Abstract:
Importance:Supplemental oxygen is commonly administered to pregnant women at the time of delivery to prevent fetal hypoxia and acidemia. There is mixed evidence on the utility of this practice. Objective:To compare the association of peripartum maternal oxygen administration with room air on umbilical artery (UA) gas measures and neonatal outcomes. Data Sources:Ovid MEDLINE, Embase, Scopus, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials were searched from February 18 to April 3, 2020. Search terms included labor or obstetric delivery and oxygen therapy and fetal blood or blood gas or acid-base imbalance. Study Selection:Studies were included if they were randomized clinical trials comparing oxygen with room air at the time of scheduled cesarean delivery or labor in patients with singleton, nonanomalous pregnancies. Studies that did not collect paired umbilical cord gas samples or did not report either UA pH or UA Pao2 results were excluded. Data Extraction and Synthesis:Data were extracted by 2 independent reviewers. The analysis was stratified by the presence or absence of labor at the time of randomization. Data were pooled using random-effects models. Main Outcomes and Measures:The primary outcome for this review was UA pH. Secondary outcomes included UA pH less than 7.2, UA Pao2, UA base excess, 1- and 5-minute Apgar scores, and neonatal intensive care unit admission. Results:The meta-analysis included 16 randomized clinical trials (n = 1078 oxygen group and n = 974 room air group). There was significant heterogeneity among the studies (I2 = 49.88%; P = .03). Overall, oxygen administration was associated with no significant difference in UA pH (weighted mean difference, 0.00; 95% CI, -0.01 to 0.01). Oxygen use was associated with an increase in UA Pao2 (weighted mean difference, 2.57 mm Hg; 95% CI, 0.80-4.34 mm Hg) but no significant difference in UA base excess, UA pH less than 7.2, Apgar scores, or neonatal intensive care unit admissions. Umbilical artery pH values remained similar between groups after accounting for the risk of bias, type of oxygen delivery device, and fraction of inspired oxygen. After stratifying by the presence or absence of labor, oxygen administration in women undergoing scheduled cesarean delivery was associated with increased UA Pao2 (weighted mean difference, 2.12 mm Hg; 95% CI, 0.09-4.15 mm Hg) and a reduction in the incidence of UA pH less than 7.2 (relative risk, 0.63; 95% CI, 0.43-0.90), but these changes were not noted among those in labor (Pao2: weighted mean difference, 3.60 mm Hg; 95% CI, -0.30 to 7.49 mm Hg; UA pH<7.2: relative risk, 1.34; 95% CI, 0.58-3.11). Conclusions and Relevance:This systematic review and meta-analysis suggests that studies to date showed no association between maternal oxygen and a clinically relevant improvement in UA pH or other neonatal outcomes.
journal_name
JAMA Pediatrjournal_title
JAMA pediatricsauthors
Raghuraman N,Temming LA,Doering MM,Stoll CR,Palanisamy A,Stout MJ,Colditz GA,Cahill AG,Tuuli MGdoi
10.1001/jamapediatrics.2020.5351subject
Has Abstractpub_date
2021-01-04 00:00:00eissn
2168-6203issn
2168-6211pii
2774699pub_type
杂志文章相关文献
JAMA Pediatrics文献大全abstract:IMPORTANCE:Most studies examining the association of prenatal antiretroviral (ARV) exposures with congenital anomalies (CAs) in children born to human immunodeficiency virus (HIV)-infected women have been reassuring, but some evidence suggests an increased risk with specific ARV agents. OBJECTIVE:To evaluate the assoc...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2014.1889
更新日期:2015-01-01 00:00:00
abstract:Importance:Zika virus infection can be prenatally passed from a pregnant woman to her fetus. There is sufficient evidence to conclude that intrauterine Zika virus infection is a cause of microcephaly and serious brain anomalies, but the full spectrum of anomalies has not been delineated. To inform pediatric clinicians ...
journal_title:JAMA pediatrics
pub_type: 杂志文章,评审
doi:10.1001/jamapediatrics.2016.3982
更新日期:2017-03-01 00:00:00
abstract:Importance:The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) uses the Sequential Organ Failure Assessment (SOFA) score to grade organ dysfunction in adult patients with suspected infection. However, the SOFA score is not adjusted for age and therefore not suitable for children. Objec...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2017.2352
更新日期:2017-10-02 00:00:00
abstract:IMPORTANCE:Early adversity is an important risk factor that relates to internalizing symptoms and altered brain structure. OBJECTIVE:To assess the direct effects of early adversity and child internalizing symptoms (ie, depression, anxiety) on cortical gray matter (GM) volume, as well as the extent to which early adver...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2015.1486
更新日期:2015-10-01 00:00:00
abstract:Importance:Adverse childhood experiences (ACEs) are associated with long-term poor mental health. Less is known about factors that improve long-term mental health among those with ACEs. Objective:To evaluate, among those exposed to ACEs, whether team sports participation during adolescence is associated with better me...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2019.1212
更新日期:2019-07-01 00:00:00
abstract:Importance:The associations between hydration status, intravenous fluid administration, and outcomes of patients infected with Shiga toxin-producing Escherichia coli (STEC) remain unclear. Objective:To determine the relationship between hydration status, the development and severity of hemolytic uremic syndrome (HUS),...
