scholarly journals SAT-103 Extrauterine Growth Restriction (EUGR) in Preterm Infants: Incidence, Risk Factors, Nutrition, Auxological and Neurological Outcome.A Retrospective Study from 2010 to 2016

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Marta Del Pistoia ◽  
Maria Giulia Tozzi ◽  
Alessandra Carmignani ◽  
Massimiliano Ciantelli ◽  
Rosa Teresa Scaramuzzo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Enteral Feeding ◽  
Gestational Age ◽  
Minimum Weight ◽  
Gradual Improvement ◽  
Increased Risk

Abstract EUGR is still a serious problem in very low birth weight preterm infants. The gradual improvement in neonatal intensive care has allowed the survival of newborns with increasing low weight and gestational age, with a higher incidence of major nutritional problems and diseases (Goldenberg 2008). EUGR was defined as growth parameters ≤ 10° centile at discharge, compared to the expected intrauterine growth for post-menstrual age. Recently EUGR was defined, in a dynamic way, as the reduction in anthropometric parameters z-score between birth and discharge >1SD (Griffin 2016). Aims of our study were to evaluate: the incidence of EUGR, the nutritional intake, the main risk factors, the auxological and neurological outcome. We enrolled 346 newborns admitted to our NICU from 2010 to 2016 with gestational age (GA) at birth < 30 weeks and/or birth weight <1500 gr. Infants with malformations or syndromes were excluded. The incidence of EUGR was 73.1% for weight, 66.3% for length and 39.3% for head circumference. We observed a decrease in SD mainly during the first 14 days of life. From two weeks to discharge, no significant catch-up growth was observed. Risk factors for EUGR were: male gender, reduced GA (p=0.000), low birth weight (p=0.000), lower minimum weight achieved (p=0.000), more time to recover birth weight (p=0.000), lower growth rate per day (p=0.001), longer period of total parenteral nutrition (p=0.008), later onset of minimal enteral feeding (p=0.006), later achievement of the full enteral feeding (p=0.000), cesarean section (p=0.006), incomplete corticosteroid prophylaxis (p=0.025), postnatal steroids use (p=0.000), mechanical ventilation (p=0.000), pulmonary bronchodysplasia (p= 0.000), leukomalacia (p=0.06), patent ductus arteriosus (p=0.000), retinopathy of prematurity (p= 0.008), late onset sepsis (p= 0.09). In 197 patients post-discharge clinical follow up at 1, 3 and 24 months of correct age (CA) was performed. Around 88% of all our sample showed normal neurological development. 12% at 1 and 3 months had abnormal general movements (both writhing and fidgety movements) or absent (p = 0.001). At 24 months CA patients with abnormal/absent fidgety movements had neurological disabilities and 83% were EUGR. At 24 months, 17% had weight <10th centile and all were EUGR. 25% showed an overgrowth (weight >75th centile) with a probably increased risk of metabolic disease later in life. The incidence of EUGR increased over the years due to the augmentation in preterm births with lower GA. The first 14 days of life were a critical period and nutrition is known to be mandatory to promote newborns’ growth (Asbury 2019). The EUGR condition negatively affected the neurological (Chien 2018) and auxological (Takayanagi 2018, Wood 2018) outcome of preterm infants and the early recognition of this condition is extremely important in order to implement a careful and prolonged follow-up.

scholarly journals Late hyponatremia: its risk factors in preterm infants and short-term outcome

2021 ◽  
Vol 43 (5) ◽  
pp. 434-443
Author(s):  
Manizheh Gharehbaghi ◽  
Sadollah Yegane Dust ◽  
Elmira Naseri
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Osteopenia Of Prematurity

