Ultrasound and Maternal Data Predict Prolonged NICU Stay
Maternal factors, particularly social deprivation, 36-week ultrasound scan results, and labour/delivery data independently predicted the risk for prolonged NICU admission at term.
METHODOLOGY:
Researchers conducted a retrospective analysis of a prospective cohort study including 107,762 women with singleton pregnancies who underwent a routine 36-week ultrasound scan (35 + 0 to 36 + 6 weeks of gestation) between March 2014 and November 2023.
They assessed maternal factors (maternal demographics, obstetric and medical history, and pregnancy characteristics) and findings from the scan at week 36 including estimated foetal weight (EFW) and Doppler measurements (uterine artery, umbilical artery, and middle cerebral artery).
Other outcomes such as gestational age at delivery, mode of delivery, and birth weight were evaluated.
The primary outcome was prolonged NICU admission (> 2 days) for high-dependency or intensive care (total parenteral nutrition or invasive ventilation).
TAKEAWAY:
Of 107,762 singleton pregnancies, 946 (0.88%) delivered neonates requiring NICU admission.
Social deprivation (Index of Multiple Deprivation [IMD]) was an independent predictor of prolonged NICU admission (IMD quintile 1 [most deprived] vs 5 [least deprived]: adjusted odds ratio [aOR], 1.96; P < .001), surpassing ethnicity and other maternal factors.
The combined model (maternal factors + 36-week scan data) showed that EFW < 10th percentile (aOR, 1.85; P < .001) and > 90th percentile (aOR, 1.58; P < .001) were significant predictors of the risk for NICU admission.
The combined model (maternal factors + 36-week scan data + delivery data) detected 39.1% of prolonged NICU admissions; however, more than 40% of these admissions remained unpredictable.
IN PRACTICE:
"Our findings illustrate that most prolonged NICU admissions are not predictable based on routinely available variables and, even when analyses were restricted to those admissions theoretically predictable by maternal factors or 36-week scan findings, more than 40% of prolonged NICU admissions were not predictable," the authors wrote. "These data should be included in informed decision-making with regards to place of birth, given the importance of continuous monitoring and ready access to skilled maternity-care providers," they added.
SOURCE:
This study was led by A. Arechvo, Fetal Medicine Research Institute, King's College Hospital, London, England. It was published online on June 21, 2025, in Ultrasound in Obstetrics & Gynecology.
LIMITATIONS:
Although IMD was the standard measure of social deprivation in the UK, it was based on the postcode of residence and may not have accurately reflected individual-level deprivation. This study lacked data on maternal mental health problems, medications, infections, and operative vaginal delivery.
DISCLOSURES:
This study was supported by a grant from the Fetal Medicine Foundation.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Newsweek
21-07-2025
- Newsweek
Petition to 'Release Trump's FULL Medical Records' Grows
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. More than 8,000 people have signed a petition calling for President Donald Trump to release all his medical records. On July 17, the White House confirmed Trump had been diagnosed with chronic venous insufficiency following growing concerns about visible swelling in the president's legs and bruises on his hands. Newsweek has contacted the White House for comment via email. Why It Matters Historically, U.S. presidents and presidential candidates have released their medical information to build public trust and reassure voters. The issue has become more urgent as the median age of presidents in the U.S. has risen, with cognitive and physical decline becoming pointed campaign topics. The health of then-President Joe Biden was a major issue before he dropped out of the 2024 presidential race, with Trump repeatedly questioning whether he was fit for office. What To Know The author of the Care2 petition titled "Release Trump's FULL Medical Records NOW" wrote: "After everyone with eyes was able to plainly see Trump's swollen legs, discolorations, and other troubling symptoms, the White House FINALLY released a snippet of health information—Trump has 'chronic venous insufficiency.' In tones normally reserved for a hangnail, they said this was no big deal, very common, nothing to see here... "Except that this can indicate a very serious heart condition, possibly life-threatening, along with a range of other very dangerous ailments. But we don't have the full records, so we have to take the word of chronic liars. "Add your name, and demand that ALL Trump's medical records be released, as has been common practice for presidents for decades. "This also must include cognitive, memory, and related tests, given the rapidly worsening symptoms Trump has