scholarly journals Survival and morbidities in very low birth weight (VLBW) infants in a tertiary care teaching hospital

2017 ◽  
Vol 4 (6) ◽  
pp. 2170
Author(s):  
Sweta Mukherjee ◽  
Subhash Chandra Shaw ◽  
Amit Devgan ◽  
Ajay K Srivastava ◽  
Ashish Mallige
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Teaching Hospital ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
Maternal Risk ◽  
Vlbw Infants ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching

Background: Very low birth weight (VLBW) infants often need institutional advanced neonatal care. There is paucity of literature about the survival and morbidities of this very vulnerable group of preterm very low birth weight infants in tertiary care teaching hospitals. The aim of the study was to measure the outcome of VLBW infants in terms of survival and various short-term morbidities in a tertiary care teaching hospital.Methods: This was a retrospective data analysis of all VLBW infants born in a tertiary care teaching hospital of eastern India, between 01 July 2014 and 31 December 2016. 35 VLBW infants were studied for the outcomes in terms of survival and morbidities like respiratory distress, apnoea of prematurity, intra ventricular haemorrhage, necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity and broncho pulmonary dysplasia.Results: The overall survival rate of VLBW infants weighing >750 g (n=30) was 96.6% and <750 gm (n=5), was 40%. The commonest complications were respiratory distress (65.7%), neonatal hyperbilirubinemia (74.3%) and suspect early onset sepsis (51.4%) based on maternal risk factors.Conclusions: The majority of VLBW infants above 750 g at birth or ≥ 26 weeks POG, survived in a tertiary care teaching hospital. 

scholarly journals Clinical and demographic study of scrub typhus in a tertiary care teaching hospital in Puducherry during 2015-2018

2018 ◽  
Vol 6 (11) ◽  
pp. 3534
Author(s):  
I. Sariga ◽  
S. S. Karthik ◽  
P. Vivian Joseph Ratnam
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Teaching Hospital ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Demographic Profiles

Background: Scrub typhus is a vector borne rickettsial disease commonly found in many parts of India. Scrub typhus can frequently cause complications like pneumonia, acute respiratory distress syndrome (ARDS) and has a mortality rate of 30 to 45% in untreated cases. Diagnosis of scrub typhus is difficult, with serum IgM capture ELISA being the most sensitive test. Present study objectives were to study the clinical and demographic profiles of scrub typhus cases in a tertiary care teaching hospital in the Union Territory of Puducherry, India.Methods: A descriptive study was carried out to analyze clinical and demographic profiles of patients who were positive for IgM antibodies against Orientia tsutsugamushi by scrub typhus IgM ELISA during a three year period (April 2015 to March 2018). Demographic details like age and sex of the patients, clinical signs, symptoms and complication if any were analyzed.Results: A total of 428 patients were found to have been diagnosed with scrub typhus during the study period. Among them, 46% were males and 54% were females. Among all the positive cases, 23.5% were paediatric cases, the second highest group was the 31 to 40 years age group (17.7%). Thirteen percent of positive cases were above 60 years of age. Fever was the most common symptom (92.9%) and eschar was found in 22.9% of patients. The most common complication found in the patients with scrub typhus was acute respiratory distress syndrome (15.9%). Other complications like hepatic dysfunction, pleural effusion and meningoencephalitis were noted.Conclusions: Adequate knowledge about scrub typhus helps in early diagnosis, which facilitates early appropriate antibiotic and supportive therapy, which helps in the recovery of the patient without acquiring complications.

scholarly journals Predictors of early growth failure in preterm, very low birth weight infants during hospitalization

2019 ◽  
Vol 59 (1) ◽  
pp. 44-50
Author(s):  
Noviyani Leksomono ◽  
Retno Sutomo ◽  
Ekawaty Lutfia Haksari
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Medical Records ◽  
Very Low Birth Weight ◽  
Growth Parameters ◽  
Growth Failure ◽  
Early Growth ◽  
Vlbw Infants