Background. Prematurity is one of the major health problems and common causes of neonatal mortality. One of the complications of premature infants is hyponatremia. The effect of hyponatremia on the prognosis of preterm infants has not been well studied. This study aimed to evaluate infants with late hyponatremia, its risk factors, and prognosis. Methods. This descriptive analytical study reviewed preterm infants (<34 weeks) admitted to Al-Zahra or Children’s Hospital in Tabriz for one year (2019). Neonates diagnosed with hyponatremia after the second week were identified and evaluated for risk factors and short-term outcome. Results. A total of 186 neonates were studied. The mean gestational age of the neonates was 30 weeks (first and third quarters = 29-32 weeks). 101 (54.3%) infants were male. The route of delivery was the cesarean section in 60.7% of cases. Late hyponatremia was present in 50 (26.8 %) infants. Gestational age and birth weight were significantly lower in infants with hyponatremia than in the control group. Multivariate analysis showed that low birth weight, the use of prenatal steroids, and inappropriate weight for gestational age status independently predict the incidence of late hyponatremia. There was a significant relationship between the presence of prolonged late hyponatremia (over 7 days) and bronchopulmonary dysplasia and osteopenia of prematurity. However, no significant association was found between the presence of prolonged late hyponatremia in preterm infants with the length of hospital stay and in-hospital mortality. Conclusion. Based on the findings of this study, low birth weight, prenatal steroid use, and lack of appropriate weight for gestational age were risk factors for late hyponatremia in preterm infants. Prolonged hyponatremia is associated with bronchopulmonary dysplasia and osteopenia of prematurity

scholarly journals Retinopathy of prematurity in preterm babies in a local medical college and hospital

2020 ◽  
Vol 8 (4) ◽  
pp. 1463
Author(s):  
Shantisena Mishra ◽  
Anjali Saji ◽  
Saiprasanna Behera ◽  
Sridhar Mohanty
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Mode Of Delivery ◽  
Multiple Gestation ◽  
Maternal Risk ◽  
Preterm Babies

Background: Retinopathy of prematurity is a multifactorial vasoproliferative retinal disease that increases in incidence with decreasing gestational age and is one of the leading causes of preventable childhood blindness in India. Advances in neonatology have led to dramatic increase in survival of preterm neonates and in turn, to the risk of developing ROP. Since most of the risk factors associated with ROP mentioned above arise in the neonatal intensive care unit (NICU) itself and most of them are avoidable, cautious monitoring of the risk factors, early screening, follow up and surgical intervention have been shown to reduce the incidence and improve the outcome of ROP.Methods: This was a prospective observational study conducted for a period of 2 years. A total of 151 infants admitted in NICU /SNCU who satisfied the inclusion criteria were enrolled in this study. Initial and follow up screening was conducted in three phases the results were documented in proforma after ethical clearance.Results: Comparison of risk factors between eyes with and without ROP was done using Chi-square test. A p-value of<0.05 was considered to be statistically significant. Incidence of ROP in centre is found to be 33.8%. Among maternal risk factors, multiple gestation and PROM/PPROM is found to be significant in the development of ROP from this study. However, mode of delivery and gestational hypertension, were found to be not significant in ROP. Among neonatal risk factors, low birth weight, lower gestational age, prolonged oxygen exposure, blood transfusion, mechanical ventilation, sepsis, phototherapy was found to be significant in this study.Conclusions: ROP, being an emerging cause for potentially blinding visual disability, needs to be diagnosed early. Due to the advancements in neonatology and better survival of preterm babies, timely screening, regular follow up, early detection and intervention is mandatory. A multidisciplinary approach is required in diagnosis and treatment of the disease. Proper counselling and motivation for parents of preterm and low birth weight babies for regular follow up is also essential.

scholarly journals Prevalence and outcome of retinopathy of prematurity in preterm infants, with low birth weight at KMCH, Tamil Nadu, India

2019 ◽  
Vol 6 (2) ◽  
pp. 264
Author(s):  
R. Nikhil ◽  
K. Rajendran ◽  
Bala Krishnan
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Inclusion Criteria ◽  
Very High

Background: Premature infants have avascular or incompletely vascularized retina at birth and ROP evolves over 4-5 weeks after birth. The aim of this study is to know the prevalence of retinopathy of prematurity in preterm infants, with birth weight ≤ 1500 grams and/or gestational age ≤32 weeks in a tertiary care center.Methods: The study was conducted in Kovai Medical Centre and Hospital Coimbatore in 2016. The sample size is 95 babies. All preterm infants admitted with a birth weight of ≤1500 grams and/or ≤ 32 weeks of gestation and baby those at risk of ROP.Results: 95 babies have enrolled during the study period of which 78 babies fulfilled the inclusion criteria and completed this prospective study.12 babies could not complete the follow-up protocol and 5 babies died before full vascularization of the retina. 78 babies who fulfilled the inclusion criteria were screened and 15 babies were found to have ROP. The prevalence of ROP in this study is 19.2%.Conclusions: Among the preventable causes of blindness in children, ROP figures very high on the agenda. Low birth weight and gestational age were found to be the most important risk factors for the development of ROP.