been showing on that front as well (including an utterly bizarre public rant about the Unabomber and Trump's uncle). "This man has his finger on the nuclear button, which is already frightening. But if he's falling apart physically and mentally, that takes it to a whole other level. And we need to know that, so we can act accordingly." The White House announced Trump's diagnosis in a memo from Sean Barbabella, the president's physician. "The president underwent a comprehensive examination, including diagnostic vascular studies. Bilateral lower extremity venous Doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign and common condition, particularly in individuals over the age of 70," the memo said. Press secretary Karoline Leavitt later said in a news briefing that the president's medical team found "no evidence of deep vein thrombosis or arterial disease." She said Trump was not in any discomfort with the condition. The diagnosis came after members of the public began questioning photographs showing Trump with heavily swollen ankles. The president's health has long been a subject of public scrutiny, especially given his age. Trump, who turned 79 last month, became the oldest person to be inaugurated president when he began his second term in January. While Trump has released intermittent updates over the years, calls for full transparency have intensified, particularly following then-Vice President Kamala Harris' detailed medical disclosure in October. Trump has shared limited information—including a November 2023 letter from his physician, which describes him as being in "excellent health." The letter cited favorable lab results, weight loss and "exceptional" cognitive performance. However, it lacked specific metrics. The president also scored 30 out of 30 on a Montreal Cognitive Assessment in 2018, according to then-White House physician Ronny Jackson, but no recent cognitive evaluations have been released. His medical history includes high cholesterol, coronary artery disease and a COVID-19 hospitalization in 2020. According to various reports, Trump takes medications for cholesterol, cardiac prevention and rosacea. In 2024, he underwent cataract surgery and a colonoscopy that showed a benign polyp and diverticulitis. President Donald Trump in the East Room of the White House in Washington, D.C., on July 18. President Donald Trump in the East Room of the White House in Washington, D.C., on July 18. AP What Is Chronic Venous Insufficiency? CVI is a condition in which the veins in the legs are unable to efficiently return blood to the heart. This occurs when the one-way valves inside the leg veins—responsible for keeping blood flowing upward—become damaged or weakened. As a result, blood can pool in the lower extremities, leading to swelling, discomfort and a range of other symptoms. The condition is most often caused by factors such as aging, obesity, prolonged periods of sitting or standing, a history of blood clots (such as deep vein thrombosis), or the presence of varicose veins. Over time, the increased pressure from trapped blood can lead to visible changes in the skin and even open sores, particularly around the ankles. Symptoms of CVI include leg swelling, aching or cramping, heaviness, visible varicose veins, skin discoloration, and in more advanced cases, ulcers around the ankles. These symptoms often worsen after long periods of standing or sitting and improve with leg elevation. President Donald Trump's foot and swollen ankle as he sits with Bahrain's Crown Prince Salman bin Hamad Al Khalifa in the Oval Office of the White House on July 16. President Donald Trump's foot and swollen ankle as he sits with Bahrain's Crown Prince Salman bin Hamad Al Khalifa in the Oval Office of the White House on July 16. AP What People Are Saying Sean Barbabella, the president's physician, shared the following details from a physical in a memo shown to Newsweek in April: "President Trump remains in excellent health, exhibiting robust cardiac, pulmonary, neurological, and general physical function. His active lifestyle continues to contribute significantly to his well-being. "President Trump's days include participation in multiple meetings, public appearances, press availability, and frequent victories in golf events. President Trump exhibits excellent cognitive and physical health and is fully fit to execute the duties of the Commander-in-Chief and Head of State." Then-Vice President Kamala Harris said in October: "I put out my medical records. He won't put out his medical records. And you have to ask, why is this staff doing that? And it may be because they think he's just not ready, and [is] unfit and unstable and should not have that level of transparency for the American people." What Happens Next It remains to be seen how the administration will respond to concerns about Trump's health and the ongoing push for transparency.
