Vaginal Delivery and Low Gestational Age are Key Risk Factors for Hypernatremia in Neonates < 32 Weeks

2021 ◽  
Author(s):  
Nadia S. Eugster ◽  
Florence Corminboeuf ◽  
Gilbert Koch ◽  
Julia E. Vogt ◽  
Thomas Sutter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Preterm Neonates ◽  
Multiple Birth ◽  
Plasma Sodium ◽  
Delivery Mode ◽  
Antenatal Corticosteroids ◽  
Clinical Complications

Abstract Background Preterm neonates frequently experience hypernatremia (plasma sodium concentrations >145 mmol/l), which is associated with clinical complications, such as intraventricular hemorrhage. Study design In this single center retrospective observational study, the following 7 risk factors for hypernatremia were analyzed in very low gestational age (VLGA, below 32 weeks) neonates: gestational age (GA), delivery mode (DM; vaginal or caesarian section), sex, birth weight, small for GA, multiple birth, and antenatal corticosteroids. Machine learning (ML) approaches were applied to obtain probabilities for hypernatremia. Results 824 VLGA neonates were included (median GA 29.4 weeks, median birth weight 1170 g, caesarean section 83%). 38% of neonates experienced hypernatremia. Maximal sodium concentration of 144 mmol/l (interquartile range 142–147) was observed 52 hours (41–65) after birth. ML identified vaginal delivery and GA as key risk factors for hypernatremia. The risk of hypernatremia increased with lower GA from 22% for GA ≥ 31–32 weeks to 46% for GA < 31 weeks and 60% for GA < 27 weeks. A linear relationship between maximal sodium concentrations and GA was found, showing decreases of 0.29 mmol/l per increasing week GA in neonates with vaginal delivery and 0.49 mmol/l/week after cesarean section. Sex, multiple birth and antenatal corticosteroids were not associated hypernatremia. Conclusion VLGA neonates with vaginal delivery and low GA have the highest risk for hypernatremia. Early identification of neonates at risk and early intervention may prevent extreme sodium excursions and associated clinical complications.

scholarly journals Risk factors for patent ductus arteriosus in preterm neonates

2014 ◽  
Vol 54 (3) ◽  
pp. 132 ◽  
Author(s):  
Novia Bernati ◽  
Ria Nova ◽  
Julniar M. Tasli ◽  
Theodorus Theodorus
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Prevalence Ratio ◽  
Hyaline Membrane Disease ◽  
Preterm Neonates ◽  
Antenatal Corticosteroids ◽  
Cross Sectional ◽  
Patent Ductus

Background The reported prevalences of patent ductus arteriosus(PDA) in preterm neonates vaty, and are currently unknown inPalembang. Birth weight, ges tational age, asphyxia, histoty ofantenatal steroid use, hyaline membrane disease (HMD), raceand ethnicity, are potential risk factors for PDA.Objective To determine the prevalence of PDA and its riskfactors in preterm neonates at Mohammad Hoesin Hospital,Palembang.Methods This cross-sectional study was conducted from October2011 to April 2012. Echocardiographic examinations wereperformed on 242 preterm neonates aged 15 hours to 7 days. Datawas taken from medical records and interviews, and analyzed byChi square and logistic regression analyses.Results Patent ductus arteriosus was found in 142 (58.7%)preterm neonates with a prevalence ratio of 1.43. Neonates withbirthweight ::;;2,000 grams tended to have 1.9 (95% CI 1.17 to3.32) rimes higher risk for PDA (P=0.01). Neonates ::;;JO weeksgestation were also at 1.9 rimes higher risk for PDA (P=0.16).Probabilities for PDA occurrence in neonates with asphyxia,without antenatal corticosteroids and HMD were 1.6 (95%CI 1.13 to 3.36) rimes, 1.3 (95%CI 0.73 to 2.50) times and 2.2(95%CI 1.29 to 3.72) rimes higher risk for PDA, respectively(P=0.22, 0.41, and 0.005, respectively).Conclusion Birth weight and HMD are statistically significantrisk factors of PDA, but the more significant one is HMD.

