Dataset on neonatal and maternal factors influencing neurodevelopmental outcomes in preterm infants: A study focused on the healthcare context of Mashhad, Iran.

This dataset offers an insight into the neurodevelopmental trajectories of preterm infants, encapsulating a wide array of neonatal and maternal factors. The data variables include demographic details alongside a detailed account of maternal health during pregnancy, encompassing aspects and other complications. Furthermore, the dataset documents neonatal health conditions. It also records critical indicators of neonatal health. The dataset is enriched with data on medical interventions and hospitalization details. It also contains information on the mother's drug usage during pregnancy and sonography results. A significant portion of the dataset is dedicated to the developmental assessment of the infants, utilizing the Bayley Scales to evaluate various domains such as cognitive, language, perceptual, fine motor, and coarse motor skills. The data are categorized to denote normal and abnormal outcomes in these domains, providing a detailed view of the developmental progress of the infants. The reuse potential of this dataset is substantial, serving as a rich resource for researchers and clinicians aiming to delve deeper into the multifaceted influences on preterm infant development. It can significantly contribute to the formulation of early intervention strategies, fostering a better understanding and enhancement of developmental outcomes in preterm infants.

Investigating the impact of Sinopharm COVID-19 vaccination on antibody response in pregnant women and their newborns.

This study aims to investigate the levels of receptor-binding domain (RBD), spike, and neutralizing antibodies in pregnant women who received the Sinopharm vaccine and their newborns. A cross-sectional study was conducted at a tertiary center, Mashhad, Iran. We included 88 pregnant women who had received at least two doses of the Sinopharm vaccine. Maternal and umbilical cord blood samples taken at delivery were analyzed for antibodies using ELISA tests. Antibody levels did not vary significantly between women with two or three vaccine doses. Only 1.1% of mothers had undetectable levels of RBD antibodies, but detectable antibodies were observed in all newborns. A significant linear correlation was found between the levels of neutralizing antibodies (r = 0.7, p < 0.001) and RBD antibodies (r = 0.833, p < 0.001) in mothers and their newborns, but not for Spike antibodies (r = 0.214, p = 0.045). In mothers, high titers of antispike and RBD antibodies were observed at the time of delivery. The high titers of RBD and antispike antibodies were found in cord blood, suggesting potential neonatal immunity. Detectable levels of antibodies were found in both groups, regardless of the timing of vaccination. The Sinopharm vaccine generates detectable levels of antibodies in pregnant women, which are efficiently transferred to their newborns. The number of vaccine doses (two or three) did not significantly impact the levels of detectable antibodies. This underscores Sinopharm's potential efficacy in protecting pregnant women and their infants from COVID-19.

Predicting neurodevelopmental outcomes in preterm infants: A comprehensive evaluation of neonatal and maternal risk factors.

OBJECTIVE: This retrospective cohort study aimed to evaluate neurodevelopmental outcomes of preterm infants (≤ 34 weeks gestational age) in the NICU. METHODS: This retrospective cohort study included 89 preterm infants admitted to the NICU of Ghaem hospital, Mashhad, between 2016 and 2020. Data on neonatal and maternal factors were collected. By recalling the mentioned infants in 2021, the neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development. Data analysis included descriptive statistics, non-parametric tests, and binary logistic regression conducted with SPSS V.26 and R program software. RESULTS: The sample comprised 48.3 % males with a mean gestational age of 32.10 weeks. Bayley Scale analysis revealed significant associations of Intrauterine Growth Restriction, Pneumothorax, and Bronchopulmonary Dysplasia with impairments in all domains. Diabetes in Pregnancy, Surfactant use, and Necrotizing Enterocolitis were also significantly linked to various impairments. Lower Apgar scores, gestational age, birth weight, and extended hospitalization and oxygen therapy durations correlated with several domain impairments. Logistic regression showed hospitalization duration impacted the coarse motor domain (OR = 0.92, p = 0.019), oxygen therapy duration influenced cognitive, perceptual, and fine motor domains. CONCLUSION: This study underscores the importance of considering neonatal and maternal factors when assessing developmental outcomes in preterm infant. Long hospital stays and increase duration of oxygen therapy associated with negative developmental outcomes in different domains of Bayley scales. Early identification of these risk factors and targeted interventions may improve long-term outcomes for preterm children.