scholarly journals A study on neurodevelopmental outcome and its associated risk factors in very low birth weight babies in a tertiary care teaching hospital in Kolkata

2016 ◽  
Vol 7 (5) ◽  
pp. 61-69
Author(s):  
Somen Sur ◽  
Subhasis Das ◽  
Soumitra Masani
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Neurodevelopmental Outcome ◽  
Developmental Screening ◽  
Fine Motor ◽  
Low Birth Weight Babies

Background: Very low birth weight babies are very fragile in nature and usually undergone through stormy neonatal period, which affects significantly their neurodevelopmental outcome in long term basis.Aims and Objectives: 1. Assessment of neurodevelopmental outcome in very low birth weight (VLBW) babies at 12 month corrected gestational age. 2. Study of risk factors associated with such outcome.Materials and Methods: VLBW babies without any major congenital anomaly were included in this study. They were followed up in high risk clinic upto 12 month corrected gestational age. In follow up visits, assessment of tone was done by Amiel Tiesonmethod and 180 degree flip test. Developmental screening was done by Denver Developmental Screening Test (DDST II).Data obtained from this study were entered in Microsoft Excel and subsequently analysed with the help of Epi Info (TM) 3.5.3 software.Results: 24.4% among the study population showed neurodevelopmental abnormalities. Of them, 22.2% VLBW infants had muscle tone abnormality; 15.6% were suspect in gross motor development, 8.9% were suspect in fine motor, 11.1% were suspect in personal – social and 8.9% were suspect in language development, which were statistically significant. On assessment of risk factors, it was found that low birth weight, prematurity, non-use of antenatal corticosteroid, hypoglycaemia, intraventricular haemorrhage, sepsis, jaundice, mechanical ventilation, intra uterine growth retardation were significantly associated with various strata of neurodevelopmental outcome.Conclusion: VLBW babies are very prone to develop neurodevelopmental complications. Taking proper care regarding above said risk factors can reduce such complications. Also these babies should follow up properly to detect complication/s at earliest, and take “early intervention’’ steps.Asian Journal of Medical Sciences Vol.7(5) 2016 61-69

scholarly journals TO STUDY THE PREVALENCE OF RETINOPATHY OF PREMATURITY IN PRETERM INFANTS: AN HOSPITAL BASED OBSERVATIONAL STUDY.

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Binit Singh ◽  
Rizwan Haider ◽  
Ved Prakash Gupta
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Inclusion Criteria

Background: Premature infants have avascular or incompletely vascularized retina at birth and ROP evolves over 4-5 weeks after birth. The aim of this study is to know the prevalence of retinopathy of prematurity in preterm infants, with birth weight ? 1500 grams and/or gestational age ?32 weeks in a tertiary care center. Material and methods: The study was conducted in a tertiary care center of Bihar region India The sample size is 145 babies. All preterm infants admitted with a birth weight of ?1500 grams and/or ? 32 weeks of gestation and baby those at risk of ROP. Results: 145 babies have enrolled during the study period of which 124 babies fulfilled the inclusion criteria and completed this prospective study.15 babies could not complete the follow-up protocol and 6 babies died before full vascularization of the retina. 124 babies who fulfilled the inclusion criteria were screened and 33 babies were found to have ROP. The prevalence of ROP in this study is 26.6%. Conclusions: Among the preventable causes of blindness in children, ROP figures very high on the agenda. Low birth weight and gestational age were found to be the most important risk factors for the development of ROP. Keywords: Low birth weight, Prematurity in preterm infant, Retinopathy, Oxygen therapy

scholarly journals Prevalence and Risk Factors of Retinopathy of Prematurity in Iran

2019 ◽  
Author(s):  
Mohammad Zarei ◽  
Fatemeh Bazvand ◽  
Nazanin Ebrahimiadib ◽  
Ramak Roohipoor ◽  
Reza Karkhaneh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Extremely Low Birth Weight ◽  
Increased Risk ◽  
Extremely Preterm ◽  
History Of

