Factores de riesgo relacionados con el bajo peso al nacer

La reducción del bajo peso al nacer es importante para obtener mejores resultados en la mortalidad infantil. Por eso nos planteamos el objetivo de: identificar los factores asociados con el riesgo de bajo peso al nacer, por su incremento en el municipio Río Cauto. Se realizó un estudio descriptivo de corte transversal, que incluyó a 51 gestantes que tuvieron recién nacidos con bajo peso al nacer de enero a diciembre del año 2022. Se utilizaron las variables: edad gestacional en el momento del parto, áreas de salud, peso de los nacidos vivos y por grupos de edad materna, paridad y patologías detectadas durante el embarazo. Hubo 528 nacidos vivos y 51 tuvieron un peso inferior a 2500 gramos, con un índice de (9.66 %); el parto pretérmino predominó en el Policlínico "Camilo Cienfuegos" con 5 neonatos (5.00 %) y el crecimiento intrauterino retardado en el Policlínico "Ernesto Guevara" con 14 nacimientos (9.03 %); el mayor por ciento de bajo peso ocurrió de 20 a 34 años de edad, 35 (68.63 %), donde sobresalió el policlínico "Máximo Gómez" con 18 (75 %). En los nacimientos por grupo de edades, el índice de bajo peso fue mayor en pacientes menores de 20 años, 14 (12.84 %). En el bajo peso predominaron: las nulíparas en 25 nacimientos (49.02 %), la anemia y embarazo 27 (52.94 %) y el síndrome de flujo vaginal 20 (39.22).

Summary Reducing low birth weight is important for better outcomes in infant mortality. That is why we set ourselves the objective of: identifying the factors associated with the risk of low birth weight, due to its increase in Río Cauto. A descriptive cross-sectional study was conducted, which included 51 pregnant women who had low birth weight newborns from January to December 2022. The following variables were used: gestational age at the time of delivery, health areas, live birth weight and maternal age groups, parity and pathologies detected during pregnancy. There were 528 live births and 51 had a weight of less than 2500 grams, with a rate of (9.66%); preterm delivery predominated at the Camilo Cienfuegos Polyclinic with 5 neonates (5.00%) and intrauterine growth retardation at the Ernesto Guevara Polyclinic with 14 births (9.03%); The highest percentage of underweight occurred between 20 and 34 years of age, 35 (68.63%), where the Máximo Gómez 18 polyclinic (75%) stood out. In births by age group, the rate of low birth weight was higher in patients under 20 years of age, 14 (12.84%). Nulliparous women predominated in 25 births (49.02%), anemia and pregnancy in 27 (52.94%), and vaginal discharge syndrome in 20 (39.22).

A redução do baixo peso ao nascer é importante para melhores desfechos na mortalidade infantil. Por isso, nos propusemos a identificar os fatores associados ao risco de baixo peso ao nascer, devido ao seu aumento no Rio Cauto. Foi realizado um estudo transversal descritivo, que incluiu 51 gestantes que tiveram recém-nascidos de baixo peso ao nascer no período de janeiro a dezembro de 2022. As seguintes variáveis foram utilizadas: idade gestacional no momento do parto, áreas de saúde, peso ao vivo e faixas etárias maternas, paridade e patologias detectadas durante a gestação. Foram 528 nascidos vivos e 51 com peso inferior a 2500 gramas, com taxa de (9,66%); predomínio de parto pré-termo na Policlínica Camilo Cienfuegos com 5 neonatos (5,00%) e retardo de crescimento intrauterino na Policlínica Ernesto Guevara com 14 nascimentos (9,03%); O maior percentual de baixo peso ocorreu entre 20 e 34 anos de idade, 35 (68,63%), onde se destacou a policlínica Máximo Gómez 18 (75%). Nos nascimentos por faixa etária, a taxa de baixo peso ao nascer foi maior nas pacientes com menos de 20 anos, 14 (12,84%). Nulíparas predominaram em 25 partos (49,02%), anemia e gravidez em 27 (52,94%) e síndrome do corrimento vaginal em 20 (39,22).

Association of maternal clinical factors with neonatal respiratory morbidity in meconium‑stained labor among term parturients: A retrospective cohort study / Philippine Journal of Obstetrics and Gynecology

