Factors Associated with Neonatal Problems in Twin Gestations

1991 ◽  
Vol 40 (2) ◽  
pp. 193-200 ◽  
Author(s):  
D. Fraser ◽  
R. Picard ◽  
E. Picard
Keyword(s):  
Birth Weight ◽  
Neonatal Outcome ◽  
Medical Center ◽  
Mode Of Delivery ◽  
Beer Sheva ◽  
Factors Associated ◽  
Early Neonatal Mortality ◽  
Multiple Gestations ◽  
Congenital Heart Malformations ◽  
Neonatal Problems

AbstractWe examined the neonatal outcome of 644 twins weighing 500 g or more and 656 singletons, born in the years 1984-1986 in the Soroka Medical Center, Beer-Sheva, Israel. There was nearly a four-fold risk of antepartum death in twins vs singletons, which disappeared when birth weight was controlled for. The risks for intrapartum and early neonatal mortality were not raised in this population. A statistically significant relative risk for congenital heart malformations in twins vs singletons remained (RR = 5.0, 95% CI = 1.5-16.3), after controlling for maternal age. Significantly higher rates of hyalin membrane disease, hypoglycemia, hyperbilirubinemia, anemia and septicemia were found in twins. Controlling for the confounding of the association between twinning and mortality or morbidity caused by differences in distributions of mode of delivery or gestational age between twins and singletons, was not as efficient as the controlling for birth weight. Thus, adjustment for birth weight removed all the excess risks detected except in hypoglycemia. Our findings suggest that the-lower birth weight of twins, which is so intimately associated with multiple gestations, is probably the single most important factor associated with neonatal problems found in twin births.

scholarly journals Factors Associated With Timely Initiation Of Breastfeeding Among Mothers In JPMC

2018 ◽  
Vol 08 (02) ◽  
pp. 92-96
Author(s):  
Beena Barkat Ali ◽  
Shazia Naseeb ◽  
Razia Korejo
Keyword(s):  
Birth Weight ◽  
Middle Class ◽  
Gestational Age ◽  
Medical Center ◽  
Mode Of Delivery ◽  
Common Factors ◽  
Timely Initiation ◽  
Factors Associated ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Objective: Study the frequency of common factors Associated with timely initiation of breastfeeding. Study design: Descriptive Cross sectional. Duration and place of study: this study was conducted at, Jinnah postgraduate Medical center Karachi unit-I from 19 May to 18 November 2015. Material & Methods: A total of 108 mother infant pairs were selected by Non probability consecutive sampling technique, meeting our inclusion criteria. Informed consent was taken after explaining the pros and cons, purpose and procedure of the study. The common factors associated with timely initiation of breastfeeding like age of the mother, gestational age, parity, educational status, working status of the mother, mode of delivery, birth weight of the baby and gender of the baby were evaluated through face to face interview of the mothers . Results: In our study mean age of mothers found to be 26.1 years old. Mean birth interval found to be 3.1years. Mean birth weight of the babies was 2.86 kg. Mean gestational age of the Patients was 38.1weeks. Most of the babies were female 63(58%) other were male 45(42%).Out of 108 patients, 40(37%) received Primary education, 27 (25%) were graduated, 18(17%) were Illiterate, 13(12%) secondary and 10(9%) were Intermediate. Thirty eight (35.2%) belonged to middle class, 56(51.9%) to upper middle class and only 14(13%) to higher class. Fifty eight (53.7%) women were multiparae and 76(70.3%) were employed; And Mostly 66 (61%) delivered through Cesarean -Section. Conclusion: According to this study the main conclusion of Common factors associated to timely initiation of breastfeeding were age of mothers(74.07%) more than 20years , parity 2 or more( 61.1%), educational level secondary and above (50.9%), house wives (32.9%), male sex of infant (41.6%) and Vaginal mode of delivery (38.8%)

scholarly journals Maternal and Perinatal outcome in eclampsia at a teaching hospital of Eastern Nepal

2020 ◽  
Vol 5 (3) ◽  
pp. 1186-1190
Author(s):  
Seema Kumari Mishra ◽  
Roshan Pradhan ◽  
Roshan Pradhan ◽  
Hanoon P Pokharel ◽  
Surya B. Parajuli
Keyword(s):  
Socioeconomic Status ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Teaching Hospital ◽  
Rural Areas ◽  
Perinatal Outcome ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Case Fatality ◽  
Maternal Condition

