The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

Background: Neonatal hypoglycemia is a common metabolic problem especially in cases like prematurity, sepsis and small gestational age. Episodes of asymptomatic hypoglycemia may occur due to many risk factors. The present study aimed to evaluate the incidence of asymptomatic hypoglycemia in term new born babies weighing more than 2 kg, to study the plasma sugar level at various time points during first 48 hours of life and to study the effect of maternal factors like parity, mode of delivery, glucose infusion during labour, and time since last feed on plasma sugar level.Methods: A hospital based longitudinal study was conducted over a period of one year from April 2005 to March 2006 in Kilpauk Medical College Hospital, Chennai. 400 babies born of consecutive deliveries were included in the study. Their plasma glucose levels were assessed in cord blood, 3 hr, 12 hr and 36 hr of life. Plasma glucose levels were analysed with regards to distribution, variables like parity, mode of delivery, dextrose infusion during labour and time since last feed. The plasma glucose levels were statistically analysed by paired student ‘t’ test, multiple analysis of variance (ANOVA), chi- square test using SPSS (version 7.5) statistical package.Results: The overall incidence of hypoglycemia was seen in 20% of the neonate’s in which 29.7% in small gestational age (SGA) and 16.7% in appropriate gestational age (AGA) babies. A significant (p <0.01) association between hypoglycemia and birth weight was observed. The association between hypoglycemia with parity, mode of delivery, sex of the baby and glucose infusion received by the mother was studied, but no significant association was found. A significant difference in plasma glucose based on birth weight at 3rd hour, 12th hour and 36th hour was observed (p <0.05). None of the infants showed any clinical signs of hypoglycemia.Conclusions: The incidence of hypoglycemia was noted in 20% of the neonates. Low birth weight was considered as risk factor. A significant association was also observed between plasma glucose, mode of delivery and time since last fed.

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Changes in the physiological parameters of newborns in the first one hour of life

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192751 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1533

Author(s):

Shasidhar Reddy Y. ◽

Abdul Mohid Syed ◽

Gangadhar B. Belavadi

Keyword(s):

Heart Rate ◽

Birth Weight ◽

Low Birth Weight ◽

Oxygen Saturation ◽

Mode Of Delivery ◽

Physiological Parameters ◽

Peripheral Oxygen Saturation ◽

College Hospital ◽

Significant Difference ◽

The Mean

Background: The transition from a fetus to a newborn is the most complex adaptation that occurs in human experience. This study assessed three physiological parameters viz. temperature (core and peripheral), oxygen saturation and heart rate so as to avoid the delay in normal transitional adaptation.Methods: This cross-sectional observational study was done at Narayana Medical College Hospital, Nellore, Andhra Pradesh, India. A total of 150 neonates born from June 2017 to February 2018 were monitored for heart rate, oxygen saturation, core and peripheral temperature from birth to 60 minutes.Results: Most of the mother’s (45.33%) were aged between 22 to 25 years and the mean age was 23.75±3.64 years. History of consanguineous marriage was noted in 33.33%. The mode of delivery was vaginal in 70.67% of the babies. The mean gestational age was 38.74±1.36 weeks. The birth weight among 62% of the babies was between 2.5 to 3.49 Kgs and mean birth weight was 2.81±0.49 kgs. The meconium stained liquor and requirement of resuscitation was noted in 9.33% and 10.67% respectively.Conclusions: Significant difference was noted with regard to heart rate in babies with active resuscitation, low birth weight (<2.5 kg), meconium stained liquor and warmer care compared to normal babies. There was variation in oxygen saturation in babies who required resuscitation and warmer care, and those who had low birth weight. The mean peripheral and core temperature were different in babies with abdominal care compared to warmer care.

