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  1. Article ; Online: The association between antenatal corticosteroids exposure and postnatal growth in infants born between 23 and 29 weeks of gestation.

    Chou, Fu-Sheng / Clark, Reese H / Yeh, Hung-Wen

    Journal of perinatology : official journal of the California Perinatal Association

    2024  Volume 44, Issue 4, Page(s) 561–567

    Abstract: Objective: To assess the association between antenatal corticosteroids exposure and postnatal growth in infants born at 23-29 weeks' gestation.: Study design: This retrospective study used data from the Pediatrix Clinical Data Warehouse. Maternal- ... ...

    Abstract Objective: To assess the association between antenatal corticosteroids exposure and postnatal growth in infants born at 23-29 weeks' gestation.
    Study design: This retrospective study used data from the Pediatrix Clinical Data Warehouse. Maternal-infant dyads from 2018 to 2020 were included. Inverse propensity weighting (IPW) was applied to balance pre-treatment confounders. Primary outcomes included postnatal weight, length, and head circumference growth trajectory percentiles.
    Result: The unadjusted cohort consisted of 11,912 dyads. After IPW adjustment, there were 23,231 dyads. Exposed infants showed higher postnatal trajectory percentiles for weight (by 3.4%), length (by 1.8%), and head circumference (by 2.5%) when compared to non-exposed infants. The positive association between antenatal corticosteroids and postnatal growth was only observed in infants not exposed to preeclampsia/eclampsia/HELLP syndrome or without fetal growth restriction.
    Conclusion: Antenatal corticosteroids exposure is associated with better postnatal growth. The study is limited by its retrospective nature.
    MeSH term(s) Infant ; Pregnancy ; Humans ; Female ; Retrospective Studies ; Adrenal Cortex Hormones/adverse effects ; Gestational Age ; Cephalometry ; Prenatal Exposure Delayed Effects
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2024-01-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645021-0
    ISSN 1476-5543 ; 0743-8346
    ISSN (online) 1476-5543
    ISSN 0743-8346
    DOI 10.1038/s41372-024-01871-0
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2412: Show issues Location:
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  2. Article ; Online: Assessment of social factors influencing hospitalization cost of US preterm newborns, 2016.

    Chou, Fu-Sheng

    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

    2020  Volume 35, Issue 10, Page(s) 1978–1986

    Abstract: Background and objective: Preterm newborn (PTN) care is costly in the US, and the preterm birth (PTB) rate has not seen substantial improvement. PTB remains a significant public health issue because of risks of adverse health outcomes and the associated ...

    Abstract Background and objective: Preterm newborn (PTN) care is costly in the US, and the preterm birth (PTB) rate has not seen substantial improvement. PTB remains a significant public health issue because of risks of adverse health outcomes and the associated economic burden. Assessing factors leading to high hospital cost is imperative in order to ease economic burden associated with PTB. Social factors influencing hospitalization cost for PTN have not been studied extensively. This study aims to examine the contributions of hospital type, race/ethnicity, and median household income quartile to the cost of the PTN's initial hospitalization after birth.
    Materials and methods: Data used in this study originated from the 2016 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) which provided the most recent national records of pediatric hospitalization in the US. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes P07.2x and P07.3x were used to identify birth gestational age (GA) in complete weeks. Q00-Q99 codes were used to identify congenital anomalies. Data records reflecting hospitalization of newborns without congenital anomalies were extracted to estimate total cost in 2016. Analysis of factors influencing total cost was performed on the subset of newborns that were in-born and with birth GA from 24 to 36 weeks. Total hospital cost was calculated by multiplying total charges and cost-to-charge ratios. Per-diem cost was calculated by dividing total hospital cost by length of stay. Linear regression modeling was performed using weighted data, and the best model was selected using the Akaike information criteria.
    Results: Hospitalization cost for PTNs, who constituted 7.6% of all studied newborns, comprised 45% of total newborn hospitalization cost. PTNs in freestanding children's hospitals had significantly higher total cost compared to non-children's teaching and non-teaching hospitals. The cost difference was GA-dependent. The latter two hospital types reported similar cost for PTNs. Although race/ethnicity and median household income quartile were related, the two covariates had independent effects on total hospitalization cost. A model built to assess the roles of covariates in the association between GA and total hospitalization cost found that all three covariates independently affected total cost when controlling for one another, with hospital type also showing an interaction effect with GA.
    Conclusions: Hospitalization cost is highly influenced by hospital type, race/ethnicity, and median household income quartile. The modifiable aspects of these factors may be further dissected and targeted in order to ease the burden of high hospitalization cost associated with PTB.
    MeSH term(s) Child ; Hospital Costs ; Hospitalization ; Hospitals, Pediatric ; Humans ; Infant, Newborn ; Length of Stay ; Premature Birth ; Social Factors ; United States/epidemiology
    Language English
    Publishing date 2020-07-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2077261-0
    ISSN 1476-4954 ; 1057-0802 ; 1476-7058
    ISSN (online) 1476-4954
    ISSN 1057-0802 ; 1476-7058
    DOI 10.1080/14767058.2020.1776252
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  3. Article ; Online: Postnatal weight growth trajectory in infants born between 30 4/7 weeks and 34 3/7 weeks of gestation.

