1349 Risk Factors Associated with Bronchopulmonary Displasia (BPD) in Extremely Low Gestational Age Newborns (ELGAN)

Abstract Introduction: Transient abnormal myelopoiesis (TAM) occurs in approximately 10% of infants with Down syndrome (DS). Although most patients achieve spontaneous remission, some develop severe organ failure and die in their infancy. Previous studies have identified several risk factors associated with early death in such cases, including a high white blood cell (WBC) count, early gestational age, and ascites (Massey GV, 2006; Muramatsu H, 2008; Klusmann JH, 2008). Although chemotherapy with low-dose cytosine arabinoside (LDCA) has been applied for severe cases, its side effect profile has not been fully demonstrated in an adequate number of patients. Here we prospectively analyzed 168 infants with DS who were diagnosed with TAM, including 52 patients treated with LDCA. We assessed the efficacy and safety of LDCA therapy in these cases. Patient and Methods: Between May 2011 and February 2014, 168 infants (90 boys and 78 girls) were diagnosed with TAM and prospectively registered in the Japan Pediatric Leukemia/Lymphoma Study Group (JPLSG) TAM-10 study. GATA1 gene mutations were identified in all except 7 patients who had a very low blast percentage. The median (range) of WBC count was 38.6 (2.4-478.7) × 109 cells/L, and the median (range) of gestational age was 37 (29-40) weeks. Thirty one (18%) patients developed anasarca at diagnosis, and 23 (14%) patients developed acute megakaryocytic leukemia. Results: The overall survival (OS) rate and the event-free survival (EFS) rate at 1 year from diagnosis [95% confidential interval (CI)] were 86.3% (80.1-90.7), and 80.2% (73.2-85.5), respectively. Univariate analysis identified the following covariates as risk factors associated with early death (<9 months): early gestational age [<37 weeks; hazard ratio (HR; 95% CI) = 4.482 (1.826-10.997), p = 0.001], parenchymal bleeding [HR (95% CI) = 5.746 (2.241-14.734), p < 0.001], anasarca [HR (95% CI) = 13.344 (5.419-32.860), p < 0.001], and high WBC count [ ≥100 × 109 cells/L; HR (95% CI) = 8.013 (3.354-19.144), p < 0.001]. The multivariate Cox hazard model identified anasarca and a high WBC count (≥100 × 109 cells/L) as independent risk factors for early death. With regard to the 52 patients who received LDCA therapy, only anasarca remained an independent risk factor for early death. Subgroup analysis in patients with a high WBC count (≥100 × 109 cells/L; n = 36) showed that LDCA therapy significantly improved survival [1-year OS (95% CI) = 78.3% (55.4-90.3; n = 23) vs. 38.5% (14.1-62.8; n = 13); p = 0.009]. In contrast, the survival rate of patients with anasarca (n = 31) did not improve on receiving LDCA therapy [1-year OS (95% CI) = 58.3% (27.0-80.1; n = 12) vs. 47.4% (24.4-67.3; n = 19); p = 0.525]. The most common side effect of LDCA was neutropenia (grade 3-4 = 59%), and one patient died due to tumor lysis syndrome. Conclusion: This prospective study confirmed that a high WBC count and anasarca are risk factors for early death in patients with DS who were diagnosed with TAM. Although LDCA therapy could significantly improve the survival rate in patients with a high WBC count, it failed to change the prognosis of patients with anasarca. A new treatment modality is required for most severe TAM patients with anasarca at diagnosis. Disclosures No relevant conflicts of interest to declare.

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Prevalence and risk factors associated with low birth weight babies-a cross sectional study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212466 ◽

2021 ◽

Vol 8 (7) ◽

pp. 1168

Author(s):

Gurunathan Gopal

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Maternal Risk ◽

Factors Associated ◽

The World

Background: Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as low birth weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million LBW babies are born every year throughout the world. The present study was to explore the effects of various maternal risk factors associated with low birth-weight of institutionally delivered newborns. Across the world, neonatal mortality is 20 times more likely for LBW babies compared to normal birth weight (NBW) babies (>2.5 kg).Methods: A cross sectional study was conducted in neonatal intensive care unit (NICU) of ACS Medical College and Hospital, Chennai from December 2019 to October 2020. Altogether 350 babies were taken who were delivered at ACS hospital.Results: The number of times of ANC attendance was also significantly associated with LBW, odds ratio (OR)=1.296, and p=0.001. The number of meals was not associated with LBW OR=0.946, and p=0.831. The gestational age assessed as completed weeks of pregnancy was significantly associated with LBW OR=3.302; p=0.00001.Conclusions: This study suggests that there are several factors interplaying which lead to LBW babies. Socio-demographic factors (maternal age and gestational age) and antenatal care are more important.

