Neonatal Hypoglycemia Revisited, 1975

PEDIATRICS ◽  
1976 ◽  
Vol 58 (1) ◽  
pp. 10-17
Author(s):  
Ronald L. Gutberlet ◽  
Marvin Cornblath
Keyword(s):  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Perinatal Asphyxia ◽  
Severe Hypoglycemia ◽  
Neonatal Hypoglycemia ◽  
New Classification ◽  
Cell Hyperplasia ◽  
Prospective Survey ◽  
Stress Symptoms ◽  
Underlying Pathology

Between 1971 and 1973, the frequency of neonatal hypoglycemia was 4.4/1,000 total inborn live births or 15.5/1,000 low-birthweight infants. During that same time, of 257 transferred infants, 13 or 5.1% were hypoglycenic. The hypoglycemic manifestations differed between the inborn and outborn infants as well as from those previously described for transient symptomatic hypoglycemia. This required a new classification for low blood glucose values in the neonate, based on intrauterine nutrition, stress, symptoms, and underlying pathology. Four categories were defined: category I: early transitional hypoglycemia; category II: secondary hypoglycemia; category III: classical transient hypoglycemia; and category IV: recurrent, severe hypoglycemia. One outborn infant was in the latter group due to β-cell hyperplasia and was only cured after a 90% pancreatectomy. Data revealed that early treatment of perinatal asphyxia was associated with a decreased frequency of hypoglycemia. While not a prospective survey, the evidence suggested that current neonatal intensive care may decrease the frequency of transient symptomatic neonatal hypoglycemia.

scholarly journals Elimination of Intravenous Di-2-Ethylhexyl Phthalate Exposure Abrogates Most Neonatal Hypertension in Premature Infants with Bronchopulmonary Dysplasia

Toxics ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 75
Author(s):  
Randall Jenkins ◽  
Katia Farnbach ◽  
Sandra Iragorri
Keyword(s):  
Risk Factors ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Chi Square ◽  
Neonatal Hypertension ◽  
Vlbw Infants ◽  
Chi Square Analysis ◽  
Ethylhexyl Phthalate ◽  
Current Report

(1) Background: The incidence of hypertension in very low birthweight (VLBW) infants in a single neonatal intensive care unit (NICU) dropped markedly during a 2-year period when the IV fluid (IVF) in both the antenatal unit and the NICU temporarily changed to a di-2-ethylhexyl phthalate (DEHP)-free formulation. The objective of the current report is to document this observation and demonstrate the changes in incidence of hypertension were not associated with the variation in risk factors for hypertension; (2) Methods: The charts of all VLBW infants born in a single NICU during a 7-year span were reviewed. This time includes 32 months of baseline, 20 months of DEHP-free IVF, 20 months of IVF DEHP re-exposure, and two 4-month washout intervals. The group of interest was limited to VLBW infants with bronchopulmonary dysplasia (BPD). Chi-square analysis was used to compare incidence of hypertension among periods. Vermont Oxford NICU Registry data were examined for variation in maternal and neonatal risk factors for hypertension; Results: Incidence of hypertension in VLBW infants with BPD decreased from 7.7% (baseline) to 1.4% when IVF was DEHP-free, rising back to 10.1% when DEHP-containing IVF returned to use. Risk factors for neonatal hypertension were stable across the 3 study periods in the NICU’s group of VLBW infants; (3) Conclusions: Serendipitous removal of IVF containing DEHP resulted in near elimination of hypertension in one NICU—an effect entirely reversed after the same brand of DEHP-containing IVF returned to clinical use. These results suggest that DEHP exposure from IVF plays a major role in neonatal hypertension.

scholarly journals COVID-19 positivity associated with traumatic stress response to childbirth and no visitors and infant separation in the hospital

