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1.
Article | IMSEAR | ID: sea-232822

ABSTRACT

Background: Low birth weight is a substantial global health issue with significant consequences to the newborn, family and society. It affects nearly 25 million births worldwide.Methods: This was a prospective study. Total 100 patients included in this study. This study conducted for 6 months. at tertiary health care center.Results: Maternal variables like anemia, hypertension, lack of proper antenatal care and lower socioeconomic status significantly influenced low birth weight in newborns. Clinical intervention such as iron supplementation and proper maternal nutrition, timely management of hypertensive disorders of pregnancy and creating public awareness regarding the importance of antenatal care have shown to impact neonatal outcomes positively.Conclusions: Low birth weight is one of the leading causes of perinatal morbidity and mortality and hence it should be managed in a tertiary health care center with trained obstetricians and with facility of neonatal intensive care unit (NICU).

2.
J. pediatr. (Rio J.) ; J. pediatr. (Rio J.);100(4): 377-383, July-Aug. 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1564749

ABSTRACT

Abstract Objective: To study the association between placental efficiency with anthropometry and nutritional phenotypes in full-term newborns from a birth cohort. Method: This was a secondary cross-sectional analysis of data obtained in a cohort study (Brazilian RibeirãoPreto and São Luís Birth Cohort Studies - BRISA), whose deliveries were performed between 2010 and 2011. Standardized questionnaires were applied to mothers, and placentas and newborns were evaluated shortly after delivery. Placental efficiency was assessed using the ratio between birth weight and placental weight (BW/PW ratio); values below the lower quartile (25th percentile for gestational age) were considered to have low placental efficiency. Newborn phenotypes were small and large for gestational age, stunted and wasted, evaluated using the INTERGROWTH-21 growth standard. To identify the confounding variables theoretical model was constructed using Directed Acyclic Graphs, and unadjusted and adjusted logistic regression were performed. Placental measurements were obtained blindly from pregnancy and delivery data. Results: 723 mother-placenta-child triads were studied. 3.2 % of newborns were small-for-gestational-age (SGA), 6.5 %large-for-gestational-age (LGA), 5.7 %had stunting, and 0.27 % wasting. A significantly higher risk was found between low placental efficiency and SGA (OR 2.82;95 % CI 1.05-7.57), stunting (OR 2.23; 95 % CI 1.07-4.65), and wasting (OR 8.22; 95 % CI 1.96-34.37). No relationship was found between LGA and placental efficiency. Conclusions: Low placental efficiency was associated with increased risk for small-for-gestational-age, stunting, and wasting. Placental morphometry can provide valuable information on intrauterine conditions and neonatal health, helping to identify newborns at higher risk of future comorbidities.

3.
Article | IMSEAR | ID: sea-228042

ABSTRACT

The global burden of disease caused by particulate matter exposure has increased significantly. Increasing epidemiological evidence indicates that ambient particulate matter pollution is associated with unfavorable health outcomes, including adverse birth outcomes. In addition to several determinants studies have correlated birth weight with prenatal exposure to particulate matter. This review aims to examine the relationship of pollutants with low birth weight. A systematic literature search was performed using PubMed and Google Scholar electronic databases. A total of 96 studies were reviewed and 18 studies fulfilled the inclusion criteria. In India exposure to ambient PM2.5 is strongly associated with low birth-weight. In Thailand, the entire pregnancy exposure was associated with reduced birth weight both for PM10 and biomass burning. The multiple GAM model have shown a direct and significant relationship between exposure to PM10 and SO2 on low birth weight. A 10 ?g/m3 increase in gap-filled satellite-based whole-pregnancy PM2.5 exposures was associated with a change in birth weight. The critical window period for exposure varied between the geographical locations. All of this research is subjected to several limitations regarding the assessment of outcome-exposure. We demonstrated that, maternal exposure to particulate matter during the pregnancy could increase the risk of low birth weight, and the critical window period differed for geographical locations. These findings expand our knowledge of the harmful effects of PM2.5 and biomass burning on new-born weight. Therefore, pregnant women should be informed about the negative consequences of air pollution and avoid exposure to polluted air during pregnancy.