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The Consequences of Prior Initiation of Breast Feeding on Blood Glucose Levels in Neonates Born In a Tertiary Care Hospital

Asian Journal of Clinical Pediatrics and Neonatology ◽

10.47009/ajcpn.2020.8.2.5 ◽

2020 ◽

Vol 8 (2) ◽

pp. 23-29

Author(s):

Rizwan-U- Zama ◽

Ayesha Siddiqa ◽

A.N. Thobbi ◽

Tehseen Sajid Mudhol ◽

R Shruthi

Keyword(s):

Blood Glucose ◽

Birth Weight ◽

Plasma Glucose ◽

Glucose Concentration ◽

Blood Glucose Concentration ◽

Mode Of Delivery ◽

Postnatal Life ◽

Care Hospital ◽

Glucose Levels ◽

Blood Glucose Levels

Background: Hypoglycemia is the most common event of failure of metabolic adjustments in the newborn. Changes in maternal and fetal monitoring techniques, administration of glucose-containing solutions during labor, delivery and early feeding in neonates significantly alter blood glucose concentrations during the first week of postnatal life. Subjects and Methods: A total of 90 healthy (60 born by FTND, 30 born by LSCS) term, AGA infants were longitudinally evaluated at birth, at one hour after feeds (post feed), and after 6 hours of life. Plasma glucose was estimated from Heel Prick capillary samples by glucometer method. The influence of mode of delivery, the interval between feeds, sex, birth weight, on blood glucose was analyzed. Results: The way of delivery did not affect the plasma glucose concentration in neonates. There was a substantial increase in blood glucose concentration after the first feed irrespective of their birth weight. It was found that female babies had a higher blood glucose concentration than male babies during our study period. All babies maintained normal blood glucose with the continuation of breastfeeding. Conclusion: Plasma glucose levels are satisfactorily maintained in healthy term infants without resort to pre-lacteal feeds and mode of delivery did not influence plasma glucose. There is no need to check blood glucose levels routinely in an asymptomatic, healthy, term, breastfed infants.

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Antenatal Azithromycin to Prevent Preterm Birth in Pregnant women with Vaginal Cerclage. A Randomized Controlled Trial

QJM ◽

10.1093/qjmed/hcab115.037 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Rania Hassan Mostafa ◽

Sherif Ahmed Ashoush ◽

Hassan Awwad Bayoumy ◽

Wessam Kamal Lotfy Gabr

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Antenatal Care ◽

Gestational Age ◽

Mode Of Delivery ◽

Perinatal Morbidity ◽

Randomized Controlled ◽

Significant Difference ◽

Gestational Age At Delivery

Abstract Background Preterm birth with its complications is one of the leading causes of perinatal morbidity and mortality, as well as maternal morbidity, especially in low and middle-income countries. Cervical cerclage is a well-established preventive tool in women at high risk of preterm birth; however, subclinical maternal infection might still cause failure of this method. Thus, adding prophylactic antibiotics, namely macrolides, could prevent preterm birth. Patients and methods This was a randomized controlled clinical trial involving two groups of women who underwent vaginal cerclage at Ain Shams University Maternity Hospital. One group received azithromycin 500mg one tablet orally once daily for 3 days every month from 14th week to 34th week gestation, in addition to routine antenatal care; while the other group received usual antenatal care without antibiotic prophylaxis after cerclage. Follow-up was done and we compared the outcomes in each group: gestational age at delivery, birth weight, mode of delivery, maternal complications, and perinatal complications. ClinicalTrials.gov Identifier NCT04278937. Results Gestational age at delivery was significantly higher in the azithromycin group (36.8weeks vs 34.1weeks; P = 0.017), with significant prolongation of gestation in the azithromycin group (23.7weeks vs 21.1weeks; P = 0.005). As regards birth weight, it was significantly higher in the azithromycin group (2932.6gm vs 2401.8gm; P = 0.006); however babies with low birth weight (birth weight <2500gm) were non-significantly less frequent in the azithromycin group (3cases vs 7cases; P = 0.165). There was no significant difference between the two groups as regards other outcomes (miscarriage, stillbirth, neonatal intensive care unit admission, antepartum hemorrhage, postpartum pyrexia, need for blood transfusion). Conclusion Adding azithromycin as antenatal prophylaxis in women undergoing vaginal cerclage prolongs pregnancy and reduces risk of PTB, with slight increase in birth weight. However, there was no clear effect on incidence of low birth weight, or perinatal morbidity/mortality.

