Radiological Studies in Very Low Birth Weight and Extremely Low Birth Weight Neonates: ‘ALARA’ Revisited

2019 ◽  
Vol 66 (4) ◽  
pp. 403-411
Author(s):  
Surjit Damon Jeetoo ◽  
Johan Smith ◽  
Richard Denys Pitcher
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Diagnostic Imaging ◽  
South African ◽  
Best Practice ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Limited Data ◽  
Resource Limited ◽  
Elbw Neonates

Abstract Background Very low birth weight (VLBW) and extremely low birth weight (ELBW) neonates are particularly susceptible to the adverse effects of ionizing radiation. There are limited data on radiographic practice among this population in resource-limited environments. Aim To estimate cumulative effective dose (ED) from diagnostic imaging in VLBW (1000–1500 g) and ELBW (<1000 g) neonates in a resource-limited setting. Method A retrospective analysis of all diagnostic imaging examinations performed on ELBW and VLBW neonates born in a large South African public-sector tertiary-level hospital from January through June 2015. Data were stratified by birth weight and imaging examination. The ED was estimated according to the method of Puch-Kapst. Non-parametric t-tests compared the number of radiographs and ED in VLBW and ELBW neonates, at 5% significance. Results Three hundred and ninety-three neonates with median birth weight 1130 (IQR: 930–1340) g were included; 265 (67%) were VLBW and 128 (33%) ELBW; 48 (12%) died at a median of 7 (IQR: 2–17) days. A median of 2 (IQR: 1–5) radiographs were performed per neonate, with median ED 28.8 (IQR: 14.4–90.8) μSv. The median radiographic exposures for VLBW and ELBW neonates were 1 (IQR: 1–4) and 4 (IQR: 2–9), respectively, (p < 0.0001) with median ED 14.4 (IQR: 14.4–70.4) μSv and 71.2 (IQR: 28.8–169.3) μSv, respectively, (p < 0.0001). Radiographic exposure for VLBW neonates was lower than previously documented for this population. Conclusion Neonatal radiographic practice in resource-limited settings has the potential to contribute to the discourse on international best practice.

scholarly journals Frequency and Risk Factors for Retinopathy of Prematurity in Very Low Birth Weight Infants in NICU, BSMMU

2019 ◽  
Vol 32 (1) ◽  
pp. 54-61
Author(s):  
ANM Nurul Haque Bhuiyan ◽  
MA Mannan ◽  
Sanjoy Kumar Dey ◽  
Nuzhat Choudhury ◽  
Md Shameem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Retinopathy Of Prematurity ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Stepwise Logistic Regression ◽  
Low Birth Weight Infants ◽  
Department Of Ophthalmology ◽  
Elbw Neonates

Introduction: Retinopathy of prematurity (ROP) is emerging as an important avoidable cause of childhood blindness both in developed and developing countries that primarily affects premature and very low birth weight infants. There has been paucity of studies on this topic in Bangladesh and there is no national prevalence data on ROP to understand the real burden of the disease. Hence this study has been undertaken to see its frequency and risk factors for ROP in very low weight infants admitted in NICU, BSMMU. Objectives: To find out the frequency and risk factors for ROP in very low birth weight infants admitted in NICU, BSMMU. Methodology: It was a prospective observational study and was carried out in the Department of Neonatology and Department of Ophthalmology, BSMMU from January 2014 to June 2015. Considering all inclusion and exclusion criteria total 162 very low birth weight neonates were enrolled in the study. ROP screening was performed as per unit protocol. All eye examinations were undertaken by experienced ophthalmologist who was especially trained in ROP. Result: Out of 162 study population, one hundred forty fore (88.9%) were very low birth weight, 18(11.1%) were extremely low birth weight and mean birth weight was 1294.35 (SD: 180.96) g. Frequency of ROP was 38(23.5%), where 30(20.83%) among very low birth weight (VLBW) and 8(44.44%) were among ELBW neonates. Out of 38 ROP cases, 5(13%) had stage 1 retinopathy, 3(8%) had stage 2 retinopathy, 16(42.1%) had stage 3 and remaining 14(36.8%) neonates had APROP. On univariate analysis seventeen factors were found to be significant but on stepwise logistic regression analysis only lower gestational age [OR=5.014; CI(95%),2.160-11.640, P=.001] and use of mechanical ventilator [OR=1.925; CI(95%),1.133-3.269, P=.015] was found to be the most significant for causation of ROP. Conclusion: The overall frequency of ROP was 38(23.5%), where as 30(20.83%) were among VLBW and 8(44.44%) were among ELBW neonates. Prevention of prematurity and judicious use of ventilator may reduce the incidence and severity of ROP TAJ 2019; 32(1): 54-61

scholarly journals Morbidity and mortality pattern of very low birth weight and extremely low birth weight neonates in a tertiary care hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 1263
Author(s):  
Wani Shahid Hussain ◽  
Muzafar Jan ◽  
Rahat Abbas ◽  
Zarkah Nabi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Perinatal Asphyxia ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Extremely Low Birth Weight ◽  
Elbw Neonates