TO STUDY THE INCIDENCE AND RISK FACTORS OF RETINOPATHY OF PREMATURITY IN A TERTIARY CARE HOSPITAL IN NORTHERN INDIA

2021 ◽  
pp. 48-50
Author(s):  
Kajaldeep Kaur ◽  
Gursharn Singh
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Northern India ◽  
Retinal Examination

BACKGROUND: Retinopathy of prematurity (ROP) is a multifactorial retinal vaso-proliferative disorder which remains a leading cause of childhood blindness worldwide despite improvements in neonatal care and management guidelines. This study was conducted to determine the incidence of ROP among preterm neonates and to determine the risk factors. METHODS: All preterm infants with birth weight <1750 gm and gestation <34 weeks were screened for ROP at 4 weeks of birth for rst screening. Prenatal and postnatal risk factors, neonatal problems, treatment given, procedures and interventions done during stay in neonatal intensive care unit were recorded as per the proforma. The data from the study was systematically collected, compiled and statistically analyzed with SPSS Statistics-26 version to draw relevant conclusions. RESULTS: The incidence of ROP in 89 infants who were screened was 44%. The mean gestational age of babies with ROP was 32 weeks. In our study, pneumonia, apnea, sepsis, thrombocytopenia, NEC, shock, acidosis, IVH, BPD, the use of Bubble CPAP, Venti-CPAP and mechanical ventilator, the vasopressor use and blood transfusion were signicant risk factors. CONCLUSIONS: The incidence of ROP was signicantly higher in babies <34 weeks. It was observed in our that lower the birth weight and lower the gestational age, higher is the risk for the development of ROP. Careful and timed retinal examination of all at risk infants will minimize the development of ROP and later on blindness.

scholarly journals Risk Factors for Mortality in Neonates with Birth Weight <1500 gm

2012 ◽  
Vol 2 (1) ◽  
pp. 19-22
Author(s):  
Md Abdul Baki ◽  
Afroza Haque ◽  
Fauzia Mohsin ◽  
Jebun Nahar ◽  
Shahida Akhter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Preterm Neonates ◽  
Hospital Death ◽  
Study Population ◽  
Very High ◽  
Prevention Of Prematurity

Background and objective: Neonates with birth weight <1500 gm constitute approximately 4-7% of all live births. Mortality in this group is very high, contributing to as much as 30% of early neonatal death. This study was done to evaluate the morbidities associated with preterm neonates with birth weight < 1500 gm and possible factors determining the death of these babies. Methods: This study was done at Special Care Baby Unit (SCABU), BIRDEM Hospital from January to October 2010. The medical records of neonates with birth weight <1500 gm admitted in SCABU during the study period were retrospectively reviewed. The outcome measure was in-hospital death. Univariate analysis was done to determine the risk factors of mortality. Results: Total 64 babies with birth weight <1500 gm were admitted during this study period. Mean gestational age was 30.76 (± 2.97) weeks, mean birth weight was 1182 (±283) gm. Jaundice (59.4%), Thrombocytopenia (57.8%), apnoea (53.15), sepsis (45.3%) feeding intolerance (43.8%), and RDS (23.4%) were common co-morbidities in these neonates. Among 64 babies more than one-third died (36%). Risk factors for mortality were gestational age less than 30 wks (OR: 7.73; 95% CI: 2.43-24.53), weight <1000 gm (OR: 4.93; 95% CI: 1.28-18.87), RDS (OR: 13.81; 95% CI: 13.81- 57.86) and baby who required mechanical ventilation (OR: 61.66; 95% CI: 12.54- 303.22). Conclusion: Extreme low birth weight (birth weight <1000 gm), prematurity (gestational age <30 wks) and RDS were the significant risk factors for mortality in this study population. Prevention of prematurity and appropriate management of RDS may reduce the mortality of these neonates. DOI: http://dx.doi.org/10.3329/birdem.v2i1.12356 Birdem Med J 2012; 2(1) 19-22

scholarly journals The Incidence of Anal Sphincter Ruptures and Risk Factors

2016 ◽  
pp. 31-36
Author(s):  
Budi I Santoso ◽  
Denny Khusen
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Gestational Age ◽  
Univariate Analysis ◽  
Forceps Delivery ◽  
Fourth Degree ◽  
Control Subjects ◽  
Vaginal Deliveries