Objective@#This study aimed to determine the maternal clinical factors associated with neonatal respiratory morbidity and other adverse neonatal outcomes in meconium-stained labor among term parturients.@*Methodology@#A retrospective cohort study was done on admitted obstetric patients with term gestation and had meconium-stained labor. Maternal clinical factors such as age, parity, gestational age, manner of delivery, duration of labor, presence of term prelabor rupture of membranes (PROM), character of meconium-stained liquor (MSL), and presence of comorbidities were identified and analyzed to determine their association with neonatal respiratory morbidity and other adverse neonatal outcomes. @*Results@#In this study, there were 986 cases identified to have meconium-stained labor, and 168 developed neonatal respiratory morbidity. As to primary outcome, maternal clinical factors, such as age >35 years, multiparity, age of gestation >41 weeks, prolonged labor, presence of PROM, significant MSL upon admission, presence of change from nonsignificant to significant MSL, presence of intrauterine growth restriction, and hypertension, were all shown to be statistically significant. @*Conclusion@#The presence of maternal clinical factors in meconium-stained labor was observed to be a risk factor in developing neonatal respiratory morbidity and other adverse neonatal outcomes. Hence, identification of maternal risk factors and early detection of meconium-stained amniotic fluid are vital in administering timely intervention to labor and delivery to reduce neonatal complications.

Association Between Maternal Risk Factors and Low Birth Weight: A Hospital Based Cross-Sectional Study in Western Odisha, India

ABSTRACTBackground: World Health Organization has defined low birthweight (LBW) as birth weight less than 2,500 grams. LBW is animportant indicator of reproductive as well as general healthstatus of a given population. The aetiology of LBW ismultifactorial. The current study was conducted to find out thematernal risk factors associated with LBW delivered in V.S.SMedical College& Hospital, Burla.Materials and Methods: It was hospital based cross -sectionalstudy comprising of 1030 postnatal women and their newbornswho delivered single live baby in V.S.S Medical College&Hospital, Burla. Selection of study participants done bysystematic random sampling. The study was conducted fromOct 2012 to September 2014.Results obtained was expressedin simple number and percentages. Chi-square test was usedto measure the association between LBW and variousmaternal risk factors.Results: The proportion of LBW was found to be 27.76%. Theproportion of LBW was found high and significant in Primimothers (31.09%), birth spacing < 36 months (28.93%),gestational age < 37 weeks (62.94%), obstetric complications(31.12%), major medical illness (44.07%), Haemoglobin<11gms (34.32%), weight gain <10 kg during pregnancy(41.60%), late registration (33.62%), < 4 ANC visit (52.79%),<100 IFA tab. Consumption (44.70%) and without calciumsupplementation (33.60%).Conclusions: The finding of the present study indicates thatLBW can be tackled by maternal education, socioeconomicdevelopment and providing adequate antenatal care topregnant women in time.

Risk factors and perinatal outcome associated with low birth weight in a prospective cohort: is there a shift towards sustainable developmental goal 3

Background: Low birth weight is a socio, economic, cultural and community based health issue which reflects responsibility and commitment of local and national administrative authorities. It continues to be a cause of short and long term adverse perinatal outcome with a bearing on adult non communicable health risks.Methods: This is a prospective observational and analytic study to know the prevalence, risk factors and perinatal outcome of LBW, from July 2017 to December 2018 in department of Obstetrics and Gynecology, MIMS Medical College, Andhra Pradesh, India. Maternal risk factors and outcomes associated with LBW were defined through risk ratios.Results: 721 infants including 116 LBW and 605 NBW born during study period were included in the study. Prevalence of LBW was 16%. Preterm birth accounted for 35%, FGR for 13.8% and SGA for 51.2% of them. Maternal factors like age <20 years and >35years, social status II to IV, below higher secondary education, house maker, primi gravida, grand multi para, BMI <18.5kg/M2 or >24.9kg/M2, Hb<11 gm% were having higher RR for LBW. LBW infants showed frequent association with oligo or polyhydramnious and hemorrhagic or turbid amniotic fluid. They had higher risks for non reassuring fetal heart rate changes, for induced delivery or an elective caesarean section. More often they needed NICU care for longer duration and showed a higher risk for malformations and neonatal mortality. Overall perinatal mortality was 5.54 per 1000 live birth.Conclusions: LBW is a risk factor for neonatal morbidity and mortality; which can be minimised by institutional delivery. High prevalence PTB (35%) warrants obstetricians to be more vigilant about indentifying the risk factors and adequate management planning. Constitutionally small baby at birth probably needs redefining normal birth weight for different ethnicity.