Introduction: Eclampsia is a multisystem disorder with potential life-threatening complications that can result in significant maternal and fetal morbidity and mortality. The case fatality rate of eclampsia is 1.8% in developed countries, 17.7% in India and 13% in Nepal. The incidence of pre-eclampsia and eclampsia is high in developing countries due to hypoproteinemia, malnutrition and poor obstetric facilities. Objective: To assess the maternal and perinatal outcome in patients of eclampsia Methodology: This was a hospital based cross-sectional study where all the patients presenting with eclampsia from June 2019 to November 2020 in the department of Obstetrics & Gynecology, Birat Medical College and Teaching Hospital were enrolled for the study. Data analyzed included various maternal parameters and fetal parameters along with the mode of delivery, outcome of baby, postpartum maternal condition and maternal mortality were noted. Results: Among 6631 deliveries, 50 patients had eclampsia with the incidence of 7.54/1000 deliveries. Thirty four (68%) patients were of 20-30 years of age, 37 (74%) were primigravidas, 36 (72%) from rural areas, 34 (68%) were illiterate, 49 (98%) were low to middle socioeconomic status, 41 (82%) were unbooked and 33 (66%) patients had antepartum eclampsia. Eleven (22%) women developed eclampsia related complications. There were 02 (4%) maternal deaths and the common causes were HELLP Syndrome and pulmonary oedema. Neonatal outcome consisted of live births in 39 (78%) newborns, 03 (6%) were still births, 08 (16%) were birth asphyxia and 15 (30%) were low birth weight. Conclusion: Majority of the patients were young, illiterate, unbooked primi gravidas with poor to average socioeconomic status from rural areas. Majority of the eclamptic women nearly 39 (78%) cases delivered via caesarean section for better neonatal outcome. Two (4%) eclamptic women died as a result of eclamptic complications and three (6%) newborns had neonatal deaths because of low birth weight and prematurity. Adequate antenatal screening, early detection of hypertension, timely referral, and early initiation of treatment and termination of eclamptic patients can help to improve the maternal and perinatal outcomes.

scholarly journals Comparative study of early neonatal outcome in low birth weight babies in hypertensive disorders complicating pregnancies with the mode of delivery

2021 ◽  
Vol 8 (3) ◽  
pp. 339-345
Author(s):  
Sivajyothi Pilli ◽  
Kavitha Bakshi
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Low Birth Weight ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Survival Advantage ◽  
Hypertensive Disorders ◽  
Significant Difference

Pregnancy induced Hypertension (PIH) is strongly associated with intrauterine fetal growth restriction (IUGR), low birth weight (LBW) and admission to NICU. PIH is not by itself an indication for caesarean delivery. However, the incidence of caesarean is high because of the development of complications in mother and the need to deliver prematurely. To compare the immediate morbidity and survival advantage of LBW vertex presenting babies with the mode of delivery in hypertensive disorders complicating pregnancies. This was a comparative cross-sectional study done on women admitted to the labour ward during the study period with PIH delivering a baby through either a vaginal delivery or a caesarean section with a birthweight of <2.5kgs. A detailed history taking and clinical examination was done. Babies were followed up for one week following delivery to note down the early neonatal outcome. In this study, over all there was no statistically significant difference in neonatal outcome in both vaginal delivery and caesarean section groups. However, there was slight increased incidence of prematurity (68% vs 64%), Birth Asphyxia (14% vs 8%), Sepsis (8% vs 6%), IVH (6% vs 2%) and Hyperbilirubinemia (16% vs 14%) in vaginal delivery group. While, RDS (20% vs 14%) and NEC (4% vs 2%) had higher incidence in caesarean delivery group. Overall, prematurity and IUGR resulting in LBW, contributed to these neonatal complications. Caesarean delivery offers no short-term survival advantage compared with vaginal delivery for LBW vertex presenting foetuses in PIH patients. Neonatal outcomes are not worsened by spontaneous or induced vaginal delivery in women with hypertension with good control and also decreases morbidity due to caesarean section to the mother.

scholarly journals Newborn gender as a predictor of neonatal outcome in mixed gender twins born with very low birth weight

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bernard Barzilay ◽  
Nina Shirman ◽  
Haim Bibi ◽  
Ibrahim Abu-Kishk
Keyword(s):  
Birth Weight ◽  
Neonatal Mortality ◽  
Regression Models ◽  
Very Low Birth Weight ◽  
Neonatal Outcome ◽  
Medical Center ◽  
Morbidity And Mortality ◽  
Logistic Regression Models ◽  
Confounding Variables ◽  
Mixed Gender

Abstract Background Most studies have revealed that the incidence of morbidity and mortality of preterm male infants is greater than that of preterm female infants. Recently, conflicting outcomes have been reported regarding mixed-gender twins. The aim of this study was to estimate the association between gender and outcome in newborn twins of different gender. Methods We conducted a retrospective review of mixed-gender twins weighing < 1500 g that were born at Shamir Medical Center (Assaf Harofeh) between the years 1995 and 2016 (158 newborns). The incidence of morbidity and mortality until discharge from the hospital were evaluated while looking at gender differences. Results No significant differences were found in neonatal mortality or morbidity between females and males from different-gender twins. Even after considering confounding variables (gestational age, birth weight & birth order) in linear and logistic regression models, no significant differences were found between the genders. Conclusions Our study suggests that there are no significant differences in neonatal mortality or morbidity among different-gender twins. Our results support the need for further studies.