Comparing maternal and neonatal prooxidant-antioxidant balance during delivery

Objective: Oxidative stress (OS) is due to a disturbance in the balance between the production of free radicals and antioxidant defense, resulting in a predominance of free radicals over endogenous anti-oxidant defenses. OS may have many causes. Pregnancy, and especially delivery, are associated with increased OS. The relationship between maternal and infant prooxidant-antioxidant balance (PAB) is unclear. Therefore, the aim of the present study was to compare PAB in mother and baby pairs. Material and Methods: This cross-sectional study was conducted in 104 mothers and normal term infants during 2017-2020. PAB was measured in healthy mothers before delivery and in umbilical cord samples after delivery. Data on the infant characteristics including age, gestational age, birth weight, Apgar score, and maternal history including the duration of mother's education, weight of the last month, and gravidity were collected using a researcher-made questionnaire. The cord and maternal PAB were compared by statistical methods. Results: In this study, the mean PAB of the neonates and mothers was 30.76 and 214.87 HK, respectively. The results revealed a moderate association between the PAB neonate and maternal PAB before delivery but it was not significant. Conclusion: Overall, the level of oxidants and antioxidants reduced during pregnancy and before delivery, and it was found that the relative incidence of neonatal PAB increases by increasing maternal PAB.

Evaluation of pro-oxidant antioxidant balance in retinopathy of prematurity.

INTRODUCTION: Retinopathy of prematurity (RoP) is a vasoproliferative disorder caused by the abnormal development of retinal vessels in premature neonates. It is one of the major causes of childhood blindness, which is increasing with the increasing survival rate of low birth weight and premature neonates. This study has aimed to evaluate the role of oxidative stress and peroxidant antioxidant balance (PAB) in the pathogenesis and prediction of RoP. MATERIALS AND METHODS: A total of 154 neonates weighing <1500 g admitted at the NICU of Ghaem Hospital, Mashhad, Iran, were enrolled in this cross-sectional study between 2018 and 2020. Blood samples were collected on the first day of birth to assess the peroxidant and antioxidant balance. The demographic, prenatal, and clinical course and postnatal problems were also recorded. The neonates were examined for RoP and divided into control (healthy) and affected (ROP) groups. RESULTS: There were significant differences between the two groups in gestational age, duration of oxygen therapy, and first and fifth minute Apgar score (P < 0.005). The mean PAB in infants without and with ROP was 19.79 HK (Hamidi-Koliakos) and 38.45 HK, respectively (P < 0.0001). Also, the mean PAB in neonates with ROP grade 1 and 2 was 36.69 HK and 45.53 HK, respectively (P = 0.002). CONCLUSION: According to our findings, the PAB level can be helpful in predicting ROP incidence. With increasing PAB, the possibility of ROP severity will increase.

Comparison of hyperbilirubinemia incidence between the newborns of zinc-taking and non-zinc-taking mothers during the third trimester of pregnancy.

BACKGROUND: Identification and control of the risk factors for hyperbilirubinemia can reduce the incidence and complications of this condition. Serum zinc level in newborns is reported to be one of the factors affecting the severity and incidence of neonatal hyperbilirubinemia. Therefore, the present study was conducted to compare hyperbilirubinemia incidence in neonates of zinc-taking and non-zinc-taking mothers. METHODS: In this observational study, we compared the incidence of hyperbilirubinemia during the first week of birth between newborns whose mothers had received zinc supplement during the third trimester of pregnancy (case group) with those whose mothers had not taken zinc supplement (control group). The checklist of newborns' conditions in both case and control groups was completed based on the obtained data regarding the infants, mothers, and laboratory findings. Data was analyzed using chi-squared test and t-test. RESULTS: The mean serum levels of zinc were 79.76±15 mg/dl and 70.93±15.67mg/dl in mothers who had received zinc during the third trimester and those who had not taken zinc supplement, respectively. The mean serum level of zinc in newborns who underwent phototherapy was 41.68±9.21 mg/dl, while it was 68.53±20.85 mg/dl in neonates who did not receive phototherapy. In addition, 36% of the neonates whose mothers had not received zinc required phototherapy, while only 11% of newborns whose mothers had taken zinc supplement received phototherapy. CONCLUSION: Zinc consumption during the third trimester of pregnancy increased the serum zinc level in both newborns and mothers and reduced the incidence and severity of idiopathic hyperbilirubinemia requiring treatment.