journal_title:JAMA pediatrics
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamapediatrics.2016.2952
更新日期:2017-01-01 00:00:00
abstract:Importance:Inflammatory bowel diseases (IBD), such as Crohn disease and ulcerative colitis, are chronic relapsing conditions that affect a growing number of children worldwide. The pathogenesis of these disorders is complex and thought to be mediated by the interplay between genetic susceptibility, microbial dysbiosis,...
journal_title:JAMA pediatrics
pub_type: 杂志文章,评审
doi:10.1001/jamapediatrics.2017.2571
更新日期:2017-10-01 00:00:00
abstract:Importance:Approximately 90% of adult smokers first tried a cigarette by 18 years of age, and even infrequent smoking in adolescence is associated with established adult smoking. Noncigarette tobacco use is increasing and could stimulate subsequent conventional cigarette smoking in youths. Objective:To estimate the lo...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2017.4173
更新日期:2018-02-01 00:00:00
abstract:Importance:The prevalence of autism spectrum disorder (ASD) has been increasing rapidly, with current estimates of 1 in 68 children affected. Simultaneously, use of prenatal ultrasonography has increased substantially, with limited investigation into its safety and effects on brain development. Animal studies have demo...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2017.5634
更新日期:2018-04-01 00:00:00
abstract:IMPORTANCE:Rape on college campuses has been addressed recently by a presidential proclamation, federal legislation, advocacy groups, and popular media. Many initiatives assume that most college men who perpetrate rape are serial rapists. The scientific foundation for this perspective is surprisingly limited. OBJECTIV...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2015.0707
更新日期:2015-12-01 00:00:00
abstract:IMPORTANCE:Late-term gestation (defined as the 41st week of pregnancy) is associated with increased risk of perinatal health complications. It is not known to what extent late-term gestation is associated with long-term cognitive and physical outcomes. Information about long-term outcomes may influence physician and pa...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2016.0238
更新日期:2016-08-01 00:00:00
abstract::OBJECTIVES To determine the effect of modifiable dietary intake variables (current vitamin D supplementation and daily cow's milk intake) on 25-hydroxyvitamin D level in early childhood and to evaluate the relationship between these modifiable dietary factors and other largely nonmodifiable determinants of vitamin D s...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/2013.jamapediatrics.226
更新日期:2013-03-01 00:00:00
abstract:Importance:Home aeroallergen exposure is associated with increased asthma morbidity in children, yet little is known about the contribution of school aeroallergen exposures to such morbidity. Objective:To evaluate the effect of school-specific aeroallergen exposures on asthma morbidity among students, adjusting for ho...
journal_title:JAMA pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1001/jamapediatrics.2016.2543
更新日期:2017-01-01 00:00:00
abstract:Importance:Although breastfeeding has a positive effect on an infant's health and development, the prevalence is low in many communities. The effect of financial incentives to improve breastfeeding prevalence is unknown. Objective:To assess the effect of an area-level financial incentive for breastfeeding on breastfee...
journal_title:JAMA pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapediatrics.2017.4523
更新日期:2018-02-05 00:00:00
abstract:Importance:Administration of corticosteroids to women at high risk for delivery in the late preterm period (34-36 weeks' gestation) improves short-term neonatal outcomes. The cost implications of this intervention are not known. Objective:To compare the cost-effectiveness of treatment with antenatal corticosteroids wi...