4.
Article | IMSEAR | ID: sea-227985

ABSTRACT

Background: Children face the greatest risk of disease and death in their first 28 days. Improvements in basic neonatal care such as thermoregulation and breastfeeding have substantially reduced neonatal mortality and morbidity. There is still a need to strengthen the provision of advanced care for neonates. Identifying factors impacting neonatal mortality and morbidity and addressing them through a package of evidence-based interventions are essential to avoiding preventable deaths. Methods: The current study analyses data from a cross-sectional study in the rural outreach area of a tertiary hospital in Hyderabad, India to assess clinical and socio-demographic factors affecting neonatal morbidity. One hundred and fifty neonates admitted in neonatal intensive care unit and their mothers were included. A semi-structured questionnaire was used to obtain responses through face-to-face interview. Descriptive and inferential analyses were performed using R Statistical Software (version 4.3.2). Results: Among the 150 neonates, 99 (66%) neonates were admitted for respiratory distress. 39 (26%) males were low birth weight and 28 (18.67%) females were low birth weight. There was no significant association between low birth weight, high risk pregnancy and gender of the neonate. A significant association was obtained between low socio-economic status and low birth weight. Conclusions: Neonatal mortality and morbidity can be attributed to several factors including neonatal characteristics, maternal characteristics, health infrastructure and health manpower. However, prevalence of socio-demographic risk factors affecting neonates is disproportionately higher in low- and middle-income countries. A multi-pronged approach is required to address the multimodal causation of low birth weight and morbidity in neonates.

5.
Article | IMSEAR | ID: sea-228604

ABSTRACT

Background: The survival of very low birth weight babies has significantly improved in recent years. Postnatal growth has an impact on neurodevelopment and hence identifying the risk factors that curb growth is crucial.Methods: We did a retrospective cohort study over 3 months in our NICU studying 40 very low birth weight babies. Our objective was to observe the time taken to regain birth weight and study the risk factors affecting postnatal weight gain.Results: Among the 40 babies studied, 22 babies had significant delay in regaining birth weight. Risk factors such as birth weight, birth asphyxia, parenteral nutrition, respiratory distress syndrome, surfactant requirement, patent ductus arteriosus, necrotizing enterocolitis, sepsis, hyperbilirubinemia, anemia had statistically significant association with delay in regaining birth weight.Conclusions: Many studies have established a linear correlation between postnatal growth velocity and neurodevelopmental outcome. Ascertaining and managing the factors affecting weight gain in very low birth weight babies is essential and challenging part and anticipating the risk factors in advance helps us to achieve desirable weight gain in these babies.

6.
Article | IMSEAR | ID: sea-228591

ABSTRACT

Background: Pregnancy induced hypertension in women is a major cause of pregnancy related maternal, fetal, and neonatal morbidities and mortalities. Aim was to compare the clinical and hematological profile of newborns of mothers with and without pregnancy induced hypertension.Methods: This hospital-based case control study was conducted in Lala Lajpat Rai Hospital, Kanpur. Clinical and hematological profile of newborns of mothers with or without PIH were compared.Results: The low gestational age (35.44�89 weeks), low birth weight, thrombocytopenia (1.31�65 lakhs/mm3), absolute neutropenia (7.71�3�24�3cells/mm3) and deranged coagulation profile in newborns was found to have significant association with PIH in their mothers (p<0.05).Conclusions: This study concluded that newborns of hypertensive mothers carry a risk for prematurity, small for gestational age, infection and bleeding in early neonatal life.