Newsweek
18-07-2025
- Newsweek
Donald Trump's Vein Disorder, Chronic Venous Insufficiency, Explained
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. The White House announced on Thursday that President Donald Trump has been diagnosed with chronic venous insufficiency (CVI). The announcement followed growing public speculation over visible swelling in the president's legs and bruises on his hands. Why It Matters Trump, who is 79 years old and is the oldest person to serve a second term, has faced intensifying scrutiny over his age and cognitive fitness. While his physician recently declared him "fully fit" after a comprehensive physical that included a perfect score on the Montreal Cognitive Assessment, public concern about his health has persisted. Trump frequently criticized former President Joe Biden over concerns about his health during last year's presidential election, with Biden eventually dropping out of the race. President Donald Trump speaks during a ceremony to sign the "Halt All Lethal Trafficking of Fentanyl Act," in the East Room of the White House on July 16 in Washington, D.C. President Donald Trump speaks during a ceremony to sign the "Halt All Lethal Trafficking of Fentanyl Act," in the East Room of the White House on July 16 in Washington, D.C. Evan Vucci/AP What To Know The White House released a memo from the president's physician, Sean Barbabella, on Thursday which revealed the president was diagnosed with CVI after he noticed swelling in his legs. "The president underwent a comprehensive examination, including diagnostic vascular studies. Bilateral lower extremity venous Doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign and common condition, particularly in individuals over the age of 70," the memo said. At a press briefing, White House press secretary Karoline Leavitt added that the president's medical team found "no evidence of deep vein thrombosis or arterial disease." She also said Trump was not experiencing any discomfort related to the condition. President Donald Trump, left, reaches to shake hands with Bahrain's Crown Prince Salman bin Hamad Al Khalifa speak upon his arrival at the White House on July 16. President Donald Trump, left, reaches to shake hands with Bahrain's Crown Prince Salman bin Hamad Al Khalifa speak upon his arrival at the White House on July 16. Alex Brandon/AP It comes after Trump was spotted with heavily swollen ankles at a number of public events in recent months. A photo taken during Trump's White House meeting with Bahrain's Crown Prince Salman bin Hamad Al Khalifa on Wednesday, showed the president's left ankle which appeared to be swollen and bulging out of his shoe. Photos from the same event also showed Trump's hand with what appeared to be makeup covering up a bruise or blemish. Leavitt said the bruise on his hand was "consistent" with irritation from "frequent handshaking and the use of aspirin." She added that "the president remains in excellent health." The left foot and swollen ankle of President Donald Trump are pictured as he sits with Bahrain's Crown Prince Salman bin Hamad Al Khalifa in the Oval Office of the White House, Wednesday, July 16,... The left foot and swollen ankle of President Donald Trump are pictured as he sits with Bahrain's Crown Prince Salman bin Hamad Al Khalifa in the Oval Office of the White House, Wednesday, July 16, 2025, in Washington. More Alex Brandon/AP What Is Chronic Venous Insufficiency? CVI is a condition in which the veins in the legs are unable to efficiently return blood back to the heart. This occurs when the one-way valves inside the leg veins—responsible for keeping blood flowing upward—become damaged or weakened. As a result, blood can pool in the lower extremities, leading to swelling, discomfort, and a range of other symptoms. The condition is most often caused by factors such as aging, obesity, prolonged periods of sitting or standing, a history of blood clots (such as deep vein thrombosis), or the presence of varicose veins. Over time, the increased pressure from trapped blood can lead to visible changes in the skin and even open sores, particularly around the ankles. Symptoms of CVI include leg swelling, aching or cramping, heaviness, visible varicose veins, skin discoloration, and in more advanced cases, ulcers around the ankles. These symptoms often worsen after long periods of standing or sitting and improve with leg elevation. Is CVI Life Threatening? While CVI is generally not life-threatening, it can significantly affect quality of life if left untreated. It may also increase the risk of complications like cellulitis (a bacterial skin infection) or DVT. CVI is a manageable condition, particularly when diagnosed early. However, in older adults or those with other underlying health issues, it may point to broader concerns about circulatory health. The condition is not reversible. How Is CVI Treated? Treatment for CVI depends on severity but often starts with lifestyle changes like regular exercise, leg elevation, and wearing compression stockings. In more persistent or severe cases, medical interventions such as sclerotherapy, laser therapy, or vein surgery may be recommended to improve blood flow and relieve symptoms. How Common Is CVI? CVI is very common, especially among older adults. In the United States, it's estimated to affect more than 25 million adults, with roughly 6 million experiencing advanced stages of the condition. Prevalence studies in the general population show that 1–17 percent of men and 1–40 percent of women are affected to varying degrees. The likelihood of developing CVI increases with age—affecting up to 40 percent of women and 17 percent of men, according to the National Institutes of Health (NIH). In clinical settings, incidence rates suggest around 150,000 new cases are diagnosed annually in the U.S., with total health care costs nearing $500 million per year, the NIH reported.