Interleukin-6 as A Prognostic Biomarker in Perinatal Asphyxia.

OBJECTIVE: Early diagnosis is has a crucial role in both prevention and treatment of asphyxia-related complications. The current study aimed to evaluate the prognostic value of interleukin-6 (IL-6) and hypoxic-ischemic encephalopathy grade in the prediction of mortality and the developmental status of neonates affected by prenatal asphyxia. MATERIALS & METHODS: This cohort study was conducted on 38 term asphyxiated infants at Ghaem hospital, Mashhad, Iran, from 2013 to 2017. The HIE grade and serum IL-6 levels were determined at the time of birth. The developmental status was evaluated using the Denver II test at the end of the two-year follow-up. RESULTS: HIE grade 3 resulted in 83% mortality rate and developmental delay among all survivors. The mean IL-6 level was 2.7 ng/ml in the control group (not affected HIE), which increased up to 29, 175, and 136 ng/ml in those with HIE grades of 1, 2, and 3, respectively. According to the ROC curve analysis, the cut-off level of 24 pg/ml could predict the developmental delay with sensitivity and specificity of 96 and 92%, respectively. CONCLUSION: The IL-6 level and HIE grade are potential prognostic biomarkers for the determination of mortality and morbidity in asphyxiated neonates.

Comparison of birth weights of neonates of mothers receiving vs. not receiving zinc supplement at pregnancy.

BACKGROUND: Zinc is an essential element for normal embryogenesis and embryonic and neonatal development. Therefore, we compared the birth weights of neonates born to mothers who consumed zinc supplement during pregnancy with that of neonates born to mothers who did not. METHODS: In a cross-sectional study, we divided 200 pregnant mothers into two groups: case group (mothers receiving zinc supplement during pregnancy) and control group (mothers not receiving zinc supplement during pregnancy) Then, the neonate's cord zinc level and mother's serum level were measured and neonate's growth charts (weight, height and head circumference)were completed. RESULTS: In this study, both groups of mothers were observed to have zinc deficiency; 35% of the mothers who consumed zinc supplements and 81% of the mothers who did not consume zinc supplements (P < 0.001). Based on the results, maternal serum of zinc (P < 0.001), neonatal birth weight (P = 0.008), maternal age (P < 0.001) and parity (P < 0.01) in zinc-supplemented group were higher. Neonatal birth weight was associated moderately with mother's zinc serum levels and poorly with neonatal serum zinc levels. CONCLUSION: Zinc consumption during pregnancy increases serum zinc level of mother and neonatal weight. Neonatal weight has a higher correlation to maternal serum zinc level.

Comparison of Umbilical Cord Serum Vitamin D Levels between Infants with Transient Tachypnea of the Newborn and those without Respiratory Distress.

BACKGROUND: Transient tachypnea of the newborn (TTN) is one of the most frequent causes of respiratory distress in neonates. A relationship has been shown between vitamin D deficiency and respiratory disorders in neonates. This research was carried out to evaluate the serum level of vitamin D in TTN newborns and their mothers compared to the control group. METHODS: This case-control research was conducted during 2016-2019 in a general hospital affiliated with Mashhad University of Medical Sciences, Iran. Thirty-four infants with TTN and 82 neonates in the control group as well as their mothers were investigated. The levels of umbilical cord serum vitamin D in infants with TTN and also their mothers were compared to the control group. RESULTS: The mean levels of serum vitamin D in infants with TTN and their mothers were 8.11 ± 4.32 and 12.6 ± 10.12 ng/mL, respectively (P<0.001), whereas they were 19.21 ± 12.71 and 25.96 ± 16.6 ng/mL in the newborns of the control group and their mothers, respectively (P<0.001). The mean differences (95% CI) of neonatal and maternal vitamin D level between the two groups were 11.10 (7.92-14.28) and 13.36 (7.90-18.08), respectively. In the TTN group, 100% of the infants had vitamin D levels less than 30 ng/mL (79.4% had severe, 17.6% had moderate and 2.9% showed mild deficiency). However, vitamin D levels lower than 30 ng/mL were observed in 76.4% of the neonates in the control group (28.8% had severe, 31.1% showed moderate and 16.3% had a mild deficiency) (P<0.001). CONCLUSION: The serum vitamin D levels of infants with TTN and their mothers were significantly lower than the control group. Therefore, TTN in infants may be reduced through the treatment of vitamin D deficiency in mothers.