7.
Article | IMSEAR | ID: sea-228131

ABSTRACT

Background: Undernutrition is an important risk for premature deaths and almost 45% of deaths in the under-five population are linked to undernutrition globally, where low- and middle-income countries (LMIC) bear a major share of it. This study aimed to measure the burden of such undernutrition and its determinants among the under-five children in a slum of Kolkata. Methods: A community-based cross-sectional study was conducted between Oct 2022-February 2023 among 164 children aged between 6-59 months. Participants were selected by probabilistic sampling method; Mothers were interviewed and anthropometry of the children were measured. Prevalence of undernutrition was assessed by the composite index of anthropometric failure (CIAF). Logistic regression analysis was done to find out the associates of undernutrition. Results: Median age of the study participants was 26.5 months, 54.3% of the participants being boy children. Regarding feeding of the child, 26.2% given prelecteal feeding, 17.7% didn’t receive colostrum, 33.5% had delayed initiation of breast feeding, only 57.9% child received exclusive breastfeeding. Of the participants, 11% child delivered by home delivery and 32.9% had low-birth-weights. According to CIAF 68.9% had undernutrition, while underweight, stunting, and wasting were reported as per conventional index 44.5%, 56.7%, and 16.5% respectively. In multivariable logistic analysis undernutrition have significant association with low birth weight and repeated episode of cough and running nose [aOR= 0.99(0.98-0.99). aOR=2.32(1.06-5.09)] respectively. Conclusions: Considerable proportion of children (two out of three) had undernutrition with CIAF. Preventive measures should include improvement in antenatal care, child feeding counselling and social determinants of health.

8.
Arch. latinoam. nutr ; Arch. latinoam. nutr;74(2): 74-82, jun. 2024. tab
Article in English | LILACS, LIVECS | ID: biblio-1561530

ABSTRACT

Introduction: Child health is conditioned by the circumstances of pregnancy, childbirth, and early life. Objective: To describe the maternal and neonatal characteristics of live births (LBs) in the Information System on Live Births of Santa Catarina (SC), Brazil. Materials and methods: A cross-sectional study describedthe maternal and neonatal characteristics of 940,059 LBs, from 2010 to 2019. Pearson's chi-square test and Fisher's exact test were conducted, with a statistical significance level of p < 0.05. Results: The mean values of maternal age, number of live children, and number of fetal deaths as well as abortions were 27.1 years, 0.9, and 0.2, respectively. The averages of the number of gestation weeks, number of prenatal consultations, the start date of the prenatal care, and birth weight were 38.5 weeks, 8.1 months, 2.5 monthsand 3,217.1 grams, respectively. Low birth weight (LBW) was prevalent among mothers without education (p < 0.001), including those without prenatal visits (p < 0.001). A higher prevalence of being underweight was observed among female neonates (p < 0.001) and with a maternal age of ≥ 40 years (10.8%; p < 0.001) compared to newborns with good vitality. Newborns with good vitality had a low prevalence of underweight (p < 0.001). The frequency of the variables studied increased, comparing the beginning and end of the period and whether the differences are statistically significant. Conclusions: The study draws attention to the need for interventions to improve the indicators that determine LBW(AU)


Introducción: La salud infantil está condicionada por las circunstancias del embarazo, parto y primeras etapas de la vida. Objetivo: Describir las características maternas y neonatales de los nacidos vivos en el Sistema de Información de Nacidos Vivos de Santa Catarina, Brasil. Materiales y métodos: Estudio transversal describiendo las características maternas y neonatales de 940.059 nacidos vivos entre 2010 y 2019. Se realizó la prueba de chi cuadrado de Pearson y exacta de Fisher y se estableció p < 0,05. Resultados: Los valores medios para la edad materna, el número de nacidos vivos y el número de mortinatos y abortos espontáneos fueron 27,1, 0,9 y 0,2, respectivamente. Las medias del número de semanas de gestación, el número de visitas prenatales, la fecha de inicio de la atención prenatal y el peso al nacer fueron 38,5 semanas (DE 2,2), 8,1 meses, 2,5 meses y 3 217,1 gramos, respectivamente. El bajo peso al nacer (BPN) fue prevalente entre las madres sin estudios (p < 0,001), incluidas las que no acudieron a una cita prenatal (p < 0,001). Hubo una mayor prevalencia de BPN en neonatos de sexo femenino (p < 0,001) con madres de edad ≥ 40 años (10,8%; p < 0,001). Los neonatos con buena vitalidad tuvieron una baja prevalencia de BPN (p < 0,001). La frecuencia de las variables estudiadas aumentó al comparar el inicio y el final del período y si las diferencias son estadísticamente significativas. Conclusiones: El estudio llama la atención sobre la necesidad de intervenciones para mejorar los indicadores que determinan el BPN(AU)


Subject(s)
Infant, Newborn , Infant, Newborn , Pregnancy , Child Health , Maternal Age , Live Birth , Child Health Services
9.
Article | IMSEAR | ID: sea-228753

