Cord Blood Lipid Profile of Term and Preterm Newborns in a Tertiary Hospital in South East Nigeria: Relationship with Gestational Age and Birth Weight

Background: Early-onset atherosclerosis is a marker of future cardiovascular diseases. However, indicators of early dyslipidemia for primary prevention are generally lacking in sub-Saharan Africa. This study aimed at describing the cord blood lipid profile among apparently healthy newborns in a tertiary hospital in Southeast Nigeria, and its relationship with gestational age and birth weight.Methods: Cross-sectional study of 167 consecutively recruited apparently well newborns in a tertiary hospital whose cord blood lipid profile parameters (total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL ­C), low-density lipoprotein cholesterol (LDL ­C) and very low-density lipoprotein cholesterol (VLDL ­C)) were assessed using an autoanalyzer (BiOLis 24i). Lipid variables were presented with descriptive statistics whereas their relationship with gestational age and birth weight was highlighted using Spearman's rank correlation analysis. Dunnett's T3 Post Hoc analysis was used for pairwise comparisons.Results: The 167 newborns recruited included 15 (9%) moderate preterm, 46 (27.5%) late preterm and 106 (63.5%) term babies of which 79 (47.3%) were males and 88 (52.7%) were females. The number of recruited SGA, AGA and LGA were respectively 13 (7.8%), 142 (85%), 12 (7.2%). Mode of delivery was majorly vaginal delivery (69.5%) while the rest (30.5%) was by caesarean section. The median values (in mg/dL) of TC, TG, HDL ­C, LDL ­C and VLDL ­C were 60.0, 30.5, 29.0, 25.8 and 6.1 respectively, all within the normal international ranges. Triglycerides and VLDL-C had a moderate positive correlation with gestational age (rs = 0.4;p < 0.001) and were significantly higher in small-for-gestational-age newborns. Total cholesterol, HDL ­C, and LDL-C had a weak negative correlation with gestational age and birth weight (spearman rs˂-0.3). Birth weight, gestational age, and paternal age were the common predictors of lipid profile variability.Conclusion: The finding of a significant relationship between lipid variables with gestational age and birth weight underscores the need to clinically interpret these given the relationship. The relationship with paternal age is another interesting finding which needs to be replicated and the mechanism(s) elucidated.

Accuracy of the product of symphysio-fundal height and abdominal girth in prediction of birth weight among term pregnant women at Keffi, Nigeria

Background: A reliable prediction of foetal birth weight aids in decision regarding time and mode of delivery. Aim: This study aimed to determine the accuracy of the product of symphysio-fundal height and abdominal girth in predicting birth weight among pregnant women in Keffi, Nigeria. Setting: The study involved pregnant women presenting for delivery at the Federal Medical Centre, Keffi, Nigeria from July to October 2017. Methods: One hundred and fifty-three pregnant women at term with singleton foetuses were recruited by systematic random sampling. An interviewer-administered questionnaire was used to obtain their socio-demographic data, past medical and obstetric history. Symphysio-fundal height and abdominal girth measurements were used to calculate the estimated foetal weight. This was compared with the actual birth weight. Absolute percentage error was used to determine the overall predictive error of Dare's formula. Data were analysed using SPSS version 20.0. Statistical significance was set at p < 0.05 and 95% confidence level. Results: The mean age of the participants was 29.65 ± 5.15 years. The mean gestational age was 39.5 ± 1.2 weeks. There was a significant correlation (r = 0.52, p < 0.001) between the estimated foetal weight and the actual birth weight. Ninety (66.2%) of the babies within normal weight and six (85.7%) of macrosomic babies were correctly predicted. None of the low birth weight babies was correctly predicted by the formula. Conclusion: Dare's formula accurately predicted normal weight and macrosomic babies, but less accurately predicted low birth weight babies

The effects of maternal age and parity on the birth weight of newborns among mothers with singleton pregnancies and at term deliveries

Background: Birth weight is the most important factor determining the survival, growth and development of a newborn. Parity and maternal age have been shown to increase the risk of adverse neonatal outcomes, such as intra-uterine growth restriction (IUGR), low birth weight (LBW) and mortality. Objective of the study: The study was aimed at investigating the effects of maternal age and parity on the birth weight of newborns from singleton pregnancies and term deliveries. Materials and Methods: An institutional-based, retrospective, cross-sectional study design was employed at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia from April to July 2018. In total, 4,590 mothers with term delivery and singleton pregnancy from June 2015 to May 2017 were included in the study. Data on gestational age (GA), parity, history of ANC follow-up, source of referral and birth weight of the child was included. The collected data were analyzed using SPSS version 23 statistical package, and multiple logistic regression was carried out to determine the effect of maternal age and parity with respect to LBW. Results: Grand multiparous women (parity ≥5) have an adjusted odds ratio (AOR) of 3.89 with 95% confidence interval (CI = 2.19, 6.93) compared to multiparous women (p=2-4). Nulliparous women (p=0) have an AOR of 0.23 (95%CI = 0.19, 0.38) compared to multiparous women. Primiparous women (p=1) have an AOR of 0.22 (95% CI = 0.16, 0.30) compared to multiparous women. Women aged 40 and above have an AOR of 1.96 (95% CI = 1.22, 3.20) compared to women aged 30-34. The mean birth weight (MBW) of newborns was 3,075.41±569.58 grams (mean±SD). Conclusions: In this study, the risk of LBW was higher in grand multiparous women compared to multiparous women. Primiparous and nulliparous women have less risk of having an LBW baby compared to multiparous women. A maternal age of 40 and above were associated with a higher risk of delivering an LBW newborns compared to a maternal age of 30-34. Therefore, special attention should be given to deliveries at an advanced age and multiparous cases to reduce the incidence of LBW