Clinical and endoscopic findings of children hospitalized in Qa'em Hospital of Mashhad due to caustic ingestion (2011-2013).

INTRODUCTION: One of the leading causes of damage to the gastrointestinal tract in children is caustic ingestion which is sometimes life-threatening. The most reliable way to study the severity and extent of damage is endoscopy, which can be harmless in terms of time and technique. The aim of this study was to investigate, evaluate and compare clinical findings and endoscopic results of caustic ingestion. METHODS: This retrospective cross-sectional study was conducted on the records of children diagnosed with caustic ingestion, and hospitalized in Qa'em Hospital of Mashhad from March 2011 to December 2013. Intended data were extracted from patients' records and in case of any ambiguity, it was removed by phone call. Obtained data were analyzed using SPSS 11.5 and chi-square test. RESULTS: Of 54 patients, there were 36 cases of burn with acidic substance and 16 cases of burn with alkaline. The highest value was related to caustics related to acid batteries (31.5%) and in 77.5% of cases the container of caustic agent was not standard. In endoscopic results, 50 patients out of 54, had esophagus burn such that in 6 cases it was grade I burn, in 15 cases grade IIa, 27 cases with grade IIb and 2 cases with Grade IIIa burn. In addition, mild erythema of stomach in 6 cases, average erythema in 5 cases, mild ulcer in 15 cases, average ulcer in 5 cases and 3 cases with severe ulcer were reported. There was no significant relation between clinical findings and endoscopic results (p=0.68). CONCLUSION: Since caustic ingestion can be regarded as a life-threatening factor for children, the importance of observing precautions in the storage of caustics and the role of training and adequate attention of parents to this issue to prevent such accidents is clear.

Long-Term Neurodevelopmental Outcome of Neonates with Hypernatremic Dehydration.

BACKGROUND: Neonatal hypernatremic dehydration (NHD) is a dangerous condition that can lead to severe weight loss, renal impairment, and central nervous system complications. We aimed to evaluate the consequences of NHD in infants in their second year of life. MATERIALS AND METHODS: This was a prospective case-control study in Ghaem hospital, Mashhad, Iran. Sixty-five healthy breastfed neonates (serum sodium concentration <150 mmol/L) and 65 hypernatremic (serum sodium concentration ≥150 mmol/L) neonates were followed up from 2008 to 2011. Maternal and neonatal factors were compared between the two groups together with their growth parameters, and developmental milestones (using Denver II developmental assessment scores) were assessed and compared in ages 6, 12, 18, and 24 months, respectively. RESULTS: The weight of infants at 6 months of age was significantly different between the two groups (7,264 ± 1,089 g vs. 7,596 ± 957 g, p = 0.009). Twenty-five percent of infants in the group who had developed NHD had a delay in development at 6 months of age, with corresponding values of 21% at 12 months, 19% at 18 months, and 12% at 24 months of age. Developmental delay was ∼0.3% for the control group at similar ages. The severity of hypernatremia was strongly correlated with poor developmental outcome at 6 months (p = 0.001). Serum sodium concentration of neonates was 153-195 mg/dL in the NHD group. Median peak serum sodium was 158 ± 16 in case group and 141 ± 9 in control group. Serious complications were cerebral edema (five cases), hemorrhage (five cases), and kidney stones (six cases). Hypernatremic dehydration has an adverse effect on child development especially in the first year of life, their prevalence decreases with advanced age. Growth problems are also present during their first year of life. The major signs and symptoms of infants with poor prognosis on admission were poor feeding (8 infants, 61.5%), seizure (3 infants, 23.1%), hyperthermia (1 infant, 7.7%), and lethargy (1 infant, 7.7%). CONCLUSIONS: NHD affects growth parameters and developmental milestones of children. Occasionally the child's weight gain was normalized by the end of first year of life; although developmental delay continued, its severity was reduced, with age.

