Association of maternal clinical factors with neonatal respiratory morbidity in meconium‑stained labor among term parturients: A retrospective cohort study / Philippine Journal of Obstetrics and Gynecology

Objective@#This study aimed to determine the maternal clinical factors associated with neonatal respiratory morbidity and other adverse neonatal outcomes in meconium-stained labor among term parturients.@*Methodology@#A retrospective cohort study was done on admitted obstetric patients with term gestation and had meconium-stained labor. Maternal clinical factors such as age, parity, gestational age, manner of delivery, duration of labor, presence of term prelabor rupture of membranes (PROM), character of meconium-stained liquor (MSL), and presence of comorbidities were identified and analyzed to determine their association with neonatal respiratory morbidity and other adverse neonatal outcomes. @*Results@#In this study, there were 986 cases identified to have meconium-stained labor, and 168 developed neonatal respiratory morbidity. As to primary outcome, maternal clinical factors, such as age >35 years, multiparity, age of gestation >41 weeks, prolonged labor, presence of PROM, significant MSL upon admission, presence of change from nonsignificant to significant MSL, presence of intrauterine growth restriction, and hypertension, were all shown to be statistically significant. @*Conclusion@#The presence of maternal clinical factors in meconium-stained labor was observed to be a risk factor in developing neonatal respiratory morbidity and other adverse neonatal outcomes. Hence, identification of maternal risk factors and early detection of meconium-stained amniotic fluid are vital in administering timely intervention to labor and delivery to reduce neonatal complications.

Impact of Pollen Counts and Air Pollution Over Hospital Visits for Respiratory Illnesses in North Delhi Region

Background. Ambient aeroallergens and organic or inorganic air pollutants are known to cause asthma exacerbation and subsequent asthma-related hospital admissions. Methods. This study was carried out to study the impact of meteorological factors, air pollution, pollens over hospital visits for respiratory illness in north Delhi region from July 2014 to June 2015. Daily monitoring of pollen grains was done on the roof of the multistorey building (height up to 20m) of the Institute. Meteorological factors including temperature, relative humidity, and precipitations were recorded daily. Daily concentrations of nitric dioxide (NO2), particulate matter (PM2.5) and sulphur dioxide (SO2) were also recorded. Number of hospital visits of patients with respiratory illness were assessed in relation to air pollutants (NO2, SO2 and PM2.5) and climate change (temperature, relative humidity and rain). Results. During the study period, 113,462 pollen counts were recorded. Two highest peaks of mean pollen counts were observed in post-monsoon season (October-2014) and in the spring season (March 2015). The maximum and minimum pollen concentration was observed in the month of March 2015 (18818/m3) and August 2014 (4731/m3). Our results showed that pollen numbers significantly correlated with respiratory emergency department patient visits (P=0.037, r=0.604), and temperature and humidity (P=0.711, r=-120, and (P=0.670, r=-0.137), respectively. NO2 significantly correlated with SO2, respiratory emergency department patient visits and new respiratory OPD patients (P=0.017, r=0.670, P=0.031, r=0.622 and P=0.016, r=0.675, respectively). A statistically significant correlation between rainfall and SO2 was observed (P=0.004, r=-0.757) in the present study. Conclusion. Our study suggests that significant increase in pollen concentration and air pollutants in the ambient environment causes respiratory illness.

Average treatment effects of a single-dose antenatal corticosteroid on the respiratory morbidity of Filipino preterm neonates

