scholarly journals Factors Affecting the Weaning from Nasal CPAP in Preterm Neonates

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Shantanu Rastogi ◽  
Hariprem Rajasekhar ◽  
Anju Gupta ◽  
Alok Bhutada ◽  
Deepa Rastogi ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Birth Weight ◽  
Gestational Age ◽  
Retrospective Review ◽  
Univariate Analysis ◽  
Preterm Neonates ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Successful Weaning ◽  
Postmenstrual Age

Objective. Identification of the weight and postmenstrual age (PMA) at successful weaning of NCPAP in preterm neonates and the factors influencing the successful wean.Study Design. Retrospective review of 454 neonates ≤32 weeks of gestational age (GA) who were placed on NCPAP and successfully weaned to room air was performed.Results. Neonates had a mean birth weight (BW) of grams with a mean GA of weeks. Neonates were weaned off NCPAP at mean weight of grams and mean PMA of weeks. Univariate analysis showed that chorioamnionitis, intubation, surfactant use, PDA, sepsis/NEC, anemia, apnea, GER and IVH were significantly associated with the time to NCPAP wean. On multivariate analysis, among neonates that were intubated, BW was the only significant factor () that was inversely related to time to successful NCPAP wean. Amongst non-intubated neonates, along with BW (), chorioamnionitis (), anemia (), and GER () played a significant role in weaning from NCPAP.Conclusion. Neonates were weaned off NCPAP at mean weight of grams and mean PMA of weeks. BW significantly affects weaning among intubated and non-intubated neonates, though in neonates who were never intubated chorioamnionitis, anemia and GER also significantly affected the duration on NCPAP.

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 Intestinal Permeability in Preterm Neonates is not Related to Gestational Age or Birth Weight. 75

1996 ◽  
Vol 40 (3) ◽  
pp. 527-527
Author(s):  
Ruurd M van Elburg ◽  
Femke M van Overbeek ◽  
Carin M Bunkers ◽  
Willem PF Fetter ◽  
Sidarto Bambang Oetomo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Intestinal Permeability ◽  
Gestational Age ◽  
Preterm Neonates

Retrolental Fibroplasia: Further Clinical Evidence and Ultrastructural Support for Efficacy of Vitamin E in the Preterm Infant

PEDIATRICS ◽  
1983 ◽  
Vol 71 (3) ◽  
pp. 423-432 ◽  
Author(s):  
Helen Mintz Hittner ◽  
Louis B. Godio ◽  
Michael E. Speer ◽  
Arnold J. Rudolph ◽  
Martha M. Taylor ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Birth Weight ◽  
Vitamin E ◽  
Gap Junction ◽  
Gestational Age ◽  
Plasma Membranes ◽  
Tocopheryl Acetate ◽  
Plasma Vitamin ◽  
Retrolental Fibroplasia ◽  
Spindle Cells

To further evaluate the efficacy of oral vitamin E in preventing the development of severe retrolental fibroplasia (RLF) in very low-birth-weight infants, 100 infants treated with 100 mg/kg/d of vitamin E (dl-α-tocopheryl acetate) were compared with 75 infants treated with 5 mg/kg/d of vitamin E (dl-α-tocopherol) in the same nursery during the previous year. All 175 infants weighed ≤1,500 g at birth and required supplemental oxygen. A total of 120 infants (69 treatment; 51 control) survived ≥ 10 weeks. Multivariate analysis of the control population identified five risk factors (P ≤ .10): gestational age, level and duration of oxygen administration, intraventricular hemorrhage, sepsis, and birth weight. When multivariate analysis was applied to both control and treatment groups, the severity of RLF was found to be significantly reduced in infants given the treatment dose of vitamin E(P = .003). Ultrastructural analyses of 58 pairs of whole-eye donations from high-risk infants surviving less than 10 weeks suggest that the initial morphologic event is gap junction increases between the plasma membranes of adjacent spindle cells of the vanguard retina. Such extensively gap junction-linked spindle cells are apparently removed from the vasoformative process as early as 4 days of life, forming a barrier to further normal vascular development and triggering retinal and vitreal neovascularizations approximately 8 weeks later. These events are maximally suppressed by elevated plasma vitamin E levels in infants ≥27 weeks gestational age.

scholarly journals Confounders for Neonatal Intensive Care Unit Admission ın Neonates of Mothers with Preeclampsia

2018 ◽  
Vol 24 (3) ◽  
pp. 162
Author(s):  
Cetin Kilicci ◽  
Cigdem Yayla Abide ◽  
Enis Ozkaya ◽  
Evrim Bostancı Ergen ◽  
İlter Yenidede ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Intensive Care Unit Admission ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Apgar Scores ◽  
Gestational Age At Delivery