Combination of Serum Interleukin-1ß and 6 Levels in the Diagnosis of Perinatal Asphyxia.

BACKGROUND: Perinatal asphyxia is an important cause of death, as well as permanent neurological and developmental complications. Diagnosing in time would lead to better prognosis and applying the most proper treatment. We sought to define the predictive values of serum concentrations of interleukin-1ß (IL-1ß) and interleukin-6 (IL-6) in newborns with perinatal asphyxia to see if there is a relation between the short-term neurological deficit and serum IL-1ß and IL-6 concentrations. METHODS: This was a prospective (case-control) study conducted between March 2006 and April 2013, at the Neonatal Intensive Care Unit, Mashhad, Iran. Serum IL-1ß and IL-6 levels were measured at birth in 38 consecutive uninfected neonates with perinatal asphyxia (blood pH < 7.2, low Apgar score, signs of fetal distress) and 47 randomly selected healthy newborns. The results were compared between the groups, using Chi-Square, t-tests, and Mann-Whitney tests, as well as receiver operator characteristics (ROC) curves and regression models. RESULTS: Serum IL-1ß and IL-6 concentrations in the infants who developed perinatal asphyxia were significantly higher compared to values in the normal infants [16.88 vs  3.34 pg/mL for IL-1ß, (P = 0.006), and 88.15 vs 6.74 pg/ mL for IL-6, (P < 0.001) respectively]. The sensitivity and  specificity for the diagnosis of perinatal asphyxia using serum IL-6 were 80.5% and 81.6% respectively. The sensitivity and specificity using serum IL-1ß were 71% and 89.1%, respectively. CONCLUSION: Evaluating serum IL-6 and 1ß simultaneously, could improve the sensitivity and specificity of early diagnosis of the perinatal  asphyxia. The most appropriate indicator of perinatal asphyxia is combined measurement of interleukin 1ß and interleukin 6.

Evaluation of serum interleukins-6, 8 and 10 levels as diagnostic markers of neonatal infection and possibility of mortality.

OBJECTIVE(S): Bacterial infection contributes substantially to neonatal morbidity and mortality. Early diagnosis of neonatal sepsis is difficult because clinical signs are non-specific. We have evaluated serum IL-6, 8 and 10 as potential early diagnostic markers of neonatal infection and their relationship to mortality rate and poor prognosis. Materials and Methods : A total of 84 infants, aged ≥ 72 hr were enrolled in this prospective case-control trial. The case group (n=41) included babies with clinical and laboratory findings compatible with sepsis and/or positive blood or cerebrospinal fluid cultures. The control group (n=43) included healthy infants. IL-6, 8 and 10 were measured for all infants. Receiver-operating characteristic (ROC) curves were used for the determination of thresholds. Results : Statistically significant differences were observed between control and case groups for serum median level of IL-6, 8 and 10 (P<0.001). IL-6 cut-off values of 10.85 Pg/ml for discriminating between cases and controls and 78.2 Pg/ml for predicting mortality are suggested. IL-8 at a cut-off value of 60.05 Pg/ml was valuable for differentiation of definite versus indefinite infection. Conclusion : Evaluating the IL-6, 8 and 10 simultaneously, could improve the sensitivity and specificity of early diagnosis of the neonatal sepsis. Regarding our results, interleukin 6 had the greatest value for predicting infection and possible mortality, whereas IL-8 was valuable for diagnosing definitive infection.

Effect of prenatal selenium supplementation on cord blood selenium and lipid profile.

