A study on vitamin D levels in preterm and term neonates and their mothers

Background: Vitamin D is a fat-soluble vitamin which has immunomodulatory and anti-inflammatory effects. Vitamin D deficiency is a worldwide problem and yet is one of the most under diagnosed and under treated nutritional deficiency. Despite India being in the tropical zone with plentiful sunlight, there is a wide prevalence of vitamin D deficiency.Methods: Cross sectional descriptive study done in a tertiary care hospital involving 30 mother baby dyads equally divided into term and preterm babies. Maternal vitamin D levels (before delivery) and cord blood vitamin D levels (after delivery) were estimated.Results: All the mothers had low vitamin D levels, 93% having deficiency and 7% having insufficiency. The maternal vitamin D levels correlated with cord blood vitamin D levels. There was significant correlation between maternal vitamin D levels and cord blood vitamin D levels with maternal age and parity. There was no correlation between maternal vitamin D levels with gestational age, sociodemographic profile or neonatal anthropometry.Conclusions: Vitamin D deficiency is widely prevalent even in well-nourished mothers. Vitamin D supplementation may be helpful in antenatal mothers. Larger studies are needed to study the prevalence of vitamin D deficiency in mothers and babies and look for effectiveness of supplementation.

Neonatal morbidity pattern in early term births

Background: Late preterm births are defined' as birth between 34 and 36 completed weeks gestation and term births as' born after 37 weeks of gestation. Maturation is a continuous' process till term and the severity of adverse outcomes with birth increases with decreasing gestational age. Recent studies showed increased risk of' morbidities for babies' at 37 weeks than its term counterpart babies' at 39 weeks. Considering the risk for adverse neonatal outcomes in early term births, various studies recommended that the label 'term' be redefined as early term, full term and late term designations to more accurately acknowledge deliveries occurring at or beyond 37' weeks of gestation. This designation will help precise' identification and targeting these early term' babies for early intervention and for better neonatal outcomes.Methods: This is a prospective study which included all' term births delivered during the 12-month study between January 2017 and December 2017. Babies born between 37 and 38 6/7 weeks were designated as early term and those born after 39 weeks as full-term babies. Neonatal outcomes of these babies were recorded and monitored till discharge.Results: There were 660 term live births during the study period. The incidence of early term births account for 19.7%, as compared with full term births representing 80.3 %. Compared with term babies, early term births were at risk for transitional problems such as respiratory distress (61.5% vs 38.5%), hypoglycemia (76.2% vs 23.8%), hyperbilirubinemia requiring phototherapy (53.7% vs 46.7%) and feeding' problems (59.1% vs 40.9%).Conclusions: Early term births are associated with increased risk of neonatal morbidities as compared with full term births. This indicates need for more attention towards preventing early term births.

Comparative study of serum iron and zinc levels in term and preterm babies delivered in RMMCH

Background: Malnutrition is an important factor that influences the course of pregnancy and fetal development. It is a serious international problem which leads to a deficiency of metals, trace elements, vitamins, and proteins. Much attention has been given to the effects associated with protein deficiency. Nowadays the effects due to the deficiency of trace elements have been given much importance. Trace elements are essential for life. Deficient intake- leads to impairment of some functions. The impairment may be corrected by intake of the element in physiological amount. With the deficiency of these elements, the organisms can neither grow nor complete its life cycle. Death of an organism results when there is an absolute deficiency. Aim: To compare serum iron and zinc level in term and preterm babies. Materials and methods: Sixty pregnant women who came from in and around Chidambaram who fulfilled the inclusion criteria during the period from July 2001 to March 2002 were included in this study. Among them, 50 delivered at term (37 to 42 weeks) and the rest delivered prematurely (< 37 weeks). Serum iron and zinc level were estimated by standardized technique. The results are analyzed accordingly. Results: The estimated mean iron value for the term babies was found to be 114.34 μg/dl with the standard deviation of 34 μg/dl. In case of preterm babies, the estimated mean value for iron was found R. Manimozhi Malathi, S. Ramesh, D. Rajkumar. Comparative study of serum iron and zinc levels in term and preterm babies delivered in RMMCH. IAIM, 2018; 5(9): 58-62. Page 59 to be 97.35 μg/dl with the standard deviation of 46 μg/dl. The mean zinc value of term babies was found to be 76.26 μg/dl with the standard deviation of 23 μg/dl. For preterm babies mean zinc value was found to be 56.53 μg/dl with the standard deviation of 29 μg /dl. Conclusion: Preterm birth deprives the fetus of a significant accumulation of iron in storage that occurs beyond 32nd week, total body iron deposits in tissues, Hb and zinc are low in premature babies. Iron deficiency affects perinatal growth, maturation, and function of multiple organ systems including the heart, skeletal muscle, gastrointestinal tract, and brain. Anemia of prematurity has been defined as low hematological constant levels of hemoglobin (Hb), hematocrit (Ht), serum iron, number of erythrocytes, the reticulocytes.

