Acoustic Reflex Testing in Neonatal Hearing Screening and Subsequent Audiological Evaluation

2018 ◽  
Vol 61 (7) ◽  
pp. 1784-1793
Author(s):  
Lilian Cássia Bórnia Jacob-Corteletti ◽  
Eliene Silva Araújo ◽  
Josilene Luciene Duarte ◽  
Fernanda Zucki ◽  
Kátia de Freitas Alvarenga
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Pure Tone ◽  
Broadband Noise ◽  
Acoustic Reflex ◽  
Group I ◽  
Group Ii ◽  
Gestational Age At Birth ◽  
Age At Birth

Purpose The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR). Method We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator. Results In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz. Conclusions Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.

scholarly journals Retinopathy of prematurity in a tertiary facility: an initial report of a screening programme

2020 ◽  
Vol 47 (2) ◽  
pp. 55-60
Author(s):  
B.A. Olusanya ◽  
T.S. Oluleye ◽  
O.O. Tongo ◽  
M.O. Ugalahi ◽  
Y.O. Babalola ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Screening Criteria ◽  
Screening Programs ◽  
Significant Difference ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Rop Screening

Background: Retinopathy of prematurity (ROP) screening in Nigeria is at a nascent stage and at the moment there are no National guidelines for ROP screening in Nigeria. Thus it is desirable for screening programs to report findings amongst screened preterm infants in order to facilitate the  development of national ROP screening criteria and guidelines. The aim of this report is to describe the frequency, severity and risk factors for retinopathy of prematurity (ROP) among preterm and very low-birth-weight babies screened within the first year of initiating an ROP screening  program at a Nigerian tertiary facility. Methods: A cross-sectional study of infants born at less than 34 weeks gestational age; or with birth weight less than 1500g between May 2016 and May 2017. ROP screening examinations were performed by ophthalmologists with the use of an indirect ophthalmoscope, after pupillary dilation, in collaboration with the neonatology team. Information on gestational age at birth, birth weight, oxygen therapy and presence of other risk factors were recorded and analyzed. Results: A total of 74 infants were screened during the period. There were 36 (48.6%) males. Mean gestational age at birth was 29.6 (±2.35) weeks.  Mean birth weight was 1.26 (±0.27) kg with a range of 800 to 1950g. ROP was detected in 9 (12.2%) infants. Two (22.2%) of these had Threshold ROP. There was no significant difference between the mean birth weight and mean gestational age of the infants who had ROP compared to those  without ROP. The two infants with Threshold ROP were treated with intravitreal Bevazicumab and had regression of ROP. Conclusion: Retinopathy of prematurity was diagnosed in at risk infants in this facility. There is, therefore, a need to establish ROP screening  programs in all neonatal units across the country. In addition, established programs need to evaluate their screening criteria with a view towards  developing country-specific screening guidelines. Keywords: Retinopathy; Prematurity; Preterm; Neonates; Nigeria; Africa

scholarly journals Maternal biological age assessed in early pregnancy is associated with gestational age at birth

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eva E. Lancaster ◽  
Dana M. Lapato ◽  
Colleen Jackson-Cook ◽  
Jerome F. Strauss ◽  
Roxann Roberson-Nay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Cellular Aging ◽  
Biological Age ◽  
Potential Candidate ◽  
A Genome ◽  
Gestational Age At Birth ◽  
Age At Birth

AbstractMaternal age is an established predictor of preterm birth independent of other recognized risk factors. The use of chronological age makes the assumption that individuals age at a similar rate. Therefore, it does not capture interindividual differences that may exist due to genetic background and environmental exposures. As a result, there is a need to identify biomarkers that more closely index the rate of cellular aging. One potential candidate is biological age (BA) estimated by the DNA methylome. This study investigated whether maternal BA, estimated in either early and/or late pregnancy, predicts gestational age at birth. BA was estimated from a genome-wide DNA methylation platform using the Horvath algorithm. Linear regression methods assessed the relationship between BA and pregnancy outcomes, including gestational age at birth and prenatal perceived stress, in a primary and replication cohort. Prenatal BA estimates from early pregnancy explained variance in gestational age at birth above and beyond the influence of other recognized preterm birth risk factors. Sensitivity analyses indicated that this signal was driven primarily by self-identified African American participants. This predictive relationship was sensitive to small variations in the BA estimation algorithm. Benefits and limitations of using BA in translational research and clinical applications for preterm birth are considered.

scholarly journals Birth-weight centiles and the risk of serious adverse neonatal outcomes at term

2018 ◽  
Vol 46 (9) ◽  
pp. 1048-1056 ◽  
Author(s):  
Joanna Yu ◽  
Christopher Flatley ◽  
Ristan M. Greer ◽  
Sailesh Kumar
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Neonatal Outcomes ◽  
Predicted Probability ◽  
Exposure Variable ◽  
Adverse Neonatal Outcomes ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Age At Birth

Abstract Background: Birth-weight is an important determinant of perinatal outcome with low birth-weight being a particular risk factor for adverse consequences. Aim: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies. Materials and methods: This was a retrospective cohort study of singleton term births at the Mater Mother’s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤−12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile. Results: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06–4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30–1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60–7.75). Conclusions: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.