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Determination of Factors Associated with Low Birth Weight among Babies Born in Sulaimania City, Kurdistan-Iraq

Journal of the Faculty of Medicine Baghdad ◽

10.32007/jfacmedbagdad.6231751 ◽

2020 ◽

Vol 62 (3) ◽

Author(s):

Sardar Weli

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Chronic Diseases ◽

Gestational Age ◽

Kurdistan Region ◽

Level Of Education ◽

Factors Associated ◽

Low Level

Background: Low birth weight (LBW) is the main leading cause of infant death. It is contributing to a variety of short and long term poor health outcomes. Determination of risk factors associated with LBW is important to select a suitable action to prevent or reduce this outcome. Studies on LBW and maternal risk factors in the Kurdistan region of Iraq are scarce.Objectives: This study aimed to determine risk factors associated with Low birth weight in Sulaimania city, Kurdistan region of Iraq.Cases and Methods: This study was carried out in the Maternity Hospital in Sulaimania from first of July, 2019 to first of February, 2020. Participants were 300 randomly selected mothers who gave a live birth. The questionnaire form, which contains information about factors associated with low birth weight (infant’s weight at birth lower than 2.5 kg) were filled by collectors. Infants were weighed immediately after delivery, and the weight was recorded in addition to sex of the infants, gestational age (weeks), age of the mother, job of the mothers, mother’s educational levels, antenatal care attendance, gravidity, residency, exercise and history of chronic diseases of mothers were recorded.Results: The results of the present study indicate that LBW was reported in 44.7% of the participants. For the LBW group, 48.5% were males and 51.5% were females. The highest percentage of LBW was among those born preterm 75.4% and the lowest was among full term 24.6%. Many factors such as an employed mother (85.8%), no exercise during pregnancy (88.1%), residency in urban (61.9%), mothers with chronic diseases (86.6%) and low level of education (illiterate and primary) (67.9%) were found as the significant risk factors of LBW. However, other factors such as prenatal care visits, age of mothers and gravidity were not found to be associated with LBW.Conclusion: The current study concludes that multiple risk factors may be associated with LBW in Sulaimania city, Kurdistan region of Iraq. Gestational age (preterm delivery), working mothers, no regular exercise, urban residence, low level of education and mother’s diseases such as hypertension, respiratory conditions, chronic infections and diabetes mellitus were considered as the risk factors associated with LBW.

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Risk Factors Associated with Intraventricular Hemorrhage in Preterm Infants with ≤28 Weeks Gestational Age

Klinische Pädiatrie ◽

10.1055/s-0042-111689 ◽

2016 ◽

Vol 228 (05) ◽

pp. 245-250 ◽

Cited By ~ 6

Author(s):

M. Waitz ◽

S. Nusser ◽

M. Schmid ◽

J. Dreyhaupt ◽

F. Reister ◽

...

Keyword(s):

Risk Factors ◽

Preterm Infants ◽

Gestational Age ◽

Intraventricular Hemorrhage ◽

Factors Associated

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Factors Associated With Treatment for Hypotension in Extremely Low Gestational Age Newborns During the First Postnatal Week

PEDIATRICS ◽

10.1542/peds.2006-1138 ◽

2007 ◽

Vol 119 (2) ◽

pp. 273-280 ◽

Cited By ~ 93

Author(s):

M. Laughon ◽

C. Bose ◽

E. Allred ◽

T. M. O'Shea ◽

L. J. V. Marter ◽

...

Keyword(s):

Gestational Age ◽

Factors Associated ◽

Extremely Low Gestational Age

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Five Year Follow Up of Extremely Low Gestational Age Infants after Timely or Delayed Administration of Routine Vaccinations

Vaccines ◽

10.3390/vaccines9050493 ◽

2021 ◽

Vol 9 (5) ◽

pp. 493

Author(s):

Ingmar Fortmann ◽

Marie-Theres Dammann ◽

Alexander Humberg ◽

Bastian Siller ◽

Guido Stichtenoth ◽

...

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Regression Models ◽

Univariate Analysis ◽

Significant Proportion ◽

Linear Regression Models ◽

Long Term Consequences ◽

Extremely Low Gestational Age

This study is aimed at detecting the rate of untimely immunization in a large cohort of extremely low gestational age neonates (ELGANs) of the German Neonatal Network (GNN) and at addressing risk factors for delayed vaccination and associated long-term consequences. We performed an observational study of the GNN between 1st January 2010 and 31st December 2019. The immunization status for the hexavalent and pneumococcal immunization was evaluated in n = 8401 preterm infants <29 weeks of gestation. Univariate analysis and logistic/linear regression models were used to identify risk factors for vaccination delay and outcomes at a 5-year follow-up. In our cohort n = 824 (9.8%) ELGANs did not receive a timely first immunization with the hexavalent and pneumococcal vaccine. Risk factors for delayed vaccination were SGA status (18.1% vs. 13.5%; OR 1.3; 95% CI: 1.1–1.7), impaired growth and surrogates for complicated clinical courses (i.e., need for inotropes, necrotizing enterocolitis). At 5 years of age, timely immunized children had a lower risk of bronchitis (episodes within last year: 27.3% vs. 37.7%; OR 0.60, 95% CI: 0.42–0.86) but spirometry measures were unaffected. In conclusion, a significant proportion of ELGANs are untimely immunized, specifically those with increased vulnerability, even though they might particularly benefit from the immune-promoting effects of a timely vaccination.