Introduction@#Prematurity-related respiratory disorders are an important public health concern that should be treated efficiently and effectively. Antenatal corticosteroid (ACS) therapy has been recommended to hasten fetal lung maturation in pregnancies at risk but has not been delivered adequately in low to middle-income countries. This study aimed to estimate the treatment effects associated with the use of a single-dose antenatal corticosteroid on the incidence of respiratory-associated morbidity among prematurely delivered neonates. @*Methods@#This was a retrospective cohort study of neonates delivered at 24 to 33 weeks gestation at a tertiary hospital comparing outcomes in those given single-dose ACS with those given no ACS. Association was estimated using logistic and propensity score (PS) analyses, as well as average treatment effect (ATE) and among those treated (ATET). @*Results@#Most neonates (78.11%) received a single dose before delivery (single-dose ACS group) and only a few (21.89%) did not receive any dose (no ACS dose group). The odds ratio of respiratory morbidity in the single-dose ACS group was 0.44 (0.23-0.84) from an adjusted logistic regression model and 0.33 (0.17-0.80) from the PS matching model. The latter model was used to estimate that the average treatment effect from a single-ACS dose on the entire sample was -0.09 (-0.03 to -0.15), while its effect among the actual recipients was -0.08 (-0.02 to -0.15). @*Conclusion@#There is a small benefit attributed to the single-dose ACS, reinforcing the need for dose administration and completion. Future studies are recommended to clarify the estimated association and improve on the methodological constraints encountered.

A Study of Respiratory Symptoms and Disorders among Rice Mill Workers

In India, rice is the staple food for most people and many people are employed in rice mills. With lack of specific guidelines for rice mills’ establishment and operation, workers face a lot of problems especially from respiratory illness. We wanted to determine the pattern of respiratory symptoms and pulmonary function disorders among rice mill workers and provide health education to reduce respiratory morbidity. METHODSA cross-sectional study was conducted during the period October 2016 – 2018. A total of 50 rice mill workers and 50 normal individuals were assigned to the exposure and control groups respectively. Each individual was interviewed using the British Medical Research Council questionnaire and was later subjected to physical examination, routine laboratory investigations, and pulmonary function tests (PFT). Data was statistically analysed and presented. RESULTSThere was a higher prevalence of respiratory symptoms among the rice mill workers when compared to their control counterparts. Cough (28 %) was the predominant symptom and was high in those involved in sweeping and cleaning activities (80 %). There was a statistically significant difference (p < 0.05) among all the spirometric parameters tested like FEV1, FVC, FEV1 / FVC and PEFR except for FEF. About 74 % had respiratory morbidity and obstructive lung diseases (36 %) were predominant as compared to restrictive lung diseases (26 %) and mixed lung disorders (12 %) in the exposure group. Obstructive pattern was predominantly seen in those with a working history of < 10 years and restrictive and mixed patterns were predominantly seen in those with a working history of >10 years. With increase in duration of work, prevalence of respiratory symptoms as well as the severity increased. CONCLUSIONSIt can be concluded that rice mill workers are at a higher risk of acquiring respiratory symptoms and lung impairments. Therefore, it is necessary to implement preventive measures by means of controlling dust emission, educating the workers, etc. Workers should also have periodical clinical and spirometric evaluation and those showing significant impairment should be readjusted in other sections of the industry.

Prevalence and risk factors for respiratory morbidity, among high school students of South India.

Background: The prevalence of asthma and other respiratory diseases among children and adolescents has been on the rise in recent years and this can affect the quality of life and scholastic performance of school students. Therefore, it is essential to find out the actual prevalence of respiratory morbidity among high school students so that we can plan early interventions against this problem. Methods: A cross sectional study was conducted among the students from classes 8 to 10, from a public school in Pathanamthitta district of Kerala state, using a modified American Thoracic Society Questionnaire (ATS-DLD-78-A) to assess respiratory symptoms among general population. Results: The prevalence of cough was 40.8% (95% CI 34.8% to 46.9%) and that of wheeze was found to be 19.6% (95% CI 15.1% to 24.9%). Among the possible risk factors for developing respiratory diseases, it was found that only family history of respiratory problems had a significant association with symptoms of respiratory disease (P = 0.002). Conclusion: The very high prevalence of respiratory symptoms in the study may be due to the fact that the study was conducted during the rainy season in which there is a higher incidence of respiratory infections. But these findings point towards the need to conduct more comprehensive and objective studies on the subject.