Profile of Babies Born before Arrival at Hospital in a Peri-Uban Setting

Background. Babies born before arrival (BBAs) at hospital constitute a special group at risk of high morbidity and mortality.Objective. We conducted a 12-month retrospective review to describe maternal and neonatal characteristics of BBAs; and their outcomes compared with babies born in the state health sector.Methods. Using case-control sampling; all babies born outside a health facility and who presented to hospital within 24 hours of life were included and compared to the next in-hospital delivery occurring immediately after each BBA presented. Results. During the period reviewed; 135 BBAs (prevalence 1.8) presented; 71 after hours with most deliveries occurring at home (73.8). There was no birth attendant present at 70.5 of deliveries. Average birth weights were similar (2.86 kg in the BBA group; 95 confidence interval (CI) 2.73 - 2.95; 2.94 kg in the control group; 95 CI 2.78 - 3.02); but significantly more preterm babies were found in the BBA group (23 v. 9; respectively; p0.0001). Admitted BBAs had significantly lower average weights than those who were not admitted (2.19 kg v. 2.96 kg; respectively; p0.0001). No significant differences were found when maternal age; parity; co-morbidities and distance from the hospital were compared. There were significantly more unbooked mothers in the BBA group (23.0 v. 6.7; respectively;p0.0001). Only 54.40 of the admitted BBAs' mothers had booked antenatally; compared with 78.89 of mothers whose babies were discharged. Admission and complication rates were similar between the groups; but average length of stay was longer in admitted BBAs compared with controls. Conclusion. The prevalence of BBAs in this study is comparable to that in other developing countries; and is associated with poor antenatal attendance; prematurity; delay in presentation to hospital and lengthier hospital stays. These factors have implications for prehospital care of newborns and access to maternal and child healthcare in general

Birth Weight Recovery among very Low Birth Weight Infants Surviving to Discharge from Charlotte Maxeke Johannesburg Academic Hospital; Neonatal unit

Background. The recommended growth velocity (GV) of very low birth weight (VLBW) infants is 15 g/kg/day. Several factors have been associated with poor postnatal weight gain. Objective. To provide current information on the postnatal growth of VLBW infants at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).Methods. This was a longitudinal study of VLBW infants surviving to discharge from CMJAH neonatal unit from August to October 2013.Results. Sixty-nine infants were included in the study. The mean GV was 13.2 g/kg/day; the median weight loss was 7.69 and the median time for regaining birth weight was 16 days. Fifty-one infants (73.9) regained their birth weight at or before 21 days. There was a decrease in mean z-scores for weight (ZSWs) from -0.32 (standard deviation 1.25) at birth to -1.94 (1.35) at discharge. A multiple linear regression showed a negative association between ZSW at discharge and number of days nil per os without parenteral nutrition (PN). Antenatal steroids were associated with poor GV. There were no factors associated with regaining birth weight after 21 days on multiple logistic regression.Conclusion. This study showed a GV in VLBW infants approaching recommended standards. Number of days without PN and use of antenatal steroids were associated with poor postnatal growth

Stillbirth Rates in Singleton Pregnancies in a Stable Population at Karl Bremer and Tygerberg Hospitals Over 50 Years

Objectives. To determine the changes in stillbirth rates in singleton pregnancies in a stable population over a period of 50 years. Methods. Stillbirth rates for singleton pregnancies where the fetus weighed 1 000 g or more were collected from 1962 to 2011. From 1972 to 2011; rates included fetuses weighing 500 g or more at birth. Results. When the birth weight was 1 000 g or more the stillbirth rate declined from 70 to 12.6 per 1 000 births; and when the birth weight was 500 g or more it dropped from 34.2 to 24.5. The decline was very much slower towards the end of the study period. Conclusion. To achieve further sustained reductions in stillbirth rates; healthcare workers should continue to emphasise quality of healthcare; but they should also address and prevent specific conditions associated with stillbirth; such as smoking and drinking during pregnancy

