A close connection exists between acute perinatal problems and prepartum diseases of mother and foetus. Good antenatal care of the mother, and both well-established and modern methods of assessing foetal well-being are important in prenatal care of the foetus. Close collaboration between obstetricians and neonatologists is essential to diagnose the high risk foetus. Some medical and surgical foetal conditions can now be treated in utero. Usually, however, the obstetrician and the neonatologist have to decide on the correct timing for delivery of the high risk foetus and the route of delivery. Even during normal vaginal delivery there is progressive foetal acidosis and hypoxia. Despite this, with modern obstetric care, most newborn infants are well, with adequate respiration when 1-2 minutes old. Only about one neonate in 50 requires active resuscitation in the labour ward. This article summarizes the principles of this resuscitation, as well as the principles for treating some of the acute diseases in the perinatal period.
The number of young adults on disability pension (DP) is increasing in European countries, creating a need to understand the related risk factors. This study aimed to determine whether adverse perinatal conditions are associated with receiving a DP early in life.
This longitudinal cohort study consisted of all persons (N = 453,223) born in Sweden during 1973-1977, observed from 1991 through 2010 when they were aged between 16 and 37 years. Statistics Sweden provided linked national data on the children and their parents. We used logistic regression to assess the association between perinatal health conditions (birth defect, Apgar score, and small for gestational age) and receiving a DP, adjusting for maternal education and the sex of the child.
New recipients of DP were significantly more likely to have had a birth defect (adjusted odds ratio [AOR] 2.74, 95% CI: 2.49-3.00), to have had low Apgar score (AOR 2.12, 95% CI: 1.77-2.52), to have been small for gestational age (AOR 1.73, 95% CI: 1.54-1.94) and to be females (AOR 1.55, 95% CI: 1.46-1.64). Higher maternal education was associated with lower odds of receiving a DP (AOR 0.74, 95% CI: 0.69-0.79) for those with high school education and (AOR 0.67, 95% CI: 0.59-0.75) for those with university education. Age-stratified analysis confirmed increased odds of receiving a DP among those with birth defects and small for gestational age, but this effect reduced with increasing age. Apgar score was significantly associated with starting to receive a DP at ages 16-18 and 19-29, but not at ages 30-33. Women had lower odds of receiving a DP at ages 16-18 (AOR 0.73, 95% CI: 0.64-0.85); however, this reversed from age 19 and upwards (AOR 1.53, 95% CI: 1.41-1.67) and (AOR 2.16, 95% CI: 1.95-2.40) for the age groups of 19-29 and 30-33, respectively. Persons with high maternal education were less likely to receive a DP regardless of age at receiving a DP.
Having a birth defect was the strongest indicator of receiving a DP during early adulthood, followed by small for gestational age and low Apgar score. Overall, the effects of the studied perinatal health conditions were pronounced in those who received a DP at 16-18 years, but this effect weakened with increasing age at receiving a DP. Our findings suggest that policies and programs geared at promoting optimal health at birth might contribute to a reduction in receiving a DP.
The FADS1/FADS2 gene cluster encodes Delta-5 and Delta-6 desaturase, rate-limiting enzymes in metabolism of linoleic (LA) to arachidonic (ARA) and alpha-linolenic to eicosapentaenoic and docosahexaenoic acid (DHA). Single nucleotide polymorphisms (SNPs) in FADS1/FADS2 contribute to variability in blood lipid fatty acids. Altered n-6 and n-3 fatty acids have been related to perinatal depression (PPD).
We genotyped rs174553, rs99780, rs174575, and rs174583 in FADS1/FADS2, analyzed blood lipid fatty acids and assessed PPD risk as an Edinburgh Postnatal Depression Scale (EPDS) score > or =10 for 69 pregnant women.
21, 12 and 15% women had an EPDS score > or =10 at 36 weeks' gestation, 2 and 6 months postpartum, respectively. Quantitative trait analysis showed an association between rs174575 and PPD risk at 36 weeks' gestation and 6 months postpartum. With haplotype ACCC (major alleles) for rs174553, rs99780, rs174575, rs174583, respectively, as reference, GTCT was positively associated with PPD risk at 36 weeks' gestation, p = 0.028, and higher LA and lower ARA in plasma (p = 0.0001, p