scholarly journals A study of survival of very low birth weight neonates in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 857
Author(s):  
Rajendra Shinde ◽  
Kiran Haridas ◽  
Pritesh Nagar ◽  
Hemant Parakh

Background: Preterm birth is one of the major clinical problems in Obstetrics and Neonatology as it is associated with perinatal mortality, serious neonatal morbidity and in some cases childhood disability. Very low birth weight (VLBW) neonates comprise between 4-8% of live-births but about one-third of deaths during the neonatal period occur in this group of newborns. Data on the probability of survival of infant in high risk pregnancies can be of great value in guiding management. The objective is to study the survival at discharge of VLBW neonates admitted in a tertiary care hospital.Methods: Retrospective observational study of all VLBW infants admitted in Aditya Hospital NICU over 3 years between 1-7-2011 to 30-6-2014. Descriptive and inferential statistical analysis has been carried out in the present study.Results: In the present study maternal PROM was seen in 32.9% of cases, Preeclampsia in 31.7% of cases which constituted the most important antenatal risk factor for VLBW followed by multiple gestations in 25.2%. Common morbidities in VLBW neonates are Neonatal jaundice, Probable sepsis, Apnea of prematurity and RDS. Survival improved with increasing gestational age and weight.Conclusions: Birth weight and gestational age specifically predicts survival of preterm VLBW babies, facilitating decision making for obstetricians, neonatologists and parents. In the present study total survival rate was 86.6% with a mortality of 13.4%.

Author(s):  
Arjun Chandra Dey ◽  
Farid Uddin Ahmed ◽  
Md Abdul Mannan ◽  
Laxmi Saha ◽  
Chowdhury Chiranjib Barua ◽  
...  

Background: Birth weight is the single most important determinant of survival and subsequent growth and development of the newborn. In Bangladesh there is high prevalence of low birth weight (LBW) babies and most of them are small for gestational age. The study was conducted to identify the proportion and category of the small for gestational age babies and determination of the short-term outcome with the aim to the reduction of neonatal mortality and morbidity by problem-wise intervention. Methods: This cross sectional study was conducted in the Neonatal Unit of Chittagong Medical College Hospital, Chittagong between December 2000 and July 2001. Neonates admitted into this unit weighing less than 10th percentile of weight for gestational age were included. On admission the weight was taken and gestational age was calculated using last menstrual period and Ballard score. The infants were monitored daily till discharge or death. Result: A total of 200 SGA babies were included in the study. Among 200 cases 114 were male and 86 were female. All cases were included within 24 hours of age. The anthropometric analysis of the SGA babies showed more than 80% of the SGA babies were normal in length whereas 19.5% fell below 10th percentile of normal. Seventy three percent of SGA babies were asymmetrically (disproportionate) and 27% of babies were symmetrically (proportionate) growth retarded. The main problems associated with the SGA babies were perinatal asphyxia (65.5%), sepsis (54%), jaundice (42.0%), hypothermia (31%), apnea (29%), hypoglycemia (25%), and bleeding manifestations (9%). Asymmetrical SGA babies were at higher risk of infection and jaundice. Present study revealed the mortality of SGA babies were 17% and mortality was significantly higher among the neonates from low socio-economic status and having very low birth weight, hypothermia, apnea, sepsis, bleeding manifestations, and polycythemia. Conclusion: Findings in this study could be important in identifying the areas requiring attention to improve perinatal care in order to prevent SGA babies and also to manage the problems associated with them. DOI: 10.3329/bjch.v31i1.6066 Bangladesh Journal of Child Health 2007; Vol.31(1-3): 1-7


Author(s):  
F. Al Hazzani ◽  
S. Al-Alaiyan ◽  
A. Kattan ◽  
A. Binmanee ◽  
M.B. Jabr ◽  
...  

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.


2021 ◽  
Vol 41 (1) ◽  
pp. 29-34
Author(s):  
Pareshkumar A Thakkar ◽  
Himanshu G Pansuriya ◽  
Sheela Bharani ◽  
Khushboo Kamal Taneja

Introduction: Mechanical ventilation is an important factor contributing to the reduced neonatal mortality in NICU. However, many ventilated babies are left with detrimental sequelae. This study was undertaken to know the prognostic predictors and survival outcome in the ventilated neonates. We assessed the clinical profile, outcome of mechanical ventilation and analysed the risk factors for mortality and complications resulting from mechanical ventilation. Methods: A prospective study was conducted at the NICU of a tertiary care hospital in India. The study period was from May 2015 to April 2016. Neonates who underwent mechanical ventilation and met the inclusion criteria were enrolled in the study. Their demographic profile, outcomes and risk factors were documented and analysed using appropriate statistical methods. Results: 285 neonates required mechanical ventilation during the study period. Among them, 190 were included in the study. Overall mortality was 99 out of the 190 enrolled (52%). The most common indications for mechanical ventilation were Respiratory Distress Syndrome (RDS), Meconium Aspiration Syndrome (MAS) and apnea. Risk factors contributing significantly to higher mortality of ventilated neonates were very low birth weight (VLBW), gestation of less than 32 weeks, shock, ventilator- associated complications like pneumothorax and pulmonary haemorrhage. In multiple regression analysis, very low birth weight, circulatory disturbances, pneumothorax, pulmonary haemorrhage, and higher initial FiO2 requirement were found to be independent risk factors of mortality. Conclusions: The commonest indications for mechanical ventilation were RDS and MAS. Significantly higher mortality was seen amongst VLBW, preterm neonates. Co-morbidities like circulatory disturbance, and complications like pneumothorax and pulmonary haemorrhage contributed to adverse outcomes.


2018 ◽  
Vol 5 (3) ◽  
pp. 720 ◽  
Author(s):  
Kabilan S. ◽  
Mekalai Suresh Kumar

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.


2021 ◽  
Vol 8 (6) ◽  
pp. 1027
Author(s):  
Ujjwala S. Keskar ◽  
Anjali H. Parekh

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.


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