Objective: To analyze the incidence of anal sphincter ruptures and to evaluate risk factors of obstetric anal sphincter ruptures in Dr. Cipto Mangunkusumo Hospital. Method: We reviewed 2009 vaginal deliveries based on the analysis of obstetric data base and patient records of our department during 2012. Cases and control subjects were chosen randomly and patient’s records were reviewed for the following variable: maternal age, parity, gestational age, labor induction, duration of 2nd stage labor, use of forceps, use of vacuum, use of episiotomy, birth weight, and presentation of the baby. Result: There were 91 (4.53%) anal sphincter ruptures during period of study (91 of 2009 patients). An univariate analysis of these 91 case and 91 randomly selected control subjects show that primiparity (p = .000), gestational age (p = .016), duration of second-stage labor (p = .000), forceps delivery (p = .000), vacuum delivery (p = .001), episiotomy (p = .000), and birth weight (p = .000) increased the risk for anal sphincter ruptures. In multivariate re-gression models, only 5 of the 10 predictor variables were significantly related to the likelihood of having a severe perineal trauma greater than second degree. Primiparity (p = .023; OR 2.74, 95% [CI], 1.15-6.51), forceps delivery (p = .000; OR 18.18, 95% [CI] 3.84-86.07), vacuum delivery (p = .005; OR 6.83, 95% [CI] 1.77-26.42), episiotomy (p = .015; OR 2.86, 95% [CI] 1.23-6.65), and birth weight (p = .000; OR 0.99, 95% [CI] 0.997-0.999). Conclusion: Damage of the anal sphincter resulting in a third- or fourth- degree perineal tear is a relatively rare but severe complication of vaginal delivery. We found that factors as sociated with anal sphincter ruptures were primiparity, forceps, vacuum, episiotomy and birth weight. [Indones J Obstet Gynecol 2016; 1: 31-36] Keywords: anal sphincter ruptures, third- or fourth- degree perineal tear, vaginal delivery

scholarly journals Human Milk Virome Analysis: Changing Pattern Regarding Mode of Delivery, Birth Weight, and Lactational Stage

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1779
Author(s):  
Meltem Dinleyici ◽  
Vicente Pérez-Brocal ◽  
Sertac Arslanoglu ◽  
Ozge Aydemir ◽  
Sibel Sevuk Ozumut ◽  
...  
Keyword(s):  
Birth Weight ◽  
Human Milk ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Mode Of Delivery ◽  
Large For Gestational Age ◽  
Delivery Mode ◽  
Age Group ◽  
Spontaneous Vaginal Delivery

The human milk (HM) microbiota is a significant source of microbes that colonize the infant gut early in life. The aim of this study was to compare transient and mature HM virome compositions, and also possible changes related to the mode of delivery, gestational age, and weight for gestational age. Overall, in the 81 samples analyzed in this study, reads matching bacteriophages accounted for 79.5% (mainly Podoviridae, Myoviridae, and Siphoviridae) of the reads, far more abundant than those classified as eukaryotic viruses (20.5%, mainly Herpesviridae). In the whole study group of transient human milk, the most abundant families were Podoviridae and Myoviridae. In mature human milk, Podoviridae decreased, and Siphoviridae became the most abundant family. Bacteriophages were predominant in transient HM samples (98.4% in the normal spontaneous vaginal delivery group, 92.1% in the premature group, 89.9% in the C-section group, and 68.3% in the large for gestational age group), except in the small for gestational age group (only ~45% bacteriophages in transient HM samples). Bacteriophages were also predominant in mature HM; however, they were lower in mature HM than in transient HM (71.7% in the normal spontaneous vaginal delivery group, 60.8% in the C-section group, 56% in the premature group, and 80.6% in the large for gestational age group). Bacteriophages still represented 45% of mature HM in the small for gestational age group. In the transient HM of the normal spontaneous vaginal delivery group, the most abundant family was Podoviridae; however, in mature HM, Podoviridae became less prominent than Siphoviridae. Myoviridae was predominant in both transient and mature HM in the premature group (all C-section), and Podoviridae was predominant in transient HM, while Siphoviridae and Herpesviridae were predominant in mature HM. In the small for gestational age group, the most abundant taxa in transient HM were the family Herpesviridae and a species of the genus Roseolovirus. Bacteriophages constituted the major component of the HM virome, and we showed changes regarding the lactation period, preterm birth, delivery mode, and birth weight. Early in life, the HM virome may influence the composition of an infant’s gut microbiome, which could have short- and long-term health implications. Further longitudinal mother–newborn pair studies are required to understand the effects of these variations on the composition of the HM and the infant gut virome.

scholarly journals A study of the incidence of retinopathy of prematurity in a tertiary care centre in Karnataka

2021 ◽  
Vol 8 (6) ◽  
pp. 1033
Author(s):  
Manjunathaswmy R. ◽  
Anjana H. Rao ◽  
Vinayaka P. Hegade ◽  
Pradeep Kumar ◽  
Ravindra B. Patil
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Tertiary Care ◽  
Argon Laser ◽  
Preterm Neonates ◽  
Multiple Gestation ◽  
Care Centre ◽  
Tertiary Care Centre

