scholarly journals Incidence, risk factors and consequences of preterm birth – findings from a multi-centric observational study for 14 months in Nepal

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Abhishek Gurung ◽  
Johan Wrammert ◽  
Avinash K. Sunny ◽  
Rejina Gurung ◽  
Netra Rana ◽  
...  
2020 ◽  
Author(s):  
Abhishek Gurung ◽  
Johan Wrammert ◽  
Avinash K Sunny ◽  
Rejina Gurung ◽  
Netra Rana ◽  
...  

Abstract Background: Preterm birth is a worldwide epidemic and a leading cause of neonatal mortality. In this study, we aimed to evaluate the incidence, risk factors and consequences of preterm birth in Nepal.Methods: This was an observational study conducted in 12 public hospitals of Nepal. All the babies born during the study period were included in the study. Babies born <37 weeks of gestation were classified as preterm births. For the association and outcomes for preterm birth, univariate followed by multiple regression analysis was conducted. Results: The incidence of preterm was found to be 93 per 1000 live births. Mothers aged less than 20 years (aOR 1.26 ;1.15-1.39) had a high risk for preterm birth. Similarly, education of the mother was a significant predictor for preterm birth: illiterate mothers (aOR 1.41; 1.22-1.64), literate mothers (aOR 1.21; 1.08-1.35) and mothers having basic level of education (aOR 1.17; 1.07-1.27). Socio-demographic factors such as smoking (aOR 1.13; 1.01-1.26), use of polluted fuel (aOR 1.26; 1.17-1.35) and sex of baby (aOR 1.18; 1.11-1.26); obstetric factors such as nulliparity (aOR 1.33; 1.20-1.48), multiple delivery (aOR 6.63; 5.16-8.52), severe anemia during pregnancy (aOR 3.27; 2.21-4.84), antenatal visit during second trimester (aOR 1.13; 1.05-1.22) and third trimester (aOR 1.24; 1.12-1.38), <4 antenatal visits during pregnancy (aOR 1.49; 1.38-1.61) were found to be significant risk factors of preterm birth. Preterm has a risk for pre-discharge mortality (10.60; 9.28-12.10). Conclusion: In this study, we found high incidence of preterm birth. Various socio-demographic, obstetric and neonatal risk factors were associated with preterm birth. Risk factor modifications and timely interventions will help in the reduction of preterm births and associated mortalities. Trial registration: ISRCTN30829654


2020 ◽  
Author(s):  
Abhishek Gurung ◽  
Johan Wrammert ◽  
Avinash K Sunny ◽  
Rejina Gurung ◽  
Netra Rana ◽  
...  

Abstract Background: Preterm birth is a worldwide epidemic and a leading cause of neonatal mortality. In this study, we aimed to evaluate the incidence, risk factors and consequences of preterm birth in Nepal.Methods: This was an observational study conducted in 12 public hospitals of Nepal. All the babies born during the study period were included in the study. Babies born <37 weeks of gestation were classified as preterm births. For the association and outcomes for preterm birth, univariate followed by multiple regression analysis was conducted. Results: The incidence of preterm was found to be 93 per 1000 live births. Mothers aged less than 20 years (aOR 1.26 ;1.15-1.39) had a high risk for preterm birth. Similarly, education of the mother was a significant predictor for preterm birth: illiterate mothers (aOR 1.41; 1.22-1.64), literate mothers (aOR 1.21; 1.08-1.35) and mothers having basic level of education (aOR 1.17; 1.07-1.27). Socio-demographic factors such as smoking (aOR 1.13; 1.01-1.26), use of polluted fuel (aOR 1.26; 1.17-1.35) and sex of baby (aOR 1.18; 1.11-1.26); obstetric factors such as nulliparity (aOR 1.33; 1.20-1.48), multiple delivery (aOR 6.63; 5.16-8.52), severe anemia during pregnancy (aOR 3.27; 2.21-4.84), antenatal visit during second trimester (aOR 1.13; 1.05-1.22) and third trimester (aOR 1.24; 1.12-1.38), <4 antenatal visits during pregnancy (aOR 1.49; 1.38-1.61) were found to be significant risk factors of preterm birth. Preterm has a risk for pre-discharge mortality (10.60; 9.28-12.10). Conclusion: In this study, we found high incidence of preterm birth. Various socio-demographic, obstetric and neonatal risk factors were associated with preterm birth. Risk factor modifications and timely interventions will help in the reduction of preterm births and associated mortalities. Trial registration: ISRCTN30829654


