Association between maternal and neonatal blood pressure

This study aims to describe the blood pressure profile of newborns of preeclampsia mothers in Vali-e-Asr hospital during 2003-2004. In this cross-sectional descriptive analytical study 200 mothers and their newborns were studied. Blood pressure of all newborns was checked by oscillometric method on the first day after birth and recorded in a questionnaire along with information pertaining to the mother, obtained by interview or through medical file retrieval. The newborns of mothers with high systolic [>140 mmHg] and diastolic [>90 mmHg] blood pressure had mean systolic [65.40 mmHg] and diastolic [42.85 mmHg] blood pressures higher than that in neonates of normotensive mothers[P <0.006]. Mean systolic and diastolic blood pressure of neonates whose mothers were preeclampsia [68.2/42.11 mmHg or chronically hypertensive [68.59/ 41.50 mmHg-] were significantly higher than neonates of normotensive mothers [P<0.0001 and P<0.002, respectively].Newborns of smokers had significantly higher blood pressures too [P<0.02]. Mother's blood pressure can affect neonatal blood pressure. Chronic hypertension, pre-eclampsia, and cigarette smoking in mothers can adversely alter neonatal blood pressure. These maternal conditions should be screened and managed as soon as possible

Risk factors for neural tube defects: a study at university-affiliated hospitals in Tehran

Neural tube defects have a complex and imperfectly understood etiology involving both genetic and environmental factors. In this case-control study, we tried to determine the association of known risk factors for neural tube defects in patients referred to university-affiliated hospitals with neurosurgical services in the city of Tehran. Risk factors were assessed in-person through interviews with infants' mothers. We found 192 neural tube defect cases. One hundred and ninety-three apparently normal babies were randomly selected from the same hospitals to serve as control cases. Maternal age of less than 18 years [P = 0.02], female sex of the child [P = 0.01], birth in spring and summer seasons [P = 0.001], history of not using folic acid [P = 0.001], less than 5 prenatal visits [P = 0.001], and poverty [P = 0.02] were the most important risk factors for neural tube defects. Logistic regression analysis of these risk factors confirmed these correlations. A negative history of consuming folic acid had the most significant statistical correlation with these malformations. Poor quality diets were an important environmental risk factor in this study

Pedunculated sacral lipoma presenting as a human pseudotail

A long pedunculated egg-shaped lipoma of the sacrum in a newborn infant, presenting as a tail, was treated surgically.Occult spinal dysraphism may be accompanied with this entity. Investigations for underlying dysraphism and its treatment are mandatory

Comparison of morbidities between infants of pregestional and gestational diabetic monthers

To describe and compare the clinical outcome of infants born to mothers with gestational and pregestational diabetes mellitus, this study was conducted between January 2000 to January 2002 in Tehran Vali -E-Asr Hospital. Among 4472 deliveries, we found 107 infants born to diabetic mothers out of whom 6 were twins. The prevalence of diabetes in total deliveries was 2.39%. Mean age of gestational and pregesstational diabetic mothers was 30.9 +/- 5.86 and 31 +/- 5.37 respectively. 74 infants [69%] belonged to gestational diabetic mothers. 50% of infants were males. Mean birth weight of infants was 3067 +/- 784.917 [700-5600g]. Gestational age in 57% of was less than 38 weeks. APGAR score at 1 and 5 minutes was <6 in 10 and 5 cases respectively. Hypoglycemia was detected in 31%, hypocalcemia in 13%, hypomagnesemia in 4.5%, polycythemia in 6.8%, macrosomia in 28.6%, small for gestational age in 2%, respiratory distress syndrome in 8.2%, early sepsis in 9.2%, NICU admission in 23.7%, and hyperbilirubinemia in 34%. The incidences of most of these morbidities were higher in infants of pregestational diabetic mothers. The differences between the incidence of hypoglycemia, hypocalcemia and 5 minute APGAR score in infants of pregestational and gestational diabetic mothers were significant [p<0.05]. There was a significant correlation between the incidence of hypoglycemia and birth weight of infants [p<0.05]. The existence of congenital anomalies in infants of gestational diabetic mothers could be due to unrecognized cases of noninsulin dependent diabetes mellitus, and with respect to mean age of mothers it is advisable to detect diabetes before pregnancy in high risk groups and correct the level of hemoglobin A [1c] before pregnancy. Cleft palate and undescended testes among the anomalies support this hypothesis that prostaglandin deficiency may have a role in the pathophysiology of congenital malformations in these infants

value of ponderal index as a prognostic factor in predicting complications in term neonates

Rohrer's ponderal index in newborns [birth weight [*] 100/height] has been used as an indicator of fetal growth status, especially to assess asymmetrical intrauterine growth retardation. Low ponderal index or disproportionate intrauterine growth retardation has higher neonatal morbidity and there are some specific guidelines in intrauterine growth retarded infants to control some of their prevalent complications like hypoglycemia. As there are no specific guidelines to control and screen some possible morbidities in babies with more than 2500 gram weight, we decided to determine the association between different ponderal index values and neonatal complications such as hypoglycemia, meconium aspiration syndrome, hyperbilirubinemia, perinatal resuscitation and duration of hospital stay in first born term infants. Three-hundred and sixty-one first born infants were studied during April 2000 to April 2001. Low, appropriate and high ponderal indexes were detected in 20.5%, 51% and 28.5% of infants respectively. Among these infants, there were 47 intrauterine growth retarded cases. The frequency of hypoglycemia, meconium aspiration syndrome, hyperbilirubinemia and age at hospital discharge with a stay of more than 7 days were higher in the low ponderal index group than the other two groups and the statistical differences were significant [p< 0.05]. Comparing neonatal morbidities according to birth weight [more or less than 2500 g], we could not find significant differences except in hypoglycemia [p< 0.05]. This study showed that a low ponderal index could be used as a prognostic factor in predicting some morbidity in term neonates