Background: Although the mortality and morbidity rates for Very Low Birth Weight (VLBW) and Extremely Low Birth Weight (ELBW) neonates have improved over last few decades, they still remain highly vulnerable groups. This study determines the neonatal morbidity and mortality within first four weeks of life in VLBW and ELBW neonates.Methods: It was a hospital based prospective study conducted in the department of paediatrics at GB Pant hospital, an associated hospital of Government Medical College Srinagar. All included neonates were evaluated in neonatology section and were followed up to 4 weeks of life. Standard protocols were used for management of these neonates.Results: A total of 116 neonates were included in the study. Among the 116 neonates 82 (70.69%) were VLBW and 34 (29.31%) were ELBW. 28 (34.14%) VLBW and 18 (52.94%) ELBW neonates died. Among the morbidities Respiratory Distress Syndrome was found in 35.37% of VLBW and 70.59% of ELBW neonates, out of which 12.20% VLBW and 20.58% ELBW neonates developed Bronchopulmonary dysplasia. Perinatal asphyxia was found in 20.73% of VLBW and 29.41% of ELBW neonates and Pathological apnea occurred in 28.04% VLBW and 85.29% ELBW neonates. 40.24% VLBW and 73.53% ELBW neonates developed clinically significant jaundice requiring treatment. Clinical sepsis was found in 43.90% VLBW and 67.65% ELBW neonates while as culture proven sepsis was found in 26.83% VLBW and 41.18% ELBW neonates. Intra ventricular haemorrhage was found in 15.85% VLBW and 52.94% ELBW neonates. Necrotizing enterocolitis developed in 18.29% VLBW and 35.29% ELBW neonates. Retinopathy of prematurity was found in 21.95% VLBW and 26.47% ELBW neonates. Patent ductus arteriosus was found in 14.63% VLBW and 32.35% ELBW neonates.Conclusions: Present study has shown Respiratory distress syndrome, perinatal asphyxia and sepsis as the predominant causes of neonatal morbidity and mortality and these are preventable with a proper health care system and policy directed to the primary prevention.

scholarly journals Amikacin or Vancomycin Exposure Alters the Postnatal Serum Creatinine Dynamics in Extreme Low Birth Weight Neonates

2021 ◽  
Vol 18 (2) ◽  
pp. 662
Author(s):  
Tamara van Donge ◽  
Anne Smits ◽  
John van den Anker ◽  
Karel Allegaert
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Serum Creatinine ◽  
Potential Effect ◽  
Extremely Low Birth Weight ◽  
Treatment Modalities ◽  
Antibiotic Exposure ◽  
Sensitive Tool ◽  
Elbw Neonates ◽  
The Impact

Background: Disentangling renal adverse drug reactions from confounders remains a major challenge to assess causality and severity in neonates, with additional limitations related to the available tools (modified Kidney Disease Improving Global Outcome, or Division of Microbiology and Infectious Diseases pediatric toxicity table). Vancomycin and amikacin are nephrotoxic while still often prescribed in neonates. We selected these compounds to assess their impact on creatinine dynamics as a sensitive tool to detect a renal impairment signal. Methods: A recently developed dynamical model that characterized serum creatinine concentrations of 217 extremely low birth weight (<1000 g, ELBW) neonates (4036 observations) was enhanced with data on vancomycin and/or amikacin exposure to identify a potential effect of antibiotic exposure by nonlinear mixed-effects modelling. Results: Seventy-seven percent of ELBW patients were exposed to either vancomycin or amikacin. Antibiotic exposure resulted in a modest increase in serum creatinine and a transient decrease in creatinine clearance. The serum creatinine increase was dependent on gestational age, illustrated by a decrease with 56% in difference in serum creatinine between a 24 or 32-week old neonate, when exposed in the 3rd week after birth. Conclusions: A previously described model was used to explore and quantify the impact of amikacin or vancomycin exposure on creatinine dynamics. Such tools serve to explore minor changes, or compare minor differences between treatment modalities.

scholarly journals Pregnancy Outcome during the First COVID 19 Lockdown in Vienna, Austria

2021 ◽  
Vol 18 (7) ◽  
pp. 3782
Author(s):  
Sylvia Kirchengast ◽  
Beda Hartmann
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Negative Effects ◽  
Gestational Length ◽  
Live Births

The COVID 19 pandemic represents a major stress factor for non-infected pregnant women. Although maternal stress during pregnancy increases the risk of preterm birth and intrauterine growth restriction, an increasing number of studies yielded no negative effects of COVID 19 lockdowns on pregnancy outcome. The present study focused on pregnancy outcome during the first COVID 19 lockdown phase in Austria. In particular, it was hypothesized that the national lockdown had no negative effects on birth weight, low birth weight rate and preterm birth rate. In a retrospective medical record-based single center study, the outcome of 669 singleton live births in Vienna Austria during the lockdown phase between March and July 2020 was compared with the pregnancy outcome of 277 live births at the same hospital during the pre-lockdown months of January and February 2020 and, in addition, with the outcome of 28,807 live births between 2005 and 2019. The rate of very low gestational age was significantly lower during the lockdown phase than during the pre-lockdown phase. The rate of low gestational age, however, was slightly higher during the lockdown phase. Mean birth weight was significantly higher during the lockdown phase; the rates of low birth weight, very low birth weight and extremely low birth weight were significantly lower during the lockdown phase. In contrast, maternal gestational weight gain was significantly higher during the lockdown phase. The stressful lockdown phase in Austria seems to have no negative affect on gestational length and newborn weight among non-infected mothers.