Maternal risk factors and immediate outcome of late preterms

Background: This study was conducted to analyse the immediate outcome of late preterm babies and also to evaluate the various maternal risk factors in these babies so that close monitoring of these babies for the complications is done and immediate problems can be addressed.Methods: Prospective observational study done in level 3 NICU setting for 6 months. All babies born between 34-36/7 weeks are included in the study and they constitute the cases. Term (above 36 weeks 6 days gestation) newborns babies born during the study period are controls. Maternal history is taken in detail. Risk factors during pregnancy including maternal age, gravida, mode of delivery, medical conditions and birth details. Baby details like gestational age, sex, birth weight, and neonatal morbidities are recorded. The babies are either shifted to NICU or to mother's side based depending on the baby's condition. All of them are followed up till discharge.Results: 89 late preterm babies born in the hospital during the study period are included in the study. Out of 89 babies 45are females constituting 50.6% and 44are male babies constituting 49.4%. 20 (22.5%) babies had gestational age between 34-35 weeks.29 babies (32.5 %) had gestational age between 35-36 weeks and 40 babies (45%) are between 36-37 weeks of gestation. 47 babies (52.9%) have birth weight between 1.5-2.49 kg.42 babies (47.1%) have birth weight between 2.5-3.5 kg. The number of babies born by LSCS were 48 (54%) and 41 babies 46% are born through vaginal route.42 babies constituting 48.3% are appropriate for gestational age and 43 babies (49.4%) are small for gestationalage.34 (39.1%) babies required NICU admission and 55 (60.9%) babies did not require NICU admission. Among the maternal risk factors PIH was the commonest risk factor in 22babies (24.7 %), followed by PROM13 (14.6 %), oligohydramnios 6 (6.7 %) ,twin gestation 6 (6.7 %), MSAF 3 (3.4%), IDM 3 (3.4%), Antepartum hemorrhage 3 (3.4%), eclampsia 1 (1.1%) and maternal cardiac disease 1.1%. Neonatal morbidities are 25 late preterm babies had jaundice (28.7%) followed by RDS in 15 (17.2%), sepsis in 9 (10.3%), NEC 2 (2.3%), Hypoglycemia 5 (5.6%) late preterm babies required ventilation/ CPAP constituting 5.7%. Surfactant was used in 2 late preterm babies 2.3%. 87 babies (97.8%) got discharged and mortality is 2.2%.Conclusions: Late prematurity is associated with significant neonatal morbidity.

Maternal risk factors and its association with low birth weight: a study from rural area of Maharashtra

Background: Low birth weight is single most important factor determining the survival chances of the child. A high percentage of low birth weight points to deficient health status of pregnant women, inadequate prenatal care and the need for improved care of the newborn. Present hospital based study was undertaken to identify the maternal risk factors associated with low birth weight babies.Methods: The present hospital based descriptive study was conducted at Swami Ramanand Teerth Rural Govt. Medical College and Hospital. The data collection was done during 1st March 2012 to 28th February 2013. All deliveries occurring on alternate days were included in the study which comes to, 1154 deliveries. Data was analysed by using SPSS 16.0 version.Results: The percentage of low birth weight babies was more in primipara mothers (25.53%). The percentage of low birth weight babies was high (34.56%) when pregnancy interval was 1 year. Percentage of low birth weight was maximum among mothers with no antenatal visits (42.93%). Percentage of low birth weight babies was more (38.75%) in mothers who had not consumed iron and folic acid tablets. Percentage of low birth weight babies was higher (35.62%) among mothers who had antenatal history of radiological exposure. Percentage of low birth weight babies was more (30.27%) in mothers who received inadequate afternoon rest.Conclusions: In our study low birth weight was commonly observed in primipara mothers, pregnancy interval less than a year, mothers with no antenatal visits, in mothers who had not consumed iron and folic acid tablets and with history of radiological exposure.

A study to assess the association between early childhood caries and relationship of Streptococcus mutans in saliva of mother, child and sibling pairs

Background: Early childhood caries (ECC) is a specific form of rampant caries that initially affects the primary maxillary anterior teeth of infants and children.' According to American Academy of Pediatric Dentistry (AAPD) 2011, early childhood caries is defined as the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries) or filled tooth surfaces in any primary tooth in a child under the age of six. The objective of this study was to assess the association between early childhood caries and relationship of Streptococcus mutans in saliva of mother, child and sibling pairs.Methods: Group 1 consists of fifty children with early childhood caries along with their mothers and siblings with the child age between 15 months to 5 years and sibling's age between 4 years to 10 years, whereas group 2 consists of fifty caries free children along with their mothers and siblings. For both groups, saliva samples were taken from the child, mother and sibling pairs to estimate the Streptococcus mutans count and to determine pH of saliva in these children. DMFT scores, debris scores checked for child, mother and sibling pairs.Results: Streptococcus mutans count was significantly high in group 1 than that of the group 2. Mothers were more co related to the children in the acquisition of Streptococcus mutans than the siblings. Increased no of meals of the child, pacifier use, low socio-economic status and low maternal education showed significant high correlation with caries prevalence. Low pH score was also significantly correlated with the increase in caries rate.Conclusions: Maternal factors such as high DMFT scores, low education levels, prolonged bottle-feeding with sweetened milk, pacifier use are strong risk indicators for identifying high caries-susceptible children.