Yahoo
18-07-2025
- Yahoo
Trump diagnosed with minor vein condition after noticing swelling in legs
Washington — President Trump has been diagnosed with a "benign and common" vein condition known as chronic venous insufficiency after he noticed swelling in his legs, the White House said Thursday. The president's physician, Sean Barbabella, said in a memo that the president underwent a thorough health examination after he noticed mild swelling in his legs, and it revealed no evidence of a more serious condition like deep vein thrombosis or arterial disease. White House press secretary Karoline Leavitt read the memo at Thursday's press briefing, and the White House later released it. According to Johns Hopkins and the Cleveland Clinic, chronic venous insufficiency occurs when veins in the legs struggle to bring blood back up to the heart. Barbarella said the president, who is 79, remains in "excellent" overall health. Photos of the president at the Club World Cup soccer final in New Jersey over the weekend showed him with noticeably swollen ankles, fueling speculation about the cause. The president's doctor said he was "thoroughly evaluated" by the White House medical unit "out of an abundance of caution" after noticing swelling in recent weeks. "The president underwent a comprehensive examination, including diagnostic vascular studies. Bilateral lower extremity venous Doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign and common condition, particularly in individuals over the age of 70," the memo said. Barbarella said there was "no evidence" of blood clots or arterial disease. The president underwent multiple tests, including a complete blood count, comprehensive metabolic panel, and coagulation profile, Barbabella said. "All results were within normal limits," the memo said. "An echocardiogram was also performed and confirmed normal cardiac structure and function. No signs of heart function, renal impairment, or systemic illness were identified." The White House doctor also noted recent photos that have shown minor bruising on the back of the president's hand. "This is consistent with minor soft tissue irritation from frequent handshaking and the use of aspirin, which is taken as part of a standard cardiovascular prevention regimen," the memo said. What is chronic venous insufficiency? Chronic venous insufficiency, also known as CVI, is a form of venous disease that occurs when veins in your legs are damaged, resulting in them not managing blood flow back to the heart as well as they should. "Chronic venous insufficiency is not a serious health threat. But it can be painful and disabling," Johns Hopkins Medicine notes on its website. Venous disease in general is very common, according to the Cleveland Clinic, with about 1 in 20 adults being affected by chronic venous insufficiency. It usually affects people over age 50, with the risk increasing with age. Someone who is overweight, has a family history of the issue, or who has prior leg damage can be more at risk. Other contributing factors can include lack of exercise, smoking and high blood pressure in the leg veins due to long periods of sitting or standing. The insufficiency can cause a variety of symptoms, including discolored reddish-brown, leathery or itchy skin, swelling in the legs and ankles, and legs that are achy, tired, cramping or tingling. Treatment options can include improving blood flow through weight loss, exercise, elevation and compression socks, and in some cases, medicines or minor procedures may be recommended. In severe cases, surgery is also an option. Read the full memo on Trump's diagnosis Son of man who was violently detained by ICE reacts after release 7.3 magnitude earthquake hits southern Alaska Wall Street Journal reports Trump sent "bawdy" birthday letter to Epstein, Trump threatens to sue Solve the daily Crossword