ABSTRACT

Background: Twin births are often associated with increased risks and complications compared to singleton births. This study aims to analyze the clinical profile, morbidity pattern, and risk factors associated with twin births, focusing on maternal characteristics, neonatal outcomes, and the prevalence of conditions such as low birth weight (LBW) and preterm births.Methods: This hospital-based observational study was conducted at a tertiary care center, involving 25 mothers who had given birth to twins and their 50 neonates. The study assessed maternal age, antenatal care, parity, medical history, and neonatal outcomes including birth weight, gestational age, respiratory and cardiac parameters, and overall health status. Data were collected through medical records and direct observations in the neonatal intensive care unit.Results: The majority of mothers (64%) were aged between 21-30 years, with a mean age of 24.8 years. A significant proportion (92%) had regular antenatal visits, and 96% were multiparous. The majority of neonates (68%) were aged ?12 hours at assessment, with a near-equal distribution between very low birth weight (VLBW) and LBW. Preterm births were common, affecting 84% of the neonates. Respiratory challenges were evident, with 62% of neonates having SpO2 levels below 94%. The mortality rate among the neonates was 32%.Conclusions: The study highlights the high-risk nature of twin pregnancies, characterized by a significant prevalence of LBW, VLBW, and preterm births. The findings emphasize the need for enhanced prenatal care and specialized neonatal interventions. The high mortality rate among neonates indicates the critical need for targeted strategies to improve neonatal outcomes in twin pregnancies. These insights are crucial for informing clinical practices and developing comprehensive care protocols for managing twin pregnancies and their associated risks.

10.
Article | IMSEAR | ID: sea-228572

ABSTRACT

Background: Odisha has built 44 special newborn care units to treat severely sick infants at various levels. This study aimed to determine morbidity and mortality profiles among neonates admitted to the SNCUs and extend efforts to improve outcomes by investigating crucial variables.Methods: We conducted a cross-sectional descriptive study on all neonates admitted to SNCUs of 4 districts (Balangir, Kalahandi, Koraput, and Rayagada) between two calendar years (January 2020 and December 2021). We collected data on epidemiology, clinical presentation, and neonatal and maternal characteristics. We used Microsoft Excel to analyze categorical and continuous variables, with the Chi2 test for proportion comparison.Results: 17615 neonates were admitted in 2020-2021, 58% below one day and 59% male. ST babies were predominant. Outborn unit had 52% admissions, with 67% full-term and 31% pre-term. 74% of outborns used government vehicles for transportation. Most diagnoses were birth asphyxia, HIE, neonatal jaundice, low birth weight, and neonatal sepsis. The study found that 43% of neonates died from hypoxic ischaemic encephalopathy /perinatal asphyxia, 22% from Sepsis, 12% from extremely low birth weight babies, and 9% from prematurity. The Chi2 test showed a statistically significant difference in survival rates between doctors and dai, with a 91% survival rate and a 71% survival rate.Conclusions: Birth asphyxia was found to be the most essential cause of morbidity and mortality. Regular training at district levels is crucial for ensuring proper newborn care, including warmth, feeding, cleanliness, and prevention of asphyxia, to reduce preterm birth and low birth weight.

11.
Article | IMSEAR | ID: sea-228566

ABSTRACT

Background: This pinnacle抯 the importance for alternative measurements which predicts birth weight and gestational age (GA). Foot length is a simple measure and does not require expertise. The aim of this study was to study correlation of foot length and GA among preterm, term and post-term neonates.Methods: This study was a prospective observational study done in 155 babies. Anthropometric measurements were taken within the first 24 hours of life. GA estimation was done using modified Ballard score. Foot length, head circumference and chest circumference were measured and noted. Weight of the baby was recorded using electronic weighing scale.Results: Foot length statistically correlated (p<0.05) with GA assessment using NBS, weight, length, head circumference and chest circumference. The highest correlation of foot length in term SGA and term AGA babies for foot length was with head circumference (r=0.74 and 0.64 respectively). In pre-terms, foot length correlated well with head circumference and birth weight (r=0.92, 0.84 and 0.92 respectively). There were no babies in preterm LGA group and post term SGA and LGA group.Conclusions: Foot length also statistically correlated with other parameters like birth weight, length, head circumference and chest circumference.