Study on etiological profile of respiratory distress in new borns in a teaching hospital

Background: The aim is to study the various risk factors associated with development of severe respiratory distress in the new born.Methods: This was a prospective study of 200 new-borns with respiratory distress. Clinical details, etiology for the respiratory distress, system-wise factors responsible for the distress, severity and duration of respiratory distress, oxygen therapy, type of treatment, mortality, maternal and antenatal risk factors, radiological findings were noted in all the cases and were analysed.Results: Of the 200 cases with respiratory distress, 118 (59%) had severe respiratory distress. 154 cases with distress were of respiratory system in origin out of which 45% (70 out of 154) were due to Meconium aspiration syndrome, 42% (64 out of 154) were due to Respiratory distress syndrome, 12% (18 out of 154) were due to transient tachypnea of new-born and 2% were due to congenital pneumonia. More number of female patients had severe respiratory distress. Mortality was 2.5%.Conclusions: Meconium aspiration syndrome is the most common cause of respiratory distress in new born. Almost 60% of new borns with respiratory distress developed severe respiratory distress who required intensive monitoring. Risk factors like meconium stained liquor, vaginal delivered new borns, preterm gestation age, and female gender of new born were associated with severe respiratory distress in new borns.

Fetal Echocardiography: A Screening Tool for Congenital Heart Disease in Maternal Diabetes

Background: The imbalance of the adipoinsular axis has been shown recently to predispose to cardio renal syndromes. Epigenetics, which deals with the metabolic influences on genetic signaling, is a new concept. Diabetes during gestation can also cause an inflammatory response in placenta. The levels of leptin/adiponectin in the neonate of a mother with diabetes can affect post insulin signaling leading to fuel mediated teratogenicity. The reactive oxidative species generated at the maternal-fetal interface can alter inhibitory or permissive gene expression resulting in chromatin epigenetic remodeling of genes in multiple organs dysfunction, including the pancreas, kidney, heart, and the muscle. The fetal cardiac malformations can be mediated by these modifications of the transcriptome. Objectives: The primary objective of the study was to explore the relationship between maternal type II diabetes mellitus and gestational diabetes with congenital heart disease in new-borns. The secondary outcome of the study was to do pre-conception counseling and emphasize the importance of peri-conceptional sugar control. Materials and Methods: This prospective study involved cardiovascular system examination of 229 single pregnancies with pre-gestational and gestational diabetes (19 pregnant women were lost for follow up in control group). Two hundred twenty nine non-diabetic women of were taken as matched controls. The case and control group were comparable with no significant differences in maternal age, ethnicity and parity. Diabetic pregnant women were also offered fetal echocardiography at 24-28 weeks of gestation in second trimester. Results: In this study, 1 out of 78 gestational diabetes and 7 out 132 pregnancies with type 2 diabetes mellitus resulted in Congenital Heart Defects. Overt diabetes mellitus (p value significant) as compared to gestational diabetes was found to be a more likely risk factor associated with CHD. There were two cases of Ventral Septal Defect (VSD) in non-diabetic pregnant women diagnosed postnatally. Conclusion: Community education programmes should be initiated in high-risk population to promote better fetal surveillance in diabetic mothers for early in utero detection of cardiac defects. Maternal counseling for peri-conceptional control of blood glucose, adequate weight maintenance, intake of Insulin and exercise is needed to prevent CHD. Fetal echocardiography is a useful tool to screen high-risk fetus that require tertiary neonatal set up and emergency cardiac surgical interventions.

Maternal Risk Factors Predisposing to Congenital Heart Disease: A study in South India

Background: Congenital Heart Diseases (CHD) are defined as malformations of the heart and great vessels that develop in utero which may manifest at birth or later in childhood. They can be caused by numerous genetic and environmental factors. Genetic factors are nonmodifiable. However, identification of modifiable environmental risk factors is important to develop population based prevention strategies to reduce the incidence of CHD. Objectives: The primary objective of the study was to find an association of the maternal lifestyles with CHD in new-borns. The secondary outcome of the study was to identify maternal factors that can be modified for the primary prevention of CHD. Materials and Methods: This prospective study involved cardiovascular system examination of newborns after delivery in term gestations in 1394 singleton pregnancies. The maternal risk factors considered were age, prepregnancy Body Mass Index (BMI), consanguineous marriage, caffeine intake, diabetes, stress and intake of periconceptional Folic acid tablets. Results: In this study, 22 (1.58%) out of 1394 pregnancies resulted in Congenital Heart Defects. Teenage pregnancy (p value= 0.0002), consanguineous marriage (p value=0.0004), overt diabetes mellitus (p value=0.0001), caffeine intake (p value=0.0031), prepregnancy BMI>24(p value=0.0001), maternal stress (p value<0.0001, history of previous congenital malformations (p value=0.004) and non intake of folic acid tablets in the first trimester (p value=0.0023 were found to be the most likely risk factor associated with CHD. Conclusion: Community education programmes should be initiated in the high-risk population to prevent teenage pregnancies and consanguineous marriages. Maternal counseling for periconceptional control of blood glucose, adequate weight maintenance, intake of folic acid tablets, avoidance of stress and caffeine is needed to prevent CHD.