Background Preterm, very low birth weight (VLBW) infants experience intrauterine nutritional deficits and perinatal comorbidities that may impair early growth parameters. Early growth failure has detrimental effects on later growth and neurodevelopment in childhood. Objective To analyze predictors of early growth failure in preterm, VLBW infants and differences in early growth parameters between small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) infants. Methods This retrospective cohort study was conducted at Dr. Sardjito Hospital, Yogyakarta from 2011 to 2016. Subjects were preterm infants, with birth weights of 1,000-1,499 g. Twins, those who died during hospitalization, were discharged against medical advice, or had incomplete medical records were excluded. Adequate intrauterine growth was determined by the Lubchenco table criteria. Growth parameters and perinatal comorbidities were collected from medical records. Growth failure was defined as discharge weight less than 10th percentile of the Fenton growth curve. Bivariate and multivariate analysis were used to analyze potential predictive factors of early growth failure. Results Of 646 preterm, VLBW infants during the study period, 398 were excluded. Respiratory distress and SGA were predictors of early growth failure (AOR 6.94; 95%CI 2.93 to 16.42 and AOR 34.44; 95%CI 7.79 to 152.4, respectively). Mean weight velocities in SGA and AGA infants were not significantly different [16.5 (SD 5.9) and 17.5 (SD 5.3) g/kg/day, respectively; (P=0.25)]. Median time to regain, time to reach full feeding, and time to reach 120 kcal/kg/day were also not significantly different between SGA and AGA infants. Conclusions SGA and respiratory distress are predictors of early growth failure in preterm, VLBW infants during hospitalization. The SGA infants grow slower than AGA infants.

scholarly journals Morbidity and mortality pattern of very low birth weight infants admitted in SNCU in a South Asian tertiary care centre

2018 ◽  
Vol 5 (3) ◽  
pp. 720 ◽  
Author(s):  
Kabilan S. ◽  
Mekalai Suresh Kumar
Keyword(s):  
Mechanical Ventilation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Normal Vaginal Delivery ◽  
Vlbw Infants ◽  
The Mean

Background: Around 4-8% of all live births are very low birth weight (VLBW) infants.  In India currently 8 million VLBW infants are born each year which constitutes 40% of global burden the highest for any country. The present study was done to determine frequency of disease, complications, survival rate and risk factors for morbidity and mortality in VLBW babies.Methods: Between October 2016 and September 2017, we did a cross-sectional retrospective study at level three SNCU with >98% inborn admissions and about more than 10000 deliveries per year. The American Academy of Pediatrics protocol for neonatal resuscitation was followed for the management of VLBW. Data were entered in predetermined proforma and statistical analysis was done.Results: There were 154 registered cases of VLBW [75 females (48.7%) and 79 males (51.3%)]. The mean birth weight=1.198 (SD=0.211). The mean gestational age in weeks was 31.9 (SD=3.095).  Majority of them were in the gestational age 33-36 weeks (n=68, 44.2%), small for gestational age (n=89, 57.8), delivered through normal vaginal delivery (n=95, 61.7%), singletons (n=126, 81.8%), inborn (n=152, 98.7%), maternal age between 21-30 (n=95, 61.6%), clear amniotic fluid (n=137, 89%), on antenatal steroids (n=59, 38.3%), maternal disease were present in 55 mothers (33%) and gestational hypertension being more common (n=14, 9.6%). Majority of babies had Respiratory Distress Syndrome (n=56, 33.6%), birth asphyxia (n=54 32.4%) and sepsis (n=46, 27.6%). Mortality of 40.3% (n=62) observed in present study. Forty three babies with RDS, twenty babies with asphyxia and eight babies with sepsis expired.Conclusions: Multiple regression analysis with adjusted estimates of odds ratio showed that very low birth weight, low Apgar score at 5 minute, intubation and mechanical ventilation were predictors of outcome of VLBW babies. Birth weight and mechanical ventilation were significant predictors of the outcome of ELBW babies.

scholarly journals Study on prevalence of maternal risk factors, morbidity and mortality in very low birth weight neonates

2021 ◽  
Vol 8 (6) ◽  
pp. 1027
Author(s):  
Ujjwala S. Keskar ◽  
Anjali H. Parekh
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Antenatal Steroids

Background: Very low birth weight babies with respiratory complications are the commonest reason for admission in NICU. We wanted to identify maternal risk factors associated with it and ways to prevent it. The objective of the current study was to study the prevalence of maternal risk factors, morbidity and mortality in VLBW babies admitted in tertiary care hospital NICU.Methods: Cross sectional observational study performed on all very low birth weight (VLBW) neonates admitted in neonatal intensive care unit of tertiary care hospital attached with Smt. Kashibai Navale medical college, Pune from January 2019 to March 2020.Results: In our study VLBW babies were 2.2% (78/3545). Mean gestational age was 31.15±3.21 weeks; mean birth weight was 1226.24±250.95 grams. Small for gestational age (SGA) babies were 41% and 96% were preterm. Maternal risk factors were present in 61.53% of deliveries, commonest were anaemia in 30.06 % and preeclampsia in 24.35%. Resuscitation at birth was required in 30.76% babies. Morbidity profile showed respiratory distress syndrome in 46.15%, neonatal sepsis in 19.23% and patent ductus arteriosus in 16.66% babies. Overall survival was 74.35%. Prematurity and its complications like RDS requiring surfactant therapy and mechanical ventilation were significant contributors for mortality but only 23.07% mothers were found to have received antenatal steroids in the hospital .Conclusions: Anaemia and preeclampsia were commonly found risk factors present in 61.53% of mothers of VLBW babies. Use of antenatal steroids in mothers should be made compulsory to decrease mortality in VLBW preterm newborns.

