Postoperative Complications after Major Abdominal Surgery in Preterm Infants: A Single Institute Record

Backgrounds: Post-operative complications in pediatric surgery are important issues, especially that after major abdominal surgery for preterm infants: complications sometimes lead to mortality/morbidity even though the surgical procedures were successful. We here attempted to demonstrate and record post-operative complications in preterm infants after major abdominal surgery. This is a secondary analysis of our cohort (n = 594) previously reported regarding pediatric postoperative complications (not confined to preterm infants). Methods: Of 594 patients, 25 preterm (born <37 weeks of gestation) infants underwent major abdominal surgery. We identified their characteristics, especially the postoperative complications. The Ethics Committee approved this study. Results: The mean weight was 2.43 ± 0.75 kg. Of 25, nine suffered postoperative complications: postoperative respiratory failure (n = 4), pulmonary sepsis (n = 2), and the followings were observed in one patient: intra-operative cardiac arrest, wound sepsis, septicemia, and multi-organ sepsis. There was no in-hospital mortality. Conclusion: In preterm infants undergoing major abdominal surgery, the most common postoperative complication was respiratory;respiratory failure and pulmonary sepsis. This data is roughly the same as that observed in the previous studies, which made us reconfirm the importance of the vigilance on respiratory complications in this population.

Perinatal outcomes of frozen-thawed embryo transfer following blastocyst-stage embryo transfer compared to those of cleavage-stage embryo transfer:analysis of 9408 singleton newborns using propensity score analysis

Objective:Regarding frozen-thawed embryo transfer(FET),there is limited consensus on whether extending embryo culture from the cleavage stage to the blastocyst stage affects perinatal outcomes.This study aimed to compare perinatal outcomes of singletons between blastocyst-stage embryo transfer(BT)and cleavage-stage embryo transfer(CT)in FET.Methods:A total of 9408 FET cycles that met the inclusion criteria were included in this retrospective cohort study between 2019 and 2022.Blastocyst-stage embryo transfers were performed in the BT group,and cleavage-stage embryo transfers were performed in the CT group.Multivariate logistic regression analyses were performed,as well as propensity score matching(PSM)to adjust for confounders.Results:After PSM,a higher risk of pre-term birth(PTB;odds ratio[OR]:1.23,95%confidence interval[CI]:1.00-1.50,P=0.048)and being large for gestational age(LGA;OR:1.16,95%CI:1.00-1.35,P=0.050)was observed in the BT group compared to that in the CT group.After stratified PSM,in the subgroup under 35 years of age,only an increased risk of LGA was observed in the BT group compared to the CT group.Perinatal outcomes in the double-embryo transfer subgroup were similar to those in the unstratified group.However,in the subgroup beyond 35 years of age and the single embryo transfer subgroup,perinatal outcomes were not statistically different between the BT and CT groups(P>0.05).Conclusions:In FET,prolonged embryo culture to the blastocyst stage increased the risk of PTB and LGA in single fetuses.However,stratified analysis based on age and the number of transferred embryos yielded different results,necessitating further mechanistic studies.