RESUMO
Considering the various evidences due to effects of trace elements on the outcome of pregnancy, we decided to assess the effect of these elements levels in maternal and cord serum on low birth weight. An Analytical cross-sectional study was performed on 344 pregnant women in labour and their neonates in Maryam, Akbarabadi and Vali-e-Asr hospitals in Tehran, Iran. Iron, zinc, copper, magnesium and calcium concentrations in cord and mother serum were measured. Collected data were analyzed by spss13 software, using Chi-square and Logistic regression tests with significant level p<0/05.The characteristics of studied subjects were: Mean age: 27.02 +/- 5.3 years, pregnancy duration: 38.9 +/- 1.3 weeks, number of low birth weight neonates: 13 [3.8%]. Prevalence of trace elements deficiencies in mothers were: zinc: 26.7%, copper: 53.5%, magnesium: 72.4%, Iron:. 6%, calcium: 49.4%, and in neonates were: zinc: 3.5%, copper: 41.6%, magnesium: 67.4%, Iron: 3.2% and calcium: 2.3%. In Chi-square test, a significant negative relationship between maternal calcium deficiency and low birth weight [p=.011] was found and logistic regression analysis showed a significant negative relationship between maternal calcium serum and low birth weight [odd: 0.27,%95CI: 0.09-0.77]. Delivering low birth weight neonates were more common in mothers with calcium deficiency and other elements did not show any significant relationships with low birth weight. It is possible to find different results about the effect of these minerals on pregnancy outcome with more samples and in different settings. It is recommended to perform more research on effects of trace elements on neonatal and maternal pregnancy outcomes to help prevent mother and fetus mortality and morbidity
RESUMO
This study aims to assess the utility of a scoring system as predictor of neonatal mortality rate among the neonates admitted within one year to the neonatal intensive care unit [NICU] of the Children's Medical Center in Tehran, Iran. Data were gathered from 213 newborns admitted to the NICU from September 2003 to August 2004. In addition to demographic data, Apgar scores at 1 minute and 5 minutes, history and duration of previous hospital ization, initial diagnosis and final diagnosis, and scoring system by using the score for the neonatal acute physiology-perinatal extension II [SNAP-PE II] were carried out within 12 hours after admission to the NICU. All of the parameters were prospectively applied to the admitted newborns. The exclusion criteria were discharge or death in less than 24 hours after NICU admission. 198 newborn infants met the inclusion criteria. The mean and standard deviation [SD] of the variables including postnatal age, birth weight, SNAP, and finally Apgar scores at 1 minute and 5 minutes of neonates under this study were 7.6 [0.5] days, 2479.8 [29.4] grams, 21.6 [1.1], 7.47 [0.08], and 7.71 [0.06], respectively. Twenty five of the 198 patients died [12.6%]. Gestational age [p=0.03], birth weight [P=0.02], Apgar score at 5 minutes [0.001], and SNAP-PE II [P=0.04] were significantly related to the mortality rate. By Analyzing through logistic regression to evaluate the predictive value of these variables in relation to the risk of mortality, it was shown that only SNAP-PE II and Apgar score at 5 minutes could significantly predict the neonatal mortality. According to this study SNAP-PE II and Apgar score at 5 minutes can be used to predict mortality among the NICU patients. SNAP-PE II score had the best performance in predicting mortality in this study. More studies with larger samples are suggested to evaluate all of the above-mentioned parameters among neonates who are admitted to NICUs countrywide