    Chou, Fu-Sheng / Yeh, Hung-Wen / Clark, Reese H

    Journal of perinatology : official journal of the California Perinatal Association

    2023  Volume 44, Issue 4, Page(s) 575–577

    MeSH term(s) Infant ; Humans ; Pregnancy ; Infant, Newborn ; Female ; Infant, Premature ; Birth Weight ; Gestational Age
    Language English
    Publishing date 2023-11-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645021-0
    ISSN 1476-5543 ; 0743-8346
    ISSN (online) 1476-5543
    ISSN 0743-8346
    DOI 10.1038/s41372-023-01837-8
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  4. Article: Machine Learning for Mortality Prediction in Pediatric Myocarditis.

    Chou, Fu-Sheng / Ghimire, Laxmi V

    Frontiers in pediatrics

    2021  Volume 9, Page(s) 644922

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2021-04-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2021.644922
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  5. Article ; Online: A comparative study of postnatal anthropometric growth in very preterm infants and intrauterine growth.

    Chou, Fu-Sheng / Yeh, Hung-Wen / Clark, Reese H

    Nature communications

    2023  Volume 14, Issue 1, Page(s) 5626

    Abstract: Most growth references for very preterm infants were developed using measurements taken at birth, and were thought to represent intrauterine growth. However, it remains unclear whether the goal of approximating an intrauterine growth rate as stated by ... ...

    Abstract Most growth references for very preterm infants were developed using measurements taken at birth, and were thought to represent intrauterine growth. However, it remains unclear whether the goal of approximating an intrauterine growth rate as stated by the American Academy of Pediatrics is attainable by very preterm infants. Using real-world measurement data from very preterm infants born between 2010 through 2020, we develop models to characterize the patterns of postnatal growth, and compare them to intrauterine growth. By assessing the weight growth rate, we show three phases of postnatal growth not evident in intrauterine growth. Furthermore, postnatal length and head circumference growth exhibit a slow rate after birth, followed by an acceleration. Collectively, postnatal and intrauterine growth are distinctly different. Although postnatal growth models do not represent optimal growth of very preterm infants, they can serve as a practical tool for clinical assessment of growth and for nutrition research.
    MeSH term(s) Infant, Newborn ; Infant ; Humans ; Child ; Infant, Premature ; Anthropometry ; Acceleration
    Language English
    Publishing date 2023-09-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-023-41069-0
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  6. Article ; Online: A comparative study of postnatal anthropometric growth in very preterm infants and intrauterine growth

    Fu-Sheng Chou / Hung-Wen Yeh / Reese H. Clark

    Nature Communications, Vol 14, Iss 1, Pp 1-

    2023  Volume 9

    Abstract: Abstract Most growth references for very preterm infants were developed using measurements taken at birth, and were thought to represent intrauterine growth. However, it remains unclear whether the goal of approximating an intrauterine growth rate as ... ...

    Abstract Abstract Most growth references for very preterm infants were developed using measurements taken at birth, and were thought to represent intrauterine growth. However, it remains unclear whether the goal of approximating an intrauterine growth rate as stated by the American Academy of Pediatrics is attainable by very preterm infants. Using real-world measurement data from very preterm infants born between 2010 through 2020, we develop models to characterize the patterns of postnatal growth, and compare them to intrauterine growth. By assessing the weight growth rate, we show three phases of postnatal growth not evident in intrauterine growth. Furthermore, postnatal length and head circumference growth exhibit a slow rate after birth, followed by an acceleration. Collectively, postnatal and intrauterine growth are distinctly different. Although postnatal growth models do not represent optimal growth of very preterm infants, they can serve as a practical tool for clinical assessment of growth and for nutrition research.
    Keywords Science ; Q
    Subject code 610
    Language English
    Publishing date 2023-09-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Sex differences in postnatal weight gain trajectories of extremely preterm newborns.

    Chou, Fu-Sheng / Yeh, Hung-Wen

    Journal of perinatology : official journal of the California Perinatal Association

    2021  Volume 41, Issue 8, Page(s) 1835–1844

    Abstract: Objective: Both postnatal growth and sex play a crucial role in long-term outcomes of extremely preterm newborns (EPNs), but the relationship between sex and postnatal growth is not clear. This study aims to assess sex differences in weight trajectories. ...