A multi-center research on risk factors of hyperbilirubinemia in late preterm infants / 中华全科医师杂志

Objective To investigate the risk factors of hyperbilirubinemia in late preterm infants. Methods The clinical data of 815 late preterm infants (449 males and 366 females) from 25 hospitals in Beijing were collected from October 2015 to April 2016, including 340 cases(41.7％) with hyperbilirubinemia (hyperbilirubinemia group), and 475 cases without hyperbilirubinemia (control group). The clinical data of two groups were compared, and the maternal factors influencing hyperbilirubinemia in late preterm infants were analyzed with logistic regression. Results There were no significant differences in gender ratio (M:F 1.39 vs. 1.12, t=1.811,P=0.172)and birth weight[(2502.6±439.6)g vs. (2470.2±402.9)g,χ2=2.330,P=0.127)]between two groups. The incidence rates of hyperbilirubinemia in infants of 34 wks, 35 wks and 36 wks of gestational age were 22.9％(87/174), 35％(119/300) and 42.1％(143/341) respectively (χ2=1.218,P=0.544). The multivariate logistic regression analysis indicated that the maternal age(OR=1.044,95％ CI:1.010-1.080,P=0.011)was independent risk factor and multiple births(OR=1.365,95％CI:0.989-1.883,P=0.048), premature rupture of membranes(OR=2.350,95％ CI:1.440-3.833,P=0.001), cesarean section(OR=1.540,95％CI:0.588-4.031,P=0.014)were risk factors for hyperbilirubinemia in late preterm infants. Conclusions The incidence of hyperbilirubinemia in late preterm infants is relatively high. Maternal age, multiple births, premature rupture of membranes and cesarean section are risk maternal factors related to hyperbilirubinemia in late preterm infants.

Sepsis neonatal temprana y ruptura prematura de membranas como factor de riesgo en las UCI neonatales / Early neonatal sepsis and premature rupture of membranes as a risk factor in neonatal ICUs

Propósito: conocer el perfil sociodemográfico de madres con factores de riesgo que acuden al Hospital Carlos Andrade Marín, con hijos ingresados al área de neonatología por sepsis neonatal temprana, durante el periodo de enero 2013 a diciembre 2014, a fin de establecer la asociación de factores de riesgo maternos con sepsis neonatal temprana. Diseño: estudio observacional, documental. Resultados: la edad promedio fue 29 años, solteras y empleadas privadas; respecto a los factores de riesgo asociados a sepsis neonatal temprana, la ruptura prematura de membranas fue el único factor asociado con una probabilidad 3,3 veces superior de desarrollar sepsis comparado con madres sin ruptura prematura de membrana. No se estableció asociación estadística de sepsis neonatal temprana con corioamnionitis no se estableció asociación con sepsis neonatal temprana, sin embargo que todos los recién nacidos presentaron sepsis neonatal temprana si se presentó concomitantemente corioamnionitis. Con infección de vías urinarias o vaginosis no hubo asociación. Conclusión: existe asociación estadística entre sepsis neonatal temprana y ruptura prematura de membranas, observándose un 33,5% de incremento riesgo (p<0.01). La infección de vías urinarias y la vaginosis bacteriana, asociadas a ruptura prematura de membranas son considerados como factores de riesgo, pero al ser analizadas independientemente, son factores de riesgo de prematurez y no de sepsis neonatal temprana. Hijos de madres con corioamnionitis fueron catalogados potencialmente sépticos y recibieron tratamiento profiláctico, sin demostrarse asociación estadística. (AU)

Purpose: to know the social-demographic profile of mothers with risk factors attending Hospital Carlos Andrade Marín who have children admitted at neonatology with early neonatal sepsis in the period from January 2013 to December 2014; and establish the relation of such risk factors to early neonatal sepsis. Design: observational and retrospective study. Results: the social-demographic profile of the mothers under study shows an average age of 29 years old, private employees, single. From the risk factors associated to early neonatal sepsis, the premature membrane rupture is the only related factor with an OR 3.3 times higher of having children from mothers with this factor. Although chorioamnionitis established no relation to early neonatal, it did appear as a neonatal sepsis risk factor, since all the newborn presented early neonatal sepsis. There was no relation to urinary tract infection and bacterial vaginosis. Conclusions: statistically significant relation to early neonatal sepsis was found with premature membrane rupture, which shows an absolute increase of the risk of 33.5% (p<0.01). When urinary tract infection and bacterial vaginosis vas are associated to premature membrane rupture these are considered risk factors. Although they are not the cause of early neonatal sepsis in themselves, the premature element is considered a risk factor. Newborn from mothers with chorioamnionitis were catalogued as potentially septic and received early treatment, although the association was not established. Keywords: early neonatal sepsis, maternal risk factor, early membrane rupture, chorioamnionitis, urinary tract infection, bacterial vaginosis.