Timing of Spontaneous Birth and the Risk of Adverse Perinatal Outcome

Abstract:The study aspired to assess the impact of time of birth on spontaneous onset of labour and delivery. A retrospective descriptive study was conducted from the Empangeni Hospital delivery registry on 9;397 infant births between January to December 2005; weighing more than 1;000 g. Logistic regression; adjusting for birth weight and for gender was used to estimate the relationship between spontaneous birth and timing of birth. A higher proportion of births (59) occurred between 10h00 and 22h00 of the day. Estimating the hourly births; we found that the daytime peak is 5.3 and occurred at 10h00 while the night-time peak is 4.9 and occurred at 20h00. Maternal age was significantly associated with the timing of spontaneous births (p 0.05). A higher proportion of preterm babies was born during the day (6.4) and early night (3.4) compared to late night births (1.6). There were significant differences between multiple births and low birth weight infants born during the day (1.1; 6.9) and night (0.8; 6.3). However; low birth weight babies were born mostly during early night rather than late night (4 vs. 2.3; p 0.05). Adverse pregnancy outcome; measured by estimating the perinatal mortality rate; was the same for day and night and was equally distributed between early and late night. Timing of birth of infants did not influence the negative outcomes of pregnancy among this study population

Incidence of Delivery of Low Birthweight Infants in Twin Gestations

Twin gestations are commonly associated with delivery of low birthweight infants. Despite the fact that Nigeria has the highest incidence of twinning in the world; there is paucity of information on the characteristics ofLBWtwin infants in Nigeria. To determine the incidence and document some of the characteristics of low birth weight (LBW) twin infants. Adescriptive analysis of data on 119LBWtwin infants delivered between 1st January; 2000 and 31st December; 2003 in a Nigerian mission hospital in Benin City was carried out. The characteristics of the LBW twin infants was studied in relation to perinatal mortality. The overall incidence of LBWtwin infants was 51.7with a female preponderance. Of the 107 liveborn LBWtwins; 74 (69.2) compared to 33 (30.8) were preterm and term small-for-gestational age (SGA) infants respectively (p

Poids de naissance; infection palustre placentaire et deficit ponderal saisonnier a Bobo-Dioulasso (Burkina Faso)

L'Insuffisance ponderale a la naissance a ete definie comme correspondant a un poids inferieur a 2500g. Differentes enquetes sur le couple mere-enfant ont ete effectuees dans la ville de Bobo-Dioulasso (Burkina Faso); par l'Antenne ORSTOM aupres du Centre Muraz/OCCGE entre 1983 et 1985. Un examen clinique est effectue en maternite (fiche d'enquete mere/nouveau-ne) pour connaitre a l'interrogatoire l'histoire de la grossese; rechercher des episodes febriles et d'eventuels traitements palustres. Le deficit ponderal du nouveau-ne a Bobo-Dioulasso est de 2892g (+-023g). Ce poids moyen de naissance est dans les limites de ce qui est observe dans les differents autres pays africains; c'est a dire situe entre 2800g et 3100g pour les nouveau-nes d'Afrique noire inter-tropicale. La responsabilite de cette infection palustre dans les petits poids de naissance doit etre ponderee; l'infection palustre n'est qu'un facteur supplementaire dans ce groupe a risque obstetrical que constituent les jeunes parturientes

Influence of maternal bio-social factors on birthweight

Influence of maternal bio-social factors; including age; pre-pregnancy weight/height; social class; birth-order; birth-spacing; educational level and use of antenatal-care facilities; on birthweights of 1;238 singletons was studied over a period of six months at three hospitals in Ibadan. There was a significant (p0.001) influence on birthweight by the age of the mother; such that teenage mothers gave birth to lighter babies than older mothers. The study also revealed that the most appropriate period in life for a woman to have normal size babies was between 25 and 29 years of age. There was a significant difference (p0.05) between the mean birthweight of babies delivered by mothers weighing less than 70kg and those whose weights were 70kg and above

The effect of mother's age; parity and antenatal clinic attendance on infant birth weight

Data from 252 deliveries at a rural hospital during 1988 and 1989 showed that infants born to adolescent mothers had the lowest mean birth wieght and highest incidence of low birth weight. Adolescent mothers were; in general; mothers of low parity level; and highest incidence of low birth weight was observed in mothers of parity 0 or 1. Average virth weights were higher at parity levels of 4 and 5. Although almost every woman attended the antenatal clinic; women who attended the clinic more than 3 times during pregnancy tended to have higher birth weight infants. More detailed data from 40 of these deliveries suggested that low socioeconomic status and household food insecurity during pregnancy are also associated with lower birth weight infants

Research and intervention issue concerning infant and child mortality and health

The Harare population birthweight for gestation standards were constructed using data from 5 872 singleton livebirths. A further 18 091 births were analysed to determine the relationship; if any; between birthweight for gestation centiles and risk of perinatal mortality. The results showed an overall perinatalmortality of 41.1/1000. The least perinatal mortality occurred at a gestation of39 weeks at a birthweight of 3 500 - 3 750 gms. The lease perinatal mortality occurred when the birthweight was between the 50th and 95th centiles at any given gestation. When the perinatal mortality for each week of gestation and birthweight cell of 250g size was calculated; this showed a pattern which could be represented graphically in zones of perinatal risk. Such zones form the basis for a simple method of determining perinatal mortality risk using both birthweight and gestation

Report

In appreciating the importance of food and nutrition surveillance as a tool for identifying problems of household food and economic security; the workshop papers discuss and examine the results of two research projects namely - the impact of the agricultural commercialization on nutrition and food consumption in Malawi; and maternal and child nutrition in Malawi