Maternal predictors of intrauterine growth retardation

Objective: To identify maternal factors associated with intrauterine growth restriction [IUGR]

Study Design: A case-control study

Place and Duration of Study: Neonatal Unit of The Aga Khan Hospital for Women [AKHW], Karimabad, from January 2014 to December 2015

Methodology: Cases were IUGR live born babies [n=90], while control were appropriate-for-gestational age [AGA] babies [n=180]. Information recorded in pre-designed proforma included gestational age and birth weight of baby, demographics of mothers, pregnancy related medical and obstetric complications. Data were analysed through SPSS-19. Multivariable logistic regression was used to determine the maternal factors associated with the intrauterine growth restriction

Results: Maternal factors associated with IUGR after adjusting for confounders in the multivariable model included younger age [OR=0.9, CI=0.8-0.9], poor gestational weight gain [OR=3.0, CI=1.6-6.1] and history of previous abortion [OR=3.06, CI=1.1-8.0]. Significant interaction was found between pregnancy-induced hypertension [PIH] and parity of mother, primary-para mother with PIH having an increased risk for IUGR babies [OR=10.1, CI=1.0-23.2]

Conclusion: Young age, primigravida status, low gestational weight gain, previous history of abortion, PIH and GDM have strong association with IUGR; hence, special consideration is essential to overcome these issues in order to improve maternal and neonatal health

Meconium stained liquor and its neonatal outcome

Objective: To determine the maternal factors and neonatal outcome of pregnancy complicated by meconium stained amniotic fluid

Methods: This one year retrospective study was conducted at the Agha Khan Hospital for Women-Garden Campus, it is a secondary care private teaching hospital. Demographics information included gestational age, gender and birth weight of baby, medical and obstetric complications during pregnancy, mode of delivery, neonatal outcome [Meconium Aspiration Syndrome [MAS] and need for admission in nursery] were recorded on a pre-designed proforma

Results: In our study the frequency of meconium stained amniotic fluid [MSAF] was 7.85%, out of them 12 % babies developed MAS. There was significant association between grades of meconium and MAS, babies with thick meconium were prone to develop MAS [P = 0.02]. Emergency cesarean section was significantly associated with MAS. Gestational diabetes [GDM] and pregnancy induced hypertension [PIH] were the significant factors associated with MAS

Conclusion: Thick Meconium stained amniotic fluid was associated with low APGAR score, high rate of emergency cesarean section and meconium aspiration syndrome. Anemia during pregnancy, PIH and GDM were important risk factor associated with MAS

Screening for G6PD deficiency among neonates with neonatal jaundice admitted to tertiary care center: a need in disguise

This study was conducted to determine the association of Glucose-6-Phosphate Dehydrogenase [G-6-PD] deficiency among neonates admitted with jaundice at the neonatal intensive care unit, well baby nursery and neonatal step down nursery of the Aga Khan University Hospital, Karachi, Pakistan, from January to June 2010. A total of 205 neonates following the selection criteria were included. All selected neonates have their venous blood drawn, saved in EDTA bottle and sent to laboratory of The Aga Khan University Hospital [AKUH]. The laboratory results of whether G-6-PD deficiency was present or not was recorded in the proforma. G-6-PD was deficient in 19 neonates [9.3%]. All neonates were male