scholarly journals Respiratory distress in vigorous babies born through meconium stained amniotic fluid: incidence, onset, risk factors and predictors at birth

2017 ◽  
Vol 4 (2) ◽  
pp. 390
Author(s):  
Kulkarni Poornima Prakash ◽  
Shilpa Dinesh B. K.
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Significant Risk ◽  
P Value ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
Increased Risk ◽  
Meconium Stained Amniotic Fluid

Background: One in every seven pregnancies ends with meconium-stained amniotic fluid (MSAF). MSAF can be harmful to the newborn with short and long-term sequelae. This study was aimed to find out the incidence, predictors, onset and severity of respiratory distress among vigorous babies born through meconium stained amniotic fluid which may or may not be evident at birth.Methods: It is a prospective observational study. One hundred forty-one neonates were studied. Data was collected on perinatal risk factors, clinical course and development of respiratory distress. Significance of the perinatal risk factors were identified by fisher’s exact test (p-value) and score based on odds ratio was assigned for significant risk factors. Results: This study included one hundred and forty-one vigorous babies born through meconium stained amniotic fluid, of which 36.9% (52) babies developed respiratory distress. Of the 52 babies who developed respiratory distress 19.23%(10 babies) developed meconium aspiration syndrome (MAS). In our study, it was observed factors like caesarean section and thick meconium increased risk of respiratory distress in the neonates born through meconium stained amniotic fluid who were vigorous.Conclusions: The incidence of respiratory distress in vigorous babies born through meconium stained liquor in this study was observed to be 36.9% (52 babies). 98.07% (51 babies) developed respiratory distress at birth or within one hour of life. All the babies who developed MAS had mild or moderate form of MAS. None of the babies required assisted ventilation. Risk factors like thick meconium, caesarean section showed significant increase in the incidence of respiratory distress. Therefore intrapartum monitoring and timely intervention can prevent the complications of MAS.

scholarly journals Risk Factors of Meconium-Stained Amniotic Fluid in Term Pregnancy - A Case Control Study

2021 ◽  
Vol 8 (13) ◽  
pp. 806-810
Author(s):  
Asha P.S ◽  
Sujatha T.L.
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Control ◽  
Inclusion Criteria ◽  
Term Pregnancy ◽  
Meconium Stained Amniotic Fluid ◽  
Control Study

BACKGROUND Meconium stained amniotic fluid is a significant contributor to perinatal and neonatal morbidity and mortality. The study was conducted to determine the risk factors of meconium stained amniotic fluid in term pregnancy. METHODS This study is a prospective case control study done in a tertiary care hospital in South India over a period of one year. 100 women with meconium stained amniotic fluid detected at any time during the course of labour, prior to it or meconium detected in hind waters were enrolled in the study group. The inclusion criteria were term pregnancy, cephalic presentation and singleton pregnancy. 200 women who satisfied the same set of inclusion criteria with clear amniotic fluid, selected on random basis were taken as controls. A standardised pretested proforma was used for data collection. RESULTS In the study, incidence of grade 1, grade 2 and grade 3 meconium were 31 %, 42 % and 27 % respectively. 83 % of cases were in the 20 – 24 year age group and advanced maternal age was not a risk factor in the study. Primiparity (86 % cases vs. 47 % controls) and advanced gestational age (56 % cases and 33 % controls) were significant risk factors. Maternal obesity, socioeconomic status and treatment for infertility were not significant risk factors. Among medical disorders, gestational diabetes mellitus (21 % cases vs. 5 % controls), gestational hypertension (12 % vs. 3.5 %) and hypothyroidism (13 % cases vs. 4.5 % controls) showed statistical significance. Oligoamnios (9 % vs. 1 %), fetal growth restriction (13 % vs. 4.5 %) and maternal infection (12 % vs. 2 %) were significant risk factors. Induced labour and prolonged labour were the significant intrapartum risk factors. Caesarean section rates were nearly doubled in cases (40 %) compared to controls (21.5 %). Babies born to mothers with meconium stained amniotic fluid had low Apgar scores at birth (25 %) and increased neonatal intensive care unit (NICU) admission. CONCLUSIONS Meconium stained amniotic fluid is associated with increased rates of maternal morbidity due to higher rates of operative deliveries and increased incidence of perinatal asphyxia, perinatal morbidity and mortality. Meticulous antenatal care and early identification of risk factors help in reducing the incidence of meconium stained amniotic fluid and preventing adverse maternal and neonatal outcome. KEYWORDS Risk Factors, Meconium, Amniotic Fluid, Term Pregnancy, Caesarean Section, Perinatal Outcome

