Use of Child Safety Seat and its Determinants in Jeddah, Saudi Arabia: A Cross-sectional Study.

Background: A child safety seat protects children from injury during motor vehicle accidents (MVAs). However, there is a lack of enforcement of regulation regarding its use in Saudi Arabia. Objectives: This study aimed to determine the use of child safety seat and its determinants and barriers in Jeddah, Saudi Arabia. Materials and Methods: This cross-sectional study was based on a structured face-to-face interview across Jeddah among families who drove in cars with children aged ≤5 years. The study used stratified multistage random sampling across the population of the governorate of Jeddah. Results: A total of 675 parents were included, of which 311 (46.1%) reported having a child safety seat in their vehicle, and only 165 (24.4%) reported its regular use. Awareness levels among parents regarding child safety seat use and its benefits, parents' level of education, family size, family income, and the belief in the need for laws governing child safety seat were key determinants of child safety seat use. Poor awareness among parents regarding the utility of child safety seat in reducing child injuries, low education levels among parents, larger families with multiple children, poor affordability, low family income, and a clear lack of laws mandating the use of child safety seat were identified as key barriers. Conclusions: The regular use of child safety seat for children aged ≤5 years is low in even one of the most urban populations of Saudi Arabia. This indicates the need for large-scale awareness drives and stricter implementation of laws enforcing the use of child safety seat in Saudi Arabia.

Hypoglycemia and associated comorbidities among newborns of mothers with diabetes in an academic tertiary care center.

Background: Hypoglycemia is considered the common metabolic problem in newborns with serious long-term sequelae. This study evaluates the incidence of hypoglycemia in the newborns of mothers with diabetes mellitus and assesses the comorbidities that affect the newborns of mothers with gestational diabetes compared with the newborns of mothers with pregestational diabetes mellitus. Methods: This retrospective cohort study was conducted between January-2018 and December-2020. All admissions to the hospital nursery of the newborns of diabetic mothers with diabetes mellitus were included. Results: The study comprised 1,036 mothers with diabetes, of the newborns of mothers with pregestational diabetes, 22% had hypoglycemia, and of mothers with gestational diabetes, 12%. Mothers with pregestational diabetes had a significantly higher risk of needing an emergency cesarean section (OR: 2.1, 95% CI: 1.3-3.4); and of having a baby who is large for its gestational age (OR: 9.5, 95% CI: 2.6-35.5), must be admitted to the NICU (OR: 2.9, 95% CI: 1.5-5.6), has respiratory distress syndrome (OR: 3.3, 95% CI: 1.5-7.4), and needs gavage feeding (OR: 3.5, 95% CI: 1.4-8.9). Conclusion: About 13% of the newborns of mothers with diabetes had hypoglycemia. Significantly more of these newborns were of mothers with pregestational diabetes than of mothers with gestational diabetes. Newborn of mothers with pregestational diabetes mellitus have the risk of large weight and neurological problems, such as sucking difficulties, length of hospital stay, NICU admission, and respiratory distress syndrome.

Primary Peritoneal Drainage Versus Laparotomy for Perforated Necrotizing Enterocolitis in Very-Low-Birth-Weight Infants: A Retrospective Cohort Study at an Academic Center in Saudi Arabia.

Background and objective Necrotizing enterocolitis (NEC) is a detrimental complication of the gastrointestinal tract among preterm infants with very low birth weight (VLBW) and is associated with high morbidity and mortality. About one-third of these cases require surgical intervention due to intestinal perforation. The preferred method for the surgical management of perforated NEC is still a matter of controversy. In light of this, we aimed to compare the outcomes of treating perforated NEC in VLBW infants with primary peritoneal drainage (PPD) versus laparotomy. Method We conducted a retrospective chart review of VLBW infants with perforated NEC treated at King Abdulaziz University Hospital between January 1, 2015, and March 31, 2020. Results Twenty-seven infants with perforated NEC were identified; 12 were managed initially with PPD, and 15 underwent laparotomy. There was no difference between groups in terms of postoperative outcomes, length of hospital stay, or mortality before discharge. Among infants managed with PPD, 50% (5/10) underwent second drainage and survived, while 33% (4/12) underwent laparotomy. Conclusion We identified no difference in postoperative outcomes and mortality between managing perforated NEC in VLBW infants with either PPD or laparotomy. However, randomized clinical trials with larger sample sizes and defined outcome measures are needed for reaching definitive conclusions.