<p><strong>Objective:</strong> The aim of this study was to investigate the effect of some maternal and neonatal clinical parameters on the neonatal intensive care unit admission rates of neonates born to mothers who had preeclampsia. </p><p><strong>Study Design:</strong> Study included 402 singleton pregnant women with preeclampsia who admitted to Maternal-Fetal Medicine Unit of Zeynep Kamil Children and Women’s Health Training and Research Hospital. Pregnancies with uterine rupture, chorioamnionitis and congenital malformations were excluded. Some maternal and neonatal clinical characteristics were assessed to predict neonatal intensive care unit admission.</p><p><strong>Results:</strong> Among 402 neonates, 140 (35%) of them had an indication for neonatal intensive care unit admission, among 140 neonates, 136 (97%) of them were preterm neonates. Comparison of groups with and without neonatal intensive care unit admission indicated significant differences between groups in terms of gestational age, Apgar scores at 1st and 5th minutes, birth weight, some maternal laboratory parameters (Hemoglobin, hematocrit, alanine aminotransferase, aspartate aminotransferase, albumin). In multivariate analysis, among all study population, gestational age at delivery, birth weight and Apgar scores were found to be significantly associated with neonatal intensive care unit admission. On the other hand, in subgroup of term neonates, none of the variables was shown to be associated with neonatal intensive care unit admission.</p><p><strong>Conclusion:</strong> Gestational age at delivery and the birth weight are the main risk factors for neonatal intensive care unit admission of neonates born to mothers who had preeclampsia.</p>

scholarly journals How to Manage Synchronous Endometrial and Ovarian Cancer Patients?

2021 ◽  
Author(s):  
wonkyo shin ◽  
Sang-yoon Park ◽  
Sokbom Kang ◽  
Myongcheol Lim ◽  
Sang-Soo Seo
Keyword(s):  
Ovarian Cancer ◽  
Multivariate Analysis ◽  
Metastatic Cancer ◽  
Univariate Analysis ◽  
Influential Factors ◽  
Factors Affecting ◽  
Gynecology And Obstetrics ◽  
Aortic Lymph Node ◽  
Risk Patients ◽  
The Difference

Abstract Backgrounds: We aimed to evaluate the prognosis in patients with synchronous endometrial and ovarian cancer (SEOC) by comparing the differences between double primary cancer (DPC) and metastatic cancer (MC). Methods: The medical records of 47 patients diagnosed synchronously with endometrial and ovarian cancer between January 2006 and December 2018 were retrospectively reviewed. Twenty-eight and 19 patients were diagnosed with DPC and MC, respectively. Demographics, recurrence-free survival (RFS), and 5-year overall survival (OS) were compared. The clinical factors affecting survival were evaluated using univariate and multivariate analyses.Results: The demographics were not different between both groups. Endometrioid histology and the International Federation of Gynecology and Obstetrics grade were higher in the MC group than in the DPC group (42.1% vs. 10.7 %; P=0.018, P=0.002, respectively). The ratio of post-operative adjuvant therapy was not different in both groups. Recurrence occurred in five patients with DPC and seven with MC. The difference in RFS was not significantly different (P=0.131) but the OS was different between both groups (P = 0.020). Histology and para-aortic lymph node metastasis were associated wtih RFS in univariate analysis, but no difference was found in multivariate analysis.Conclusions: Although DPC patients had longer OS, multivariate analysis did not identify any influential factors. Focus should be placed on defining the appropriate adjuvant treatment for high-risk patients, which will improve prognosis, rather than on discriminating between DPC and MC.

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.

28-Day Survival Rates of 6676 Neonates With Birth Weights of 1250 Grams or Less

PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 7-17
Author(s):  
Dale L. Phelps ◽  
David R. Brown ◽  
Betty Tung ◽  
George Cassady ◽  
Richard E. McClead ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Very Low Birth Weight ◽  
Survival Rates ◽  
Survival Advantage ◽  
Lower Birth Weight ◽  
Single Birth

Survival rates specific for birth weight, gestational age, sex, and race are described for 6676 inborn neonates who weighed less than 1251 g at birth and were born during 1986 through 1987. Overall 28-day survival increased with gestational age and birth weight, from 36.5% at 24 weeks' gestation to 89.9% at 29 weeks' gestation, or from 30.0% for neonates of 500 through 599 g birth weight to 91.3% for neonates of 1200 through 1250 g. The expected birth weight-specific survival advantage for female neonates and black neonates diminished when the data were controlled for gestational age, showing that certain previously reported survival advantages are based on lower birth weight for a given gestational age. Multivariate analysis showed that all tested variables were significant predictors for survival, in order of descending significance: gestational age and birth weight, sex, race, single birth, and small-for-gestational-age status. The powerful effect of gestational age on survival highlights the need for an accurate neonatal tool to assess the gestational age of very low birth weight neonates after birth.