12.
Article | IMSEAR | ID: sea-234050

ABSTRACT

Background: The state of Odisha is one of the leading states in the country for infant mortality in India. Odisha has established 44 special neonatal care units (SNCUs) to improve neonatal survival. The study aims to assess the morbidity, mortality, and referral trends to develop targeted suggestions to lower newborn deaths. Methods: We conducted a cross-sectional descriptive retrospective study on all admitted neonates, taking the secondary data from 8 SNCUs of District Hospitals in the State of Odisha for the period of 3 calendar years (2020-2022). We profiled the type of admission, age, gender, birth weight, admission indication, maturity, mortality profile and referral. Data was extracted in Excel 2021 and analyzed using Excel and Epi info. Results: Of the 43050 neonates admitted to the SNCU, 21069 (49%) were inborn. There were 58% male neonates. (59%, n=29401) were low birth weight neonates (<2500 gms); out of that, 869 babies (2%) were below 1000 gm. The median duration of stay in the SNCUs was 4 days. Perinatal asphyxia (n=13093) constitutes 30% of the admissions, followed by neonatal jaundice (7561, 18%), low birth weight <1800 gm (5728, 13%), refusal to feed (4745, 11%), and prematurity (n=3888, 9%). 75% of the total were discharged, 11% were referred, 10% died, and 4% left the SNCU against medical advice. The primary reasons for mortality & referral were birth asphyxia, hypoxic ischaemic encephalopathy (HIE), sepsis, and prematurity. Conclusion: Birth asphyxia is the primary cause of morbidity, mortality, and referral in newborns. Early referrals, effective intervention, and high-quality prenatal care are essential to prevent it.

13.
Article | IMSEAR | ID: sea-227851

ABSTRACT

Background: The nutritional status of preschool children is a critical indicator of their overall health and development. Breastfeeding provides best start of life to babies as well as improves the health of mothers and babies. Objectives were to assess the nutritional status of preschool children and to Investigate the impact of breastfeeding practices on children’s nutritional outcomes and breastfeeding practices of their mothers. Methods: This cross-sectional study was conducted in an urban slum area and involved a sample of preschool children aged 3 to 6 years. Complete enumeration of children of 3-6 years age group was done. Nutritional status was assessed through anthropometric measurements, including height, weight and mid upper arm circumference. Data on breastfeeding practices were collected through structured interviews. Data was analysed using MS excel and chi-square statistical tests was applied. Results: There were 334 study participants of which 7.5% had stunting and 62.87% were underweight. It was found that 18.56% had history of low birth weight. 90.12% were exclusively breastfed and breastfeeding was continued up to 2 years for 28.14% and more than 2 years for 71.86% children. It was also found that history of low birth weight of children is significantly associated with malnourishment (p?0.05). Conclusions: The study revealed that a substantial proportion of preschool children in the urban area were experiencing malnutrition. The breastfeeding practices were fair among the mothers of the children. Targeted education and awareness programs to enhance the nutrition can improve the overall health of preschool children in the urban setting.

14.
Article | IMSEAR | ID: sea-232663

ABSTRACT

Background: Bacterial vaginosis is a condition characterized by alteration in the vaginal flora. It is a common occurrence during pregnancy and is one of the established risk factors for preterm delivery, premature rupture of membranes and chorioamnionitis. The objective of the study was to study the prevalence and effects of bacterial vaginosis during pregnancy.Methods: : The study was a hospital based prospective study conducted in the department of obstetrics and gynaecology, RIMS, Imphal from January to December, 2021. 250 women between 20-28 weeks of gestation underwent examination and testing for bacterial vaginosis and were followed up till delivery. Pregnancy outcomes like pre-term labour, premature rupture of membrane; fetal outcomes like birth-weight, APGAR score, NICU admission, or any other complications were noted.Results: Out of the 250 singleton pregnancies, 48 women (19.2%) were found to have bacterial vaginosis. Pregnancies associated with bacterial vaginosis had more chances of premature rupture of membranes, low birth weight babies. But, there was no significant association of the same to preterm labor and to the rate of NICU admission of the newborns.Conclusions: Vaginal infection during pregnancy should also be entertained seriously and treated well since bacterial vaginosis may directly or indirectly be related to preterm delivery and low birth weight babies.

