Risk factors for neonatal mortality among very low birth weight neonates

The objective of this study is to determine risk factors causing increase in very low birth way [VLBW] neonatal mortality. The medical files of all neonates weighing <1500 gram, born in Vali-e-Asr hospital [2001-2004] were studied. Two groups of neonates [living and dead] were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age [P=0.02], low birth weight, lower than 1000 gram [P=0.001], Apgar score <6 at 5[th] minutes [P=0.001], resuscitation at birth [P=0.001], respiratory distress syndrome [P=0.001] need for mechanical ventilation [P=0.001], neurological complications [P=0.001] and intraventricular hemorrhage [P=0.001]. Regression analysis indicated that each 250 gram weight increase up to 1250 gram had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 gram should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 gram. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage

Caffeine consumption and incidence of hypertension in pregnancy

To study the effects of caffeine consumption on incidence of pre-eclampsia and gestational hypertension. In a case-control study, two groups of pregnant women were selected as follows: one group included 40 women suffering from hypertension in pregnancy, while the other group comprised 100 healthy pregnant women. Inclusion criteria for both groups were normal BMI [19-22] before pregnancy, no high-risk age group [18 -35 years] for preeclampsia, no underlying disease, no history of abortion, and regular prenatal care. We evaluated the amount an duration of caffeine consumption in both groups. In nine [25.5%] mothers of preeclampsia group and15 [15.8%] mothers of healthy pregnant group were observed to consume excessive amount of tea [more than four cups a day]. In the preeclampsia group, excessive consumption of tea was seen, but this difference [difference in what??] was not significant. Among 21 [51%] mothers in preeclampsia group and 64 [64.7%] mothers in the other group, there is not a significant relation in drinking different types of caffeine, like dark coca, soft drinks, or coffee with occurring of preeclampsia. After evaluation the obtained data, we did not observe any relationship between the risk of preeclampsia and consumption of different types of caffeine [tea, coffee, or soft drinks]. Perhaps, more holistic and broader studies in this area are required

Congenital hypothyroidism: a review of the risk factors

This study was aimed to evaluate the situation of congenital hypothyroidism [CH] in Guilan using the screening program and determine the correlation of CH with birth weight, gestational age and seasonality. During 2006 to 2010, in Guilan province, neonatal screening for CH by measurement of serum TSH level was performed in 3-5 days after birth. All neonates with TSH level >/= 5mu/l were referred to endocrinologists and serum TSH, T3 and T4 were measured. Based on public health data and profiles, total number of newborns, gestational age, route of delivery, birth season and birth weight in all screened neonates was reviewed and for ones with CH, their TSH measurements was also recorded. During 5 years, 119701 neonates were screened and CH was confirmed in 10.8% [221] of the referral cases [prevalence=1:542]. No significant statistical difference was seen between gender and birth season among patients with CH and the rest of the population. Interestingly, low birth weight [LBW] [31% vs. 4.9%, P<0.01], postdate delivery [1.4% vs. 0.2%, P<0.01] and macrosomia were more prevalent in CH versus normal population [Odds ratio for post-date delivery was 6.9 and for LBW was 3.2]. Rate of normal vaginal delivery [NVD] was significantly higher in neonates with CH compared to normal population [39.2% vs. 29.2%, P=0.01]. LBW, postdate delivery and macrosomia are risk factors for CH. No association between sex, birth season or caesarian section delivery was seen

Perinatal risk factors for neonatal asphyxia in Vali-e-Asr hospital, Tehran-Iran

Asphyxia is a medical condition in which placental or pulmonary gas exchange is impaired or they cease all together, typically producing a combination of progressive hypoxemia and hypercapnea. In addition to regional differences in its etiology; it is important to know its risk factors. This is a case-control study, all neonates born from May 2002 to September 2005 in Vali-e-Asr Hospital were studied. 9488 newborns were born of which 6091 of the live patients were hospitalized in NICU. 546 newborns were studied as case and control group. 260 neonates [48%] were female and 286 neonates [52%] were male. Among the neonates who were admitted, 182 of them were diagnosed with asphyxia and twice of them [364 newborns] were selected as a control group. The variables consist of; gestational age, type of delivery, birth weight, prenatal care, pregnancy and peripartum complications and neonatal disorders. Our studies showed that 35 [19.2%] patients had mild asphyxia, 107 [58.8%] had moderate asphyxia and 40 [22%] were diagnosed as severe asphyxia. Mean maternal age was 34.23 +/- 4.29yr; [range: 23-38 yr]; and mean of parity was 2 +/- 1.2; [range: 1-8]. Risk factors in our study included emergent Caesarian Section, preterm labor [<37w], low birth weight [<2500g], 5 minute Apgar [less than 6], need for resuscitation, nuchal cord, impaired Biophysical Profile, neonatal anemia, and maternal infertility. All risk factors listed above play a role in asphyxia. The majority of these factors are avoidable by means of good perinatal care

randomized controlled clinical trial of olive oil added to human breast milk for weight gaining in very low birth weight infants

Evaluating the effect of vegetable oil, as a supplement to breast milk in increase the weight gaining of VLBW neonates. In this single blind; Randomized clinical trials, in NICU of Vali-asr Hospital, Tehran University of Medical Sciences, 2005-2006;A total of 48 VLBW neonates referred and admitted to NICU, who did not have any major GI [especially NEC], respiratory or cardiac diseases; participated randomly in two groups: intervention and control.Vegetable oil was added to the milk of 25 neonates [0.5 cc per 30cc of milk] and the other 25neonates with similar conditions that were selected as a control group, did not get any type of supplementary nutrition. Daily feeding volume in both groups was 150-200 cc for each kilogram of body weight. Weight gaining in interventional groups was considerably more than control group. [p<0.04].There were also significant statistical differences in hospitalization period between the two groups, 28.9 days in interventional and 20.33 days in control group, [p<0.03].However, no significant side effects were observed. There is no report regarding contraindication linking the use of vegetable oil intended for appropriate weight gaining or reducing hospitalization period to neonatal chronic diseases

Comparison of two regimens of RhG-CSF in neutropenic neonatal septicemia: a randomized clinical trial

Considering the 50% mortality rate of neonatal septicemia associated with neutropenia and increasing resistance to antibiotics, simultaneous antibiotic therapy strategies are becoming more important. However, few studies have been performed to evaluate effectiveness of RhG-CSF in the treatment of neutropenia in neonates. This randomized clinical trial was performed on 40 neutropenic neonates with septicemia who were hospitalized in Vali-e-Asr and Mirza Koochak Khan Hospitals [Tehran, Iran]. The neonates were randomly divided into two equal groups RhG-CSF was administered as a subcutaneous single dose of 10 micro g/kg/s.c. to neonates in group A and as 10 micro g/kg/s.c./day once daily for 3 days to neonates in group B. CBC and differential count was checked 6, 24 and 48 hours after the last dose. There was no significant difference in mean birth weight, gender, age, and risk factors between two groups. Neutropenia was improved 48 hours after the last dose, whilst there was no significant statistical difference between two groups [P>0.05]. The final outcome including death, duration of hospitalization and duration of antibiotics therapy after RhG-CSF administration did not differ between two groups [P>0.05]. The results of this study showed that administration of a single dose of RhG-CSF [10 micro g/kg] was effective in treating neonatal septicemic neutropenia