scholarly journals A retrospective study of predisposing factors and outcome of persistant pulmonary hypertension among newborns at rural tertiary care centre

2020 ◽  
Vol 8 (1) ◽  
pp. 92
Author(s):  
B. C. Yelamali ◽  
Gangadhar S. Mirji ◽  
Mirnalini Rajput
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Retrospective Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Birth Asphyxia ◽  
Male Gender ◽  
Predisposing Factors ◽  
Positive Pressure ◽  
Increased Risk

Background: Persistent pulmonary hypertension in newborns (PPHN) remains a significant cause of perinatal morbidity and mortality. Early recognition of factors that increase the risk of PPHN is of great importance in either to prevent or to treat PPHN optimally. Aim was to study the neonatal predisposing factors, profile and outcome of PPHN.Methods: This retrospective study was conducted in level III neonatal care unit, a rural referral centre of North Karnataka, India from January 2018 to April 2020.Results: During the study period a total of 50 infants with PPHN were identified with the incidence of 5.43/1000 live births. Mean gestation age (±SD) was 38.28±2.49 weeks and mean birth weight (±SD) was 2624±512 gm. The most noted risk factors were meconium aspiration syndrome (42%), birth asphyxia (16%), RDS (10%), positive pressure ventilation at birth (52%) and male gender (62%). Out of 50 infants with PPHN, high mortality was seen in low birth weight babies (66.6%). Use of sildenafil showed increased mortality (56.2%) whereas use of surfactant scored better with decreased mortality of 42.8%.Conclusions: Major risk factors for PPHN are MAS, birth asphyxia, RDS and low birth weight. Poor prognosis is seen in male gender, prematurity and CDH with increased risk of mortality. The use of systemic pulmonary vasodilators can be considered with caution and use of surfactant has a role in management of PPHN.

scholarly journals Clinical profile and factors determining outcome of intramural very low birth weight babies in a tertiary care centre: a retrospective study

2017 ◽  
Vol 5 (2) ◽  
pp. 520
Author(s):  
Devi Meenakshi K. ◽  
Arasar Seeralar A. T. ◽  
Srinivasan Padmanaban
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Logistic Regression Analysis ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
P Value ◽  
Increased Risk

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality.

scholarly journals Risk Factors and Outcome of Neonatal Thrombocytopenia

2020 ◽  
Vol 24 (3) ◽  
pp. 229-234
Author(s):  
Hira Arif ◽  
Nadeem Ikram ◽  
Shangraf Riaz ◽  
Asma Nafisa
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Birth Asphyxia ◽  
P Value ◽  
Maternal Risk ◽  
Significant Difference ◽  
Neonatal Thrombocytopenia ◽  
A Prospective Study

Introduction: About 30% of neonates develop thrombocytopenia during hospital admission. Inevitable and irreversible complications can be prevented by determining the risk factors of neonatal thrombocytopenia. The present study was undertaken to determine the risk factors and outcome of neonatal thrombocytopenia in neonates admitted to Neonatal Intensive Care Unit Benazir Bhutto Hospital Rawalpindi. Materials and Methods: A prospective study was conducted to evaluate the risk factors for neonatal thrombocytopenia (NT) in 160 neonates. Neonatal and maternal risk factors were recorded and neonates were categorized into three groups based on the severity of thrombocytopenia. Results: A higher percentage of the neonates 89 (55.6%) were male. The majority (61.9%) had moderate neonatal thrombocytopenia while 21.9% had severe neonatal thrombocytopenia. A highly significant difference was observed for the distribution of gestational age, platelet count, birth weight, and age at admission (for all p-value ≥0.0001) among different groups. Multivariate logistic regression revealed a significant independent association of prematurity, birth asphyxia, and low birth weight with neonatal thrombocytopenia. Conclusion: Prematurity, low birth weight, and birth asphyxia were the significant causes of Neonatal thrombocytopenia. The mortality rate increased significantly with the severity of thrombocytopenia.

