Effect of Maternal Race on Outcome of Preterm Infants in the Military

PEDIATRICS ◽  
1993 ◽  
Vol 91 (3) ◽  
pp. 572-577
Author(s):  
David N. Greenberg ◽  
Bradley A. Yoder ◽  
Reese H. Clark ◽  
Clifford A. Butzin ◽  
Donald M. Null
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Military Hospital ◽  
Free Access ◽  
Multiple Gestation ◽  
Entire Study ◽  
The Mean ◽  
Maternal Race

Previous studies suggest that low birth weight black infants have less morbidity and birth-weight-specific mortality during the perinatal period than low birth weight white infants. We studied the effect of maternal race on outcome in preterm infants born at a military hospital that offers free access to obstetric and neonatal care. Between January 1, 1986, and December 31, 1991, data were prospectively collected on all 667 infants delivered at Wilford Hall USAF Medical Center with an estimated gestational age of less than 35 weeks. Three hundred ninety-two white infants and 165 black infants were included in the data analysis. The mean (±SD) birth weight was 1701 ± 65 g for white infants and 1462 ± 66 g for black infants. The mean estimated gestational age was 31.0 ± 3.2 weeks for white infants and 29.9 ± 3.8 weeks for black infants. Preeclampsia was more frequent in black mothers than in white mothers for the entire study population (21% vs 14%), but the birth weight differential between races remained after correction for preeclampsia. There were no significant differences between races in stillbirths, gender, maternal age, maternal transfer status, number of prenatal visits, or percentages of mothers with small-for-gestational-age infants, multiple-gestation infants, prolonged rupture of membranes, or initial prenatal visit during the first trimester. Intraventricular hemorrhage was more frequent in white infants at 27 through 29 weeks estimated gestational age (50% vs 13%). There were no significant differences between the two groups in survival or in the occurrence of severe infraventricular hemorrhage or bronchopulmonary dysplasia. It is concluded that preterm black infants are smaller than preterm white infants when matched for gestational age despite essentially equal utilization of prenatal care. However, maternal race has little direct effect on the survival of liveborn preterm infants in this population.

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.

Pre-discharge growth pattern of very low birth weight infants (VLBW): A 5 year single center experience

2020 ◽  
pp. 1-6
Author(s):  
S.H. Elbeely ◽  
M.A. AlQurashi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Growth Pattern ◽  
Very Low Birth Weight ◽  
Single Center ◽  
Low Birth Weight Infants ◽  
Cross Sectional ◽  
Vlbw Infants ◽  
The Mean

BACKGROUND: Very low birth weight infants born prematurely are at greater risk for growth delays that lead to Ex-utero Growth Restriction (EUGR) during vulnerable periods of organ structural and functional development. There is considerable evidence that early growth failure has adverse effects on long term neurodevelopment in children which often persists into adulthood. METHODS: This is a single-center cross-sectional study on live newborn infants with birth weight ranges from 500 to 1500 grams (VLBW) and gestational age (GA) between 24–32 weeks who were admitted to NICU at KAMC-Jeddah over a 5 year period (2009–2013). This study aims to evaluate predischarge growth pattern of VLBW infants in terms of weight, head circumference (HC) and length and to identify important variables that have influenced such growth pattern. RESULTS: Of the 135 infants included in the final analysis, 68 (50.4%) were male and 67 (49.6%) were female and the mean gestational age was 28.83±2.064 weeks and the mean birth weight 1166.74±256 grams. Ninety-two infants (68%) had discharge weight at ≤10th percentile and forty four (32%) had their weight >10th percentile. HC was the lowest affected among the anthropometric measurements with 42% ≤10th percentile. In terms of linear growth, 62% had their length ≤10th percentile. Amongst infants born ≤750 grams, 71% and 70% had HC and height at ≤10th percentile respectively, at the time of discharge. BPD was significantly associated with EUGR (p = 0.026). CONCLUSIONS: This study demonstrates that almost 2/3rd of VLBW infants born at KAMC-Jeddah with birth weight ≤750 grams were discharged home with EUGR as demonstrated by their weight, length, and HC ≤10th percentile. BPD was found to be significantly associated with EUGR amongst post-natal factors influencing EUGR.