15.
Article | IMSEAR | ID: sea-232597

ABSTRACT

Background: Preterm delivery is an important cause of neonatal morbidity and mortality. Various infections in the pregnant mother may play a role. Periodontal disease in pregnancy is associated with preterm, low birth weight and small for gestational age neonates. The objective of this study was to correlate the association between periodontal disease and pregnancy outcome in low-risk pregnant women.Methods: This was a prospective observational study from November 2019 to May 2021 at Ramaiah medical college and hospitals, Bengaluru. All pregnant women with gestational age <32 weeks and without any risk factors receiving antenatal care at Ramaiah hospitals were included.Results: The study included 109 pregnant women without any risk factors. Periodontitis was found in 50.45%. The Plaque Index mean was 1.237 in cases and 0.844 in controls and was significant. Mean gingival index of cases was 1.282 and of control was 0.913. Nearly 94.5% of cases were having gingivitis and only 24.1% were having gingivitis in controls. The difference was significant. Preterm delivery was seen in 63.6% of cases and in 7.4% of controls which was significant. The birth weight of newborns was <2.5 kg in 69.1% in cases and 9.3% in controls which was significant.Conclusions: Periodontal disease in pregnancy is an important risk factor for preterm delivery and low birth weight. Periodontal disease can be diagnosed by simple oral examination and can be treated. Early treatment in pregnancy leads to a successful outcome.

16.
Salud UNINORTE ; 40(1): 109-126, ene.-abr. 2024. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1576816

ABSTRACT

RESUMEN Objetivo: Estimar la frecuencia de la hemorragia intraventricular y los factores asociados en neonatos pretérmino hospitalizados en una unidad de cuidado intensivo neonatal de alta complejidad. Metodología: Estudio de cohorte, en el que se incluyeron neonatos menores de 37 semanas de gestación, atendidos en una institución de alta complejidad, entre enero de 2015 hasta diciembre de 2018; se valoró el desarrollo de hemorragia intraventricular diagnosticada por métodos de imagen. Los datos se obtuvieron a partir de la revisión de las historias clínicas electrónicas y se analizaron variables sociodemográficas y clínicas. Resultados: Se incluyeron 296 pacientes, 128 (43,2%) eran mujeres; 23 pacientes (7,8%) desarrollaron hemorragia intraventricular, la cual predominó en el sexo femenino (11,7%). La mediana de edad gestacional fue de 34 semanas. Los factores asociados al desarrollo de hemorragia intraventricular fueron el peso al nacer por debajo de 1500 gr, las infecciones (p<0,0001), los cuadros de apneas (<0,0001), la hiperglicemia (p = 0,025) y la necesidad de surfactante (p= 0,019); por su parte, los esteroides prenatales se comportaron como un factor protector (p=0,002). Los pacientes con hemorragia intraventricular tuvieron mayor necesidad de ventilación mecánica, mayor uso de inotrópicos o vasopresores, más transfusiones y mayor estancia hospitalaria. Conclusiones: A pesar de que la hemorragia intraventricular resultó ser una patología poco frecuente en la población de neonatos analizada, existen factores de riesgo que se relacionan con su desarrollo, como la edad gestacional, el bajo peso al nacer, las infecciones, las apneas y la hiperglicemia.


ABSTRACT Objective: Estimate the frequency of intraventricular hemorrhage and associated factors in hospitalized preterm infants in a highly complex neonatal intensive care unit. Methodology: Cohort study, which included neonates younger than 37 weeks gestation, attended in a highly complex institution, between January 2015 and December 2018; The development of intraventricular hemorrhage diagnosed by imaging methods was assessed. The data was obtained from the review of the electronic medical records and sociodemographic and clinical variables were analyzed. Results: 296 patients were included, 128 (43.2%) were women; 23 patients (7.8%) developed intraventricular hemorrhage, which predominated in the female sex (11.7%). The median gestational age was 34 weeks. The factors associated with the development of intraventricular hemorrhage were birth weight below 1500 gr, infections (p <0.0001), apnea symptoms (<0.0001), hyperglycemia (p = 0.025) and surfactant requirement (p = 0.019); meanwhile, prenatal steroids behaved as a protective factor (p = 0.002). Patients with intra-ventricular hemorrhage had a greater need for mechanical ventilation, use of inotropics or vasopressors, more transfusions, and a longer hospital stay. Conclusions: Despite the fact that intraventricular hemorrhage turned out to be a rare pathology in the analyzed neonatal population, there are risk factors related to its development, such as gestational age, low birth weight, infections, apneas, and hyperglycemia.

