An epidemiological study on sociodemographic and antenatal factors associated with low birth weight in a tertiary care hospital of Kolkata, West Bengal

Background: Birth weight is a critical determinant of child survival and growth and a valuable indicator of maternal health, nutrition, and quality of life. Antenatal care (ANC) provides an array of available medical, nutritional, and educational interventions intended to reduce the incidence of low birth weight (LBW). Objective: This study was done to find out the sociodemographic and antenatal factors associated with LBW among babies delivered in a tertiary care health facility in Kolkata. Materials and Methods: It was a cross-sectional institution based observational study conducted from November 2016 to October 2018 among 410 postnatal mothers in the postnatal ward of the Department of Obstetrics and Gynaecology, Medical College, Kolkata, West Bengal. Data were obtained by interview method along with record analysis (medical and hospital records). Dependent variable was LBW (<2.5 kg). Ethical clearance was obtained from Local Ethics Committee of All India Institute of Hygiene and Public Health Kolkata and Medical College, Kolkata. Results: Out of 410 babies, 112 (27.3%) were LBW. Out of 112 LBW babies, 59 (52.7%) were preterm (<37 weeks); 51(45.5%) were term (37–42 weeks), and 2 (1.8%) were post-term (>42 weeks). Multi-variable logistic regression showed LBW to be significantly associated with poor economic status (below middle class), mothers who belonged to nuclear family, delayed registration (≥12 weeks), anemia in pregnancy, pregnancy-induced hypertension, gestational diabetes mellitus, weight gain in kg less than normal (i.e., below 9 kg), and poor consumption of specific nutritional supplements. Conclusion: Poor economic status and inadequate ANC continue to remain the most important factors for LBW. A good quality ANC package will ensure prevention of LBW babies.

Caracterización del Programa Familia Canguro / Characterization of the Program Family Kangaroo / Caracterização do Programa Família Canguru

Introducción: el Método Madre Canguro (MMC) es una alternativa de cuidado neonatal para el recién nacido pretérmino o de bajo peso al nacer. Se realiza ambulatoriamente basado en el contacto piel a piel entre cuidador y recién nacido, junto con la implementación de lactancia materna exclusiva, medidas esenciales para mejorar la calidad de vida de dicha población. Objetivo: determinar las características sociodemográficas y clínicas de la población perteneciente al Programa Familia Canguro en un hospital de alta complejidad de la Ciudad de Medellín (Colombia) durante el periodo 2015-2016. Método: estudio descriptivo, retrospectivo. Se incluyeron neonatos prematuros y de bajo peso al nacer pertenecientes al Programa Familia Canguro entre 2015 y 2016. Se excluyeron pacientes con enfermedades congénitas o cuyas madres no podían dar lactancia materna por fallecimiento o cualquier condición que las incapacitara para ello. Resultados: la edad materna promedio fue de 26 años, y el 47 % eran amas de casa; la enfermedad más común durante el embarazo fue la preeclampsia. La gran mayoría de los bebés canguro eran del sexo masculino (51,1 %), con un peso promedio al nacer de 2195; el 60 % de los niños tenía lactancia materna exclusiva al ingreso del programa, y un porcentaje menos amplio (34 %) complementaba la lactancia con leche de fórmula. Conclusiones: la población perteneciente al Programa Familia Canguro demostró tener características sociodemográficas similares a las reportadas en otras investigaciones; sin embargo, se presentaron estrategias de salud pública particulares para responder a las necesidades de esta población.

Introduction: The Mother Kangaroo Method (MKM) is a neonatal care alternative for low-weight newborn or preterm babies. It is an outpatient method based on the direct skin contact between the caregiver and the newborn baby. It includes nurturing the baby only by breastfeeding, and some essential measures to improve the baby quality of life. Objective: To determine the clinical and sociodemographic characteristics of the population included in the program Family Kangaroo at a high-complexity hospital in Medellín (Colombia) during 2015- 2016. Method: It is a retrospective descriptive study including both low-weight newborn and preterm babies treated in the program Family Kangaroo during 2015 and 2016. Patients with congenital diseases, dead mothers or mothers unable to breastfeed mothers were excluded. Results: The average mother age was 26 years and 47% of them were housewives. The most frequently found disease in the pregnancy was the preeclampsia. Most of the babies Kangaroo were males (51.1 %), with an average weight at birth of 2195 grams. Sixty percent of them were nurtured only by breastfeeding when they entered in the program and 34% received formula as a supplementary feeding. Conclusions: The population included in the program Family Kangaroo had sociodemographic characteristics similar to those reported in other researches. However they provided specific public health strategies in response to the needs in this population.