scholarly journals The Post-Discharge Growth of Very Low Birth Weight Preterm Infants

2020 ◽  
pp. 1
Author(s):  
Tuba Ozdemir ◽  
Abdullah Baris Akcan ◽  
Munevver Kaynak Turkmen
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Somatic Growth ◽  
Growth Time ◽  
Appropriate For Gestational Age ◽  
Catch Up

<p>OBJECTIVE: In the present study, we investigate the growth characteristics of very low birth weight premature infants of up to two years corrected age, considering the factors affecting growth and catch-up growth time.</p><p>STUDY DESIGN: The demographic data, clinical features, and comorbidities of 77 preterm infants with birth weights of less than or equal to 1.500 g were examined, the infants’ growth statuses in the 40th gestational week (gw) and at 6, 12, 18 and 24 months the corrected age, including their weight, height and head circumference, were evaluated.</p><p>RESULTS: The findings revealed that very low birth weight infants should be closely monitored either during their stay in the Neonatal Intensive Care Unit, or for up to 6 months corrected age, paying particular attention to growth data, and the appropriate supportive treatment should be administered. The applied support process is influential on the future somatic growth of preterm infants. It was noted in the study that bronchopulmonary dysplasia, proven sepsis, respiratory distress syndrome, steroid treatment for more than three days, patent ductus arteriosus, and ibuprofen treatment seemed to affect somatic growth negatively.</p><p>CONCLUSION: Small for gestational age newborns were found to catch up with appropriate for gestational age newborns at 2 years corrected age in terms of growth, although the percentage of catch-up growth during follow-up at the 40thgw, and at the 6th, 12th and 18th months was lower than that of appropriate for gestational age newborns.</p>

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

Short-term outcome of very low-birth-weight infants in a tertiary care hospital in Saudi Arabia over a decade

2020 ◽  
pp. 1-6
Author(s):  
F. Al Hazzani ◽  
S. Al-Alaiyan ◽  
A. Kattan ◽  
A. Binmanee ◽  
M.B. Jabr ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Research Centre ◽  
Published Data ◽  
Care Hospital ◽  
Short Term ◽  
Low Birth Weight Infants

BACKGROUND: Knowledge on short-term outcomes of preterm infants is important for quality control. Our objective was to analyze the outcomes of very low birth weight infants admitted to our neonatal intensive care unit over a ten years’ period and to compare the results with internationally published data. METHODS: We analyzed the outcome measures for all live born infants with birth weight (BW) of 400–1500 grams and gestational age (GA) of 23–32 weeks born at King Faisal Specialist Hospital & Research Centre between 2006 and 2015. Results were compared to data from three international neonatal networks. RESULTS: During the study period, we admitted 528 infants born at a gestational age of≥23 and≤32 weeks with a very low birth weight (VLBW) of 400–1500 grams. Mean (SD) GA was 28 (2.4) weeks and mean (SD) BW was 1007 (290) grams. A hundred and twenty-nine (24.4%) infants were small for gestational age and major congenital anomalies were present in 56 (10.6 %) infants. The rate of bronchopulmonary dysplasia (BPD) was 24.4 %, necrotizing enterocolitis (NEC) 9.1%, patent ductus arteriosus (PDA) 29.9%, severe intraventricular hemorrhage (IVH)10.8 %, periventricular leukomalacia (PVL) 5.7%, severe retinopathy of prematurity (ROP) 8%, and late-onset sepsis was 18.8%. The incidences of major neonatal outcomes such as CLD, NEC, severe IVH and severe ROP were comparable to the international cohorts. CONCLUSION: In our population of preterm infants, survival rates and complications of prematurity were comparable to international data.

scholarly journals External ventricular drainage for posthemorrhagic ventricular dilatation in preterm infants: insights on efficacy and failure

2021 ◽  
pp. 1-9
Author(s):  
Laura C. De Angelis ◽  
Alessandro Parodi ◽  
Marianna Sebastiani ◽  
Alessandro Consales ◽  
Giuseppe M Ravegnani ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Free Group ◽  
Gestational Age ◽  
External Ventricular Drain ◽  
External Ventricular Drainage ◽  
Ventricular Dilatation ◽  
Ventricular Drainage ◽  
Posthemorrhagic Hydrocephalus ◽  
The Mean