    Abstract Objective: Both postnatal growth and sex play a crucial role in long-term outcomes of extremely preterm newborns (EPNs), but the relationship between sex and postnatal growth is not clear. This study aims to assess sex differences in weight trajectories.
    Study design: Weight data in the first 200 days of life from 4327 EPNs were used for generalized additive mixed modeling. We considered gestational age and sex as fixed-effects, and included random intercepts and random slopes for postnatal age. We assessed interactions between fixed-effects and postnatal age.
    Results: Male EPNs had higher predicted weight trajectories than females. Weight z-score trajectories decreased in both sexes before term-equivalent age comparably, but females showed faster increases afterward. Although weight gain velocity was comparable between both sexes, weight gain velocity in male EPNs was lower compared to the corresponding reference values from the 2013 Fenton growth charts, which explained slower z-score rises.
    Conclusion: Sex disparity exists in postnatal weight gain trajectories of EPNs after reaching the term-equivalent age.
    MeSH term(s) Birth Weight ; Body-Weight Trajectory ; Female ; Gestational Age ; Growth Charts ; Humans ; Infant, Extremely Premature ; Infant, Newborn ; Male ; Sex Characteristics
    Language English
    Publishing date 2021-05-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645021-0
    ISSN 1476-5543 ; 0743-8346
    ISSN (online) 1476-5543
    ISSN 0743-8346
    DOI 10.1038/s41372-021-01099-2
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    Zs.A 2412: Show issues Location:
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  8. Article: The SLC25A42 Transcript Is a Biomarker for Fetal Reprogramming in Response to Placental Insufficiency in Preterm Newborns Under 32 Weeks Gestation-A Pilot Study.

    Chou, Fu-Sheng / Wang, Pei-Shan

    Frontiers in pediatrics

    2020  Volume 8, Page(s) 459

    Abstract: Introduction: ...

    Abstract Introduction:
    Language English
    Publishing date 2020-08-28
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2020.00459
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  9. Article ; Online: When the Unknown Is Unknowable: Confronting Diagnostic Uncertainty.

    Faison, Giulia / Chou, Fu-Sheng / Feudtner, Chris / Janvier, Annie

    Pediatrics

    2023  Volume 152, Issue 4

    Abstract: The neonatology literature often refers to medical uncertainty and specifically the challenges of predicting morbidity for extremely premature infants, who can have widely varying outcomes. Less has been written about situations in which diagnoses are ... ...

    Abstract The neonatology literature often refers to medical uncertainty and specifically the challenges of predicting morbidity for extremely premature infants, who can have widely varying outcomes. Less has been written about situations in which diagnoses are simply unknown or unattainable. This case highlights the importance of communication amidst uncertainty from a lack of knowledge about aspects of a patient's condition. Using epidemiologic and clinical reasoning, the authors challenge the assumption that diagnostic uncertainty must necessarily portend prognostic uncertainty. When physicians' quest for a diagnosis becomes burdensome and detrimental to the infant's quality of life, this should be abandoned and replaced by focusing on prognosis. The authors focus on the shift of the physician's role toward one of support, assisting the family in ascribing meaning to the dying experience. By focusing on prognosis and support, communication can proceed with more clarity, understanding, and empathy.
    MeSH term(s) Humans ; Uncertainty ; Quality of Life ; Physicians ; Neonatology ; Prognosis
    Language English
    Publishing date 2023-10-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2023-061193
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  10. Article ; Online: Developing a machine learning-based tool to extend the usability of the NICHD BPD Outcome Estimator to the Asian population.

    Patel, Monalisa / Sandhu, Japmeet / Chou, Fu-Sheng

    PloS one

    2022  Volume 17, Issue 9, Page(s) e0272709

    Abstract: The NICHD BPD Outcome Estimator uses clinical and demographic data to stratify respiratory outcomes of extremely preterm infants by risk. However, the Estimator does not have an option in its pull-down menu for infants of Asian descent. We hypothesize ... ...

    Abstract The NICHD BPD Outcome Estimator uses clinical and demographic data to stratify respiratory outcomes of extremely preterm infants by risk. However, the Estimator does not have an option in its pull-down menu for infants of Asian descent. We hypothesize that respiratory outcomes in extreme prematurity among various racial/ethnic groups are interconnected and therefore the Estimator can still be used to predict outcomes in infants of Asian descent. Our goal was to apply a machine learning approach to assess whether outcome prediction for infants of Asian descent is possible with information hidden in the prediction results using White, Black, and Hispanic racial/ethnic groups as surrogates. We used the three racial/ethnic options in the Estimator to obtain the probabilities of BPD outcomes for each severity category. We then combined the probability results and developed three respiratory outcome prediction models at various postmenstrual age (PMA) by a random forest algorithm. We showed satisfactory model performance, with receiver operating characteristics area under the curve of 0.934, 0.850, and 0.757 for respiratory outcomes at PMA 36, 37, and 40 weeks, respectively, in the testing data set. This study suggested an interrelationship among racial/ethnic groups for respiratory outcomes among extremely preterm infants and showed the feasibility of extending the use of the Estimator to the Asian population.
    MeSH term(s) Bronchopulmonary Dysplasia/epidemiology ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Infant, Premature, Diseases ; Machine Learning ; National Institute of Child Health and Human Development (U.S.) ; United States
    Language English
    Publishing date 2022-09-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0272709
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