Customized birthweight standard for an Iranian population.

OBJECTIVE: To produce a customized birthweight standard for Iran. METHOD: Retrospective study of a pregnancy database collected from five hospitals across Iran. The cohort consisted of 4994 consecutive term births with complete data, delivered between July 2013 and November 2014. Coefficients were derived using a backwards stepwise multiple regression technique. RESULTS: Maternal height, weight in early pregnancy and parity as well as the baby's sex were identified as significant physiological variables affecting birthweight. Paternal height and weight were also significant although weaker factors. The expected 280-day birthweight, free from pathological influences, of a standard size mother (height 163 cm, weight 64 kg) in her first pregnancy was 3390 g. Pathological factors found to affect birthweight in this cohort included village housing, anemia, preexisting and gestational diabetes and preeclampsia. CONCLUSION: The analysis confirmed the main physiological variables that affect birthweight in other countries and shows paternal factors also to be significant variables. Development of a country-specific customized birthweight standard will aid clinicians in Iran to distinguish between fetuses that are either constitutionally or pathologically small, thereby avoiding unnecessary interventions, and improving identification of at-risk pregnancies and perinatal outcome.

Effect of NIDCAP home care follow-up program of preterm newborns on maternal anxiety and stress.

BACKGROUND: Birth of the preterm babies creates a huge amount of stress in mothers and makes it hard for them to contribute to the care of their off springs. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP)is designed to empower the parents in comprehensively caring for their preterm baby after discharge from the hospital. The present research was intended to study the effects of NIDCAP follow up on the stress and anxiety of the mothers. METHODS: In this clinical trial, 20 mothers of preterm babies with the gestational age of 26 to 32 weeks were studied at Omolbanin Hospital, Mashhad, Iran. The NIDCAP was performed during the hospital stay and two times after discharge. The control group received routine care without the NIDCAP. Anxiety and stress of the mothers were assessed through the Spielberger and Cohen questionnaires. Data were analyzed by Independent t-test, Chi-square and Fisher's Exact test in SPSS 20 software. RESULTS: At the baseline, there were no statistically significant differences between the experimental and the control group. After the intervention, the average score of anxiety was significantly lower among mothers in the experimental group compared to the control group(P=0.009). NIDCAP and its follow up also reduced the stress of the mothers in the experiment group (P=0.033). CONCLUSIONS: Implementation of the NIDCAP and its home follow up was effective in reducing the stress and the anxiety of the mothers of preterm babies. Execution of the NIDCAP is recommended to all hospital of the country for mothers of preterm babies.

Comparison of maternal characteristics in low birth weight and normal birth weight infants.

Low birth weight is a key determinant in the risk of morbidity and mortality in the neonatal period and during childhood. This unmatched case-control study in Hamadan, Islamic Republic of Iran, compared the characteristics of mothers of low- and normal-birth-weight infants. Maternal sociodemographic data, pregnancy history, anthropometric data and cord plasma zinc level were collected from 134 mothers of low-birth-weight infants and 134 mothers of normal infants at the time of delivery. Significant differences in maternal characteristics namely gravida, parity, body mass index, maternal weight gain during pregnancy and plasma cord blood zinc were found between low- and normal-birth-weight infants. There were no significant differences in maternal age, maternal education, maternal occupation, family income, previous abortion, previous preterm labour, birth Iinterval, type of clinic and place of residence between the 2 groups.

Study of intraventricular hemorrhage in VLBW neonates admitted in Al-Zahra Hospital, Tabriz, Iran.