2020 ◽  
Author(s):  
Abhishek Gurung ◽  
Johan Wrammert ◽  
Avinash K Sunny ◽  
Rejina Gurung ◽  
Netra Rana ◽  
...  

Abstract Background: Preterm birth is a worldwide epidemic and a leading cause of neonatal mortality. In this study, we aimed to evaluate the incidence, risk factors and consequences of preterm birth in Nepal. Methods: This was an observational study conducted in 12 public hospitals of Nepal. All the babies born during the study period were included in the study. Babies born <37 weeks of gestation were classified as preterm births. For the association and outcomes for preterm birth, univariate followed by multiple regression analysis was conducted. Results: The incidence of preterm was found to be 93 per 1000 live births. Mothers with age less than 20 years (aOR 1.21; 1.09-1.34) and 35 years and above (aOR 1.30; 1.05-1.63) had a high risk for preterm birth. Similarly, education of the mother was a significant predictor for preterm birth: illiterate mothers (aOR 1.90; 1.66-2.19), literate mothers (aOR 1.48; 1.33-1.65) and mothers having basic level of education (aOR 1.25; 1.14-1.38). Socio-demographic factors such as smoking (aOR 2.02; .84-2.22) and use of polluted fuel (aOR 1.38; 1.28-1.50); obstetric factors such as nulliparity (aOR 1.44; 1.28-1.61), multiple delivery (aOR 1.92; 1.33-2.76), severe anemia during pregnancy (aOR 2.43; 1.55-3.82), antenatal visit during second trimester (aOR 1.10; 1.02-1.19) and third trimester (aOR 1.44; 1.30-1.60) were found to be significant risk factors of preterm birth. Preterm has a risk for pre-discharge mortality (10.60; 9.28-12.10). Conclusion: In this study, we found high incidence of preterm birth. Various socio-demographic, obstetric and neonatal risk factors were associated with preterm birth. Risk factor modifications and timely interventions will help in the reduction of preterm births and associated mortalities.


Author(s):  
Aditi Jain Garg ◽  
Rehana Najam ◽  
Ritika Agarwal ◽  
Rajul Rastogi

Background: Hydrocephalus is a heterogeneous disease marked by abnormal dilatation of the cerebral ventricles secondary to varying etiologies. This study was aimed to determine the incidence, risk factors, severity, and outcome of hydrocephalic fetuses presenting to a tertiary healthcare hospital located in northern India.Methods: In this prospective observational study, pregnant women visiting the obstetrics outpatient department of our hospital from 01 July 2017 to 31 June 2018 were screened for hydrocephalic fetuses via ultrasonography along with a detailed history, and a comprehensive battery of diagnostic investigations. They were followed up for a minimum period of two months after delivery/termination of pregnancy.Results: A total of 3627 pregnant women were screened, of which 10 had hydrocephalic fetuses in the observed time period. The incidence of hydrocephalus was determined to be 2.75 per 1000 live births. Low socio-economic status was identified as a major risk factor. 50% of the hydrocephalic fetuses were severely afflicted and were discontinued. The remaining 50% were successfully delivered and were managed via a ventriculo-peritoneal shunt or are under close observation in the postnatal period without any adverse outcome.Conclusions: The burden of hydrocephalus is considerably high in India, as compared to western countries. In rural settings, low socioeconomic status and lack of folic acid supplementation have a major influence in the etiopathogenesis of hydrocephalus. Management of hydrocephalus requires a multidisciplinary approach and is tailored according to the severity of the presentation. Severe cases of hydrocephalus and cases with associated anomalies have a poor prognosis.