Developmental and Psychological Test Scores in Children of Low Birth Weight

PEDIATRICS ◽  
1970 ◽  
Vol 45 (5) ◽  
pp. 886-887
Author(s):  
Linda C. Eaves ◽  
Harry Klonoff ◽  
Henry G. Dunn
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Test Scores ◽  
Personal Communication ◽  
Psychological Test ◽  
January Issue ◽  
The Subject ◽  
Gestational Age At Birth ◽  
Age At Birth

In the printing of our article on the subject in the January issue of Pediatrics (45:9, 1970) the wording of a sentence on page 10 was unfortunately changed in such a manner as to distort the personal communication we had received from Dr. Ruth Griffiths in London, England. As printed, the sentence is: "It does not seem admirable to try and meaningful to correct such D.Q. figures according to gestational age at birth." The statement we wished to make was: "It does not seem advisable to try and correct such D.Q. figures according to gestational age at birth."

scholarly journals Peri-intraventricular hemorrhage in newborns weighing less than 1500 grams: comparative analysis between 2 institutions

2003 ◽  
Vol 58 (6) ◽  
pp. 299-304
Author(s):  
Marinice Duarte da Ponte ◽  
Sérgio Tadeu Martins Marba
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
World Literature ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Maternity Hospital ◽  
State University ◽  
Gestational Age At Birth ◽  
Age At Birth

PURPOSE: This study aims to characterize the peri-intraventricular hemorrhages in the neonatal period in very low birth weight newborns in 2 institutions that provide neonatal tertiary assistance. METHOD: This was a comparative and observational study in 2 neonatal intensive care units, the Maternity Hospital of Campinas and the "Centro de Atenção Integrada à Saúde da Mulher" of the State University of Campinas, from December 01, 1998 to November 30, 1999. We examined 187 newborns for peri-intraventricular hemorrhages, using transfontanel ultrasound (76 and 11 respectively at the first and second unit), and classified them into 4 grades. We observed their gender, intrauterine growth, weight, and gestational age at birth. RESULTS: We diagnosed 34 cases of peri-intraventricular hemorrhages (13 and 21, respectively), and both groups differed as to the birth weight and the adequacy of weight to the gestational age at birth. There was no difference in the prevalence or extent of peri-intraventricular hemorrhages among cases. There was a statistically significant occurrence of lower birth weight at gestational ages of less than 30 weeks. CONCLUSIONS: The prevalence of peri-intraventricular hemorrhages in our study was compared to that reported in the world literature. Although the cases of the second institution had a smaller mean birth weight, the prevalence of peri-intraventricular hemorrhages was similar to that at the first institution, probably because in the first one, 69% of the gestational ages of the neonates with hemorrhage were less than 30 weeks as compared to 48% in the second one. We stress the importance of the ultrasonographic method for diagnosing peri-intraventricular hemorrhages in very low birth weight newborns.

scholarly journals High-Dose Erythropoietin in Extremely Low Gestational Age Neonates Does Not Alter Risk of Retinopathy of Prematurity

Neonatology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Dennis E. Mayock ◽  
Zimeng Xie ◽  
Bryan A. Comstock ◽  
Patrick J. Heagerty ◽  
Sandra E. Juul ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
High Frequency ◽  
High Dose ◽  
Heart Murmur ◽  
Treatment Groups ◽  
Increased Risk ◽  
Gestational Age At Birth ◽  
Age At Birth