17.
Arch. argent. pediatr ; 122(2): e202310051, abr. 2024. tab, graf
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1533067

ABSTRACT

Introducción. El tamaño al nacer se encuentra sujeto a influencias genéticas y ambientales; la altura geográfica es muy influyente. El peso al nacer (PN) es el indicador más utilizado para evaluarlo; existen diferentes estándares y referencias. Debido a la variabilidad de la distribución del PN en relación con la altura en la provincia de Jujuy (Argentina), este trabajo analiza la distribución percentilar del PN para tierras altas (TA) y tierras bajas (TB) jujeñas según edad gestacional (EG) y sexo, y su comparación con una referencia nacional y el estándar internacional INTERGROWTH-21st (IG-21). Población y métodos. Se analizaron los registros de 78 524 nacidos vivos en Jujuy en el período 20092014. Utilizando el método LMS, se estimaron los percentiles 3, 10, 50, 90 y 97 de PN/EG por sexo, para TA (≥2000 msnm), TB (<2000 msnm) y el total provincial, y se compararon gráficamente con la referencia poblacional argentina de Urquía y el estándar IG-21. La significación estadística se determinó mediante la prueba de Wilcoxon. Resultados. El PN en Jujuy presentó distribución heterogénea, con diferencias estadísticamente significativas (p <0,05) entre TB y TA. Al comparar con la referencia nacional y el estándar IG-21, se observaron diferencias por altitud, principalmente en los percentiles 90 y 97 para ambas regiones, y en los percentiles 3 y 10 en TA comparados con el estándar. Conclusiones. Se observó variabilidad de la distribución del PN asociada a la altura geográfica, por lo que, para evaluar el crecimiento intrauterino, resulta fundamental incluir la EG y el contexto donde transcurre la gestación.


Introduction. Size at birth is subject to genetic and environmental influences; altitude is highly influential. Birth weight (BW) is the most widely used indicator to assess size at birth; different standards and references are available. Due to the variability in BW distribution in relation to altitude in the province of Jujuy (Argentina), the purpose of this study is to analyze the percentile distribution of BW in the highlands (HL) and the lowlands (LL) of Jujuy based on gestational age (GA) and sex and compare it with a national reference and the INTERGROWTH-21 st (IG-21) international standard. Population and methods. The records of 78 524 live births in Jujuy in the 2009­2014 period were analyzed. Using the LMS method, the 3 rd, 10 th, 50 th, 90 th, and 97 th percentiles of BW/GA by sex were estimated for the HL (≥ 2000 MASL), the LL (< 2000 MASL), and the total for Jujuy, and compared with the Argentine population reference by Urquía and the IG-21 standard using growth charts. The statistical significance was established using the Wilcoxon test. Results. BW in Jujuy showed a heterogeneous distribution, with statistically significant differences (p < 0.05) between the LL and the HL. When compared with the national reference and the IG-21 standard, differences in terms of altitude were observed, mainly in the 90 th and 97 th percentiles for both regions and the 3 rd and 10 th percentiles in the HL compared with the international standard. Conclusions. BW distribution varied in association with altitude; therefore, to assess intrauterine growth, it is critical to include GA and the environment in which the pregnancy takes place.