INTRODUCTION AND AIM: Intra-ventricular hemorrhage (IVH) is an important predictor of adverse neurodevelopmental outcome. IVH risk factor identification may conduct improvement of quality of care in neonatal intensive care units. The aim of the current study was to determine possible risk factors associated with IVH in VLBW neonates admitted in our hospital. PATIENTS AND METHODS: All neonates with birth weight below 1500 gr admitted to NICU. Cranial ultrasonography was done for premature neonates weighed <1000 g in 3 to 5 days and in 1 month again. In premature infants weighed >1000 g, sonography was done in 7 days and 30 days of life respectively. If there is any conditions such as apnea, seizure, significant decrease in level of hemoglobin, increased head circumference, increased oxygen consumption, and other significant changes another sonography was done again. Exclusion criteria were cerebral malformations, metabolic disturbances, chromosomal anomalies, central nervous system infection, and genetic syndromes. Data was analyzed by SPSS ver 16.0 (SPSS Inc, Chicago, IL, USA). RESULTS: In this study 64 cases with IVH and without IVH were included. Mean of gestational age was 28.78 +/- 12.08. From neonates, 54.6% were boys and 45.4% were girls. Vaginal delivery and cesarean section was done in 56 (32.2%) and 118 (67.8%) cases respectively. Mean +/- SD of pH in cases with IVH and without IVH was 7.19 +/- 0.22 and 7.30 +/- 0.12 respectively (p = 0.001). Mean ISD of pco2 in cases with IVH and without IVH was 65.15 +/- 29.89 and 49.88 +/- 40.89 respectively(p = 0.001). Mean of 5th min APGAR score in patients required CPR was 7.36 +/- 1.57 and in patients without CPR was 8.68 +/- 1.25 (P = 0.001). From cases with IVH, hydrocephaly was detected in 20 cases. From cases without IVH, hydrocephaly was detected in 6 cases. Result of chi-square show significant correlation between IVH and prematurity (chi2 = 21.94, df=1, P < 0.001). From cases with IVH, 18 cases (28.1%) expired. From cases without IVH, 11 cases (10%) expired (chi2 = 9.398, df=1, P = 0.002). Results of chi-square test showed that there were a corelation between IVH and PDA, pressure support, surfactant therapy drug administration, vaginal delivery, neonatal resuscitation, and antenatal corticosteroid therapy (p < 0.05). Hyaline membrane disease, history of preclampsia in mother was significantly higher in cases without IVH (chi-square, p < 0.05). CONCLUSION: PDA, pressure support, surfactant therapy, inotrop drug administration, vaginal delivery, neonatal resuscitation, and antenatal corticosteroid therapy were significantly higher in cases with IVH. Hyaline membrane disease and preeclampsia in mother was significantly higher in cases without IVH.

Congenital anomalies in Iran: a cross-sectional study on 1574 cases in the North-West of country.

BACKGROUND: At least one congenital anomaly is present in between 1% and 6% of all infants throughout the world. The aim of this study was to document some epidemiological features of congenital anomalies in the North-West of Iran. METHODS: The study cases (n = 1574) comprised all births registered/notified to three university-hospitals of Tabriz University of Medical Sciences, Iran, from 2000 to 2004. RESULTS: Total prevalence of congenital anomalies was 165.5 per 10 000 births [95% confidence interval (CI): 157-174]. Genito-urinary tract and kidney defects, anomalies of nervous system and limb anomalies accounted proportionally for more than 65% of anomalies in the region. The total prevalence of congenital anomalies in the study area increased from 104.6 per 10 000 births in 2000 (95% CI: 90-119) to 170.1 per 10 000 births in 2004 (95% CI: 152-189). CONCLUSIONS: It is concluded that the data from this cross-sectional study of congenital anomalies in the North-West of Iran may be used as the baseline information to establish a population-based registry of birth defects in the area for health care and research purposes.

Pulmonary complications in primary hypogammaglobulinemia: a survey by high resolution CT scan.

BACKGROUND: Primary hypogammaglobulinemia disorders are a group of heterogeneous immunodeficiency syndromes with an increased susceptibility to pulmonary complications. METHODS: The aim of this study was to evaluate the extent of lung abnormalities in primary hypogammaglobulinaemic patients by high resolution computed tomography (HRCT) scan and pulmonary function test (PFT). HRCT and PFT were performed in 22 Iranian patients with primary hypogammaglobulinemia. RESULTS: Pathological bronchial findings were observed in thirteen patients: three patients showed only peribronchial thickening and the remaining ten patients suffered from both bronchiectasis and peribronchial wall thickening. Mild type of bronchiectasis and peribronchial wall thickening were the most common type, predominantly observed in the right middle and both right and left lower lobe segments of lungs. Although bullae were not found, emphysema, air-trapping, and collapse/consolidation were observed in two patients. Bronchial involvement was mostly limited to 1 up to 5 bronchopulmonary segments; only one HRCT indicated bronchial involvement in more than nine bronchopulmonary segments. Pathological bronchial findings mostly observed in the proximal bronchi; meanwhile the involvement of the distal bronchi was less common. Decreasing FEVI and FVC were observed in 65% and 55% of patients, respectively. There was a significant correlation between the HRCT score and the predicted values by PFT. The delay of diagnosis in patients with bronchiectasis was significantly higher than those without bronchiectasis. CONCLUSIONS: It seems that the majority of hypogammaglobulinaemic patients suffer from the mild type of bronchiectasis, which is mostly observed in the proximal bronchi of the lower lobe segments. The delay of diagnosis plays an important role in the occurrence of this complication in these patients.