OBJECTIVE The objective of this study was to describe the clinical and neuroradiological characteristics of a cohort of preterm infants who had undergone external ventricular drain insertion as a temporary measure to treat posthemorrhagic ventricular dilatation. In addition, the authors investigated the factors predicting permanent shunt dependency. METHODS The authors retrospectively reviewed the medical records of a cohort of preterm infants who had undergone external ventricular drain insertion at Gaslini Children’s Hospital (Genoa, Italy) between March 2012 and February 2018. They also analyzed clinical characteristics and magnetic resonance imaging data, including diffusion- and susceptibility-weighted imaging studies, which were obtained before both catheter insertion and removal. RESULTS Twenty-eight infants were included in the study. The mean gestational age was 28.2 ± 2.7 weeks, and the mean birth weight was 1209 ± 476 g. A permanent ventriculoperitoneal shunt was inserted in 15/28 (53.6%) infants because of the failure of external ventricular drainage as a temporary treatment option. Compared with the shunt-free group, the shunt-dependent group had a significantly lower gestational age (29.3 ± 2.3 vs 27.2 ± 2.7 weeks, p = 0.035) and tended toward a lower birth weight (p = 0.056). None of the clinical and neuroradiological characteristics significantly differed between the shunt-free and shunt-dependent groups at the time of catheter insertion. As expected, ventricular parameters as well as the intraventricular extension of intracerebral hemorrhage, as assessed using the intraventricular hemorrhage score, were reportedly higher in the shunt-dependent group than in the shunt-free group before catheter removal. CONCLUSIONS External ventricular drainage is a reliable first-line treatment for posthemorrhagic hydrocephalus. However, predicting its efficacy as a unique treatment remains challenging. A lower gestational age is associated with a higher risk of posthemorrhagic hydrocephalus progression, suggesting that the more undeveloped the mechanisms for the clearance of blood degradation products, the greater the risk of requiring permanent cerebrospinal fluid diversion, although sophisticated MRI investigations are currently unable to corroborate this hypothesis.

scholarly journals Transient Hypothyroxinaemia in Full Term Low Birth Weight Neonates

1970 ◽  
Vol 6 (1) ◽  
pp. 8-11
Author(s):  
Z Parveen ◽  
N Begum ◽  
MM Hossain
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Low Birthweight ◽  
Full Term ◽  
Military Hospital ◽  
Control Group ◽  
Base Line ◽  
Group A ◽  
The Mean ◽  
Group B

This prospective study was done in Combined Military Hospital, Dhaka from July 2002 to June 2003 todocument the postnatal changes of thyroid hormones in full term low birth weight (LBW) neonates. Theparameters were- serum TT4 (total thyroxin), TT3 (total triiodothyronine), FT4 (free thyroxin) and TSH(thyroid stimulating hormone). Twenty seven healthy full term neonates formed the control group (group A)who were studied on day 5 to observe the base line data. Study group (group B) consisted of 27 low birthweight (LBW) neonates. They were studied twice on day 5 (B1) and day 45 (B2). The mean ± SD gestational agewas 38.41±0.93 and 38.63±1.08 weeks in group A and B respectively. The mean ± SD birth weight were3.41±0.55 and 2.11±0.33 kg in group A and B respectively and the difference was statistically significant (p<0.0001). All neonates of group A had normal serum levels of TT4, TT3, FT4 and TSH on day 5 but in LBW fullterm neonates though FT4 level remained within normal range, 48% neonates of group B had significantlydecreased levels of TT4, TT3 and TSH (p<0.001) but on day 45 all of these hormone levels were significantlyincreased (p<0.001) and attained normal values. This study showed that 48% LBW neonates had transienthypothyroxinaemia on day 5 which was corrected spontaneously by day 45.Key words: Hypothyroxinaemia; Low birth weight (LBW).DOI: 10.3329/jafmc.v6i1.5984Journal of Armed Forces Medical College, Bangladesh Vol.6(1) 2010 p.8-11

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