Radioactive ion beam facilities are transforming nuclear science by making beams of exotic nuclei with various properties available for experiments. New infrastructures and development of existing ...installations enlarges the scientific scope continuously. An overview of the main production, separation and beam handling methods with focus on recent developments is done, as well as a survey of existing and forthcoming facilities world-wide.
Objective
To examine the relationship between maternal characteristics, serum biomarkers and preterm birth (PTB) by spontaneous and medically indicated subtypes.
Design
Population‐based cohort.
...Setting
California, United States of America.
Population
From a total population of 1 004 039 live singleton births in 2009 and 2010, 841 665 pregnancies with linked birth certificate and hospital discharge records were included.
Methods
Characteristics were compared for term and preterm deliveries by PTB subtype using logistic regression and odds ratios adjusted for maternal characteristics and obstetric factors present in final stepwise models and 95% confidence intervals. First‐trimester and second‐trimester serum marker levels were analysed in a subset of 125 202 pregnancies with available first‐trimester and second‐trimester serum biomarker results.
Main outcome measure
PTB by subtype.
Results
In fully adjusted models, ten characteristics and three serum biomarkers were associated with increased risk in each PTB subtype (Black race/ethnicity, pre‐existing hypertension with and without pre‐eclampsia, gestational hypertension with pre‐eclampsia, pre‐existing diabetes, anaemia, previous PTB, one or two or more previous caesarean section(s), interpregnancy interval ≥ 60 months, low first‐trimester pregnancy‐associated plasma protein A, high second‐trimester α‐fetoprotein, and high second‐trimester dimeric inhibin A). These risks occurred in 51.6–86.2% of all pregnancies ending in PTB depending on subtype. The highest risk observed was for medically indicated PTB <32 weeks in women with pre‐existing hypertension and pre‐eclampsia (adjusted odds ratio 89.7, 95% CI 27.3–111.2).
Conclusions
Our findings suggest a shared aetiology across PTB subtypes. These commonalities point to targets for further study and exploration of risk reduction strategies.
Tweetable
Findings suggest a shared aetiology across preterm birth subtypes. Patterns may inform risk reduction efforts.
Preterm delivery is often performed by Caesarean section. We investigated modes of anaesthesia and risk factors for general anaesthesia among women undergoing preterm Caesarean delivery.
Women ...undergoing Caesarean delivery between 24+0 and 36+6 weeks’ gestation were identified from a multicentre US registry. The mode of anaesthesia was classified as neuraxial anaesthesia (spinal, epidural, or combined spinal and epidural) or general anaesthesia. Logistic regression was used to identify patient characteristic, obstetric, and peripartum risk factors associated with general anaesthesia.
Within the study cohort, 11 539 women had preterm Caesarean delivery; 9510 (82.4%) underwent neuraxial anaesthesia and 2029 (17.6%) general anaesthesia. In our multivariate model, African-American race adjusted odds ratio (aOR)=1.9; 95% confidence interval (CI)=1.7–2.2, Hispanic ethnicity (aOR=1.5; 95% CI=1.2–1.8), other race (aOR=1.4; 95% CI=1.1–1.9), and haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome or eclampsia (aOR=2.8; 95% CI=2.2–3.5) were independently associated with receiving general anaesthesia for preterm Caesarean delivery. Women with an emergency Caesarean delivery indication had the highest odds for general anaesthesia (aOR=3.5; 95% CI=3.1–3.9). For every 1 week decrease in gestational age at delivery, the adjusted odds of general anaesthesia increased by 13%.
In our study cohort, nearly one in five women received general anaesthesia for preterm Caesarean delivery. Although potential confounding by unmeasured factors cannot be excluded, our findings suggest that early gestational age at delivery, emergent Caesarean delivery indications, hypertensive disease, and non-Caucasian race or ethnicity are associated with general anaesthesia for preterm Caesarean delivery.
PDF