journal_title:JAMA pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamapediatrics.2019.0032
更新日期:2019-05-01 00:00:00
abstract:Importance:Pediatric patients often encounter anxiety and distress in hospital settings, and virtual reality education, providing a vivid, immersive, and realistic experience, has been introduced to mitigate these anxiety responses. Objective:To evaluate whether virtual reality education for pediatric patients before ...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2019.3000
更新日期:2019-09-09 00:00:00
abstract:Clinical Question:Do dietary interventions, such as probiotics, improve pain in children with recurrent abdominal pain? Clinical Application:Compared with placebo, children who were treated with probiotic preparations were more likely to experience improvement in pain in the short term (odds ratio, 1.63; 95% CI, 1.07-...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2018.4575
更新日期:2019-02-01 00:00:00
abstract:Importance:Preterm and postterm births are associated with adverse neuropsychiatric outcomes. However, it remains unclear whether variation of gestational age within the 37- to 42-week range of term deliveries is associated with neurodevelopment. Objective:To investigate the association of gestational age at birth (GA...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2020.2991
更新日期:2020-09-21 00:00:00
abstract::Addressing the childhood obesity epidemic continues to be a challenge. Given that once obesity develops it is likely to persist, there has been an increasing focus on prevention at earlier stages of the life course. Research to develop and implement effective prevention and intervention strategies in the first 2 years...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2014.3554
更新日期:2015-05-01 00:00:00
abstract:Importance:Corporal punishment is a leading risk factor for physical abuse. Strong anecdotal evidence from physicians and other professionals working in child protection suggest that punishment-initiated physical abuse for school-aged children increases after release of report cards. However, no empirical examination o...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2018.4346
更新日期:2019-02-01 00:00:00
abstract:IMPORTANCE:As of 2015, almost half of US states allow medical marijuana, and 4 states allow recreational marijuana. To our knowledge, the effect of recreational marijuana on the pediatric population has not been evaluated. OBJECTIVE:To compare the incidence of pediatric marijuana exposures evaluated at a children's ho...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2016.0971
更新日期:2016-09-06 00:00:00
abstract:Importance:Millions of low-income children in the United States reside in substandard or unaffordable housing. Relieving these burdens may be associated with changes in asthma outcomes. Objectives:To examine whether participation in the US Department of Housing and Urban Development's (HUD) rental assistance programs ...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2019.6242
更新日期:2020-06-01 00:00:00
abstract:Importance:Infantile beriberi, a potentially fatal disease caused by thiamine deficiency, remains a public health concern in Cambodia and regions where thiamine-poor white rice is a staple food. Low maternal thiamine intake reduces breast milk thiamine concentrations, placing breastfed infants at risk of beriberi. Obj...
journal_title:JAMA pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapediatrics.2016.2065
更新日期:2016-10-03 00:00:00
abstract::After pediatric injury, transient traumatic stress reactions are common, and about 1 in 6 children and their parents develop persistent posttraumatic stress (PTS) symptoms that are linked to poorer physical and functional recovery. Meta-analytic studies identify risk factors for persistent PTS, including preinjury psy...
journal_title:JAMA pediatrics
pub_type: 杂志文章,评审
doi:10.1001/jamapediatrics.2013.2741
更新日期:2013-12-01 00:00:00
abstract:IMPORTANCE:Although cancer remains the most common cause of disease-related death in adolescents and young adults (AYAs) in high-income countries, their overall survival rates continue to increase and now exceed 80% at 5 years in several high-income countries. This has been accomplished through progressive improvements...
journal_title:JAMA pediatrics
pub_type: 杂志文章,评审
doi:10.1001/jamapediatrics.2015.4689
更新日期:2016-05-01 00:00:00
abstract:Importance:Rapid and accurate diagnosis of late-onset infection in newborn infants could inform treatment decisions and avoid unnecessary administration of antibiotics. Objective:To compare the accuracy of serum C-reactive protein (CRP) with that of microbiological blood culture for diagnosing late-onset infection in ...
journal_title:JAMA pediatrics
pub_type: 杂志文章,meta分析
doi:10.1001/jamapediatrics.2019.5669
更新日期:2020-03-01 00:00:00
abstract:IMPORTANCE:Efforts to transform primary care through the medical home model may have limited effectiveness if they do not incorporate families' preferences for different primary care services. OBJECTIVE:To assess parents' relative preferences for different categories of enhanced access services in primary care. DESIG...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2014.3534
更新日期:2015-04-01 00:00:00
abstract:Importance:It is unknown whether the age threshold (≤24 months) for preterm infants with chronic lung disease (CLD) to receive immunoprophylaxis for respiratory syncytial virus (RSV) as currently recommended by American Academy of Pediatrics guidelines correctly identified infants at higher risk for hospitalization for...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2017.3792
更新日期:2018-02-01 00:00:00
abstract::Although screening for elevated blood pressure (BP) in adults is beneficial, evidence of its beneficial effects in children is not clear. Elevated BP in children is associated with atherosclerosis early in life and tracks across the life course. However, because of the high variability in BP, tracking is weak, and hav...
journal_title:JAMA pediatrics
pub_type: 杂志文章,评审
doi:10.1001/jamapediatrics.2013.438
更新日期:2013-03-01 00:00:00
abstract:IMPORTANCE:It is unclear whether the benefits of tobacco control policies extend to pregnant women and infants, especially among racial/ethnic minority and low socioeconomic populations that are at highest risk for adverse birth outcomes. OBJECTIVE:To examine the associations of state cigarette taxes and the enactment...
journal_title:JAMA pediatrics
pub_type: 杂志文章
doi:10.1001/jamapediatrics.2014.2365
更新日期:2014-11-01 00:00:00