Factors Affecting Heart Rate Variability in Preterm Infants

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Luis A. Cabal ◽  
Bijan Siassi ◽  
Bernardino Zanini ◽  
Joan E. Hodgman ◽  
Edward E. Hon
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Good Prognosis ◽  
Factors Affecting ◽  
Rate Level ◽  
Heart Rate Level

Neonatal heart rate variability (NHRV) was studied in 92 preterm infants (birth weight, 750 to 2,500 gm; gestational age, 28 to 36 weeks). Each infant was monitored continuously during the first 6 hours and for one hour at 24, 48, and 168 hours of life. During each hour NHRV was quantified and related to the following parameters: sex, gestational age, postnatal age, heart rate, and the presence and severity of respiratory distress syndrome (RDS). NHRV in healthy preterm infants was inversely related to heart rate level and directly related to the infant's postnatal age. In healthy babies with gestations of 30 to 36 weeks there was no significant correlation between NHRV and gestation. Decrease in NHRV was significantly related to the severity of RDS, and the reappearance of NHRV in infants with RDS was associated with a good prognosis. Decreased NHRV significantly differentiated the infants with RDS who survived after the fifth hour of life. The data reveal that NHRV (1) should be corrected for heart rate level and postnatal age; (2) is decreased in RDS; and (3) can be used as an indicator of morbidity and mortality in preterm infants with RDS.

New modifications of Swedish ROP guidelines based on 10-year data from the SWEDROP register

2019 ◽  
Vol 104 (7) ◽  
pp. 943-949 ◽  
Author(s):  
Gerd Holmström ◽  
Ann Hellström ◽  
Lotta Gränse ◽  
Marie Saric ◽  
Birgitta Sunnqvist ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Neonatal Care ◽  
Coverage Rate ◽  
Natural Course ◽  
Web Based ◽  
Postmenstrual Age ◽  
Over Time

Background/aimsDuring the last decade, improved neonatal care has resulted in increased survival of the most immature infants and improved health of more mature infants. We hypothesise that this has affected incidence and treatment of retinopathy of prematurity (ROP), enabling guidelines for screening to be modified.MethodsIn Sweden, all infants with gestational age (GA) at birth ≤30 weeks are screened for ROP. Results are registered in a web-based register, Swedish National ROP Register, with a coverage rate of 97%. Incidence of ROP and frequency of treatment, aspects on natural course of ROP and number of examinations, are calculated in relation to GA at birth in infants born during 2008–2017.ResultsOf 7249 infants, 31.9% (2310) had ROP and 6.1% (440) were treated. No infant with GA 30 weeks was treated. Incidence of ROP remained similar, but frequency of treatment increased (p=0.023). Over time, GA and birth weight were reduced in infants with ROP and with treated ROP. In the most immature infants, postmenstrual age was lower and postnatal age was higher when any ROP and stage 3 ROP were first detected (p<0.001). At treatment, postmenstrual but not postnatal age of the infant was associated with GA (p<0.001). During the 10-year period, 46 038 examinations were performed.ConclusionModification of Swedish guidelines is proposed, including only infants with a GA of <30 weeks and postponing the first examination with 1 week in infants with GA 26–29 weeks. This would spare many infants from stressful examinations and reduce eye examinations with at least 20%.

scholarly journals OUTCOME OF PRETERM BABIES WITH RESPIRATORY DISTRESS SYNDROME

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Shaitan Singh Balai ◽  
Vivek Arora
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Prospective Study ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Preterm Neonates ◽  
Medical College ◽  
Preterm Babies

Background: To study outcome of preterm babies with RDS in babies admitted in NICU. Methods: This study was hospital based prospective study of preterm neonates with respiratory distress syndrome admitted in NICU of MBGH RNT medical college Udaipur, from February 2017 to January 2018. Results: Among 200 preterm neonates included in the study 31 neonates expired. Mortality was 15.5%. The mortality was 10.17% among the preterm neonates with RDS and hospitalized within 6 hrs. It was 31.81% among neonates hospitalized between 6-12 hrs and 62.5% and 66.66% among neonates hospitalized between 12-24 hrs and after 24 hrs of birth respectively. Conclusion: Mortality rate is inversely related to birth weight and gestational age and directly related to age at admission and severity of respiratory distress (Silverman-Anderson score). Keywords: Preterm, Neonates, Birth weight.

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