The Effects of Booking Status on the Outcome of Infants of ≥32 Weeks Gestational Age Admitted to the Neonatal Intensive Care Unit in a Tertiary Academic Center.

Introduction Antenatal care (ANC) is a systematic examination and follow-up of pregnant women that involves education, counseling, screening, and treatment of any complications encountered. ANC is an essential measure that significantly decreases devastating maternal and fetal outcomes. This study aimed to explore the maternal and fetal outcomes of mothers who did and did not book follow-ups and had their newborns admitted to the neonatal intensive care unit (NICU) at the King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Methodology We conducted a cross-sectional study between January 1, 2021, and January 1, 2022, at KAUH in Jeddah, Saudi Arabia. Data were collected from electronic medical records and paper documents. Maternal demographic and pregnancy information were collected in addition to neonatal outcomes. Results The study included 186 participants, with a median maternal age of 32 years (interquartile range (IQR) 27-36). Cesarean section was the predominant mode of delivery (67.2%), with a median gestational age at birth of 36 weeks (IQR 34-38). Most women (69.4%) booked follow-ups, while 40.3% developed chronic comorbid conditions during pregnancy. The newborn sex ratio was nearly even between males and females, with a median birthweight of 2325 g (IQR 1740-2900) and median Apgar scores of 7 (IQR 5-9) and 9 (IQR 8-10) at 1 and 5 min, respectively. Jaundice was the most common postnatal complication (51.6%), followed by hypoglycemia (18.8%), while 23.7% of babies had congenital anomalies. There was a significant association between booking status and nationality, maternal age, cesarean section, maternal comorbid conditions, the outcome of multiple gestations, and postnatal complications, including jaundice and hypoglycemia. Decreasing maternal age (odds ratio (OR) 0.755, 95% confidence interval (CI) 0.585-0.974) and Apgar score at 5 min (OR 0.096, 95% CI 0.012-0.795) were the only significant predictors of fetal mortality. Conclusion The study revealed suboptimal adherence to ANC among pregnant women with newborns admitted to the NICU, along with poorer maternal and fetal outcomes, with respect to neonatal jaundice, hypoglycemia, and the need for resuscitation.

Incidence of Hyponatremia and Associated Factors in Preterm Infants in Saudi Arabia.

OBJECTIVE: To investigate the incidence of hyponatremia in preterm infants. The secondary aim was to determine the risk factors of late-onset of hyponatremia (LOH) and their influence on neonatal outcomes. STUDY DESIGN: The present study is a retrospective cohort study of 71 preterm infants born before 32 weeks of gestation at King Abdulaziz University Hospital and admitted to the neonatal intensive care unit, level 3, from January to December 2019. Hyponatremia was defined as a sodium level ≤ 132 mEq/L. Retrieved maternal characteristics included age, parity, booking status, medical problems, antenatal steroids, and method of delivery. Retrieved infant characteristics included birth weight, gestational age, Apgar scores, total parenteral nutrition (TPN), breast milk or formula feeding, and body weight. as well as data on early onset of sepsis, chronic lung disease (CLD), patent ductus arteriosus, retinopathy of prematurity, severe intraventricular hemorrhage, and prescribed antibiotics and diuretics. RESULTS: Out of 72 preterm infants, 27% were diagnosed with hyponatremia. Early-onset hyponatremia (EOH) affected 7% (n=5) of the infants while 22.5% (n=16) of preterm neonates developed LOH (two infants developed both EOH and LOH). None of the investigated maternal characteristics were significantly associated with hyponatremia. Some infant characteristics were significantly associated with LOH: lower birth weight, lower gestational age, exclusive breastfeeding, longer duration TPN, and use of diuretics and antibiotics. Infants with LOH had longer hospital stays (p < 0.001) and higher risks of extra-uterine growth retardation (p = 0.007), CLD (p < 0.001), and sepsis (p = 0.001). CONCLUSION: Twenty-seven percent of preterm infants in King Abdul Aziz University Hospital are born with or develop hyponatremia. Risk factors significantly associated with LOH included lower gestational age, lower birth weight, exclusive breastfeeding, long-term TPN, and prescribed diuretics and antibiotics. Possible outcomes of hyponatremia were long-term hospital stays, growth retardation, sepsis, and CLD.