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gus A. Mayopoulos ◽  
Tsachi Ein-Dor ◽  
Kevin G. Li ◽  
Sabrina J. Chan ◽  
Sharon Dekel
Keyword(s):  
Traumatic Stress ◽  
Neonatal Intensive Care ◽  
Acute Stress ◽  
Psychiatric Morbidity ◽  
Neonatal Intensive Care Units ◽  
Stress Symptoms ◽  
Increased Risk ◽  
The Us ◽  
Control Survey ◽  
Novel Coronavirus

AbstractAs the novel coronavirus (COVID-19) has spread globally, a significant portion of pregnant and delivering women were infected with COVID-19. While emerging studies examined birth outcomes in COVID-19 positive women, knowledge of the psychological experience of childbirth and maternal wellness remains lacking. This matched-control survey-based study included a sample of women recruited during the first wave of the pandemic in the US who gave birth in the previous six months. Women reporting confirmed/suspected COVID-19 (n = 68) during pregnancy or childbirth were matched on background factors with women reporting COVID-19 negativity (n = 2,276). We found nearly 50% of COVID positive women endorsed acute traumatic stress symptoms at a clinical level in response to childbirth. This group was more than twice as likely to endorse acute stress and to have no visitors during maternity hospitalization than COVID negative women; they were also less likely to room-in with newborns. The COVID positive group reported higher levels of pain in delivery, lower newborn weights, and more infant admission to neonatal intensive care units. Our findings suggest COVID-19 affected populations are at increased risk for traumatic childbirth and associated risk for psychiatric morbidity. Attention to delivering women’s wellbeing is warranted during the pandemic.

scholarly journals Unprecedented reduction in births of very low birthweight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a ‘natural experiment’ allowing analysis of data from the prior two decades

2020 ◽  
Vol 5 (9) ◽  
pp. e003075 ◽  
Author(s):  
Roy K Philip ◽  
Helen Purtill ◽  
Elizabeth Reidy ◽  
Mandy Daly ◽  
Mendinaro Imcha ◽  
...  
Keyword(s):  
Poisson Regression ◽  
Rate Ratio ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Well Being ◽  
Very Low Birthweight ◽  
Live Births ◽  
Regional Trends ◽  
Extremely Low Birthweight ◽  
Health And Well Being

BackgroundAetiology of births involving very low birthweight (VLBW) and extremely low birthweight (ELBW) infants is heterogeneous and preventive strategies remain elusive. Socioenvironmental measures implemented as Ireland’s response to the SARS-CoV-2 virus (COVID-19) pandemic represented a national lockdown, and have possibly influenced the health and well-being of pregnant women and unborn infants.MethodsRegional trends of VLBW and ELBW infants in one designated health area of Ireland over two decades were analysed. Poisson regression and rate ratio analyses with 95% CI were conducted. Regional data covering most of the lockdown period of 2020 were compared with historical regional and national data and forecasted national figures for 2020.ResultsPoisson regression analysis found that the regional historical VLBW rate per 1000 live births for January to April, 2001–2019 was 8.18 (95% CI 7.21 to 9.29). During January to April 2020, an unusually low VLBW rate of just 2.17 per 1000 live births was observed, reflecting a rate ratio of 3.77 (95% CI 1.21 to 11.75), p=0.022, representing a 73% reduction of VLBW during the first 4 months of 2020 compared with same period for the preceding two decades. There were no ELBW infants admitted to the regional neonatal intensive care unit. National Irish VLBW rate for 2020 is forecasted to be reduced to approximate 400 per 60 000 births compared with the historical 500–600 range.ConclusionAn unprecedented reduction in regional births of VLBW and ELBW infants was observed in Ireland coinciding with the COVID-19 lockdown. Potential determinants of this unique temporal trend possibly reside in the summative socioenvironmental impact of the COVID-19 lockdown. Our findings, if mirrored in other regions that have adopted a lockdown, demonstrate the potential to evaluate these implicated behavioural and socioenvironmental modifiers to positively influence VLBW and ELBW rates globally.

