Frequency of Leiden Mutation in Newborns with Birth Weight below 1500 g.

It has been hypothesized that fetal prematurity or Intrauterine Growth Restriction (IUGR) could be related to the presence of factor V of Leiden mutation. This mutation is associated with a higher incidence of pregnancy difficulties that can result in preterm birth. The frequency of Leiden mutation was investigated in the group of newborns with a low birth weight below 1500 g over a six-year period from 2015 to 2020. During this period, 339 newborns were tested, of which 42 newborns with V Leiden mutation (12.4%) were detected. The average of its occurrence frequency in the Czech population was determined as 5.0% based on published studies. In our research, the occurrence of the V Leiden mutation was found significantly higher in newborns under 1500 g. At the same time, we did not demonstrate an increased frequency of births at lower gestational weeks, lower birth weight, or an association with sex in newborns with a positive diagnosis of the Leiden V factor.

The impact of air pollution in the Southern Bohemia Region on fetuses and newborns.

Air pollution with increased concentrations of carcinogenic polycyclic aromatic hydrocarbons (c-PAHs, represented by benzo[a]pyrene, B[a]P) affect fetal development, reduce birth weights (LBW) of newborns, and increases intrauterine growth retardation (IUGR). The Southern Bohemia Region is believed to be one of the least air polluted regions in the Czech Republic. Monitoring air pollution in the city of Ceské Budejovice from 2011-2015, PM2.5 (particulate matter <2.5 µm) decreased from 20.3 ± 14.5 µg/m3 to 14.3 ± 8.6 µg/m3, but concentrations of B[a]P did not change between the years 2007-2015: 1.5 ± 0.6 ng/m3 vs. 1.4 ± 1.4 ng/m3. Higher B[a]P concentrations the winter induce genetic damage in newborns, increase frequency of micronuclei (chromosomal aberrations), deregulate genes for immunity in umbilical cord blood, and increase incidence of IUGR and LBW in newborns.

Oxidative stress in newborns by different modes of delivery.

OBJECTIVES: The aim of our study is to investigate the impact of the type of delivery - vaginal vs. cesarean section on oxidative damage determined as the lipid peroxidation (15-F2t-isoprostane (15-F2t-IsoP) in the cord blood of newborns and venous blood from mothers in two localities with different levels of air pollution: Ceske Budejovice (CB), a locality with a clean air, and Karvina, a locality with high air pollution. RESUTLS: In Karvina, the concentration of PM2.5 was higher than in CB in the summer 2013 (mean±SD: 20.41±6.28 vs. 9.45±3.62 µg/m3, p<0.001) and in the winter 2014 (mean±SD: 53.67±19.76 vs. 27.96±12.34 µg/m3, p<0.001). Similarly, the concentration of B[a]P was higher in Karvina than in CB in the summer 2013 (mean±SD: 1.16±0.91 vs. 0.16±0.26 ng/m3, p<0.001) and in the winter 2014 (5.36±3.64 vs. 1.45±1.19 ng/m3, p<0.001). Delivery procedures differed by the type of anesthesia; at the Cesarean section in CB was used general anesthesia in 73.8% vs. 20.8% in Karvina (p<0.001), epidural anesthesia in CB in 26.2% vs. 77.1% in Karvina (p<0.001), at vaginal delivery was local anesthesia used in CB in 58.9% vs. 14.1% in Karvina (p<0.001). In CB was oxidative stress higher after vaginal delivery (101.7±31.0 pg 15-F2t-isoP/ml plasma) vs. Cesarean section (83.9±26.9 pg 15-F2t-isoP/ml plasma, p<0.001), no difference between the type of delivery was observed in Karvina. CONCLUSION: No difference between the types of delivery was observed in mothers in CB as well as in Karvina. Oxidative stress in newborns in Karvina was significantly affected by the concentrations of PM2.5 and B[a]P in the polluted air.

Medical and salutogenic approaches and their integration in taking prenatal and postnatal care of Czech women.