scholarly journals A study of maternal risk factors and the perinatal outcome in meconium stained amniotic fluid in central referral hospital

2019 ◽  
Vol 8 (11) ◽  
pp. 4146
Author(s):  
Kapil Singh Niranjan ◽  
Pesona Grace Lucksom
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Significant Risk ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Maternal Risk ◽  
Prolonged Labor ◽  
Meconium Stained Amniotic Fluid

Background: Meconium staining of amniotic fluid (MSAF) is a significant risk factor for the subsequent development of meconium aspiration syndrome (MAS), respiratory distress and eventual respiratory failure in neonates. To learn more about the risk factors and outcomes associated with MSAF, a prospective case control study was conducted. The objective of the study was to study various maternal risk factors associated with MSAF and to study the outcome of neonates born through MASF and to compare the perinatal outcome in patients with thick and thin meconium stained amniotic fluid.Methods: A hospital based prospective case control study was conducted comparing pregnant women with meconium stained (cases) amniotic fluid with pregnant women having clear liquor (control), 200 in each arm. Singleton pregnancies complicated with MASF were included in the cases group on the basis of predefined inclusion criteria. Various risk factors, mode of delivery, outcome of neonates and perinatal outcome in babies born through thick and thin meconium stained amniotic fluid was studied.Results: Out of 200 patients who had MSAF 114 patients (57%) had thick meconium stained liquor while remaining 86 patients (43.00%) had thin meconium stained amniotic fluid. Post-maturity, pregnancy induced hypertension; oligohydramnios and prolonged labor were found to be statistically significant risk factors for MSAF. Nonreactive non-stress test and Need for cesarean section was more common in women with MSAF as compared to women with clear liquor (p <0.05). Common morbidities in neonates were Birth asphyxia (15%) followed by meconium aspiration syndrome (10%) and hypoxic ischemic encephalopathy (15%).Conclusions: Meconium stained amniotic fluid is more commonly associated with post-maturity, pregnancy induced hypertension, oligohydramnios and prolonged labor low APGAR score and higher incidence of birth asphyxia and NICU admissions. Appropriate management of neonates with meconium aspiration syndrome is crucial to prevent neonatal mortality.

scholarly journals A study of risk factors for catheter associated urinary tract infection

2018 ◽  
Vol 5 (2) ◽  
pp. 334 ◽  
Author(s):  
Leelakrishna P. ◽  
Karthik Rao B.
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Closed System ◽  
Univariate Analysis ◽  
Significant Risk ◽  
P Value ◽  
Indwelling Catheters ◽  
Increased Risk ◽  
Catheter Size ◽  
Tract Infections

Background: Catheter associated urinary tract infections (CAUTIs) are the most common causes of UTIs in postoperative cases. Many risk factors are associated with its incidence. The present study was conducted with the aim to determine the related risk factors and to identify the causative agents contributing to the urinary tract infection.Methods: This prospective study was conducted on 210 patients meeting the requirements of inclusion criteria during September 2012 to February 2014. Detailed history of the patients was recorded. Urine culture was done at different time intervals to identify the causative agent suggestive to CAUTI. Univariate analyses of the association of each variable with CAUTI and multivariable logistic regression were done to predict CAUTI outcome.Results: The mean age of study participants was 51.61 years. Among them 141 were males and 69 were female patients. On univariate analysis purpose for urine catheterization, place of catheterization, breach in the closed system of drainage, duration of catheterization, hemoglobin value less than 10, raised renal parameters with serum creatinine more than 1.5 were all significantly associated with development of CAUTI (p value 0.000). Sex of the patient (p value 0.279) and catheter size (p value 0.279) was not found to have a significant correlation with increased risk of CAUTI. On multivariate analysis, age, catheter size, diabetes, duration of catheterization, a breach in the closed system of catheter drainage  and sex were found to be the significant risk factors associated with CAUTI (p<0.05).Conclusion: An understanding of the risk factors in development of CAUTI, significantly helps in reducing the additional burden on the health care system. Measures such as shortening the duration of catheterization, strict control of diabetes and sterile precautions in insertion and maintenance of indwelling catheters can help in prevention CAUTI.