scholarly journals RISK FACTORS ASSOCIATED WITH NEONATAL HYPOGLYCEMIA

2006 ◽  
Vol 13 (04) ◽  
pp. 687-690
Author(s):  
MUNIR AKMAL LODHI ◽  
GHULAM SHABBIR ◽  
NASIR ALI SHAH
Keyword(s):  
Risk Factors ◽  
Low Birthweight ◽  
Birth Asphyxia ◽  
Neonatal Hypoglycemia ◽  
Factors Associated ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Associated Risk Factors ◽  
Glucose Estimation

Objectives: Recurrent episodes of neonatal hypoglycemia are strongly associated with long termphysical and neuro-developmental deficits. (1) Moreover in neonates hypoglycemia can be overlooked as it may havenonspecific symptoms only. (2) This study was therefore carried out to analyse the risk factors associated with neonatalhypoglycemia and to evaluate the risk factors which have predictive value in its diagnosis. .Design: Based case controlstudy. Period: Six months from January 2005 to June 2005. Setting CMH Pano Aqil. Material and Methods: 385newborns were studied. Newborns of both civilians as well as military personnel were included in the study. 11newborns were excluded. Out of remaining 347 patients 101 were found to be hypoglycemia. Five risk factors (low birthweight, Birth Asphyxia, Neonatal sepsis, Meconeum aspiration syndrome delayed feeding ) strongly and independentlypredicated the risk of hypoglycemia. Results: The most common associated risk factor was low birth weight (47.47%)followed by delayed feeding (46.29%). Blood sampling for glucose estimation was done at birth / admission at 6 hours,12 hours, 24 hours and 48 hours. Test was initially performed by glucometer, the reading which were confirmed bylaboratory testing in border line case. Conclusions: In neonates with associated risk factors it is cost affective to carryout blood glucose levels at the time of birth and follow up readings taken as indicated by clinical progress later on.

scholarly journals Maternal and Neonatal Outcomes Associated with Psychostimulant Use in Pregnancy

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Ximena Camacho ◽  
Alys Havard ◽  
Helga Zoega ◽  
Margaret Wilson ◽  
Tara Gomes ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Cohort Analysis ◽  
Neonatal Outcomes ◽  
Increased Risk ◽  
The Usa ◽  
Maternal And Neonatal Outcomes ◽  
Adverse Pregnancy ◽  
In Pregnancy

IntroductionRecent evidence from the USA and Nordic countries suggests a possible association between psychostimulant use during gestation and adverse pregnancy and birth outcomes. Objectives and ApproachWe employed a distributed cohort analysis using linked administrative data for women who gave birth in New South Wales (NSW; Australia) and Ontario (Canada), whereby a common protocol was implemented separately in each jurisdiction. The study population comprised women who were hospitalized for a singleton delivery over an 8 (NSW) and 4 (Ontario) year period, respectively, with the NSW cohort restricted to social security beneficiaries. Psychostimulant exposure was defined as at least one dispensing of methylphenidate, amphetamine, dextroamphetamine or lisdexamfetamine during pregnancy. We examined the risk of maternal and neonatal outcomes among psychostimulant exposed mothers compared with unexposed mothers. ResultsThere were 140,356 eligible deliveries in NSW and 449,499 in Ontario during the respective study periods. Fewer than 1% of these pregnancies were exposed to psychostimulants during gestation, although use was higher in Ontario (0.30% vs 0.11% in NSW). Preliminary unadjusted analyses indicated possible associations between psychostimulant use in pregnancy and higher risks of pre-term birth (relative risk [RR] 1.7, 95% confidence interval [CI] 1.4-2.0 (Ontario); RR 1.8, 95% CI 1.2-2.6 (NSW)) and pre-eclampsia (RR 2.0, 95% CI 1.5-2.6 (Ontario); RR 2.0, 95% CI 1.2-3.5 (NSW)). Similarly, psychostimulant use was associated with higher risks of low birthweight (RR 1.6, 95% CI 1.3-1.9 (Ontario); RR 2.0, 95% CI 1.3-3.0 (NSW)) and admission to neonatal intensive care (RR 2.1, 95% CI 1.9-2.3 (Ontario); RR 1.5, 95% CI 1.1-1.9 (NSW)). Conclusion / ImplicationsUnadjusted analyses indicate an increased risk of adverse maternal and birth outcomes associated with psychostimulant exposure during pregnancy, potentially representing a placental effect. We are currently refining the analyses, employing propensity score methods to adjust for confounding.