scholarly journals The utility of delivery ward register data for determining the causes of perinatal mortality in one specialized and one general hospital in south Ethiopia

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Tesfalidet Beyene ◽  
Catherine Chojenta ◽  
Roger Smith ◽  
Deborah Loxton
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Perinatal Mortality ◽  
Maternal Deaths ◽  
Apgar Scores ◽  
Neonatal Deaths ◽  
Factors Associated ◽  
South Ethiopia ◽  
Early Neonatal Mortality ◽  
Early Neonatal Deaths

Abstract Background Globally, the burden of perinatal mortality is high. Reliable measures of perinatal mortality are necessary for planning and assessing prenatal, obstetric, and newborn care services. However, accurate record-keeping is often a major challenge in low resource settings. In this study we aimed to assess the utility of delivery ward register data, captured at birth by healthcare providers, to determine causes of perinatal mortality in one specialized and one general hospital in south Ethiopia. Methods Three years (2014–2016) of delivery register for 13,236 births were reviewed from July 12 to September 29, 2018, in two selected hospitals in south Ethiopia. Data were collected using a structured pretested data extraction form. Descriptive statistics assessed early neonatal mortality rate, stillbirth rate, perinatal mortality rate and causes of neonatal deaths. Factors associated with early neonatal deaths and stillbirths were examined using logistic regression. The adjusted odds ratios with a 95% confidence interval were reported to show the strength of the association. Result The perinatal mortality ratio declined from 96.6 to 75.5 per 1000 births during the three-year study period. Early neonatal mortality and stillbirth rates were 29.3 per 1000 live births and 55.2 per 1000 total births, respectively. The leading causes of neonatal death were prematurity 47.5%, and asphyxia 20.7%. The cause of death for 15.6% of newborns was not recorded in the delivery registers. Similarly, the cause of neonatal morbidity was not recorded in 1.5% of the delivery registers. Treatment given for 94.5% of neonates were blank in the delivery registers, so it is unknown if the neonates received treatment or not. Factors associated with increased early neonatal deaths were maternal deaths and complications, vaginal births, APGAR scores less than 7 at five minutes and low birth weight (2500 g). Maternal deaths and complications and vaginal births were associated with increased stillbirths. Conclusion Our findings show that an opportunity exists to identify perinatal death and newborn outcomes from the delivery ward registers, but some important neonatal outcomes were not recorded/missing. Efforts towards improving the medical record systems are needed. Furthermore, there is a need to improve maternal health during pregnancy and birth, especially neonatal care for those neonates who experienced low APGAR scores and birth weight to reduce the prevalence of perinatal deaths.

scholarly journals Incidence and factors associated with mortality of neonatal sepsis

2011 ◽  
Vol 51 (3) ◽  
pp. 144 ◽  
Author(s):  
I Made Kardana
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Mode Of Delivery ◽  
Developed Countries ◽  
Live Births ◽  
Factors Associated ◽  
Early Onset Sepsis

Background Neonatal sepsis is one of the major causes of mortality and long term morbidity in neonates, particularly in premature and low birth weight infants. The incidence of neonatal sepsis varies from 1 to 4 in 1000 live births in developed countries and 10 to 50 in 1000 live births in developing countries. The mortality rate of neonatal sepsis remains high, especially in developing countries.Objective To describe the incidence, mortality rate, and factors associated 'With mortality in neonatal sepsis in Sanglah Hospital, Denpasar.Methods A retrospective, cohort study was conducted in the Perinatology Ward, Department of Child Health, Sanglah Hospital, Denpasar, Bali from January to December 2008. One hundred thirty􀁄eight patients 'With neonatal sepsis were enrolled in this study. Patients' characteristic data were collected including sex, mode of delivery (spontaneous, non􀁄spontaneous), condition at birth (vigorous, asphyxic), gestational age (premature, full tenn), birth weight «2500 grams, > 2500 grams), and sepsis classifica􀁄tion (early onset sepsis, late onset sepsis). Outcomes were grouped into alive and dead.Results A total of 138 cases of neonatal sepsis were reviewed, 59.4% of whom were boys, 63.0% spontaneously delivered,39.1 % asphyxic, 53.6% 'With low birth weight, 50.7% premature, and84.8% with early onset sepsis. The incidence of neonatal sepsis was 5% of babies admitted, 'With a mortality rate of 28.3%. Low birth weight and prematurity were significantly associated withmortality in neonatal sepsis (RR8.4, 95% CI 2.4 to 29.0, P = 0.001 and RR3.4, 95% ClI.O to 11.0, P 􀀂 0.042, respectively). Conclusion The incidence of neonatal sepsis in Sanglah Hospital was 5% of babies admitted, with a mortality rate of 28.3%. Low birth weight and prematurity were significantly associated with mortality in neonatal sepsis. 2011;51:144-8].