BACKGROUND: Selenium is an essential trace element and as a component of selenoproteins it plays a key role as an antioxidant. We aimed to evaluate the effect of selenium supplementation during pregnancy on cord blood selenium content and lipid profile. METHODS: This trial was performed on 166 eligible women who were randomized to receive 100 µg of selenium, as selenium-yeast (Se group) or a placebo-yeast tablet (placebo group). Umbilical cord blood samples were collected at the time of delivery and selenium concentration and lipid profile were measured. RESULTS: Triglyceride levels were found to be significantly higher in the Se group than in the placebo group (p=0.01). However, no significant difference in cord blood selenium was observed between the groups nor were there any significant correlations between cord blood selenium and lipid profile parameters. CONCLUSION: Our findings suggest that selenium supplementation in pregnant women may be associated with an increased cord-blood triglyceride level, although total cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol levels did not change significantly. The clinical significance of the increased cord triglyceride concentration needs to be evaluated.

The Effect of Traditional Remedies (Camel's Thorn, Flixweed and Sugar Water) on Idiopathic Neonatal Jaundice.

OBJECTIVE: Jaundice is the most common reason of newborn's admission to neonatal ward. Many Iranian families give traditional remedies like sugar water, camel's thorn and flixweed extracts to breast-fed babies for reducing jaundice. This study investigated the effect of traditional remedies on idiopathic neonatal jaundice. METHODS: This prospective study has been performed on 336 babies with idiopathic jaundice in a four year period (2005-2009) at Ghaem hospital, Mashhad, Iran. The babies were divided into two groups. In case group (n=234) breast-fed babies received no remedy and in control group (n=102), traditional remedies were given additional to breast milk and the results recorded and compared. FINDINGS: In the present study significant differences were observed between the two groups in age of admission (6.8±3.2 vs 9.2±3.7 day, P<0.001), serum bilirubin values (17.8 vs 21.3 mg/dl, P<0.001) and percent of weight loss (P<0.01). There were no significant differences between the two groups in birth weight, sex, gestational age and duration of hospitalization, age at jaundice remission, hematocrit value and maternal factors (age, gestational order, pregnancy and labor problems)(P>0.05). CONCLUSION: Traditional remedies (camel's thorn, flixweed and sugar water) cause more weight loss and delayed reexamination of newborns leading to increased hyperbilirubinemia. These remedies may raise pseudo confidence in parents, which postpones reexamination and follow up of the newborns.

Neonatal hypernatremia and dehydration in infants receiving inadequate breastfeeding.

INTRODUCTION: Neonatal hypernatermic dehydration (NHD) is a potentially very serious condition, which has been reported to occur in infants who have breast feeding problems in the first week of the life. This study looked at the incidence, risk factors, clinical symptoms and complications of NHD in healthy breastfed term neonates. METHODS: A prospective case-control study was conducted on 53 neonates with serum sodium concentrations of >or=150 mmol/L (as the case group) who were recruited between June 2006 and June 2007 from the Ghaem hospital (Mashhad, Iran) to investigate the relationship between NHD and breastfeeding. Fifty-three healthy breastfed full-term neonates (serum sodium<150 mmol/L) from the same hospital were also recruited as the control group. RESULT: The results showed an average weight loss of 1.6% in the healthy neonates vs. 16.2% in infants with NHD (p<0.001). The frequency of feeds received per day was 10.2 for the healthy neonates vs. 7.6 in the NHD group (p<0.001). The NHD group had mothers who had a higher frequency of breast problems (23 vs. 7, p<0.001). Mean serum sodium concentration was significantly lower in the control group compared with the cases (137.80 vs.160.06 mmol/L, p<0.001). The main presenting features of the infants with NHD were fever, lethargy and jaundice. CONCLUSION: Breastfeeding problems are associated with the presence of NHD. Therefore, more breast examination during prenatal and postnatal periods and careful neonatal weight watch during the first week of life could decrease the incidence of NHD.

Selenium supplementation and the incidence of preeclampsia in pregnant Iranian women: a randomized, double-blind, placebo-controlled pilot trial.

