Clinical Trial - Omega-3 Fatty Acid supplementation to Prevent Preterm Birth in High Risk Pregnancies - A recently completed trial of weekly injections of 17 alpha hydroxyprogesterone caproate (17P) found significant effectiveness for 17P in preventing recurrent preterm birth. However, the group who received 17P in this trial still had a high rate of preterm birth. Several reports have shown that dietary supplementation of fish oil, which is rich in Omega-3 fatty acids, reduces the risk of preterm birth. This trial tests whether adding the Omega-3 supplement to 17P therapy has the potential for further reducing the risk of preterm birth in women who have previously had a spontaneous preterm delivery. The trial will compare Omega-3 fatty acid with placebo in women receiving 17P therapy.
PubMed Study Abstract - A retrospective analysis of 8,839 singleton deliveries was undertaken to determine the relationships of maternal age, maternal hemoglobin concentrations, and past obstetric performance to the incidence of low-birth-weight (LBC) deliveryct: Patients at high risk for low-birth-weight delivery.
NCBI NIH PubMed.gov Abstract of Finland study investigating reproductive maternal risk factors of intrapartum fetal asphyxia. The study concluded that the incidence of intrapartum fetal asphyxia was 2.5%. Placental abruption, primiparity, alcohol use during pregnancy, low birth weight, preeclampsia, male fetuses, and small-for-gestational age births were independent risk factors of intrapartum asphyxia, with adjusted relative risks of 3.74, 3.10, 1.75, 1.57, 1.49, 1.48 and 1.33, respectively. Most cases of intrapartum fetal asphyxia occur in low-risk pregnancies and, therefore, risk screening in antenatal care cannot accurately predict which women will eventually need emergency care for fetal asphyxia.
Hypothesis of study is that among women with twin or triplet pregnancies, weekly injections of 17-alpha-hydroxyprogesterone caproate (17OHP), started before 24 weeks of gestation, will reduce neonatal morbidity by reducing the rate of preterm delivery.This study involves two concurrent double-blinded randomized clinical trials of 17OHP versus placebo. Each trial will test the efficacy and safety of 17OHP in women with a specific risk factor for preterm birth. The two risk factors to be studied are: Twin pregnancy - Triplet pregnancy
PubMed.gov Study Abstract - Study to identify neonatal risk factors for cerebral palsy among very preterm babies and in particular the associations independent of the coexistence of antenatal and intrapartum factors.
Neonatal outcomes of late-preterm birth associated or not with intrauterine growth restriction.Conclusion. Our study showed that late-preterm IUGR infants present a significantly higher risk of neonatal complications when compared to late-preterm AGA infants.
Study to determine if the drug 17-hydroxyprogesterone caproate can help reduce the risk of preterm delivery in women with certain risk factors for preterm birth. We hope to learn whether this same medication can be used to prolong pregnancy in a group of patients in whom this medication has not been previously studied. Specifically, we hope to learn whether progesterone supplementation will delay delivery in women with pre-term, premature rupture of membranes (PPROM).
2010 Study - Increased morbidity in severe early intrauterine growth restriction.CONCLUSIONS: Infants born prematurely who are also severely IUGR have higher neonatal morbidity and mortality when compared to infants of similar gestational age. The surviving IUGR infants had less intraventricular hemorrhage and periventricular leukomalacia than less mature infants of comparable birth weight, but a similar incidence of ROP and length of stay. They had a higher incidence of NEC, direct hyperbilirubinemia and chronic lung disease, probably due to end-organ damage in utero from chronic placental insufficiency. These findings highlight the unique pattern of mortality and morbidity seen in infants with severe early IUGR.
Eunice Kennedy Shriver National Institute of child Health and Human Development (NICHD) Study to evaluate the safety of high-dose Erythropoietin (Epo) in infants who did not get enough oxygen during birth. Erythropoietin is a hormone normally found in the body that may protect brain cells from damage due to lack of oxygen.
Cerebral Palsy International Research Foundation CPI - Injury to the Preterm Brain and Cerebral Palsy - Part 1: Clinical Aspects of Injury to the Preterm Brain
NIH, and Eunice Kennedy Shriver National Institute of Child Health and Human Development - Review and trial to determine whether magnesium sulfate administered to women at risk of preterm delivery may reduce the risk of cerebral palsy in their children