<b><i>Introduction:</i></b> The Preterm Erythropoietin (Epo) Neuroprotection (PENUT) Trial sought to determine the safety and efficacy of early high-dose Epo as a potential neuroprotective treatment. We hypothesized that Epo would not increase the incidence or severity of retinopathy of prematurity (ROP). <b><i>Methods:</i></b> A total of 941 infants born between 24–0/7 and 27–6/7 weeks’ gestation were randomized to 1,000 U/kg Epo or placebo intravenously for 6 doses, followed by subcutaneous or sham injections of 400 U/kg Epo 3 times a week through 32 weeks post-menstrual age. In this secondary analysis of PENUT trial data, survivors were evaluated for ROP. A modified intention-to-treat approach was used to compare treatment groups. In addition, risk factors for ROP were evaluated using regression methods that account for multiples and allow for adjustment for treatment and gestational age at birth. <b><i>Results:</i></b> Of 845 subjects who underwent ROP examination, 503 were diagnosed with ROP with similar incidence and severity between treatment groups. Gestational age at birth, birth weight, prenatal magnesium sulfate, maternal antibiotic exposure, and presence of heart murmur at 2 weeks predicted the development of any ROP, while being on high-frequency oscillator or high-frequency jet ventilation (HFOV/HFJV) at 2 weeks predicted severe ROP. <b><i>Conclusion:</i></b> Early high-dose Epo followed by maintenance dosing through 32 weeks does not increase the risk of any or severe ROP in extremely low gestational age neonates. Gestational age, birth weight, maternal treatment with magnesium sulfate, antibiotic use during pregnancy, and presence of a heart murmur at 2 weeks were associated with increased risk of any ROP. Treatment with HFOV/HFJV was associated with an increased risk of severe ROP.

Treatment of 139 Pregnancies in Antiphospholipid-positive Women Not Fulfilling Criteria for Antiphospholipid Syndrome: A Retrospective Study

2013 ◽  
Vol 40 (4) ◽  
pp. 425-429 ◽  
Author(s):  
Teresa Del Ross ◽  
Amelia Ruffatti ◽  
Maria Serena Visentin ◽  
Marta Tonello ◽  
Antonia Calligaro ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Pregnancy Loss ◽  
Antiphospholipid Antibody ◽  
Birth Weight Percentile ◽  
Antibody Profile ◽  
Gestational Age At Birth ◽  
Age At Birth ◽  
Weight Percentile

Objective.The effect of low-dose aspirin (LDA) on pregnancy outcome in antiphospholipid (aPL)-positive women not fulfilling the criteria for antiphospholipid antibody syndrome (APS) was evaluated retrospectively.Methods.We evaluated 139 pregnancies of 114 aPL-positive women not fulfilling the Sydney classification criteria for definite APS (104 treated with LDA, 35 untreated). Inclusion criteria consisted of (1) any titer of aPL and no previous pregnancy or no pregnancy losses (defined as aPL carriers); (2) any titer of aPL and 1 or 2 pregnancy losses before the 10th gestational week. No women had previous thrombosis. The rate of pregnancy loss, gestational age at delivery, and birth weight percentile were compared in the treated and untreated patients. Associations between clinical and laboratory characteristics and pregnancy outcomes were investigated.Results.The rate of pregnancy loss was low in both treated and untreated groups (7.7% vs 2.9%, respectively). There were no statistically significant differences in the rate of pregnancy loss, gestational age at birth, or birth weight percentile in the treated and untreated groups. There were significant associations between gestational age at birth ≤ 34th week and positivity for lupus anticoagulant (p = 0.025) and anti-ß2-glycoprotein I IgG antibodies at titers > 99th (p = 0.016).Conclusion.LDA treatment does not appear to improve pregnancy outcome in low-risk women not fulfilling the criteria for APS. Because antibody profile seems to influence pregnancy outcome, further studies of patients stratified according to their antibody profile are warranted.

scholarly journals Factors Affecting Ultrasonographic Fetal Weight Estimation Accuracy in Low Birth Weight Newborns

2021 ◽  
Author(s):  
Nevin Tuten ◽  
Onur Guralp ◽  
Koray Gok ◽  
Abdullah Tuten ◽  
Altay Gezer
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Fetal Weight ◽  
Accurate Estimation ◽  
Weight Estimation ◽  
Factors Affecting ◽  
Fetal Weight Estimation ◽  
Gestational Age At Birth ◽  
Age At Birth

Objective: To investigate the accuracy of fetal weight estimation made by the last prenatal ultrasound measurement in low birth weight newborns (<2500 g). Study Design: A total of 1082 women were evaluated in this retrospective cohort study. Demographic and clinical information of the mother and newborn and obstetric ultrasonography measurements and findings performed in the last week before birth were recorded. Accuracy of fetal weight estimation and parameters affecting it was investigated. Results: Accurate estimation rates were lower in the term compared to the preterm delivery group; and in the SGA group compared to the AGA group (respectively, p=0.016, p=0.032). Accurate estimation rates (p=0.182) were comparable between the 500-1500 g and 1501-2500 g subgroups. The multiple linear regression analysis showed that gestational age at birth, birth weight, examination during labor, and duration between examination to delivery were statistically significant for the accurate estimation(p=0.001) Conclusions: Accurate estimation rates were lower in the term compared to the preterm delivery group, and in the SGA group compared to the AGA group. The factors affecting accurate estimation were found to be gestational age at birth, birth weight, examination during labor, and duration between examination to delivery.Keywords: Accurate estimation rate, Duration between examination to delivery, Examination during

scholarly journals What should be the protein target for adjustable Human Milk fortification in premature infants?

