP group was significant for indomethacin (OR 1.568, 95% CI 1.147–2.141, p = 0.005) but not for ibuprofen (OR 1.107, 95% CI 0.248–4.392, p = 0.894) or for the studies using both drugs (OR 1.280, 95% CI 0.935–1.751, p = 0.124). However, meta-regression showed that this difference between the drugs was not statistically significant (p = 0.404).Discussion/ConclusionOur data suggest that the pathologic condition that triggers prematurity may alter the response to pharmacological treatment of PDA. The DA of infants exposed to HDP appears to be more responsive to COX inhibitors.</p

Maternal body-mass index and odds ratios for low Apgar scores at 5 and 10 minutes: live singleton term births in Sweden 1992–2010.

a<p>Both models are adjusted for maternal country of birth, smoking in early pregnancy, education, parity, height, maternal age, and year of infant birth. Number of births included in the analysis was for Apgar score 0–3 at 5 minutes: crude model <i>n = </i>1,512,506 births, model 1 <i>n = </i>1,462,187 births, and model 2 <i>n = </i>1,374,148 births. For Apgar score 0–3 at 10 minutes, the corresponding numbers were <i>n = </i>1,504,050; <i>n = </i>1,451,501; and <i>n = </i>1,366,720, respectively.</p>b<p>Women with any type of diabetes, chronic hypertension, preeclampsia, or having infants with malformations are excluded.</p

Data_Sheet_1_Intrauterine Growth Restriction and Patent Ductus Arteriosus in Very and Extremely Preterm Infants: A Systematic Review and Meta-Analysis.pdf

It is generally accepted that intrauterine growth restriction (IUGR) increases morbidity and mortality among very preterm neonates. However, evidence is hampered by the widespread practice of using the terms small for gestational age (SGA) and IUGR as synonyms. We conducted a systematic review of studies reporting on the association between IUGR/SGA and patent ductus arteriosus (PDA). PubMed/MEDLINE and EMBASE databases were searched. Of 993 studies reviewed, 47 (50,790 infants) were included. Studies were combined using a random effects model and sources of heterogeneity were determined by subgroup and meta-regression analyses. Meta-analysis of all included studies showed a significantly reduced risk of PDA in the SGA/IUGR group with an odds ratio (OR) of 0.82, and a 95% confidence interval (CI) of 0.70 to 0.96 (p = 0.015). Of the 47 studies, only 7 used a definition for growth restriction that went beyond birth weight (BW) for gestational age (GA). When pooled, meta-analysis could not demonstrate a significant effect size (OR 1.31, 95% CI 0.75 to 2.27, p = 0.343). Moreover, the significantly reduced risk of PDA was found in the 25 studies defining SGA as BW <10th percentile (OR 0.81, 95% CI 0.66 to 0.98, p = 0.032), but not in the 6 studies defining SGA as BW <3rd (OR 1.09, 95% CI 0.70 to 1.71, p = 0.694), or in the 27 studies using a more refined definition of PDA (i.e., hemodynamically significant PDA or PDA requiring treatment, OR 0.87, 95% CI 0.72 to 1.04, p = 0.133). In addition, we found that GA was significantly higher in the SGA/IUGR group (18 studies, mean difference 0.63 weeks, 95% CI 0.24 to 1.03, p = 0.002). Meta-regression analysis confirmed the correlation between this difference in GA and PDA risk. In summary, we observed marked heterogeneity across studies in the definition of growth restriction and PDA, and we found differences between the control and growth-restricted groups in relevant baseline characteristics, such as GA. Therefore, our meta-analysis could not provide conclusive evidence on the association between growth restriction and PDA.</p

Study population diagram.

<p>Study population diagram.</p

Maternal body-mass index and odds ratios for low Apgar scores at 5 and 10 minutes: live singleton term births in Sweden 1992–2010.

<p>In addition to regression models used in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001648#pmed-1001648-t003" target="_blank">Table 3</a>, odds ratios are further adjusted for mode of delivery.</p

Prevalence, unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI) of stunted children according to maternal anthropometry, DHS/Brazil, 2006.

<p>Note: ¹Design-based Pearson chi-squared test;</p>2<p>p for trend test;</p>3<p>Prevalence ratios adjusted for maternal age, maternal education, smoking status, maternal parity, household income and household food security.</p><p>The model for waist circumference was additionally adjusted for maternal height and maternal BMI. HAZ: height-to-age z-score; BMI: body mass index.</p