Comparative study ofmaternal socio-demographic factors andlow birth weight of new-borns at a tertiary care hospital in Chennai, India

Introduction: Birth weight is an important indicator of a child's vulnerability to the risk of childhood illness and chances of survival. LBW results in a corresponding perinatal mortality. The identification of factors contributing to LBW is therefore of paramount importance. Low birth weight is a term used to describe babies who are born weighing less than 2,500 grams (5 pounds, 8 ounces). In contrast, the average newborn weighs about 8 pounds. Over 8 percent of all new-born babies in the United States have low birth weight. The primary cause is premature birth, being born before 37 weeks gestation; a baby born early has less time in the mother's uterus to grow and gain weight, and much of a fetus's weight is gained during the latter part of the mother's pregnancy. Another cause of low birth weight is intrauterine growth restriction. This occurs when a baby does not grow well in utero because of problems with the placenta, the mother's health or birth defects. The aim of the study: To study the prevalence of low birth weight babies and to study the various socio-demographic factors associated with low birth weight. Materials and methods: The present cross-sectional study was undertaken at Sree Balaji Medical College and Hospital in the year of 2015- 2016. Totally 100 babies were selected. In this study, all singleton new-born having a weight of <2.5kg was included as a case (n=50) and a weight of ≥2.5kg was included as a control (n=50). The relation of birth-weight to few maternal factors such as age, socio-economic status and occupation were studied. Saranya S, D. Aishwarya. Comparative study of maternal socio-demographic factors and low birth weight of new-borns at a tertiary care hospital in Chennai, India. IAIM, 2017; 4(11): 207-213. Page 208 Results: Our Study showed that the greatest number of mothers having LBW newborns was in the age group of 23 to 27years belonged to the low socio-economic group. The study finding showed maternal age, fetal sex, parity, number of antenatal care, gestational age, birth order, and history of abortion had an insignificant association with low birth weight (P-value <0.05). It was found that 70% of LBW babies were born to mothers who belonged to the labour class by occupation. Conclusion: This study depicted that low birth weight is a public health problem in the study area. Hence, attention should be given to increase community awareness of antenatal care service, access to family planning, prevention of abortion and community mobilization to prevent early pregnancy. This study concluded with the findings that maternal factors like age, socio-economic status, religion and occupation of the mothers were related to LBW of the new-born improving the socio-economic status (SES) of people and providing better working.

Parto Natural. ¿Qué nos dice la evidencia? / Natural birth. What does the evidence tell us?

Introducción: Es deseable que el proceso del parto concluya con una madre y un recién nacido sano, y sea un momento especial e íntimo. El Parto Natural, ha sido propuesto como una opción para mejorar la satisfacción de las mujeres con el proceso del parto. Sin embargo, no existen definiciones serias respecto a qué es el Parto Natural, introduciendo dificultades en la atención de mujeres que solicitan un Parto Natural. Métodos: El objetivo de este artículo es revisar la mejor evidencia disponible para entender cómo debe definirse un Parto Natural y analizar si se asocia a riesgos mayores que los de la atención médica habitual del parto. Resultados: Hemos comprobado que no existen definiciones científicas consensuadas para precisar qué es el Parto Natural, dejando espacio para discusión sobre su verdadero significado. No existen estudios de diseño aleatorizado y controlado que comparen el resultado materno/perinatal del parto natural comparado con la atención habitual del parto. Las intervenciones médicas, usadas en la atención médica del parto, y que podrían ser evitadas en el Parto Natural, producen algunos cambios favorables y otros deletéreos respecto de la salud materna y perinatal. Conclusiones: La decisión de optar por el Parto Natural debe ser discutida con las mujeres que lo solicitan, precisando con ella y su pareja cuál es su concepto de parto natural o qué es lo que desean incluir o evitar, los riesgos y beneficios asociados a cada una de las intervenciones deben ser expuestos por el equipo médico, para adoptar un plan de manejo individualizado.(AU)

Introduction: It is desirable that the birth process concludes with a healthy mother and newborn, while at the same time being a special and intimate moment. Natural childbirth has been proposed as a recent option to improve the satisfaction of women with the process of childbirth. However, there are no serious definitions regarding what is or should be a Natural Childbirth, introducing difficulties in the care of women who request a Natural Birth. Methods: The objective of this article is to review the best available evidence to understand how Natural Childbirth should be defined and to analyze if it is associated with greater maternal or perinatal risks than those of usual medical care at birth. Results: We verified that there are no agreed scientific definition to specify what Natural Childbirth is, leaving space for discussion about its true meaning. There are no randomized, controlled trials comparing the maternal/ perinatal outcome of natural childbirth compared to usual medical care during labor/delivery. Medical interventions used in childbirth are that could be avoided in natural birth produce some favorable changes and some deleterious changes in maternal and perinatal health. Conclusions: The decision to choose Natural Childbirth must be discussed with the women who request it, specifying with her and her partner´s concept of natural childbirth or what they wish to include or avoid, the risks and benefits associated with these interventions must be exposed by the medical team, to adopt an individualized management plan.(AU)

Maternal Risk Factor for Seizures in Term Neonate: A Hospital –Based Case Control Study.