Introdução: O Método Mae Canguru (MMC) é uma alternativa aos cuidados neonatais ao recém- nascido prematuro ou de baixo peso ao nascer. É realizado em nível ambulatorial baseado no contato pele a pele entre cuidador e recém-nascido, juntamente com a implementação do aleitamento materno exclusivo, medidas essenciais para melhorar a qualidade de vida de essa população. Objetivo: Determinar as características sociodemográficas e clínicas da população pertencente ao Programa Família Canguru em um hospital de alta complexidade da cidade de Medellín (Colômbia) durante o período 2015- 2016. Método: Estudo descritivo, retrospectivo. Incluíram-se neonatos prematuros e de baixo peso ao nascer pertencentes ao Programa Família Canguru entre 2015 e 2016. Excluíram-se pacientes com doenças congénitas ou com mães que não podiam aleitar por morte ou qualquer condição que as incapacitasse para isso. Resultados: A idade materna média foi 26 anos e 47% foram donas de casa; a doença mais comum durante a gravidez foi pré-eclâmpsia. A grande maioria de crianças canguru foi do sexo masculino (51,1 %), com peso médio ao nascer de 2195; 60% das crianças teve aleitamento materno exclusivo na admissão ao programa, e uma percentagem menos amplo de 34% complementou a aleitação com leite em pó. Conclusões: A população pertencente ao Programa Família Canguru mostrou características sociodemográficas semelhantes às relatadas em outras pesquisas; no entanto, apresentaram-se estratégias de saúde pública particulares para responder às necessidades dessa população.

Comparison of the risk of microbiological contamination between samples of breast milk obtained at home and at a healthcare facility / Comparación del riesgo de contaminación de la leche materna extraída en una unidad de cuidados intensivos neonatales y en el hogar

Introduction. Breast milk is the best food for preterm infants. Due to their inadequate suction- swallowing action, the administration of expressed breast milk should be done with an orogastric tube. There is little information available regarding the microbiological safety of expressed breast milk. The aim of this article was to evaluate if there were any differences regarding the contamination of breast milk obtained at a healthcare facility versus at home. Methods. Cross-sectional study that analyzed pairs of breast milk samples (one obtained at home and the other one at a healthcare facility, the same day) from mothers of hospitalized newborn infants with a gestational age =35 weeks. Samples with over 105CFU/mL of mesophilic aerobic bacteria, or with the presence of Escherichia coli, Staphylococcus aureus, Streptococcus faecalis, enterobacterias, Pseudomonas, Salmonella, fungi, and yeast were considered contaminated. Results. A total of 280 breast milk samples (140 pairs) from 53 mothers were analyzed; 139 samples (49.6%; 95% CI: 43.6 to 55.6) were contaminated; contamination was significantly more frequent in the samples obtained at home than in those obtained at a healthcare facility (59.6% versus 39.6%; p = 0.0008; OR 2.25; 95% IC: 1.36 to 3.7). Conclusion. Half of the breast milk samples had bacterial growth, which was more frequent in the samples obtained at home than those obtained at a healthcare facility.