scholarly journals Characteristics of SARS-CoV-2 positive and complicated COVID-19 patient cohorts in Israel: A comparative analysis

2020 ◽  
Author(s):  
Chen Yanover ◽  
Barak Mizrahi ◽  
Nir Kalkstein ◽  
Karni Marcus ◽  
Pinchas Akiva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Diseases ◽  
Significant Risk ◽  
P Value ◽  
Public Health Policies ◽  
Global Pandemic ◽  
Increased Risk ◽  
Risk Patients ◽  
Risk Of Disease

AbstractReliably identifying patients at increased risk for COVID-19 complications could guide clinical decisions, public health policies, and preparedness efforts. The most globally accepted definitions of at-risk patients rely, primarily, on epidemiological characterization of hospitalized COVID-19 patients. However, such characterization overlooks, and fails to correct for, the prevalence of existing conditions in the wider SARS-CoV-2 positive population. Here, we use the complete medical records of 4,353 Israeli SARS-CoV-2 positive individuals, of whom 173 experienced moderate or severe symptoms of COVID-19, to identify the conditions that increase the risk of disease complications, in various age and sex strata. Our analysis suggests that cardiovascular and kidney diseases, obesity, and hypertension are significant risk factors for COVID-19 complications, as previously reported. Interestingly, it also indicates that depression (e.g., odds ratio, OR, for males 65 years or older: 2.94, 95% confidence intervals [1.55, 5.58]; P-value = 0.014) as well cognitive and neurological disorder (e.g., OR for individuals ≥ 65 year old: 2.65 [1.69, 4.17]; P-value < 0.001) are significant risk factors; and that smoking and background of respiratory diseases do not significantly increase the risk of complications. Adjusting existing risk definitions following these observations may improve their accuracy and impact the global pandemic containment efforts.

scholarly journals Endogenous erythropoietin concentrations and association with retinopathy of prematurity and brain injury in preterm infants

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252655
Author(s):  
Nancy M. Fahim ◽  
Michael K. Georgieff ◽  
Lei Zhang ◽  
Scott Naisbitt ◽  
Raghavendra B. Rao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Brain Injury ◽  
Preterm Infants ◽  
Retinopathy Of Prematurity ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
Endogenous Erythropoietin ◽  
Lower Birth Weight ◽  
Increased Risk

Background Endogenous erythropoietin (EPO) concentrations vary widely in preterm infants and may be associated with perinatal risk factors and neurological outcomes. Erythropoietin is elevated in fetal hypoxia but is also a potential neuroprotectant. Methods In a prospective study of 27 infants ≤ 30 weeks gestation, serum erythropoietin concentrations were measured during the first month of life, on day 1 and weeks 1, 2, and 4, and related to perinatal risk factors and outcomes including retinopathy of prematurity and cerebral injury evaluated near term-equivalent post menstrual age using magnetic resonance imaging with quantitative scoring. Results Lower birth weight was associated with higher EPO concentrations throughout the first 2 weeks of life (r = -0.6, p < 0.01). Higher day 1 and week 1 EPO concentrations were associated with lower Apgar score at 1 minute (r = - 0.5) and 5 minutes (r = -0.7), respectively (p < 0.01). Higher day 1 EPO concentrations and 2-week area under the curve were associated with increased risk (p = 0.01) and severity (r = 0.5, p < 0.02) of retinopathy of prematurity. Higher EPO concentrations at 2 weeks were associated with increased total brain injury score (r = 0.5, p < 0.05). Conclusion Elevated endogenous erythropoietin concentrations in the first two weeks of life are associated with lower birth weight and increased risk of adverse outcomes.