Background: Assessing the maternal risk factors for seizure in first 72 hours of life in term neonate. Design: Case control study. Setting: Department of Paediatrics, Neonatology unit and Maternity ward tertiary care centre Govt. Medical College, Nagpur. Methods: A 210 cases [Term neonate with seizure within first 72 hours of life] and 210 controls [Term neonate without seizure in first 72 hours of life] were randomly selected as study subject over a period of two year. Primary exposure variables in mothers including age, parity, diabetes mellitus, hypertension, anemia, intrapartum fever, mode of delivery and prolonged second stage of labor were considered in study population. Neonates were carefully examined and observed for seizures and manage accordingly. Results: Maternal diabetes mellitus and anemia were potentially significant in their association with term neonatal seizure while maternal hypertension, intrapartum fever and prolonged second stage of labor were not significantly associated with seizure. Neonates born to diabetic mother, young maternal age, anemic mother and cesarean delivered neonate had 1.97, 0.95, 1.83 and 2.18 time more risk to developed seizure respectively. Conclusion: Early identification and timely intervention of maternal risk factor may reduces the seizure in term neonate.

Maternal risk factors associated with cleft lip with or without cleft palate: a review / Factores de riesgo materno asociados con el labio fisurado con o sin paladar hendido: una revisión

Disruptions in the development of the nasal and oral structures lead to cleft palate and cleft lip. There are many different factors that can affect this development such as genetic, mechanical traumas or teratogeny. The oral clefts are one of the most common birth defects worldwide affecting approximately 1 in 700 to 1000 children. The development of oral clefts is multifactorial and affect a significant portion of the population. The study results showed that smoking is the risk factor most associated with oral clefts (OR 1.09 to 2.11) and the least associated is the ingestion of folic acid (OR 0.59). Many of the risk factors discussed in this article will show an increase in the development of oral clefts although, some of the data could not be effectively compared due to differences in the methodology of each study and the subjective measures used.

Las interrupciones en el desarrollo de las estructuras nasales y orales conducen al paladar hendido y labio leporino. Hay muchos factores diferentes que pueden afectar este desarrollo, tal como los traumas o teratogenia mecánica genética. Las hendiduras orales son uno de los defectos de nacimiento más comunes en todo el mundo y afectan aproximadamente a 1 de cada 700 a 1000 niños. El desarrollo de fisuras orales es multifactorial y afecta a una parte significativa de la población. Los resultados del estudio mostraron que el tabaquismo es el factor de riesgo que más se asocia con fisuras orales (OR 01,09 a 02,11) y el menos asociado es la ingestión de ácido fólico (OR 0,59). Muchos de los factores de riesgo descritos en este artículo demuestran un aumento en el desarrollo de fisuras orales. No obstante, algunos de los datos no pudieron ser comparados con eficacia debido a las diferencias en la metodología de cada estudio y las medidas subjetivas utilizadas.

Factores maternos relacionados con la anemia en recién nacidos pretérminos. Hospital Dr. Verdi Cevallos Balda. Portoviejo. Ecuador. Abril septiembre 2015 / Maternal factors related to anemia in preterm infants. Hospital Dr. Verdi Cevallos Balda. Portoviejo. Ecuador. April september 2015

La anemia en los neonatos pretérrminos definida como la disminución de los glóbulos rojos, hemoglobina o del hematocrito relacionados a la edad gestacional, es una de las enfermedades más frecuentes a nivel mundial, por ello se ha realizado una investigación que relacione los factores de riesgos maternos que se involucran con la aparición de la anemia en prematuros, en el periodo de abril a septiembre 2015 en el Hospital Dr. Verdi Cevallos Balda. De tipo descriptivo, prospectivo de diseño no experimental con una muestra de 32 pacientes se obtuvo como resultado que el 56 por ciento de los pacientes correspondió al sexo masculino, el 72 por ciento se encontró entre las 32 a 37 semanas degestación, en el 75 por ciento de los casos se realizó un oportuno pinzamiento del cordón umbilical, la causa más común de anemia neonatal en estos pacientes fueron las hemorragias internas en el 25 por ciento de los casos seguido de las malformaciones de vasos umbilicales en el 22 por ciento de los casos las madres de los afectados eran en el 38 por ciento de los casos mujeres añosas y multiparas y el 25 por ciento de las madres tenían como antecedentes patológico placenta previa, se recomendó controles prenatales mensuales para prevenir dichas complicaciones, y la socialización del mismo.