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Risk Factors and Short Term Morbidities Associated With Term-Small for Gestational Age Babies Delivered at Nepalgunj Medical College

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v19i1.40439 ◽

2022 ◽

Vol 19 (1) ◽

pp. 97-100

Author(s):

Piush Kanodia ◽

Arun Kumar Verma ◽

Sumit Adhikari

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Small For Gestational Age ◽

Congenital Heart ◽

Meconium Aspiration Syndrome ◽

Short Term ◽

Factors Associated ◽

Medical College ◽

Maternal Hypertension ◽

Common Risk Factors

Introduction: Small for gestational age (SGA) refers to birth weight of neonates less than 10th percentile for gestational age or 2nd standard deviation below the population norms on the growth charts. Aims: To identify common risk factors and common morbidities for small for gestational age babies. Methods: This is a cross sectional descriptive study and it has been conducted at Department of pediatrics, Nepalgunj Medical college which is a tertiary level teaching hospital located in western part of Nepal. All term small for gestational age neonates born during study period from January 2020 to December 2020 were included. Detailed baseline demographic and clinical profile has been collected and recorded in the predesigned Proforma. Results: The most common risk factors associated with small for gestational age babies in our study were maternal hypertension (14.6%) , maternal GDM(9.6%), Urinary Tract Infection (UTI) in 1st or 2nd trimester of pregnancy, maternal anemia, smoking, alcohol consumption, hypothyroidism and congenital heart disease. The most common short term complications associated with Small for gestational age babies were hypoglycemia and Meconium aspiration syndrome. Conclusion: The most common risk factors associated with Small for gestational age babies in our study were maternal hypertension, maternal Gestational diabetes Mellitus (GDM), Urinary Tract Infection in 1st or 2nd trimester of pregnancy, maternal anemia, smoking, alcohol consumption, hypothyroidism and congenital heart disease. The most common short term complications associated with Small for gestational age babies were hypoglycemia and Meconium aspiration syndrome (MAS).

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Risk Factors for Sepsis in the Neonatal Intensive Care Unit of a Tertiary Hospital in Mexico

Journal of Biomedical Research & Environmental Sciences ◽

10.37871/jbres1370 ◽

2021 ◽

Vol 2 (12) ◽

pp. 1183-1186

Author(s):

Ilse Lizeth Villegas-Velasquez ◽

Luz Irene Pascual-Mathey ◽

Olga Lidia Valenzuela-Limon ◽

Patricia Elisa Molina-Prior ◽

Jose Locia-Espinoza ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Gestational Age ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Tertiary Hospital ◽

Factors Associated ◽

Newborn Weight

Neonatal Sepsis (NS) is a systemic infection caused by bacteria, fungi, or viruses during the first month of life. Although various studies have identified the factors associated with NS, it is a public health problem due to its high morbidity and mortality. The study aimed to identify the risk factors associated with neonatal sepsis in the Neonatal Intensive Care Unit (NICU) of a tertiary hospital in Mexico. A case-control study was carried out using records of neonates (with sepsis 39 and without sepsis 39) from January to December 2017. The risk factors studied were the sociodemographic and clinical characteristics of the mother and clinics of the neonate. The data were analyzed using the Chi2 test, Fisher's exact test, Student's t-test, and the Odds Ratio (OR). The risk factors associated with NS were gestational age (OR 0.77, CI 95% = 0.64-0.91, p = 0.004), newborn weight (OR 0.45, CI95% = 0.23-0.86, p = 0.017) and days of hospital stay (OR 1.06, CI95% = 1.02-1.10, p = 0.0014). The mother's sociodemographic and clinical factors were not associated with NS. Risk factors associated with NS were gestational age, newborn weight, and days of hospital stay.

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Maternal Factors Associated with Small-for-Dateness Among Twins

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000008357 ◽

1982 ◽

Vol 31 (3-4) ◽

pp. 241-245 ◽

Cited By ~ 2

Author(s):

Denis Hemon ◽

Colette Berger ◽

Philippe Lazar

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Gestational Age ◽

Maternal Risk Factors ◽

Maternal Factors ◽

Maternal Weight ◽

Smoking During Pregnancy ◽

Maternal Risk ◽

Factors Associated ◽

Twin Pregnancies

The maternal risk factors that correlate with small-for-dateness among twins have been analyzed using a sample of 659 twin pairs and a matched sample of singletons. Non-marital status, job involvement, and the previous delivery of a low-birth weight (<2,500g) infant present a negative interaction with twinning, as low gestational age-adjusted birth weight does not correlate significantly with these risk factors among twin gestations, while it does among singleton gestations. On the other hand, the effects of parity, habitual maternal weight, smoking during pregnancy, and twinning are additive on gestational age-adjusted birth weight. Indeed, the decrease in adjusted birth weight associated with these risk factors is of the same magnitude among twins and singletons and is statistically significant in both cases. These findings suggest that exposure of twin pregnancies to these latter risk factors, and particularly to smoking during pregnancy, can lead to the delivery of newborns with extremely low birth weights.

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