Introducción. La leche materna es el mejor alimento para los prematuros. Debido a su inadecuado mecanismo de succión-deglución, la administración de leche materna extraída debe realizarse mediante una sonda orogástrica. Se dispone de escasa información sobre las condiciones microbiológicas de seguridad para la leche materna extraída. El objetivo del presente trabajo fue evaluar si había diferencia en la contaminación de la leche extraída en la institución y en el domicilio. Métodos. Estudio transversal que analizó pares de muestras de leche (una extraída en el hogar y otra en la institución, el mismo día) de madres de neonatos internados, de edad gestacional = 35 semanas. Se consideraron contaminadas las muestras de leche que tenían más de 105 UFC/ml de aerobios mesófilos, o presencia de Escherichia coli, Staphylococcus aureus, Streptococcus faecalis, enterobacterias, Pseudomonas, Salmonella, hongos y levaduras. Resultados. Se analizaron 280 muestras de leche (140 pares) de 53 madres; 139 muestras (49,6%; IC 95%: 43,6 a 55,6) presentaron contaminación, que fue significativamente más frecuente en las muestras obtenidas en el domicilio que en las obtenidas en la institución (59,6% contra 39,6%; p= 0,0008; OR 2,25; IC 95% 1,36 a 3,7). Conclusión. La mitad de las muestras de leche materna presentaron contaminación, la cual fue más frecuente en las obtenidas en el domicilio.

Phacomatosis Pigmentokeratotica without Extracutaneous Abnormalities: A Case Study Involving a Preterm Baby

Phacomatosis pigmentokeratotica (PPK) is a rare syndrome defined by the association of an organoid nevus occasionally with sebaceous differentiation, a speckled lentiginous nevus, and other extracutaneous anomalies. A preterm male infant of only 830 g at 27 week gestational age had an organoid nevus showing sebaceous differentiation. Also, he had multiple speckled-lentiginous nevus. Correlating the observed clinical presentation with the histopathological findings, the diagnosis of PPK was established. There have been less than 10 cases of PPK without extracutaneous manifestation. We present an uncommon case of a preterm patient with PPK who had no extracutaneous abnormalities.

A Multicenter Study of Preterm Birth Weight and Gestational Age-Specific Neonatal Survival Rate and Causes of Death / 대한주산의학회잡지

OBJECTIVES: This multi-institutional study aims to investigate the survival rate of premature infants and the causes of death according to gestational age and birth weight during the past three years. METHODS: This study retrospectively examined medical records of 1,400 premature infants who were born at 23 to 34 weeks gestation and were hospitalized in the neonatal intensive care unit of seven hospitals from 2004 to 2006. Gestational age, birth weight, gender, plurality, survival rate, and cause of death were examined, and the survival rate was measured according to gestational age and birth weight. RESULTS: The average gestational age and the average birth weight of the subjects was 31+/-1.8 weeks and 1,775+/-530 g, respectively. The survival rate showed no difference by gender, plurality and years. The survival rate of very premature babies, low birth weight infants, very low birth weight infants, and extremely low birth weight infants were 87.6%, 93.8%, 83.2%, and 62.7% respectively. Causes of death were the complications of prematurity (83.8%), congenital anomalies (15.2%), birth asphyxia (5.0%) and others (2.5%). The survival rate increased significantly according to the gestational age and also by the birth weight. CONCLUSIONS: Our data do not represent of the survival rate and the causes of death in Korea. However, our data may reflect the common survival rate and the causes of death in Korean NICU, because the 7 hospitals participated in this study were common facilities and manpower in Korea.

Trend (in 2005) of Repair of Inguinal Hernia in Children in Korea : A National Survey by the Korean Association of Pediatric Surgeons in 2005

Inguinal hernia is the most common disease treated by the pediatric surgeon. There are several controversial aspects of management 1)the optimal timing of surgical repair, especially for preterm babies, 2)contralateral groin exploration during repair of a clinically unilateral hernia, 3)use of laparoscope in contralateral groin exploration, 4)timing of surgical repair of cord hydrocele, 5)perioperative pain control, 6)perioperative management of anemia. In this survey, we attempted to determine the approach of members of KAPS to these aspects of hernia treatment. A questionnaire by e-mail or FAX was sent to all members. The content of the questionnaire were adapted from the "American Academy of Pediatrics (AAP) Section on Surgery hernia survey revisited (J Pediatr Surg 40, 1009-1014, 2005)". For full-term male baby, most surgeons (85.7 %) perform an elective operation as soon as diagnosis was made. For reducible hernia found in ex-preterm infants already discharged from the neonatal intensive care unit (NICU), 76.2 % of surgeons performed an elective repair under general anesthesia (85.8 %). 42.9 % of the surgeons performed the repair just before discharge. For same-day surgery for the ex-premature baby, the opinion was evenly divided. For an inguinal hernia with a contralateral undescended testis in a preterm baby, 61.9 % of surgeons choose to 'wait and see' until 12 month of age. The most important consideration in deciding the timing of surgery of inguinal hernia in preterm baby was the existence of bronchopulmonary dysplasia (82.4 %), episode of apnea/bradycardia on home monitoring (70.6 %). Most surgeons do not explore the contralateral groin during unilateral hernia repair. Laparoscope has not been tried. Most surgeons do not give perioperative analgesics or blood transfusion.