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Pregnancy complications in COVID-19 positive primigravid patients: a comparative study

BIRDEM Medical Journal ◽

10.3329/birdem.v10i0.50984 ◽

2020 ◽

pp. 71-73

Author(s):

Rushdana Rahman ◽

Faryal Mustary

Keyword(s):

Respiratory Distress ◽

Pregnant Women ◽

Gestational Age ◽

Pregnancy Complications ◽

Metabolic Diseases ◽

Mode Of Delivery ◽

Multiple Pregnancy ◽

Normal Vaginal Delivery ◽

College Hospital ◽

Significant Difference

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new strain of corona virus causing COVID-19. Previous studies suggested that COVID-19 is more likely to affect older males with co-morbidities. But pregnant women are at greater risk of exposure to SARS-CoV-2 infection due to physiological and immunological changes during pregnancy. This study aimed to monitor the pregnancy complications and mode of delivery. Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka over from May 2020 to July 2020. A total of 20 primigravid singleton pregnant women of all trimesters having COVID-19 positive reports (mild to moderate) were included in this study. Similar numbers of primigravid singleton pregnant women of all trimester having negative COVID-19 report were included in this study. Women having age between 18 and 40 years were included. Patients with multiple pregnancy, pregnancy with hypertension, heart disease, renal disease and other metabolic diseases were excluded from this study. Results: Most of the patients were between 26 and 35 years old. Mean age was 29.25 ± 4.42 years in COVID positive group and 31.10 ± 4.65 years in COVID negative group. In positive cases, most of them had gestational age below 37 weeks but in negative cases, most of them had gestational age e•37 weeks. There was significant difference in gestational age between two groups. Regarding type of delivery, in positive cases most underwent Caesarean section and in negative cases maximum were normal vaginal delivery. Regarding antenatal complication during pregnancy, abortion, premature rupture of membrane and pre term labour was found significantly higher in positive cases than that of negative cases. Respiratory distress and psychological upset were observed significantly higher in positive cases than that of negative cases. Conclusion: Regarding antenatal complications and mode of delivery, Frequency of abortion, PROM, preterm labor and LUCS was significantly higher in COVID-19 cases. Respiratory distress and psychological upset was significantly higher in COVID-19 positive cases. COVID-19 Among postnatal complications infection might increase the risk of pregnancy complications and pregnant women could have a severe clinical course of the disease. Birdem Med J 2020; 10, COVID Supplement: 71-73

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Association of Calcium Supplementation During Pregnancy with the Birth Weight of Single-Born Neonates in Rural Northwest China

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_178 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1106-1106

Author(s):

Gao Xiangyu ◽

Mi Baibing ◽

Dang Shaonong ◽

Yan Hong

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Regression Models ◽

Calcium Supplementation ◽

Northwest China ◽

Incidence Rates ◽

Shaanxi Province ◽

Significant Difference ◽

Birth Weight Percentile ◽

Weight Percentile

Abstract Objectives To investigate the association of calcium supplementation during the pregnancy with the birth weight of single-born neonates. Methods The survey employed a multistage, stratified and random sampling to investigate 15–49 aged pregnant women in 2010 to 2013 in Shaanxi province. A self - designed questionnaire was utilized. Birth weight between the 10(th) and 90(th) percentile was classified as appropriate for gestational age(AGA) infants. Chi-square test and logistic regression models were conducted to evaluate the association of calcium supplementation with single-born neonatal birth weight. Results A total of 28,490 women was enrolled in this study, 17 349 (60.9%) of participants had calcium supplementation during pregnancy. The incidence rates of small and large gestational age infants were 13.5% and 8.3%, respectively. The study conducted that calcium supplementation had a statistically significant difference in SGA (birth weight percentile <10) (P < 0.01). After adjusting the regression models by confounding factors, we found that calcium supplementation was still protective towards SGA birth, the difference was statistically significant (OR = 0.89, 95% CI: 0.82–0.96, P < 0.05), but there was no significant difference in the birth to LGA (birth weight percentile <10). Conclusions Calcium supplementation during pregnancy reduced the risk of SGA, but was not associated with the birth of LGA. Funding Sources

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Coeliac disease presenting atypically: A much wider spectrum

Tropical Doctor ◽

10.1177/0049475521991348 ◽

2021 ◽

pp. 004947552199134

Author(s):

Avinash Lomash ◽

Abhinaya Venkatakrishnan ◽

Meenakshi Bothra ◽

Bhavna Dhingra ◽

Praveen Kumar ◽

...