OBJECTIVE: To compile a proposal of the system of taking complex prenatal, perinatal and postnatal care of pregnant women and their children in the Czech Republic with taking into account medical and salutogenic approaches. MATERIAL AND METHODS: A questionnaire was prepared comprising questions for mothers and making it possible to exactly use specified data from their healthcare documentation. The method thus consisted of a secondary data analysis and subsequent contact with mothers. This was implemented in the form a qualitative and narrative interview. The study included 541 women from five Czech regions. RESULTS: In this group, there was a high level of the preventive care with persisting preference of prenatal consulting rooms conducted by physicians. Most deliveries occurred in institutions in the presence of physicians. In the groups evaluated, there were, however, no significant differences. In spite of this, the evaluation of delivering women indicated that there is a high level of the perinatal care in terms of the medical approach. However, the salutogenic care calls for increasing the active participation of midwives in the prenatal, perinatal and postnatal care and extension and intensification of activities particularly in the psychosocial area. CONCLUSION: In the group monitored, there were no significant correlations of determined perinatal interventions with the method and result of the delivery and condition of the mother and newborn. It is to mention that the medical perinatal care is at a high level.

Relationship between cytokine IL 6 levels and early-onset neonatal morbidity.

Perinatal infections exert considerably negative effects on morbidity and mortality of newborns. HYPOTHESIS: elevations of cytokine IL levels may be used as a marker of early-onset neonatal infections. TARGETS: to establish relationships between elevated IL 6 cytokine levels and neonatal morbidity (cranial and pulmonary). METHODS: examinations of the umbilical blood for IL 6 values in 392 newborns weighing under 1500 g treated in Ceské Budejovice at the Intensive Care Unit and Unit of Intensive Care and Resuscitation. RESULTS: a statistically significant relationship was demonstrated between elevations of cytokine IL 6 levels and pulmonary morbidity in newborns. DISCUSSION: the authors recommend examination of cytokine IL levels in the umbilical blood with a possibility to acquire the result within 2 hours after the delivery, which makes neonatologists possible to initiate goal-directed antibiotic therapy.

The importance of antibiotic prophylaxis in GBS-positive parturient women.

BACKGROUND: Bacterial streptococcal colonization of the vagina of a pregnant woman can be transferred to her newborn and induce a septic disease. The aim was to emphasize the requirements of timely intrapartal administration of antibiotics to prevent the transfer of GBS strains to the newborn. MATERIAL/METHODS: Three thousand two hundred seventy-eight pregnant women were evaluated who delivered babies during a 17-month period in 2006 and 2007 at the Department of Obstetrics and Gynecology in Ceské Budejovice. The results of their screening examinations from the 36th week of pregnancy were analyzed for information concerning their vaginal smears and smears from the newborns testing for GBS strains. RESULTS: The authors demonstrate that timely intrapartal administration of antibiotics considerably reduces the colonization of newborns with GBS strains (Fisher's exact test, p=0.0490). CONCLUSIONS: It is necessary to adhere consistently to preventive provisions which lead to a reduction in the colonization of newborns with GBS strains. Late application, i.e. within four hours before parturition, statistically significantly increases the risk of colonization with GBS.

Necrotizing enterocolitis in children with low birth-weight induced with mucormycose strains.

BACKGROUND: The nosocomial occurrence of mycotic infections negatively affects results of the neonatal care in newborns in the sense of their increased mortality and morbidity. AIM: The communication presented here is focused on an analysis of predisposing factors and clinical patterns of infections induced with mucormycosis strains. The authors provided an analysis of six case reports concerning newborns that died in association with nosocomial infections, where mucormycosis strains were microbiologically and microscopically detected in autopsy. RESULTS: The newborns in the group considered died due to general metabolic breakdown induced by peritonitis based on the large intestine perforation - enterocolitis. The predisposing factors include low birth-weight, asphyxia after the delivery, catheterization of umbilical veins and v. cava inferior and introduction of the endotracheal ventilation. Nosocomial nature of the infection propagation is suggested by a delayed onset of manifestations after the delivery. CONCLUSION: The authors point out the possibility of the origination of nosocomial infection induced with mucormycotic strains. Thus, they recommend adhering to a strict anti-epidemic regimen at neonatal departments with a particular emphasis put on consequent prohibiting of the storage and use of food at the departments. They emphasize the fact that the most frequent clinical pattern induced with mucormycotic strains in newborns with low birth-weight is necrotizing enterocolitis. They also stress the fact that the final diagnosis of the infection is most typically established based on the histological examination only.