Parental Role Stress and Perception of the Newborn in Mothers of Preterm Babies / 간호학회지

The purpose of this study was to contribute to neonatal nursing and maternal nursing to reduce parental role stress in mothers of preterm babies and to improve perception of the newborn to by the parents. Data were collected through self-report questionnaires which were consisted of a parental role stress scale and a neonatal perception inventory. The subjects were 100 mothers of fullterm babies and 50 mothers of preterm babies, all in the early postpartum stage and admitted to three hospitals I the Kyoung-In area between November 8 1997 and May 30, 1998. The data were analyzed by a SPSS program and the results are as follows : 1. There were no significantly differences in the means for parental role stress between mothers of fullterm babies and preterm babies. The mean for perception of the newborn was significantly lower in mothers of preterm babies than in mothers of fullterm babies. 2. In mothers of preterm babies, the level of parental role stress was correlated to the one minute Apgar score. The level of perception of the newborn was correlated to gestational age and birth weight. 3. The mothers of preterm babies whose education level was above graduation from college had lower parental role stress than those who had a lowers level of education. The mothers who had experienced cesarean section had higher parental role stress than those who gave birth to their baby prematurely. The above findings indicate that mothers of preterm babies had lower perception of the newborn than mothers of fullterm babies. Therefore, nursing intervention should be provided for mothers of preterm babies to manage parental role stress and improve perception of the newborn.

Parental Role Stress and Perception of the Newborn in Mothers of Preterm Babies / 간호학회지

The purpose of this study was to contribute to neonatal nursing and maternal nursing to reduce parental role stress in mothers of preterm babies and to improve perception of the newborn to by the parents. Data were collected through self-report questionnaires which were consisted of a parental role stress scale and a neonatal perception inventory. The subjects were 100 mothers of fullterm babies and 50 mothers of preterm babies, all in the early postpartum stage and admitted to three hospitals I the Kyoung-In area between November 8 1997 and May 30, 1998. The data were analyzed by a SPSS program and the results are as follows : 1. There were no significantly differences in the means for parental role stress between mothers of fullterm babies and preterm babies. The mean for perception of the newborn was significantly lower in mothers of preterm babies than in mothers of fullterm babies. 2. In mothers of preterm babies, the level of parental role stress was correlated to the one minute Apgar score. The level of perception of the newborn was correlated to gestational age and birth weight. 3. The mothers of preterm babies whose education level was above graduation from college had lower parental role stress than those who had a lowers level of education. The mothers who had experienced cesarean section had higher parental role stress than those who gave birth to their baby prematurely. The above findings indicate that mothers of preterm babies had lower perception of the newborn than mothers of fullterm babies. Therefore, nursing intervention should be provided for mothers of preterm babies to manage parental role stress and improve perception of the newborn.

A Case of Dexamethasone induced Hypertrophic Cardiomyopathy in Neonate with Bronchopulmonary Dysplasia

Although hypertrophic cardiomyopathy is uncommon in infant and children, we have experienced a case of dexamethasone induced hypertrophic cardiomyopathy in preterm baby who had bronchopulmonary dysplasia. This patient had hyaline membrane disease. Therefore, he received prolonged mechanical ventilation that resulted in bronchopulmonary dysplasia. After we carried out dexamethasone therapy for 7 days, hypertrophic cardiomyopathy appeared in his echocardiographic finding. We discontinued dexamethasone and then, hypertrophic cardiomyopathy improved. We report this case with the review of the associated literatures.