2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Shazia Khalid Khan ◽  
Shahida Sheikh ◽  
Amatullah Zarreen

The aim of the study was to review the recent trends in the incidence, risk factors, pattern, diagnosis and management of various congenital anomalies in our population. This cross-sectional, observational study included sixty pregnant women aged 20-35 years. Mode of delivery was decided after considering all these aspects. Total eight (13.3%) fetuses had congenital malformations. The follow-up of these ladies revealed that 26 (43.3%) were lost on follow-up, so the incidence of congenital malformations at birth was found to be 5.8%.


2021 ◽  
pp. 36-39
Author(s):  
Rohan Ainchwar ◽  
Harshawardhan Dhanraj Ramteke ◽  
Saniya Sheikh

Introduction: Many Patients admitted to Cardiac ICU (CICU) are easily prone to Delirium, that can lead to potentially severe consequences like Cognitive Impairment and increased risks of mortality. Delirium depends on the duration of hospital stay and discharge, contrary mainly affected to the patients on mechanical ventilation, which becomes the potential reason for longer duration. Studies suggest, Delirium is a widely discussed topic, when comes to the management of the patient in Cardiac ICU. During the Rounds, it is mandatory to focus on the diagnosis of delirium and must be validated using Confusion Assessment Method (CAM). These methods not only prevent the risk of the delirium and also enhances the use of the other preventive measures like the basis of the treatment, environmental factors, quiet time, sleep promotion, family support, communication with the patient, pain and dyspnea. When conrmed with delirium, pharmacological prophylaxis must be used as soon as possible. Most often, communication between Doctor, Nurse and Patient drives the most of the depression and acute delirium, but when delirium becomes critical with severe agitation or weaning from invasive mechanical ventilation. Thus, it is very important to identify the risk, complexity of the patients and clinical case scenarios of delirium in Cardiac ICU. Strategic Efforts were done to improve the identication of the patient at risk during admission, during stay at Cardiac ICU and during discharge and orders to improve the mental state of delirium patient. In this article, we provide a panorama of the incidence, risk factors, and impact on outcome of delirium in a Cardiac Intensive Care Unit (CICU). Methods: In this case study, total of 211 patients were observed for sign and symptoms in Cardiac ICU for Delirium. We aimed to determine the incidence, risk factors, and impact on outcome of delirium in a Cardiac Intensive Care Unit (CICU) in CHLMultispeciality Hospital and Research Center, Chandrapur using a prospective observational study. Patients:All consecutive patients admitted to the CICU between April 2021 and June 2021 were included if they were aged more than 18 years, had an CICU stay of more than 24 h and no psychiatric history. Patients eligible for the study were evaluated by the medical staff to detect delirium using the CAM. Results: In a 3-month period, 211 Patients were admitted in Cardiac ICU of CHLMultispeciality Hospital and Research Center. Out of which 198 were included in our observational study. The incidence of delirium at the end of the study was 21%. The number of delirious patients were 43 and non-delirious were 155. Age played an Important factor where 86% of Delirious patients were old aged. The LOS (Length of Stay) for Delirious and non-delirious patients were 6±1 vs 5±1 respectively. The SAS (Riker Agitation Scale) has the value of 4±1 vs 3±0.5, CAM (Confusion Assessment Method) has the value of 6±1 vs 3±1 and DDS (Delirium Detection Score) was 5±1 vs 3±1 for delirious vs non-delirious patients. The SAPS II (Simplied Acute Physiology Score II) Score for delirious patients was 23±1 and 20±2. The Incidences like Removal of Catheters were more frequent in this study with 20% in delirious patients and <1% Incidence in non-delirious patients. Removal of ET Tube had the Incidence of 5% vs <1%, Removal of Urinary Catheter 7% vs <1%, Removal of Ryle's Tube 7% vs <1%, respectively for delirious vs non-delirious patients.


Sign in / Sign up

Export Citation Format

Share Document