Keyword(s):

Coeliac Disease ◽

Gestational Age ◽

Dermatitis Herpetiformis ◽

Mode Of Delivery ◽

Gastrointestinal Symptoms ◽

Stunted Growth ◽

Significant Difference ◽

High Index Of Suspicion ◽

Gestational Age At Birth ◽

Age At Birth

Atypical coeliac disease in young children is frequently missed when it presents atypically as non-gastrointestinal presentations to different specialties. There was a greater delay (54 months) in establishing the diagnosis in those with atypical coeliac disease (p < 0.001). No difference was observed in the mode of delivery or duration of breast feeding, but significant difference was observed between gestational age at birth (p < 0.001). Most cases showed stunted growth and underweight. Irritability, anaemia, rickets, dermatitis herpetiformis, alopecia and intussusception were other common predictors of atypical coeliac disease. Because of a myriad spectrum of non-gastrointestinal symptoms, at any age with diverse presentation, a high index of suspicion is therefore required.

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Rapid translocation of hepatic glucokinase in response to intraduodenal glucose infusion and changes in plasma glucose and insulin in conscious rats

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00218.2003 ◽

2004 ◽

Vol 286 (4) ◽

pp. G627-G634 ◽

Cited By ~ 51

Author(s):

Chang An Chu ◽

Yuka Fujimoto ◽

Kayano Igawa ◽

Joseph Grimsby ◽

Joseph F. Grippo ◽

...

Keyword(s):

Portal Vein ◽

Plasma Glucose ◽

Regulatory Protein ◽

Glucose Infusion ◽

Insulin Levels ◽

Conscious Rats ◽

Glucose Levels ◽

Glucose Ingestion ◽

Plasma Insulin Levels

The rate of liver glucokinase (GK) translocation from the nucleus to the cytoplasm in response to intraduodenal glucose infusion and the effect of physiological rises of plasma glucose and/or insulin on GK translocation were examined in 6-h-fasted conscious rats. Intraduodenal glucose infusion (28 mg·kg-1·min-1 after a priming dose at 500 mg/kg) elevated blood glucose levels (mg/dl) in the artery and portal vein from 90 ± 3 and 87 ± 3 to 154 ± 4 and 185 ± 4, respectively, at 10 min. At 120 min, the levels had decreased to 133 ± 6 and 156 ± 5, respectively. Plasma insulin levels (ng/ml) in the artery and the portal vein rose from 0.7 ± 0.1 and 1.8 ± 0.3 to 11.8 ± 1.5 and 20.2 ± 2.0 at 10 min, respectively, and 12.4 ± 3.1 and 18.0 ± 4.8 at 30 min, respectively. GK was rapidly exported from the nucleus as determined by measuring the ratio of the nuclear to the cytoplasmic immunofluorescence (N/C) of GK (2.9 ± 0.3 at 0 min to 1.7 ± 0.2 at 10 min, 1.5 ± 0.1 at 20 min, 1.3 ± 0.1 at 30 min, and 1.3 ± 0.1 at 120 min). When plasma glucose (arterial; mg/dl) and insulin (arterial; ng/ml) levels were clamped for 30 min at 93 ± 7 and 0.7 ± 0.1, 81 ± 5 and 8.9 ± 1.3, 175 ± 5 and 0.7 ± 0.1, or 162 ± 5 and 9.2 ± 1.5, the N/C of GK was 3.0 ± 0.5, 1.8 ± 0.1, 1.5 ± 0.1, and 1.2 ± 0.1, respectively. The N/C of GK regulatory protein (GKRP) did not change in response to the intraduodenal glucose infusion or the rise in plasma glucose and/or insulin levels. The results suggest that GK but not GKRP translocates rapidly in a manner that corresponds with changes in the hepatic glucose balance in response to glucose ingestion in vivo. Additionally, the translocation of GK is induced by the postprandial rise in plasma glucose and insulin.

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Impact of parity and gestational age of mothers with hypertension on birth weight, red blood cells and mode of delivery of their babies

African Health Sciences ◽

10.4314/ahs.v19i4.25 ◽

1970 ◽

Vol 19 (4) ◽

pp. 3038-3044

Author(s):

Helen Chioma Okoye ◽

Chilota Chibuife Efobi ◽

Josephat Maduabuchi Chinawa ◽

Odutola Israel Odetunde ◽

Awoere Tamunosiki Chinawa ◽

...