Anemia in preterm infants is called as decreased red blood cells, hemoglobin or hematocrit related to gestational age to be one of the first most common diseases worldwide, especially those in developing countries as the ours has been chosen this topic for an investigation linking maternal risk factors that are involved with the development of neonatal anemia in prematures study in the period from April to September 2015in Dr. Verdi Cevallos Balda Hospital. Descriptive, prospective non experimental design with a sample of 32 patients resulting in 56 percent of patients corresponded to male, 72 percent was found between 32-37 weeks of gestation, 75 percent cases, an oppor pinzaminto umbilical cord was performed, the most common cause of neonatal anemia in these patients were internal bleeding in 25 percent of cases followed by umbilical vessels malformations in 22 percent of cases mothers were affected in 38 percent of cases añosas and multiparous women and 25 percent of mothers had pathological history as placenta previa, monthly prenatal checkups are recommended to prevent nutritional deficiencies and complications, proper management as indicated by the regulations msp and socialization of it.

Maternal Risk Factors & Pregnancy Wastage in a Rural Population of Jammu District.

To study the association of maternal risk factors with pregnancy wastage, a prospective study was conducted for a period of one year among 305 pregnant rural women registered with fifty Anganwadi centres in field practice area of Department of Community Medicine, GMC Jammu. All the potential participants were interviewed in person using semi-structured, pre-tested proformae and evaluated clinically. All pregnant women were then followed to study the outcome in terms of abortion, live birth or still birth. Various maternal risk factors like anaemia, Hypertension, Ante partum Haemorrhage, Albuminuria, Glucosuria were studied and their association with pregnancy wastage was analysed using chi-square test. Out of 305 pregnancies followed, 43(14.1%) ended in pregnancy loss i.e. 34 abortions and 9 still births. Pregnancy wastage was statistically significantly associated with anaemia, H.T., APH and Glucosuria. Anaemia was found to independently affect adverse pregnancy outcome on multivariate analysis. Pregnancy wastage in our set up is mainly due to preventable and treatable risk factors which should be taken care of to prevent the wastage.

Maternal Risk Factors and Morbidity Pattern of Very Low Birth Weight Infants: A NICU Based Study at Eastern Nepal.

Background: Preterm deliveries of babies weighing less than 1500 grams (VLBW, very low birth weight) are of major concern because of maximum perinatal morbidity and mortality found in this group. VLBW babies overload the neonatal intensive care unit (NICU) and their mortality contributes significantly to neonatal and infant mortality. Objectives: To study the common maternal risk factors associated with VLBW births. To study the morbidity and mortality patterns of VLBW babies. Methods: This was a hospital based retrospective study done in NICU of BP Koirala Institute of Health Sciences. Data were collected from medical records of VLBW babies admitted in NICU over a period of three years (13 April 2005 to 12 April 2008). Data were analyzed with SPSS 10.0 software. Results: Data of 140 VLBW babies were analyzed. Mean birth weight was 1188.9 (±212.78), 10.7% were home deliveries, 24.3% were twins, 31.4% required active resuscitation at birth and 46.4% were exposed to antenatal steroid. Common maternal risk factors associated with premature deliveries were inadequate antenatal check up (ANC) visits (95.7%), twin pregnancy (24.3%), antepartum hemorrhage (APH, 28.6%), premature rupture of membrane (23.6%), pregnancy induced hypertension (12.9%), bad obstetric history (12.9%) and maternal age less than 20 years (8.6%). Common morbidities among VLBW babies were clinical sepsis (77.1%), non physiological hyperbilirubinemia (73.6%), apnea (48.6%), shock (42.9%), hypoglycemia(39.3%), anemia (29.3%), hyaline membrane disease (HMD, 21.4%), patent ductus arteriosus (15.0%), severe hypothermia (12.1%), culture proven sepsis (15.7%), retinopathy of prematurity (5.7%), and bronchopulmonary dysplasia (3.6%). Overall survival was 54.3% and major causes of death were HMD (51.0%) and sepsis (34.7%). Median durations of hospital stay were 17.5 days for survivors and five days for expired cases. Conclusion: Increasing the coverage of ANC visits, early diagnosis and treatment of APH and pregnancy induced hypertension, discouraging the childbirth at too young age, early diagnosis and treatment of acute infections and chronic medical diseases in mothers are important measures to decrease the burden of VLBW births. Common morbidities in VLBW babies are sepsis, HMD, apnea, hyperbilirubinemia, patent ductus arteriosus, shock, anemia, hypoglycemia, hypothermia and hypocalcemia. Common causes death of VLBW babies are HMD and sepsis. Overall survival of VLBW babies in our settings is less. More numbers of well equipped NICUs and services like surfactant therapy are needed to improve survival of VLBW infants in our set up.