Subject(s)
Humans , Pregnancy , Infant, Newborn , Altitude , Growth Charts , Reference Values , Birth Weight , Gestational Age
18.
Article | IMSEAR | ID: sea-228705

ABSTRACT

Background: Intraventricular hemorrhage (IVH) is the commonly encountered clinical event in preterm neonates which imposes significant morbidity and mortality. Although there is a rapid advancement in the neonatal care, IVH is the common cause of neonatal intensive care units admissions. The present study was carried out to evaluate the risk factors, mortality and neurological outcomes in preterm neonates with IVH.Methods: This was a prospective study conducted on 75 preterm neonates who were delivered before 37 weeks of gestation. The neonates were subjected to cranial ultrasound for the diagnosis of IVH and graded as per the severity. The neonatal and prenatal variables were recorded and analysed to find its association with IVH progression and mortality. Immediate neurological outcome was also assessed among the IVH preterm neonates. Results: In this study out of 75 preterm neonates, the prevalence of IVH was 18 (24%). The main neonatal factors for IVH are less gestational age at delivery, 28-31 weeks (p=0.001), birth weight <1500 gm (p=0.001), APGAR scores <5 at 1 and 5 minutes (p>0.05) and maternal factors associated with IVH is premature rupture of membranes (p=0.01). The mortality rate among the IVH preterm neonates was 7 (38.9%). The significant predictors of mortality were male gender (p=0.004), grade III and IV IVH (p=0.001) and birth weight (p=0.001). The main neurological outcomes observed were seizures and post-hemorrhagic ventricular dilatation.Conclusions: Increased severity of IVH, early gestational age and low birth weight were associated with mortality in preterm neonates with IVH.

19.
Article | IMSEAR | ID: sea-232573

ABSTRACT

Background: Zinc is essential for optimal fetal growth because of the role of zinc in cellular division, growth and differentiation. Low maternal serum zinc and cord blood zinc has been reported to be associated with low birth weight and, a risk factor for neonatal morbidity and mortality. The aim of this study was to evaluate the association of maternal serum zinc, cord blood zinc with neonatal birth weight.Methods: This case-control study was conducted in department of obstetrics and gynecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from November 2020 to October 2022. A total of 60 women in their postnatal period were included in this study.Results: In the present study, none of the socio-demographic characteristics in both case and control groups were statistically significant (p>0.05). Mean BMI was 23.88±1.36 kg/m2 in cases and 24.39±1.39 kg/m2 in controls, with 16.7% of cases overweight (p>0.05). Cases had lower maternal serum zinc (58.33±27.63 µg/dl) than controls (82.96±16.94 µg/dl), significantly affecting neonatal birth weight (p=0.001, r=+0.406). Low zinc levels (<68 µg/dl) increased the risk of birth weight <2.500 kg by nearly six times (OR 5.67, 95% CI 1.84-17.49; p=0.002).Conclusions: Low birth weight neonates and their mothers have significant zinc deficiency as compared to term neonates and their mothers and this deficiency is correlated with zinc deficiency in mothers of these low-birth-weight neonates.

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Article | IMSEAR | ID: sea-232437

ABSTRACT

Background: Fetal growth assessment is an important part of antenatal care. Accurate estimation of fetal weight is one of the important aspects in management of labour. Estimation of birth weight by Johnson’s formula based on symphysiofundal height has advantage of speed, economy and general applicability. Obstetric ultrasound can predict fetal weight with a great degree of precision.Methods: The prospective study was conducted at the Department of Obstetrics and Gyenecology, Yenepoya Medical College and Hospital, Mangalore on 100 pregnant women at or near term. Detailed history was taken, general, obstetric and systemic examination was done. Pelvic examination also done. Estimated fetal weight calculated using Johnson’s formula clinically and ultrasound was done to calculate estimated fetal weight using Handlock’s formula and correlated the birth weight calculated by two methods with its actual birth weight. Then the statistical analysis done to estimate the accuracy of two methods in estimated fetal weight.Results: In this study, out of 100 pregnant women, mean actual birth weight was 3041.6gms. Actual birth weight divided into 3 groups 14% birth weight <2.5kg, 73% had 2.5-3.5kg and 13% had >3.5kg. Accuracy of both methods evaluated, ultrasonographic measurement more accurate than clinical estimation but the error with Johnson’s formula was with low birth babies.Conclusions: Estimated fetal weight using Ultrasonographic Handlock’s formula was more accurate than Johnson’s formula. However, the results of Johnson’s formula were comparable to Handlock’s.

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