ABSTRACT
Objectives: To study the influence of perinatal factors on cord blood TSH (CB TSH) levels. Design: Cross-sectional study. Setting: Tertiary care private hospital. Methods: CB TSH levels were measured in 952 live-born infants using electrochemiluminescence immunoassay. The effect of perinatal factors on the CB TSH levels was analyzed statistically. Results: The median CB-TSH was 8.75 microIU/mL (IQR = 6.475 – 12.82) with 11.5% neonates having values more than 20. CB TSH was significantly raised in first order neonates (P <0.01) and in babies delivered by assisted vaginal delivery and normal delivery (P <0.01). Neonates who had fetal distress or nonprogress of labour had significantly higher CB TSH than those who were delivered by elective caesarean section. Requirement of resuscitation beyond the initial steps and low Apgar scores at 1 minute also resulted in significantly raised CB TSH (both P <0.01). Maternal hypothyroidism, maternal hypertension and neonates’ weight appropriateness for gestation, gestational age and birth weight did not have significant effect. Conclusions: The incidence of high cord blood TSH (>20 microU/mL) is 11.45%. On multivariate analysis, requirement of resuscitation, mode of delivery and fetal distress as indication for LSCS were significant factors affecting CB TSH values. Hence, these values need to be interpreted in light of perinatal factors.
ABSTRACT
Context: Birth and immediate postpartum period pose many challenges for the newborn. The neonatal mortality rates are high in India, whereas the breastfeeding rates are still low. Hence, need exists for a simple and easily applicable intervention, which may counter these challenges. Aims: The present study was undertaken to evaluate the effects of very early skin-to-skin contact (SSC), in term babies with their mothers, on success of breastfeeding and neonatal well-being. Settings and Design: Randomized control trial conducted over 2 years’ period in a tertiary care hospital. Materials and Methods: Healthy babies delivered normally were included. Very early SSC between mothers and their newborns was initiated in the study group. We studied effective suckling (using modifi ed infant breastfeeding assessment tool [IBFAT]), breastfeeding status at 6 weeks, maternal satisfaction, thermal regulation, baby’s weight and morbidity. Statistical Analysis: T-test, Pearson Chi-square test and non-parametric Mann-Whitney test were used through relevant Windows SPSS software version 16.0. Results: We observed that SSC contributed to better suckling competence as measured by IBFAT score (P < 0.0001). More babies in the SSC group were exclusively breastfed at fi rst follow-up visit (P = 0.002) and at 6 weeks (P < 0.0001). SSC led to higher maternal satisfaction rates, better temperature gain in immediate post-partum period, lesser weight loss was at discharge and at fi rst follow-up (all P < 0.0001) and lesser morbidity than the study group (P = 0.006). Conclusion: Very early SSC is an effective intervention that improves baby’s suckling competence, maternal satisfaction, breastfeeding rates and temperature control and weight patterns.