scholarly journals Clinical profile of Candidiasis in neonates

2017 ◽  
Vol 4 (5) ◽  
pp. 1875
Author(s):  
Latha G. S. ◽  
Veeresh Babu D. V. ◽  
Thejraj H. K.
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Birth Asphyxia ◽  
Central Venous Catheters ◽  
Clinical Profile ◽  
Central Venous ◽  
Factors Associated

Background: Opportunistic infections are increasing in Neonatal Intensive Care Unit (NICU). Neonates often have compromised skin integrity, gastrointestinal tract disease, chronic malnutrition, central venous catheters, long term endotracheal intubation and other factors that lead to increased risk of acquiring such infections. Infections with fungi (candida) and with coagulase-negative staphylococci (CoNS) are especially prevalent. The need of study is to know the clinical profile of candidiasis in neonates in our setup and to determine associated risk factors of candidiasis.Methods: The present study was undertaken by Dept of paediatrics, SSIMS and RC Davangere among 296 neonates of which 96 babies admitted in NICU and 200 were in PNC ward to study clinical profile of candidiasis in neonates and risk factors associated with them. Parents of 296 babies were interviewed using preformed study proforma. Clinical examination was done and investigations included KOH examination of oral swab, Gram stain of the swab and blood culture of suspected sepsis babies. There are several factors associated with development of neonatal candidiosis. Of them, prematurity, LBW, perinatal birth asphyxia, long term antibiotics, central venous catheters, mechanical ventilation, septicemia, played a major role in development of candidosis.Results: In the present study, incidence of candidiasis in neonates revealed 13.8% of babies admitted in NICU. Male babies out numbered the female babies in incidence of candidiasis in neonates. Males formed 69% and females 31% of positive cases. Most of neonates admitted in NICU (96) were of low birth weight between 1.5kg to 2.5 kg. Out of which most of cases positive for candidiasis/candidemia were belonged to 1.0-1.5 kg. In present study, 13 babies were positive for candidiasis, of which 5 babies (38.3%) were of birth weight between 1-1.5kg. Birth asphyxia alone or with mechanical ventilation played an important risk factor in development of candidiasis in neonates. In present study, birth asphyxia and mechanical ventilation per se had played a significant role in development of candidiasis in neonates admitted in NICU.Conclusions: The present study revealed the clinical profile of candidiasis in neonates associated with various risk factors. Study shows that low birth weight, birth asphyxia and mechanical ventilation were significant risk factors for candidiasis in neonates. Blood cultures were positive in babies without mucosal lesions suggesting the importance of diagnosing fungal sepsis. 

scholarly journals Predictors of mortality in extramural very low birth weight neonates: a prospective observational study

2020 ◽  
Vol 8 (1) ◽  
pp. 107
Author(s):  
Rajkumar M. Meshram ◽  
Ruchi A. Gedam ◽  
Shivangi Garg ◽  
Kalyani S. Kadu ◽  
Madhabika R. Chakraborty ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Vaginal Delivery ◽  
Very Low Birth Weight ◽  
Mode Of Delivery ◽  
Home Delivery ◽  
Male Gender ◽  
Independent Risk Factors

Background: Over the past few decades, the burdens of very low birth weight (VLBW) preterm infants are increasing due to advances in obstetrics and perinatal services. Objectives of the study were to assess predictors of mortality of extramural VLBW neonates.Methods: Prospective one year cohort study was undertaken on VLBW neonates fulfilling the inclusion criteria at a tertiary institute. Maternal and neonatal demographic data were analyzed.Results: Male to female ratio was 1.26:1. One hundred and thirty seven (74.9%) neonates had birth weights from 1000-1499 g while 46 (25.1%) had birth weights <1000 g (ELBW) and 90% were preterm. One hundred and sixty five (90.2%) neonates were admitted in early neonatal period. Anaemia was the commonest maternal illness and preeclampsia/eclampsia was the most common obstetric complication. Respiratory distress, temperature instability and lethargy were common clinical presentations. Respiratory distress, sepsis and perinatal asphyxia were common diagnoses on admission. Mortality rate in VLBW neonates was 59.6% and respiratory distress was the commonest cause of death. Male gender (p=0.01), home delivery (p=0.04), vaginal delivery (p=0.05) and positive septic screen (p=0.003) had significantly higher mortality while mode of delivery (aOR 0.27 CI 0.086-0.83 p=0.02) and positive septic screen (aOR 4.0 CI 1.67-9.84 p=0.002) were independent risk factors for mortality.Conclusions: In extramural VLBW neonates, male gender, home delivery, vaginal delivery and positive septic screen had significantly higher mortality whilst mode of delivery and positive septic screen were independent risk factors for mortality.