Keyword(s):

Birth Weight ◽

Red Blood Cells ◽

Cell Volume ◽

Gestational Age ◽

Packed Cell Volume ◽

Blood Cells ◽

Mode Of Delivery ◽

Poor Correlation ◽

Hypertensive Group ◽

The Impact

Background: Maternal factors are determinants of birth outcome which includes birth weight, haematological indices and mode of delivery of their babies.Objectives: To determine the impact of parity and gestational age of hypertensive mothers on some neonatal variables.Methods: A hospital based cross-sectional study of measurement of neonatal variables (birth weight, red blood cells and mode of delivery) among hypertensive mothers and their controls was conducted over a period of six months. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20.Results: There were statistically significant differences in means between the neonates of the hypertensive group and non-hypertensive group for maternal age (t =1.61, p = 0.002), baby weight (t =2.87, p < 0.001), haemoglobin (Hb) (t =4.65, p = 0.010) and packed cell volume (PCV) (t =4.75, p = 0.009), but none for gravidity (t =1.95, p = 0.927)For all subjects, there was poor correlation between gestational age and variables; birth weight , haemoglobin (Hb), packed cell volume (PCV), nucleated red blood cell (nRBC) and parity. Likewise, parity poorly correlated with variables; age, birth weight, Hb, PCV, and nRBC. There was a statistically significant association between mode of delivery and hypertension (χ2 =53.082, p <0.001) but none with having a family history of hypertension (χ2 =1.13, p = 0.287).Conclusion: Parity and gestational age of mothers with hypertension have no impact on birth weight and red cells when compared with their non-hypertensive counterparts. However, mothers of babies delivered by elective and emergency caesarean section were about 2-3 times more likely to be hypertensive than those that delivered through spontaneous vertex delivery.Keywords: Hypertension; neonate; gestational age; parity.

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Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04050-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fahimeh Ranjbar ◽

Leila Allahqoli ◽

Soheila Ahmadi ◽

Robab Mousavi ◽

Maryam Gharacheh ◽

...

Keyword(s):

Health Care ◽

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Health Care Services ◽

Mode Of Delivery ◽

Preterm Births ◽

Future Health ◽

Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

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OUTCOME OF SECOND BABY OF TWIN IN A RURAL TEACHING HOSPITAL OF WEST BENGAL, INDIA

10.36106/ijsr/9503113 ◽

2021 ◽

pp. 4-7

Author(s):

Kajal Kumar Patra ◽

Anirban Mandal ◽

Thyadi Himabindu

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Perinatal Outcome ◽

West Bengal ◽

Mode Of Delivery ◽

Reproductive Technologies ◽

Time Interval ◽

Age Group ◽

Multiple Pregnancies ◽

Second Twin

Background: Multiple pregnancies are a high-risk situation because of its inherent risks to mother and the fetus. Twin or multiple pregnancies are gaining importance worldwide because of the attributable rise in treatment of infertility including assisted reproductive technologies. Twin pregnancies are associated with increased fetal loss, prematurity, structural abnormalities, and fetal growth restriction. Complications associated with twin pregnancy. The conduct of a twin delivery remains one of the most challenging events in the current obstetric practice. This Methods: study was an Hospital-based cross-sectional descriptive study conducted in the Department of Obstetrics & Gynaecology of Bankura Sammilani Medical College and Hospital, Bankura, West Bengal from January 2020 to December 2020. 238 patients were included in the study after informed consent from the patient about being a part of this study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Majority 154 (64.7%) of women belonged to age group 21-30 years. Gestational age of 159 (66.8%) mothers were < 37 weeks. Perinatal outcome of second twin was highest in the maternal age group 20 years. Perinatal outcome of second twin was highest in the birth weight of the 2nd twin < 2500 grams. Delivery time interval between the babies was maximum 175 (73.5%) is < 10 minutes. Gestational age, Conclusions: presentation, mode of delivery, and birth weight are the signicant determinants of perinatal outcome of the second twin. The second twin is at higher risk of perinatal morbidity and mortality than the rst twin. Frequent antenatal care should be advised to the mothers.

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