Adverse perinatal outcomes of chlamydia infections: an ongoing challenge

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yael Eliner ◽  
Moti Gulersen ◽  
Amos Grunebaum ◽  
Erez Lenchner ◽  
Liron Bar-El ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Perinatal Outcomes ◽  
The United States ◽  
Chlamydia Infection ◽  
Suspected Sepsis ◽  
Bonferroni Adjustment ◽  
Neonatal Ventilation ◽  
Adverse Perinatal Outcomes

Abstract Objectives Chlamydia trachomatis is one of the most common sexually transmitted diseases in the world, but there are limited data on its impact on perinatal outcomes. Our objective was to investigate the association between chlamydia infections and adverse perinatal outcomes. Methods This is a retrospective analysis of the United States Centers for Disease Control and Prevention natality live birth database for the years 2016–2019. The rates of adverse perinatal outcomes were compared between patients with a chlamydia infection during pregnancy and patients without such infection, using Pearson’s chi-square test with the Bonferroni adjustment. A multivariate logistic regression was then used to adjust outcomes for potential confounders. Results Chlamydia infections were associated with small, but statistically significant, increased odds of preterm birth (<37 weeks), early preterm birth (<32 weeks), low birthweight (<2,500 g), congenital anomalies, low 5-min Apgar score (<7), neonatal intensive care unit admission, immediate neonatal ventilation, prolonged (>6 h) neonatal ventilation, and neonatal antibiotic treatment for suspected sepsis. Conclusions Chlamydia infections during pregnancy are associated with adverse perinatal outcomes. These results call for increased education regarding the potential risks of pregnancies with a chlamydia infection, as well as for increased antenatal surveillance and post-natal pediatric assessment in these pregnancies.

Perinatal outcome in gestational diabetes according to different diagnostic criteria

2019 ◽  
Vol 47 (5) ◽  
pp. 553-557 ◽  
Author(s):  
Lina Salman ◽  
Anat Pardo ◽  
Eyal Krispin ◽  
Galia Oron ◽  
Yoel Toledano ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Challenge Test ◽  
Perinatal Outcomes ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Neonatal Hypoglycemia ◽  
Glucose Challenge ◽  
Nicu Admission

Abstract Objectives To evaluate whether gestational diabetes mellitus (GDM) diagnosed by different criteria impacts perinatal outcome. Methods This was a retrospective study of deliveries with a diagnosis of GDM (2014–2016). Perinatal outcomes were compared between patients with: (1) GDM diagnosed according to a single abnormal value on the 100-g oral glucose tolerance test (OGTT); (2) two or more abnormal OGTT values; and (3) a 50-g glucose challenge test (GCT) value ≥200 mg/dL. Results A total of 1163 women met the inclusion criteria, of whom 441 (37.9%) were diagnosed according to a single abnormal OGTT value, 627 (53.9%) had two or more abnormal OGTT values and 95 (8.17%) had a GCT value ≥200 mg/dL. Diet-only treatment was significantly higher in the single abnormal value group (70.3% vs. 65.1% vs. 50.5%) and rates of medical treatment were significantly higher in the GCT ≥ 200 mg/dL group (P < 0.05). Women in the GCT ≥ 200 mg/dL group had higher rates of neonatal intensive care unit (NICU) admission (10.5% vs. 2.7% vs. 2.8%, P < 0.001) and neonatal hypoglycemia (5.3% vs. 0.5% vs. 0.8%, P < 0.001). On multivariate logistic regression, GCT ≥ 200 mg/dL was no longer associated with higher rates of NICU admission and neonatal hypoglycemia (P > 0.05). Conclusion No difference was noted in the perinatal outcome amongst the different methods used for diagnosing GDM.

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