Background: Retinopathy of prematurity is a preventable cause of childhood blindness. Proper understanding of the classification, risk factors and treatment methods is a must in tackling this disease. The aim of this study was to know the incidence of ROP in preterm infants in a tertiary care centre and to improvise the selection criteria in future in Indian babies.Methods: A retrospective study of all infants admitted to the NICU from 2016 to 2018 who met the criteria for ROP screening were included in the study. Examination of the eyes was done by a trained technician using a Ret Cam digital imaging in collaboration with KIDROP, Narayana Nethralaya and later interpreted by trained ophthalmologists using the concept of teleopthalmology. Babies were followed up and screened accordingly. Qualified infants were treated with argon laser photocoagulation within 48h of diagnosis. They were followed until the disease was successfully treated.Results: In current study, incidence of ROP was found to be 10.2%. The gestational age ranged from 28-36 weeks with a mean of 30.5±1.5 weeks. In current study, the most prevalent prenatal risk factor was multiple gestation and postnatal risk factors was anemia, low birth weight ,low gestational age and the use of oxygen therapy.Conclusions: Screening for ROP, in India, should be performed in all preterm neonates who are born <34 weeks gestation and/or <1800 grams birth weight; as well as in babies 34-36 weeks gestation or 1800-2000 grams birth weight if they have risk factors for ROP.

scholarly journals Fundus Examination of 23,861 Newborns by Digital Imaging in Ningbo

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Delin Liu ◽  
Jiao Zheng ◽  
Yi Lu
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Premature Infants ◽  
Gestational Age ◽  
Digital Imaging ◽  
Full Term ◽  
Delivery Mode ◽  
Average Birth Weight ◽  
Ocular Abnormalities ◽  
Term Newborns

Purpose. To perform fundus examinations of full-term and premature infants to identify common congenital ocular diseases and determine the incidence and additional risk factors in Ningbo, China. Methods. Fundus examinations were performed on newborns between January 2017 and July 2020 in Ningbo using a RetCam3 or PanoCam LT wide-field digital imaging system. The neonates’ birth weight, gestational age, gender, delivery mode, oxygen intake, and other conditions were recorded. We compared the incidence of ocular abnormalities in both full-term newborns and premature infants. Results. There were 23,861 newborns in this study comprising 12,605 (52.8%) male and 11,256 (47.2%) female infants, 20,938 full-term babies, and 2,923 premature babies. The average gestational age was 37.9 ± 5.6 weeks, and the average birth weight was 3,189 ± 417 g. Overall, we found ocular abnormalities in 6,645 (27.8%). The most common abnormality in full-term newborns was retinal hemorrhage (RH), which we found in 3,827 (18.3%) cases. Other diseases identified included familial exudative vitreoretinopathy (FEVR), retinoblastoma (RB), and congenital cataracts. The delivery method had a significant impact on the incidence of neonatal RH ( P < 0.001 ). Retinopathy of prematurity (ROP) was observed in 617 newborns accounting for 21.1% of all screened premature infants. Logistic analysis showed that gestational age and birth weight were important risk factors for ROP ( P < 0.001 ). For treatable diseases, such as ROP, FEVR, congenital cataract, glaucoma, and RB, early identification allows for active treatment or referral to a specialized hospital for further treatment. Conclusion. Early examination and prompt treatment of ocular disorders in newborns are important to avoid lifelong visual impairment. Eye examinations should be performed during the neonatal period and at regular follow-up visits.

scholarly journals Prevalence and Risk Factors of Retinopathy of Prematurity (ROP): A Cross-Sectional Study

2021 ◽  
pp. 1-6
Author(s):  
Kishan A. Makvana ◽  
Apurva H. Suthar
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Delayed Diagnosis ◽  
Developed Countries ◽  
Preterm Neonates ◽  
Cross Sectional ◽  
The Mean