Twin pregnancy: Neonatal outcome of second twins depending on presentation and mode of delivery

2006 ◽  
Vol 66 (S 01) ◽  
Author(s):  
D Schlembach ◽  
V Bjelic-Radisic ◽  
G Pristauz-Telsnigg ◽  
J Haas ◽  
A Guliani ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Neonatal Outcome ◽  
Mode Of Delivery

Neonatal Outcome of Macrosomia

2020 ◽  
Vol 40 (2) ◽  
pp. 114-119
Author(s):  
Subhash Chandra Shah ◽  
Anusmriti Guragain ◽  
Shreejana Pandey ◽  
Ajaya Kumar Dhakal
Keyword(s):  
Maternal Age ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Pregnancy Induced Hypertension ◽  
Factors Associated ◽  
Adverse Neonatal Outcome ◽  
Induced Hypertension ◽  
Appropriate For Gestational Age ◽  
Prolonged Hospital

Introduction: Macrosomia is an emerging public health problem, both in the developed as well as in the developing countries. This study was aimed to examine the maternal and neonatal risk factors associated with macrosomia and compare adverse neonatal outcome between appropriate for gestational age (AGA) and macrosomia. Methods: Records of all live singleton AGA and macrosomic babies delivered at a tertiary care teaching hospital in Lalitpur, Nepal, between 14th April 2013 and 13th April 2014 were retrospectively reviewed. Results: Of the 769 deliveries, 684 neonates were eligible of which 93 were born macrosomic with an incidence of 12.1%. We observed the most significant neonatal outcome to be neonatal sepsis (14%; p = 0.005) compared to AGA babies (5.9%). Macrosomia was found to be associated with increasing maternal age and parity (p = 0.007) relative to mothers of AGA babies, most of whom underwent caesarean section (55.9%) whilst the same outcome was fewer for mothers of AGA babies (29.9%). A higher incidence of pregnancy induced hypertension (PIH) as maternal comorbidity (5.4%) was associated with macrosomia contrasted with mothers of AGA babies (4.4%). Conclusion: Macrosomic birth was found to be associated with relatively higher adverse neonatal outcome, warranting prolonged hospital admission than AGA births.

Does Placental Weight Affects Perinatal Outcome? A Prospective Case-control Study

2020 ◽  
Vol 16 (1) ◽  
pp. 52-59
Author(s):  
Naina Kumar ◽  
Himani Agarwal
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Perinatal Outcome ◽  
Case Control Study ◽  
Neonatal Outcome ◽  
Case Control ◽  
Placental Weight ◽  
Tertiary Center ◽  
Control Study ◽  
Prospective Case Control Study

Background: Placenta plays a very important role in the growth and development of fetus. Objective: To know the correlation between placental weight and perinatal outcome in term antenatal women. Methods: Present prospective case-control study was conducted in the rural tertiary center of Northern India over one year (January-December 2018) on 1,118 term (≥37-≤42 weeks) antenatal women with singleton pregnancy fulfilling inclusion criteria with 559 women with high-risk pregnancy as cases and 559 low-risk pregnant women as controls. Placental weight, birth weight was measured immediately after delivery and compared between the two groups along with gestation, parity, fetal gender, and neonatal outcome. Statistical analysis was done using SPSS 22 version. Results: Mean placental weight [481.98±67.83 gm vs. 499.47±59.59 gm (p=.000)] and birth weight [2.68±0.53 Kg vs. 2.88±0.4 Kg (p=.000)] was significantly lower in high risk as compared to lowrisk participants, whereas placental birth weight ratio was higher in high-risk cases [18.35±2.37 vs. 17.41±1.38 (p=.000)] respectively. Placental weight was positively correlated with birth weight and placental weight and birth weight increased with increasing gestation in both cases and controls. Male neonates had higher placental weight [492.74±68.24 gm vs. 488±58.8 gm (p=0.224)] and birth weight [2.81±0.5 Kg vs. 2.74±0.45 Kg (p=0.033)] as compared to females. Neonatal Intensive Care Unit admission was significantly associated with low placental and birth weight (p=.000). Conclusion: There is a significant correlation between placental weight, birth weight and neonatal outcome, hence placental weight can be used as an indirect indicator of intrauterine fetal growth.

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