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Bayram Ali Dorum ◽  
Hilal Ozkan ◽  
Salih Cagri Cakir ◽  
Nilgun Koksal ◽  
Gizem Ezgi Sen
Keyword(s):  
Birth Weight ◽  
Human Milk ◽  
Premature Infants ◽  
Gestational Age ◽  
Protein Supplementation ◽  
Physical Growth ◽  
Protein Target ◽  
Group I ◽  
The Mean ◽  
Group Ii

Objective: To assess the short- and long-term effects of the adjustable fortification (ADJ) regimen on growth parameters in premature infants and to evaluate the amount of protein supplements given to reach the targeted blood urea nitrogen (BUN) levels. Methods: In this retrospective study, preterm babies who were born at ≤32 weeks gestational age and fed with human milk, were evaluated in two groups. Infants in Group-I were fed only standard fortification (STD). Infants in Group-II were fed the ADJ regimen. The study was conducted between 2011 and 2016. Results: There were 123 infants in the STD group and 119 in the ADJ group. The mean gestational age of the patients in Group-I was 29.7±1.8 weeks, and mean birth weight was 1266.1±347.1 g. The mean gestational age of the patients in Group-II was 29.5±1.9 weeks, and the mean birth weight was 1217.5±345.5 g. The daily increase in weight and weekly increase in HC were significantly higher in the ADJ group infants. Weight and HC of infants in the ADJ group were significantly higher at 40 weeks. At one year corrected age, weight, length, and HC measurements of both groups were similar. In Group-II, 63% of patients required additional protein supplementation up to 1.6 g/day to achieve the target BUN levels. Conclusion: A higher protein intake through the ADJ regimen improves the physical growth rate of premature infants in the NICU and after discharge. However, sometimes, the targeted growth and BUN values ​​cannot be achieved despite the administration of protein at the recommended increased doses. Increasing protein supplementation up to 1.6 g/day is safe, feasible, and beneficial for these infants. How to cite this:Dorum BA, Ozkan H, Cakir SC, Koksal N, Sen GE. What should be the protein target for adjustable Human Milk fortification in premature infants? Pak J Med Sci. 2019;35(1):277-281. doi: https://doi.org/10.12669/pjms.35.1.337 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Examining the association between maternal atopy and birth outcomes using a retrospective cohort in the southeastern region of the USA

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017161
Author(s):  
Ayesha Johnson ◽  
Thomas Mason ◽  
Russell S Kirby ◽  
Dennis Ledford ◽  
Hamisu M Salihu
Keyword(s):  
Birth Weight ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Retrospective Cohort ◽  
Adverse Birth Outcomes ◽  
The Usa ◽  
Gestational Age At Birth ◽  
Primiparous Women ◽  
Southeastern Region ◽  
Age At Birth

ObjectiveTo assess birth outcomes in primiparous women with diagnosis of non-asthmatic atopy (NAA). Researchers hypothesised that women with NAA would have reduced the risk of adverse birth outcomes compared with women without NAA. NAA is defined as having allergic rhinitis and/or atopic dermatitis.SettingWomen were mostly treated in primary care settings in South Carolina, USA.ParticipantsThis is a retrospective cohort study in which participants were identified using a Medicaid database. Participants were primiparous women aged 19 to 25. Births occurring between 2004 and 2014 were identified using the South Carolina’s Vital Statistics (VS) records of live births. Incomplete records (ie, information on plural birth, gestational age at birth or birth weight missing), plural births or infants born before completing 24 weeks of gestation were excluded. This provided 65 650 complete maternal–infant dyads, representing 97.6% of the maternal records and 96.9% of the VS records. Women previously diagnosed with NAA were frequency matched 1:4 to non–atopic controls for a total of 9965 maternal–infant dyads used in the statistical analysis.Primary outcome measuresLow birth weight, small for gestational age and preterm birth.ResultsLinear tests for trend were statistically significant (p<0.001), indicating that NAA was associated with improved birth weight and gestational age at birth. After controlling for potential confounders, mothers with NAA had equal risk for each outcome when compared with mothers with no diagnosis of NAA.ConclusionA diagnosis of NAA among women living in the southeastern region of the USA does not reduce the risk of adverse birth outcomes nor does it elevate the risk of same. Additional studies with more rigorous designs are warranted to confirm the findings in this study.

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