Perinatal Risk Factors for Retinopathy of Prematurity in Preterm and Low Birth Weight Neonates

2020 ◽  
Vol 12 (1) ◽  
pp. 32-38
Author(s):  
Reena Yadav ◽  
Sharad Gupta ◽  
Jyoti Baba Shrestha ◽  
Raveena Yadav ◽  
Tushar Bikram Sipaliya Yadav
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Birth Asphyxia ◽  
P Value ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
Oxygen Exposure

Background: Retinopathy of prematurity (ROP) is emerging as a leading cause of childhood blindness. The incidence of ROP is likely to increase after improvement in neonatal care unit in premature neonates. This study is conducted to determine the perinatal risk factors for ROP in preterm and low birth weight neonates. Methods: This is a prospective, descriptive and clinical; hospital based study. A total of 92 preterm neonates with gestational age of 36 weeks or less and birth weight of 2000 grams or less admitted in Neonatal Intensive Care Unit (NICU) were screened. Detailed antenatal, perinatal and neonatal history; birth asphyxia and subsequent oxygen support records were noted. All the neonates underwent detailed anterior and posterior segment eye examination with indirect binocular ophthalmoscope after pupil dilatation within 4 weeks of life. Retinal vascular changes were classified according to the International Classification of Retinopathy of Prematurity. The Chi-square test with odds ratio was performed to derive the association between ROP and antenatal, perinatal and neonatal factors. A p-value was considered significant at 0.05. Result: Out of 92 neonates, 21(22.8%) developed ROP. Twelve neonates (13%) had stage-1 ROP, 6(6.5%) had stage-2 and 3(3.3%) had stage-3 ROP. Birth weight (OR=2.9; p=0.04; 95% CI=1.0-8.3), gestational age (OR=3.9; p=0.01; 95% CI=1.3-11.8) and time span of oxygen exposure (OR=2.9; p=0.05; 95% CI=1.0-8.4) had a strong association with ROP. Conclusion: The incidence of ROP is significantly high among preterm low birth weight neonates. The risk of developing ROP becomes even greater with lower gestational age and more duration of oxygen exposure.

Risk Factors Associated with Occurrence of Febrile Neutropenia in NHL Patients in the First Cycle of Chemotherapy - A Prospective Multivariate Model.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1372-1372
Author(s):  
Ruth Pettengell ◽  
Andre Bosly ◽  
Thomas D. Szucs ◽  
Christian Jackisch ◽  
Robert Leonard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alkaline Phosphatase ◽  
Febrile Neutropenia ◽  
Statistical Significance ◽  
Significant Risk ◽  
Multivariate Model ◽  
P Value ◽  
Recent Infection ◽  
Predictive Values ◽  
Increased Risk

