scholarly journals Incidence and short outcome in multiple pregnancies: a single center cross-sectional study in Iran 2016–2017

2019 ◽  
Vol 28 (1) ◽  
pp. 28-34
Author(s):  
Behnaz Basiri ◽  
Mohammad Kazem Sabzehei ◽  
Maryam Shokouhi ◽  
Mohammad Mahdi Sabahi

BACKGROUND The incidence of multiple pregnancies in industrialized countries due to the use of assisted reproductive techniques has increased over the past two decades. Multiple births are more dangerous than single pregnancies for mother and baby. This study evaluated the frequency of multiple pregnancies and its neonatal complications.METHODS In this cross-sectional study, we assessed all multiple neonates hospitalized in Fatemieh Hospital of Hamadan, Iran from September 2016 to September 2017 in terms of gender, gestational age, birth weight, the use of assisted reproductive techniques, delivery method, cause of hospitalization, therapeutic intervention, and hospitalization outcome.RESULTS Of 10,581 deliveries during the study period, 351 (3.3%) was multiple pregnancies and 232 neonates hospitalized. The incidence of twin, triplet, and quadruplet birth were 1.7%, 0.39%, and 0.11% respectively. In this study, 178 twin and 54 triplet and quadruplet birth were compared. The mean gestational age and mean birth weight of triplet and quadruplet were lower than that of twin births (p<0.001). A significant difference was found on the frequency of assisted reproductive techniques (p<0.001). Female sex (p=0.007), lower mean gestational age (p=0.009), lower mean birth weight (p=0.017) and need to mechanical ventilation (p<0.001) were significantly associated with early neonatal death in multiple pregnancies.CONCLUSIONS The incidence of multiple births was high in the Hamadan province, which was often followed by infertility treatment. Moreover, multiple births cause prematurity, low birth weight, respiratory distress syndrome, and increased neonatal mortality rate.

2021 ◽  
Vol 5 (1) ◽  
pp. e000930
Author(s):  
Shalinder Sabherwal ◽  
Clare Gilbert ◽  
Allen Foster ◽  
Praveen Kumar

ObjectiveBlindness from retinopathy of prematurity (ROP) in middle-income countries is generally due to absence of screening or inadequate screening. The objective of this study was to assess uptake of services in an ROP programme in four district-level special newborn care units in India.DesignCross-sectional study.SettingAll four neonatal units of a state in India where model programme for ROP had been introducedPatientsInfants eligible for screening and treatment of ROP between March and May 2017.InterventionData on sex, birth weight and gestational age of eligible infants were collected and medical records reviewed for follow-up.Main outcome measuresProportion of eligible infants screened and for those screened, age at first screening, completion of screening, diagnosis and treatment received if indicated. The characteristics of infants screened and not screened were compared.Results137 (18%) of the 751 infants eligible for screening were screened at least once, with no statistically significant difference by sex. The mean birth weight and gestational age of those screened were significantly lower than those not screened. Among those screened, 43% underwent first screening later than recommended and 44% had incomplete follow-up. Fourteen infants (11% of those screened) were diagnosed with ROP. Five were advised laser treatment and all complied.ConclusionUptake, completion and timing of first screening was suboptimal. Some planned interventions including training of nursing staff, use of integrated data-management software and providing material for parent counselling, which have been initiated, need to be fully implemented to improve uptake of ROP screening services.


2021 ◽  
Vol 8 ◽  
pp. 2333794X2110196
Author(s):  
Sitotaw Molla Mekonnen ◽  
Daniel Mengistu Bekele ◽  
Fikrtemariam Abebe Fenta ◽  
Addisu Dabi Wake

Necrotizing enterocolitis (NEC) remains to be the most critical and frequent gastrointestinal disorder understood in neonatal intensive care units (NICU). The presented study was intended to assess the prevalence of NEC and associated factors among enteral Fed preterm and low birth weight neonates. Institution based retrospective cross-sectional study was conducted on 350 enteral Fed preterm and low birth weight neonates who were admitted at selected public hospitals of Addis Ababa from March 25/2020 to May 10/2020. The data were collected through neonates’ medical record chart review. A total of 350 participants were enrolled in to the study with the response rate of 99.43%. One hundred eighty-four (52.6%) of them were male. The majority 123 (35.1%) of them were (32 + 1 to 34) weeks gestational age. The prevalence of NEC was (25.4%) (n = 89, [95% CI; 21.1, 30.0]). Being ≤28 weeks gestational age (AOR = 3.94, 95% CI [2.67, 9.97]), being (28 + 1 to 32 weeks) gestational age (AOR = 3.65, 95% CI [2.21, 8.31]), birth weight of 1000 to 1499 g (AOR = 2.29, 95% CI [1.22, 4.33]), APGAR score ≤3 (AOR = 2.34, 95% CI [1.32, 4.16]), prolonged labor (AOR = 2.21, 95% CI [1.35, 6.38]), maternal chronic disease particularly hypertension (AOR = 3.2, 95% CI [1.70, 5.90]), chorioamnionitis (AOR = 4.8, 95% CI [3.9, 13]), failure to breath/resuscitated (AOR = 2.1, 95% CI [1.7, 4.4]), CPAP ventilation (AOR = 3.7, 95% CI [1.50, 12.70]), mixed milk (AOR = 3.58, 95% CI [2.16, 9.32]) were factors significantly associated with NEC. Finally, the prevalence of NEC in the study area was high. So that, initiating the programs that could minimize this problem is required to avoid the substantial morbidity and mortality associated with NEC.