OBJECTIVE: Recent studies have reported that antioxidant status, including serum selenium concentrations, is altered in women who develop preeclampsia. We wished to examine the effects of selenium supplementation in the prevention of preeclampsia in high-risk pregnant women. DESIGN: We carried out a randomized, double-blind, placebo-controlled pilot trial. A total of 166 primigravid pregnant women, who were in the first trimester of pregnancy, were randomized to receive 100 microg of selenium (n = 83; dropouts, n = 22) or a placebo (n = 83; dropouts, n = 19) per day until delivery. The incidence of preeclampsia, serum selenium concentrations, lipid profile and high-sensitivity C-reactive protein status were evaluated at baseline and at the end of the study. RESULTS: Supplementation with selenium was not associated with any reported major side effects and was associated with a significant increase in mean serum selenium concentrations at term (p < 0.001). In contrast, mean serum selenium concentrations remained unchanged in the control group (p = 0.63). The incidence of preeclampsia was lower in the selenium group (n = 0) than in the control group (n = 3), although this was not statistically significant (p > 0.05). After treatment, systolic and diastolic blood pressure, serum total cholesterol, triglycerides, low-density and high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were significantly increased in both groups compared with pretreatment levels (p < 0.05). CONCLUSION: Our findings indicate that selenium supplementation in pregnant women may be associated with a lower frequency of preeclampsia.

Early diagnosis of perinatal asphyxia by nucleated red blood cell count: a case-control study.

BACKGROUND: Perinatal asphyxia is a major cause of neurologic morbidity and mortality. The purpose of this study was to investigate variations in nucleated red blood cell (NRBC) count per 100 white blood cells (WBC) and absolute NRBC/mm3 in blood associated with perinatal asphyxia and its relationship to both the severity and short term prognosis of asphyxia. METHODS: A prospective (case-control) study was undertaken between October 2006 and December 2008, in the Neonatal Intensive Care Unit, Ghaem Hospital, Mashhad, Iran. A total of 91 infants completed the study. Levels of nucleated red blood cell per 100 white blood cells and absolute nucleated red blood cell counts in venous blood were compared for 42 asphyxiated (case group) and 49 normal neonates (control group). These parameters were also related to the severity of asphyxia and clinical outcome. RESULTS: The NRBC/100 WBC and absolute nucleated red blood cell levels in the blood of newborns in the control group were 3.87+/-5.06 and 58.21+/-87.57/mm3, respectively; whereas the corresponding values in the cases were 18.63+/-16.63 and 634.04+/-1002/mm3, respectively (P<0.001). A statistically significant negative correlation existed between nucleated red blood cell level and indicators of the severity of perinatal asphyxia, first minute Apgar score and blood pH (P<0.001), respectively. A positive correlation was demonstrated between these parameters and severity of asphyxia, acidosis, and poor outcome (P<0.05). CONCLUSION: The NRBC/100 WBC and/or absolute nucleated red blood cell are simple markers for assessment of severity and early outcomes of perinatal asphyxia.

Serum interleukin 8 level as a diagnostic marker in late neonatal sepsis.

OBJECTIVE: Late-onset sepsis is responsible for high morbidity and mortality in newborn infants in the world and in particular in developing countries. In this study, we evaluated whether clinical characteristics, laboratory parameters and measurements of serum interleukin-8 (IL-8) are able to discriminate between late neonatal sepsis and normal baby. METHODS: This was a prospective (case-control) study conducted between March 2007 and April 2008, at the neonatal intensive care unit, Ghaem Hospital, Mashhad, Iran. The study comprised 93 neonates ≥72 hours of life. The infants were categorized in two groups based on the clinical presentation, and biochemical markers including complete blood count, C-reactive protein (CRP) and blood culture: 1) Control group including 42 infants with routine screening and 2) Case group consisting of 38 infants with definitive infection (positive blood and/or cerebrospinal fluid culture) or clinical sepsis (clinical and laboratory signs of infection without positive blood or CSF culture). Receiver-operating characteristic curves were used for the determination of thresholds for the infection group versus healthy neonate group. FINDINGS: Eighty infants were enrolled in this study. IL-8 and CRP decreased in order of definitive infection, clinical sepsis and healthy subjects respectively (P<0.001). Sensitivity, specificity, positive predictive value, negative predictive value for serum levels were 0.95, 0.1, 0.97, 0.1 for IL-8 and 0.83, 0.86, 0.83, 0.69 for CRP respectively (cut-off point for IL-8 >60pg/ml and for CRP>6mg/dl). CONCLUSION: IL-8 may be a valid and early predictive marker of neonatal infection. Also, IL-8 is associated with severity of infection.