Incidence of hearing impairment in at risk babies

2021 ◽  
Vol 8 (4) ◽  
pp. 293-297
Author(s):  
Bhagya V ◽  
Manjushree R ◽  
Brid S V
Keyword(s):  
Risk Factors ◽  
Hearing Loss ◽  
Birth Weight ◽  
High Risk ◽  
Low Birth Weight ◽  
Hearing Impairment ◽  
Birth Asphyxia ◽  
Hearing Sensitivity ◽  
Medical College ◽  
Neonatal Convulsions

Babies treated in neonatal intensive care are prone for hearing problems and with the decrease in infant mortality, babies who survive many perinatal risk factors are increasing. Deafness in 1st three years of life may impair the full development & maturation of auditory system & it is well known that deafness in infancy & childhood interferes with normal development of speech & language. To prevent this & to initiate rehabilitative procedure as early in life as possible a screening method to detect auditory disabilities in newborns is of great importance. Based on this background the present study determine to evaluate to know the incidence of hearing impairment in infants at risk.This is a prospective observational study conducted in JJM Medical College, Davanagere, Karnataka. A total 940 patients attended to JJM Medical College and Hospital and diagnosed with hearing impairment according to American Joint Committee statement on infant hearing screening (JCIH) criteria. All the patients under 2 years with history of high risk factors – pre–term, low birth weight, birth asphyxia, neonatal seizures, and hyperbilirubinemia were selected for the study. Those who failed in this test underwent repeated OAE after 6 weeks, followed by brain stem evoked response audiometry (BERA) if the second OAE was negative. Out of 940 high risk cases, 350 had profound hearing loss, 83 had severe hearing loss, 125 had moderate hearing impairment, 36 had mild hearing impairment &346 had normal hearing sensitivity. Out of 48 patients with normal hearing sensitivity, 53 patients were preterm, 166 had hyperbilirubinemia, 23 had neonatal convulsions, 68 birth asphyxia, 89 were of low birth weight. Out of 147 cases 31 patients had mild/moderate hearing impairment.Neonatal jaundice carries the highest risk of hearing impairment followed by birth asphyxia, neonatal convulsions and low birth weight.BERA is the tool which can confirm the normal sensitivity of hearing whenever required & is very useful in early detection of hearing loss and planning rehabilitative procedures.

Sociodemographic risk factors associated with low birthweight in United Arab Emirates

1996 ◽  
Vol 28 (3) ◽  
pp. 339-346 ◽  
Author(s):  
A. Bener ◽  
Y. M. Abdulrazzaq ◽  
A. Dawodu
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Antenatal Care ◽  
United Arab Emirates ◽  
Maternal Smoking ◽  
Low Birthweight ◽  
Multiple Logistic Regression Analysis ◽  
Educational Status ◽  
Increased Risk

SummaryThis case-control study was undertaken to determine socio-demographic risk factors for low birth weight in Al-Ain (United Arab Emirates) over a 12-month period in 1992–93. A total of 3485 live births occurred of which 293 (8·4%) were low birth weight. The risk factors considered were mother's occupation, house conditions, place of residence (urban or rural), maternal smoking habits, antenatal care, availability of help in the home, maternal BMI and educational status. Multiple logistic regression analysis showed that mother's occupation, maternal smoking, antenatal care, and lack of help in the home were associated with increased risk of low birth weight.

scholarly journals Clinical Study on Risk Factors and Fetomaternal Outcome of Severe Preeclampsia in Bangabandhu Sheikh Mujib Medical University