Comparative study of hemoglobin and packed volume levels in term and preterm babies delivered in RMMCH

Background: Most existing accounts of hemoglobin values in healthy premature infants covering the early weeks of life were written before many of the errors of such determinations were recognized. Because of these limitations, it was decided to review the normal values for the first three months of life. The results were compared with a small series of readings made on a group of healthy, full-term infants. Aim: To compare hemoglobin and packed volume levels in term and preterm babies. Materials and methods: Sixty pregnant women who came from in and around Chidambaram who fulfilled the inclusion criteria during the period from July 2001 to March 2002 were included in this study. Among them, 50 delivered at term (37 to 42 weeks) and the rest delivered prematurely (< 37 weeks). Hemoglobin and packed cell volume as measured by standardized technique. The results were analyzed accordingly. Results: The estimated mean hemoglobin concentration of the term babies was 10.88 gm% with the standard deviation of 1.5 gm%. For preterm babies, the mean hemoglobin concentration was 10.33 gm% with the standard deviation of 2 gm%. The mean calculated packed cell volume (PCV) of the term babies was 34.03% and the standard deviation was found to be 5%. The mean packed cell R. Manimozhi Malathi, S. Ramesh, R. Aravind Kumar. Comparative study of hemoglobin and packed volume levels in term and preterm babies delivered in RMMCH. IAIM, 2018; 5(9): 54-57. Page 55 volume of the premature babies in the present study was found to be 32.75% with the standard deviation of 6.5%. Conclusion: Anemia of prematurity is a multifactorial anemia characterized by low levels of erythropoietin (EPO), iatrogenic blood loss, low circulating blood volume and lack of erythropoiesis. It is a problem due to the high incidence, associated symptoms and increased transfusion requirements. It is a normochromic normocytic anemia hypo-regenerative that occurs between the 2nd and 6th weeks of age in premature infants with gestational age (GA) up to 35 weeks.

Doença respiratória em bebês prematuros / Respiratory disease in preterm infants

As doenças respiratórias são responsáveis pela maioria dos atendimentos em salas de emergência, internações hospitalares e admissões em unidades de terapia intensiva, representando importante problema de saúde pública para qualquer população, por sua elevada demanda, pelos altos custos e pelo uso, muitas vezes, indiscriminado de antimicrobianos. Recém-nascidos prematuros, por suas próprias características físicas, nutricionais e imunitárias, apresentam maior morbidade e mortalidade associadas a essas infecções. Com o crescente aumento no número de partos prematuros, associado à maior sobrevida desses pré-termos, cada vez mais extremos, estratégias de prevenção de infecções respiratórias nesse grupo de pacientes se tornam fundamentais, a fim de se garantir a saúde dessa população, inclusive a longo prazo.Este artigo procura discutir aspectos próprios dos prematuros, suas características imunológicas, as doenças respiratórias mais freqüentes, os principais agentes virais e bacterianos envolvidos, além de abordar aspectos de sua prevenção.

Comparison between immunological markers in cord blood of preterm and term babies in Hospital USM

A cross sectional pilot study using convenient sampling method was conducted to evaluate various immunological parameters in preterm babies and term babies. Cord blood from 36 preterm and 36 term babies was taken and the following parameters were determined: Immunoglobulin G, A and M, Complement 3 and 4 and NBT. The results showed that NBT was significantly reduced in preterm babies compared to term babies (7.5% versus 12.0%; p= 0.001). The complement levels, C3 (0.5114 versus 0.7192 g/l; p<0.001) and C4 (0.07 versus 0.14g/l; p<0.001) were significantly lower in preterm babies than in the term babies. The mean IgG level in preterm babies was significantly lower than in term babies (9.5583 versus 14.2806 g/l, p<0.001). IgM (0.1 versus 0.2g/l; p<0.001) and IgA (0.210 versus 0.225g/l; p=0.036l) levels were significantly lower in the preterm than in term babies. In conclusion, we found that NBT reduction, IgG, IgA, IgM, C3 and C4 levels were significantly lower in the preterm compared to term babies.