scholarly journals Characterizing dynamics of serum creatinine and creatinine clearance in extremely low birth weight neonates during the first 6 weeks of life

2020 ◽  
Author(s):  
Tamara van Donge ◽  
Karel Allegaert ◽  
Verena Gotta ◽  
Anne Smits ◽  
Elena Levtchenko ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Mode Of Delivery ◽  
Extremely Low Birth Weight ◽  
Reference Ranges ◽  
Mixed Effect ◽  
Postnatal Maturation ◽  
Elbw Neonates

Abstract Background Characterizing the dynamics of serum creatinine concentrations (Scr) and associated creatinine clearance (CLcr) as a measure of kidney function in extremely low birth weight (≤ 1000 g; ELBW) neonates remains challenging. Methods We performed a retrospective study that included longitudinal Scr (enzymatic assay) data from 148 ELBW neonates up to 6 weeks after birth. Change of Scr and inter-individual variability was characterized with nonlinear mixed-effect modeling. Key covariates such as gestational age (GA), mode of delivery (MOD), and treatment with ibuprofen or inotropic agents were investigated. Results A total of 2814 Scr concentrations were analyzed. GA was associated with Scr at birth (higher with advancing GA), and GA and MOD showed an association with postnatal maturation of CLcr (faster clearance increase with advancing GA and after C-section). Small CLcr decrease (≤ 5%) was quantified during ibuprofen treatment. For a GA of 27 weeks, mean Scr (estimated CLcr) at birth was 0.61 mg/dl (0.23 ml/min), increasing to 0.87 mg/dl (0.27 ml/min) at day three, and decreasing to 0.36 mg/dl (0.67 ml/min) at day 42 after birth. Conclusions We report the first mathematical model able to characterize Scr and CLcr in ELBW neonates during the first 6 weeks of life in a quantitative manner as a function of GA, MOD, and ibuprofen treatment. This model allows the derivation of GA-adjusted reference ranges for ELBW neonates and provides a rationale for normative Scr concentrations, and as such will help clinicians to further optimize monitoring and treatment decisions in this vulnerable patient population.

scholarly journals The echographic characteristics of structural and functional development of organs and systems in children born with low birth weight, very low birth weight and extremely low birth weight

2020 ◽  
Vol 1 (3) ◽  
pp. 11-17
Author(s):  
P. E. Khodkevich ◽  
K. V. Кulikova ◽  
V. V. Gorev ◽  
I. A. Deev
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Negative Impact ◽  
Extremely Low Birth Weight ◽  
Small Children ◽  
Neuropsychological Development ◽  
The Past ◽  
Functional Development ◽  
Development Of Organs

Over the past decade, an increase in the survival rate of children born with low birth weight, very low birth weight, and extremely low birth weight has been observed in Russian Federation, which is due to transition to new live birth criteria. Premature infants are exposed to a number of adverse factors that have a negative impact on the development of organs and systems, which, in turn, can lead to the occurrence of acute and chronic diseases in various age periods. Therefore, neonatologists and pediatricians are dealing with a new cohort of small children who have particular features of physical and neuropsychological development which may lead to severe debilitating diseases. This review article surveys previous studies evaluating the echographic characteristics of structural and functional development of the urinary, cardiovascular and endocrine systems as a function of body weight at birth and gestational age, and in different age periods.

scholarly journals ON THE SUBJECT OF MEDICAL/SOCIAL ASPECTS OF REHABILITATION FOR VERY-LOW-BIRTH WEIGHT INFANTS IN EARLY CHILDHOOD

2019 ◽  
Vol 20 (1) ◽  
pp. 30-35
Author(s):  
A. V. Migali ◽  
K. A. Kazakova ◽  
Yu. S. Akoyev ◽  
V. M. Studenikin ◽  
M. A. Varichkina ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Very Low Birth Weight ◽  
Intensive Therapy ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Team Care ◽  
Care Approach ◽  
Paroxysmal Disorders

Innovative technologies in the reanimation and intensive therapy permitted to improve the survival of premature infants, including those with extremely low birth weight infants. There are considered various issues of practical medical care for very-low-birth weight infants in the first three years of life. The special attention is given to patients with bronchopulmonary dysplasia (BPD). There is briefly presented the own authors’ experience of the observation for premature infants in conditions of a multidisciplinary team care approach. There were described such important aspects of the mentioned category of patients as neurodietology/nutritional rehabilitation, compliance with aseptic environmental conditions, the correction of visual and hearing impairment, treatment of neurological deficit, especially neuropharmacology, treatment of paroxysmal disorders and epilepsy.

Sign in / Sign up

Export Citation Format

Share Document