2018 ◽  
Vol 17 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Aklima Sultana ◽  
Lutfun Nahar Begam Koli ◽  
Syeda Sayeeda
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pulmonary Oedema ◽  
Birth Asphyxia ◽  
Severe Preeclampsia ◽  
Control Group ◽  
Case Group ◽  
History Of ◽  
Group 5

Background: Preeclampsia (PE) especially severe or early PE, is a leading cause of morbidity and mortality among the mothers and infants.To determine the maternal risk factors and fetomaternal outcome of severe preeclampsia. Methods: It was a case control study, done in a tertiary care hospital among 100 patients with severe preeclampsia and normal pregnant women admitted. Sampling technique were consecutive sampling methods. Singleton pregnancy between 28 to 40 weeks of gestation with severe preeclampsia were selected as study patients. Written informed consent was obtained. A questionnaire was completed for each patient including patient's age, gestational age, parity, History of hypertension in family, weight and Body Mass Index (BMI). Maternal complications before or after delivery, and perinatal outcome were also be recorded in the data sheet. Data was analyzed by SPSS-20. Results: Among the 50 cases and 50 controls regarding different risk factors age >34 years, BMI, history of precelampsia, were found significant (p<0.05) between two groups. Among the case group, patients developed eclampsia 2(4.0%) abruptio placenta 3(6.0%) HELLP syndrome 2(4.0%) ascites 4(8%) and oliguria1(2.0). But none of the control group had developed these types of complications. In case group 7(14.0%) patients developed PPH and pulmonary oedema 3(6.0%). In control group 5(10.0%) developed PPH and 1(2.0%) developed pulmonary oedema. It was observed that, in case group 5(12.5%) babies had very low birth weight (<1.5 kg) but not in control group. twenty one (52.5%) of the babies had low birth weight (<2.5 kg) in case group and 8.0% of babies had low birth weight in control group. Most 56.0% of the neonates had APGAR score 4-6 at 1 minute in case group and 12(24.0%) in control group. In case group 17(34%) babies developed birth asphyxia and 15(30.0%) of babies developed prematurity, where in control group 7(14.0%) babies developed birth asphyxia and 3(6.0%) of babies developed prematurity. 32(80.0%) newborn needed admission in neonatal care unit in case group and 10(20.0%) in control group (p<0.05). Take baby in home safely in 35(70.0%) in cases group and 50(100.0%) in control group. Early neonatal death was found in 5(10.0%) in case group and not found in control group. Still birth was 10(20.0%) case group and not found control group (p<0.05). Conclusion: Preeclampsia is a leading cause of both fetal and maternal morbidity and mortality in the developing countries. Maternal and fetal outcome are worse in severe preeclampsia. Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 23-28

scholarly journals Presentation and outcomes of early and late onset neonatal sepsis in a Nigerian Hospital

2019 ◽  
Vol 19 (3) ◽  
pp. 2390-2399
Author(s):  
Ezra Ogundare ◽  
Akinyemi Akintayo ◽  
Theophilus Aladekomo ◽  
Lateef Adeyemi ◽  
Tinuade Ogunlesi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Life Support ◽  
Late Onset ◽  
Significant Risk ◽  
Birth Asphyxia ◽  
Diffusion Method

Background: Neonatal Sepsis remains a major cause of morbidity and mortality in neonates despite great advances in antimicrobial therapy and life support measures.Objectives: To compare the aetiology, risk factors, presentation and outcomes of care between early onset neonatal sepsis (EOS) and late onset neonatal sepsis (LOS).Methods: Bacterial isolates were identified using blood cultures and antibiotic susceptibility testing was done using disc diffusion method. The risk factors, clinical presentation, laboratory findings and neonatal outcomes of the babies with EOS were compared with LOS. Statistical significance was set at P <0.05.Results: Neonatal Sepsis was responsible for 16% of Special Care Baby Unit (SCBU) admissions. Of the 72 babies with sepsis, 56 (77.8%) had EOS as against 16 (22.2%) who had late-onset sepsis. Low birth weight (p=0.01) and perinatal asphyxia (p=0.01) were significantly associated with EOS while for LOS, delivery outside the health facility (p=0.01) was the only significant risk factor. Respiratory distress was more significantly observed in EOS (p = 0.01). Neonatal deaths occurred in 32% of babies with EOS while all babies with culture positive LOS survived.Conclusion: Early onset neonatal sepsis is associated with high likelihood of neonatal mortality. Unsupervised delivery, birth asphyxia and low birth weight are risk factors associated with neonatal sepsis. Efforts to ensure supervised hospital delivery and improvement in neonatal resuscitation may reduce the incidence of neonatal sepsis and its attendant complications.Keywords: Onset neonatal , Nigerian Hospital.