Background and Aim: Despite considerable progress made in the treatment of Retinopathy of prematurity (ROP), it is still a common cause of reduced vision in children in developed countries, and its prevalence is increasing. This is a preventable disease and responds to treatments appropriately if diagnosed at early stages, but in case of delayed diagnosis and treatment, it may lead to blindness. The aim of the present study is to describe the incidence, severity, and risk factors of ROP in a tertiary healthcare center. Material and Methods: This was a prospective, observational, nonrandomized study conducted in a tertiary-level neonatal intensive care unit (NICU) of a teaching hospital in Gujarat. A total of 130 preterm neonates admitted in the NICU during the study period were screened for ROP as per the guidelines of NNF of India. Screening was done under topical anesthesia, and findings were documented according to the International Classification for Retinopathy of Prematurity recommendations. The data were analyzed for gestational age, birth weight, and systemic factors predisposing to ROP. Results: Of the 130 neonates, 37 neonates were found to have ROP, with the incidence of ROP being 28.4%. The mean birth weight (1388 ± 312 g) and the mean gestational age (32.21 ± 2.50 wk) Out of the 37 neonates with ROP, 14 had a gestational age of > 32 weeks and/or birth weight of > 1500 g. ROP was classified into type 1 and type 2 as per the ETROP study, 14 (39.39%) neonates had type 1 or treatable ROP; there were no cases of APROP in our study; ROP regressed without any intervention in 13 neonates; 7 neonates were defaulters; and 11 neonates were treated with laser. Conclusion: ROP is strongly associated with smaller, more immature, and sicker neonates. However, in our study, about 40% of neonates who developed ROP were of higher gestation (> 32 wk) and birth weight (> 1500 g). The analysis of risk factors for ROP development will help to understand and predict it in severe preterm infants.

scholarly journals Retinopathy of prematurity: study of incidence, risk factors and outcome in level 3 neonatal intensive care unit in a tertiary care centre

2019 ◽  
Vol 7 (1) ◽  
pp. 90
Author(s):  
Uma Devi Rachamadugu ◽  
Sravani Devana ◽  
Srikanth Sandanala
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Prospective Clinical Study ◽  
Tertiary Care Centre

Background: Advancing technology in antenatal and neonatal care has resulted in better survival of preterm neonates in developing countries in the past few decades. This has resulted in an apparent increase in the incidence of Retinopathy of Prematurity (ROP), which is the most important cause of preventable blindness in infants.Methods: A prospective clinical study was done for 18 months in 400 preterm babies less than 34 weeks of Gestational Age (GA) or less than 1750 gm of Birth Weight (BW). ROP screening was performed. The babies who developed any stage of ROP were taken as cases and the babies who did not have ROP were taken as controls. Statistical analysis was performed using SPSS software (Version 20.0). p value <0.05 was taken as statistically significant.Results: Four hundred babies were thus examined. The overall incidence of ROP in the study group was 10.25% (41 babies). Out of them, 38 babies (92.6%) had stage-1 ROP and 3 babies (7.31%) had stage-2 ROP. three babies (7.31%) required laser treatment. Risk factor analysis revealed that gestational age at birth, low birth weight, need foroxygenation, RDS, clinical sepsis, HIE, AKI, NNS, resuscitation, apnea.Conclusions: Screening should be intensified in the presence of risk factors like resuscitation, oxygen requirement, apnoea and prolonged hospital stay, which can reduce the incidence of severe stages of ROP as shown by this study.

scholarly journals Intraventricular haemorrhage in very preterm neonates

2018 ◽  
Vol 5 (4) ◽  
pp. 1414
Author(s):  
Saurabh Kapoor ◽  
Ravi Sharma ◽  
Anil Kumar Sapare ◽  
Rajiv Aggarwal
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Significant Risk ◽  
Intraventricular Haemorrhage ◽  
Preterm Neonates ◽  
Care Hospital

Background: The objective of the current study was to evaluate the incidence of intraventricular haemorrhage and its associated risk factors in preterm neonates.Methods: This cohort study done at Neonatal Intensive Care Unit of a tertiary care hospital in south India enrolled 104 preterm neonates with either gestational age <32weeks and/or birth weight <1500 grams at birth. These babies were serially screened for intraventricular haemorrhage by doing a neurosonogram on day3 and day 14 of life.Results: Incidence of IVH was found to be 18.2%. Amongst these cases 52.6% babies had Grade I, 36.8% babies had Grade II and 10.6% babies had Grade III intraventricular hemorrhage with ventriculomegaly, as per Papile grading system. It was seen that hypotension needing use of inotropes and neonatal sepsis were significantly associated with IVH.Conclusions: The incidence of IVH in babies born with gestational age <32weeks and/or birth weight <1500 grams was 18.2% in our study. Neonatal sepsis and hypotension requiring use of inotropes were found to be the significant risk factors in this population.

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