Purpose: The present study aimed to evaluate the frequency and risk factors of retinopathy of prematurity (ROP) among Iranian infants. Methods: A retrospective cohort study was conducted on infants who had undergone screening for ROP at Farabi Eye Hospital, between March 2016 and March 2017. Data were analyzed based on the presence of extreme prematurity (gestational age ≤ 28 weeks), extremely low-birth-weight (≤ 1000 g), and multiplegestation (MG) infants. Results: The prevalence of ROP was 27.28% (n = 543) among all screened infants, 74.4% for extremely preterm (EP) infants, 77.5% for extremely low birth weight (ELBW) babies, and 27.25% for infants from MG pregnancies. On multivariate analysis, gestational age, birth weight, and history of transfusion (P < 0.0001, P < 0.0001, and P = 0.04, respectively) were found to be significantly associated with ROP. More advanced stages of ROP (P < 0.0001) were observed in EP and ELBW infants. Birth weight (P = 0.088), history of transfusion (P = 0.066), and intubation (P = 0.053) were not associated with increased risk of ROP in EP infants, while gestational age (P = 0.037) and history of transfusion (P = 0.040) were significant risk factors for ROP in ELBW infants. Gestational age (P < 0.001) and birth weight (P = 0.001) were significantly associated with ROP in infants from MG pregnancies in multivariate analysis. Conclusion: ROP remains a commonly encountered disease, especially in ELBW and EP infants. The history of transfusion may have a role in stratifying the risk for ROP and guiding future screening guidelines.

scholarly journals Single-course antenatal corticosteroids is related to faster growth in very-low-birth-weight infant

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiajia Jing ◽  
Yiheng Dai ◽  
Yanqi Li ◽  
Ping Zhou ◽  
Xiaodong Li ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Postnatal Growth ◽  
Weight Increase ◽  
Antenatal Corticosteroids ◽  
Lung Maturation ◽  
Growth Outcomes

Abstract Background Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants. Methods A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes. Results A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed. Conclusions Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.

scholarly journals Clinical profile and factors determining outcome of intramural very low birth weight babies in a tertiary care centre: a retrospective study

2017 ◽  
Vol 5 (2) ◽  
pp. 520
Author(s):  
Devi Meenakshi K. ◽  
Arasar Seeralar A. T. ◽  
Srinivasan Padmanaban
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Logistic Regression Analysis ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
P Value ◽  
Increased Risk

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality.

scholarly journals A retrospective study of predisposing factors and outcome of persistant pulmonary hypertension among newborns at rural tertiary care centre

2020 ◽  
Vol 8 (1) ◽  
pp. 92
Author(s):  
B. C. Yelamali ◽  
Gangadhar S. Mirji ◽  
Mirnalini Rajput
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Retrospective Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Birth Asphyxia ◽  
Male Gender ◽  
Predisposing Factors ◽  
Positive Pressure ◽  
Increased Risk

Background: Persistent pulmonary hypertension in newborns (PPHN) remains a significant cause of perinatal morbidity and mortality. Early recognition of factors that increase the risk of PPHN is of great importance in either to prevent or to treat PPHN optimally. Aim was to study the neonatal predisposing factors, profile and outcome of PPHN.Methods: This retrospective study was conducted in level III neonatal care unit, a rural referral centre of North Karnataka, India from January 2018 to April 2020.Results: During the study period a total of 50 infants with PPHN were identified with the incidence of 5.43/1000 live births. Mean gestation age (±SD) was 38.28±2.49 weeks and mean birth weight (±SD) was 2624±512 gm. The most noted risk factors were meconium aspiration syndrome (42%), birth asphyxia (16%), RDS (10%), positive pressure ventilation at birth (52%) and male gender (62%). Out of 50 infants with PPHN, high mortality was seen in low birth weight babies (66.6%). Use of sildenafil showed increased mortality (56.2%) whereas use of surfactant scored better with decreased mortality of 42.8%.Conclusions: Major risk factors for PPHN are MAS, birth asphyxia, RDS and low birth weight. Poor prognosis is seen in male gender, prematurity and CDH with increased risk of mortality. The use of systemic pulmonary vasodilators can be considered with caution and use of surfactant has a role in management of PPHN.

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