scholarly journals SAT-103 Extrauterine Growth Restriction (EUGR) in Preterm Infants: Incidence, Risk Factors, Nutrition, Auxological and Neurological Outcome.A Retrospective Study from 2010 to 2016

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Marta Del Pistoia ◽  
Maria Giulia Tozzi ◽  
Alessandra Carmignani ◽  
Massimiliano Ciantelli ◽  
Rosa Teresa Scaramuzzo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Enteral Feeding ◽  
Gestational Age ◽  
Minimum Weight ◽  
Gradual Improvement ◽  
Increased Risk

Abstract EUGR is still a serious problem in very low birth weight preterm infants. The gradual improvement in neonatal intensive care has allowed the survival of newborns with increasing low weight and gestational age, with a higher incidence of major nutritional problems and diseases (Goldenberg 2008). EUGR was defined as growth parameters ≤ 10° centile at discharge, compared to the expected intrauterine growth for post-menstrual age. Recently EUGR was defined, in a dynamic way, as the reduction in anthropometric parameters z-score between birth and discharge &gt;1SD (Griffin 2016). Aims of our study were to evaluate: the incidence of EUGR, the nutritional intake, the main risk factors, the auxological and neurological outcome. We enrolled 346 newborns admitted to our NICU from 2010 to 2016 with gestational age (GA) at birth &lt; 30 weeks and/or birth weight &lt;1500 gr. Infants with malformations or syndromes were excluded. The incidence of EUGR was 73.1% for weight, 66.3% for length and 39.3% for head circumference. We observed a decrease in SD mainly during the first 14 days of life. From two weeks to discharge, no significant catch-up growth was observed. Risk factors for EUGR were: male gender, reduced GA (p=0.000), low birth weight (p=0.000), lower minimum weight achieved (p=0.000), more time to recover birth weight (p=0.000), lower growth rate per day (p=0.001), longer period of total parenteral nutrition (p=0.008), later onset of minimal enteral feeding (p=0.006), later achievement of the full enteral feeding (p=0.000), cesarean section (p=0.006), incomplete corticosteroid prophylaxis (p=0.025), postnatal steroids use (p=0.000), mechanical ventilation (p=0.000), pulmonary bronchodysplasia (p= 0.000), leukomalacia (p=0.06), patent ductus arteriosus (p=0.000), retinopathy of prematurity (p= 0.008), late onset sepsis (p= 0.09). In 197 patients post-discharge clinical follow up at 1, 3 and 24 months of correct age (CA) was performed. Around 88% of all our sample showed normal neurological development. 12% at 1 and 3 months had abnormal general movements (both writhing and fidgety movements) or absent (p = 0.001). At 24 months CA patients with abnormal/absent fidgety movements had neurological disabilities and 83% were EUGR. At 24 months, 17% had weight &lt;10th centile and all were EUGR. 25% showed an overgrowth (weight &gt;75th centile) with a probably increased risk of metabolic disease later in life. The incidence of EUGR increased over the years due to the augmentation in preterm births with lower GA. The first 14 days of life were a critical period and nutrition is known to be mandatory to promote newborns’ growth (Asbury 2019). The EUGR condition negatively affected the neurological (Chien 2018) and auxological (Takayanagi 2018, Wood 2018) outcome of preterm infants and the early recognition of this condition is extremely important in order to implement a careful and prolonged follow-up.

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