Abstract Current guidelines highlight non-Hodgkin lymphoma (NHL) patients receiving standard chemotherapy regimens as having a significant risk of febrile neutropenia (FN). However, limited data are available regarding the contribution of additional risk factors to FN occurrence. The majority of initial FN events occur in the first cycle of chemotherapy. We present a logistic regression model describing cycle 1 FN occurrence in NHL. Covariates were chosen based on their clinical and statistical significance, tested at the 5% significance level. Data were obtained from the INC-EU Prospective Observational European Neutropenia Study, which was conducted to assess the incidence and predictors of neutropenia, FN and reduced chemotherapy administration for breast cancer and lymphoma patients in European practices. 240 NHL patients were recruited from 37 centres in Belgium, France, Germany, Spain, and the UK. Ann Arbor stages were distributed: I 18%; II 26%; III 17%; IV 40%. Chemotherapy regimens received were 3-weekly CHOP-like (74%), 2-weekly CHOP-like (17%), ACVBP-like (4%) and other regimens (5%). Prophylactic use of colony stimulating factor (CSF) in the first cycle was 33%. Overall incidence of FN in cycle 1 was 9%. In the multivariate model of cycle 1 FN occurrence, the final set of covariates included low baseline albumin; high baseline alkaline phosphatase; glomerular filtration rate (GFR); height; recent infection; previous chemotherapy; planned cyclophosphamide, cytarabine and etoposide doses and prophylactic CSF. Missing categories were added for albumin and alkaline phosphatase to avoid loss of observations. Clinically relevant components of the model are shown in the table. The area under the receiver operating characteristic curve was 0.89. When the optimal probability cut-off was used to predict FN occurrence, test characteristics were 81% sensitivity and 80% specificity; corresponding to positive and negative predictive values of 29% and 98%, respectively. GFR is inversely related to age and height is related to weight. Replacing GFR and height with age and weight slightly affected predictive ability but did not affect overall model stability. Prophylactic CSF use suggested a significant protective effect. Low baseline albumin, high alkaline phosphatase, low GFR or high age, low height or weight, recent infection, previous chemotherapy, and high planned cyclophosphamide dose, may be important clinical signals of an increased risk of first cycle FN occurrence. This study was supported by an unrestricted educational grant from Amgen, Europe. Covariate Odds ratio (95% CI) p-value 1Baseline albumin <35 g/dl, baseline alkaline phosphatase >250 IU/l;2 Per additional 10 ml/min; inversely related to age;3Per additional 10 cm, related to weight;†mg/m2 body surface area, per additional 50 mg/m2;‡Before FN occurrence in cycle 1 Albumin (low)1 4.35 (0.95, 19.94) 0.059 Alkaline phosphatase (high)1 5.22 (0.99, 27.51) 0.051 GFR2 0.60 (0.45, 0.80) 0.001 Height3 0.68 (0.42, 1.10) 0.114 Recent infection (60 days prior to start of chemotherapy) 4.74 (1.70, 13.19) 0.003 Previous chemotherapy 6.37 (1.59, 25.49) 0.009 Planned dose cyclophosphamide† 1.17 (1.05, 1.31) 0.006 CSF‡ 0.22 (0.05, 1.02) 0.052

scholarly journals Value of Neutrophil to Lymphocyte Ratio in Early Prediction of Meconium Aspiration Syndrome

2020 ◽  
Vol 10 (01) ◽  
pp. e207-e211
Author(s):  
Suzan Gad ◽  
Abeer Alkhalafawi ◽  
Syed Raza ◽  
Mervat Hesham ◽  
Mohamed Sheta
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Significant Risk ◽  
Meconium Aspiration Syndrome ◽  
Neutrophil To Lymphocyte Ratio ◽  
Meconium Aspiration ◽  
Lymphocyte Ratio ◽  
Meconium Stained Amniotic Fluid ◽  
Minute Apgar Score

AbstractMeconium aspiration syndrome (MAS) is a serious neonatal condition. Prediction of MAS is challenging particularly in low-resource setting. Neutrophil to lymphocyte ratio (NLR) is a new simple index used for diagnosis of many inflammatory conditions. The present study was an attempt to determine whether NLR can predict the occurrence of MAS. The present study included 101 children with meconium-stained amniotic fluid. They comprised 22 patients who developed MAS and 79 neonates who didn't have the condition. All neonates were subjected to careful analysis of maternal and perinatal history in addition to thorough clinical assessment and radiological and laboratory evaluation. Blood samples from the umbilical cord were collected at birth and were used to obtain complete blood counts and C-reactive protein (CRP) assay. Univariate analysis revealed that elevated CRP levels, increased NLR, and 5-minute Apgar score of <7 were significant risk factors for the occurrence of MAS. Multivariate analysis revealed that low 5-minute Apgar score and increased NLR remained as significant risk factors of MAS. Receiver operating characteristic curve analysis showed good performance of NLR in prediction of MAS. NLR is useful in prediction of MAS in term neonates with meconium-stained amniotic fluid.

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