scholarly journals Targeted Quality Improvement Project Dramatically Reduced Admission Hypothermia in Very Low Birth Weight Infant in China: A Multicentre Study

2020 ◽  
Author(s):  
Li Wang ◽  
Yong-hui Yu ◽  
Zhi-jie Liu ◽  
Feng-min Liu ◽  
Shu-yu Bi ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
Improvement Project ◽  
Vlbw Infants ◽  
Targeted Interventions ◽  
Medical University

Abstract Background: Hypothermia is still a common problem and is associated with increased mortality and morbidity in preterm infants, especially in China. The objective of this study was to evaluate the efficacy of a targeted quality improvement (QI) project of hypothermia preventive measures in very low-birth weight (VLBW) infants in 3 tertiary neonatal intensive care unit (NICU) in China.Methods: Based on the literature, our preliminary findings and the needs of each unit, our team decided to focus efforts on equipment (transport incubator, pre-warmed hats and polyethylene wrap), team training and education, as well as temperature documentation and workflow. The primary outcome measure was the incidence of hypothermia, defined as temperature (rectal temperature) below 36.5ºC on admission to the NICU. This quality improvement (QI) initiative used the rapid cycle Plan - Do - Study - Act (PDSA) approach. The outcomes of pre–quality improvement (pre-QI) group (January 1, 2018– December 31, 2018) were compared with post-QI group (January 1, 2019–December 31, 2019). The study enrolled preterm infants born at less than 32 weeks’ gestation with very low birth weight less than 1500 g born at 3 academic, tertiary-care hospitals including Shandong Provincial Hospital, The First Affiliated Hospital of Shandong First Medical University, LiaoCheng People’s Hospital Affiliated to Shandong First Medical University between January 2018 and December 2019.Results: A total of 636 VLBW infants were included in this analysis, of which 235 infants (36.9%) were included in the pre-QI group and 295 infants (46.4%) in the post-QI group. The incidence of hypothermia decreased significantly from 92.3% to 62% (P < 0.001), and the mean body temperature on admission to NICU increased significantly from 35.5˚C to 36˚C (P < 0.001). There were one cases (0.3%) of neonatal hyperthermia. Infants in the post-QI group had lower rates of mortality (16.1% vs 8.8%, P = 0.01). Conclusions: Targeted interventions can dramatically reduce admission hypothermia and improve the outcome of VLBW infants in China.

scholarly journals Iatrogenic Blood Loss in Very Low Birth Weight Infants and Transfusion of Packed Red Blood Cells in a Tertiary Care Neonatal Intensive Care Unit

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 847
Author(s):  
Ahmed Aboalqez ◽  
Philipp Deindl ◽  
Chinedu Ulrich Ebenebe ◽  
Dominique Singer ◽  
Martin Ernst Blohm
Keyword(s):  
Birth Weight ◽  
Length Of Stay ◽  
Low Birth Weight ◽  
Blood Loss ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
Blood Sampling ◽  
Absolute Amount ◽  
Study Objective ◽  
Vlbw Infants

An adequate blood volume is important for neonatal adaptation. The study objective was to quantify the cumulative iatrogenic blood loss in very low birth weight (VLBW) infants by blood sampling and the necessity of packed red cell transfusions from birth to discharge from the hospital. In total, 132 consecutive VLBW infants were treated in 2019 and 2020 with a median birth weight of 1180 g (range 370–1495 g) and a median length of stay of 54 days (range 0–154 days) were included. During the initial four weeks of life, the median absolute amount of blood sampling was 16.5 mL (IQR 12.3–21.1 mL), sampling volume was different with 14.0 mL (IQR 12.1–16.2 mL) for non-transfused infants and 21.6 mL (IQR 17.5–29.4 mL) for transfused infants. During the entire length of stay, 31.8% of the patients had at least one transfusion. In a generalized logistic regression model, the cumulative amount of blood sampling (p < 0.01) and lower hematocrit at birth (p = 0.02) were independent predictors for the necessity of blood transfusion. Therefore, optimized patient blood management in VLBW neonates should include sparse blood sampling to avoid iatrogenic blood loss.

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