2020 ◽  
Vol 7 (8) ◽  
pp. 414-419
Author(s):  
Dr. Abhinaya Arun Raj ◽  
◽  
Dr. K. Maheswari ◽  

Introduction: This study was done to assess the utility of foot length in determining theanthropometric parameters of a newborn in a tertiary care teaching hospital. Materials andMethods: This cross-sectional study among 270 newborns were done at Sri Venkateswaraa medicalcollege hospital and research centre, from Nov 2018 to May 2020. All the healthy live newbornswere taken into the study and newborns with congenital lower limb anomalies were excluded.Results: The mean birth weight of the neonate 2.948+0.344 kg which ranged from 2.050 kg to3.750kg. The mean foot length, head circumference and chest circumference of the foot length was8.113+0.468 cm, 48.989+1.093 cm, 34.437+0.659 cm and 32.372+0.734 cm respectively. The footlength had a maximum correlation with birth weight (r-value=0.905) followed by gestational age (r-value=0.809), length (r-value=0.786), head circumference (r-value=0.719) and chest circumference(r-value=0.603). Conclusion: Foot length had a significant correlation with birth weight andgestational age of the neonates. Foot length also correlated significantly with other anthropometricvariables like length, head circumference and chest circumference.


2021 ◽  
Vol 8 (2) ◽  
pp. 109-115
Author(s):  
Dr. Vishal Shrivastava ◽  
◽  
Dr. Purnendu Shekhar Lohia ◽  
Ms. Anita Sahu ◽  
◽  
...  

Introduction: Preterm birth is the leading cause of death in children younger than 5 yearsworldwide. Although preterm survival rates have increased in high-income countries, pretermnewborns still die because of a lack of adequate newborn care in many low-income and middle-income countries. This study was aimed to find out the effectiveness of anthropometricmeasurement, a simple and inexpensive method, for identifying premature babies at birth. Method:We conducted a cross-sectional study in a tertiary care hospital with 350 consecutively live-bornnewborns. Their birth weight, mid-arm circumference, length and head circumference weremeasured and compared with gestational age assessed by New Ballard score. We summarized thevariables using descriptive statistics, and the strength of association was determined throughcorrelation analysis. The correlation was strong for head circumference. Linear regression analysiswas done to develop predictive equations. Result: Amongst 350 newborns, 76% were term and24% were preterm. Pearson's correlation coefficient between gestational age as assessed by NewBallard score and head circumference, birth weight, mid-arm circumference and length all showed asignificant positive correlation in the decreasing order [maximum with head circumference (r =0.566)]. Linear regression analysis was done to develop predictive equations. Conclusion: Headcircumference measurement can be a surrogate marker to predict prematurity as a significantcorrelation is seen between it and gestational age assessed by the New Ballard score. Furtherstudies are needed to cross-validate our result.


2021 ◽  
Vol 8 (7) ◽  
pp. 1168
Author(s):  
Gurunathan Gopal

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.


2020 ◽  
Vol 20 (4) ◽  
pp. 1927-32
Author(s):  
Sanjay Mishra ◽  
Surajit Ghatak ◽  
Pratibha Singh ◽  
Dushyant Agrawal ◽  
Pawan Garg

Objectives: To determine accuracy of transverse cerebellar diameter (TCD) measurement in the prediction of gestational age (GA) in normal fetuses; to develop reference chart for TCD according to GA in Indian population. Design: A retrospective cross-sectional study. Method: Ultrasonographic measurements in 300 singleton pregnant women included biparietal diameter (cm), head circum- ference (cm), abdominal circumference (cm), femur length (cm) and transverse cerebellar diameter (cm). Reference chart with mean TCD for corresponding gestational age (GA) in weeks was developed. Results: Statistically significant relationship found between TCD and gestational age (R2=0.92, p=0.0006). Regression for- mulae based on TCD with other parameter can be used to predict gestational age of foetus. When TCD is compared with findings in other studies in different ethnic population, it is found that there is significant difference exists. Conclusion: In normally developing fetuses the TCD has linear correlation with advancing gestational age. A separate refer- ence chart is required for every different population because ethnicity, nutrition and environmental factors can have impact on normal TCD values. This will help to avoid misinterpretation of data to determine gestational age. Keywords: Transverse cerebellar diameter; ultrasonography; gestational age.


Author(s):  
Ananya S. L. Tenali ◽  
Ravi Kumar Tenali

Background: India is one of the countries with the highest neonatal mortality, for which preterm birth is considered as major cause (43.7%). Therefore, early identification by a simple screening tool is important for prognostication and follow-up of new-born infants, especially preterm.Methods: Cross-sectional study was conducted on 300 live newborns at Saveetha Hospital in Kanchipuram. Anthropometric measures such as birth weight, crown-heel length, head circumference, foot length were taken within 3 days of life and gestational age assessment was done by new Ballard scoring after calculation by Naegles formula. Neonates were grouped into preterm, term and post-term and also small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA). Minimum to maximum range of variables in each gestational range was calculated. The sensitivity and specificity of each variable was found using receiver operating curve. Parameter having the highest sensitivity and good specificity was considered as potential screening tool to identify high risk babies. SPSS Software version 17 for windows was used.Results: The range of gestational age, length, foot length, birth weight and head circumference was 28-42 weeks, 35-53 cm, 5-8.8 cm, 0.8-4.7 kg and 22.8-54.3 cm respectively. Among all, maximum sensitivity at 37weeks gestational age was seen with foot length (80.57%) at a cut-off of 7.58 cm. A nomogram of foot length for each gestational age group (range of 2 weeks) was also derived.Conclusions: It can be concluded that foot length has the potential to be considered as a screening tool to identify preterm neonates especially at a concentrated community level and is particularly useful in resource constraint countries.


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