scholarly journals Hemorrhagic Disease of Newborn: A Prospective Study of Clinical Features and Outcome.

2018 ◽  
Vol 5 (1) ◽  
pp. 3413-3417
Author(s):  
Dr Ajeet Gopchade
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Clinical Features ◽  
Early Onset ◽  
Late Onset ◽  
Coagulation Factor ◽  
Classical Type ◽  
Hemorrhagic Disease ◽  
Excellent Outcome ◽  
A Prospective Study

Background: Majority of the neonates have a transient deficiency of vitamin K dependant coagulation factors like II, VII, IX and X by 48-72 hours of life. This transient deficiency is resolved by the age of 7-10 days. This transient Vit K dependant coagulation factor deficiency may cause spontaneous bleeding in neonates such bleeding if occurs in between 2nd to 7th day of life is called classical HDN. The other 2 forms of HDN are early onset HDN (Manifesting within 24 hours) and late onset HDN (Occurring between 1-6 months of life). We conducted a prospective study of neonates admitted to our neonatology unit with hemorrhagic disease of newborn to know risk factors and outcome in neonates with HDN. Aims and Objectives: To study the clinical features and outcome of neonates with hemorrhagic disease of newborn. Materials and Methods: This was a prospective cohort study comprising of 30 neonates admitted in NICU with the diagnosis of hemorrhagic disease of newborn. HDN associated risk factors, age at presentation, Demographic profile, clinical features, complications and outcomes were studied. Appropriate statistical analysis was done. P-Value less than 0.05 was taken as statistically significant. Results:  In this study out of 30 neonates diagnosed with hemorrhagic disease of newborn there were 18 (60%) males and 12 (40 %) females with a M:F ratio of 1:0.66. The most common type of HDN was found to be classical type (53.33 %) followed by early onset (12 %) and late HDN (34.77 %). Majority of the infants (83.33%) with HDN were exclusively breastfed and most common site of bleeding were intracranial (23.33 %) and GI bleeding (23.33%). Outcome of neonates showed that 43.33 % babies recovered without any sequele, 13.33 % infants expired and remaining 43.34 % infants had some sequele at the time of discharge. Conclusion: Hemorrhagic disease of newborn is a common cause of bleeding in a well looking baby. Any well looking baby with bleeding manifestations should be considered to be having HDN (early onset, classical or late onset) unless proved otherwise. Appropriate treatment has an excellent outcome in these babies.

scholarly journals Homocysteine during the third trimester is a risk factor for preeclampsia: A prospective study

2020 ◽  
Author(s):  
Sha Chen ◽  
Hong Shen ◽  
Xueya Zhao ◽  
Jun Luo ◽  
Weiwei Cheng
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Folic Acid ◽  
Prospective Study ◽  
Vitamin B12 ◽  
Early Onset ◽  
Third Trimester ◽  
The Third ◽  
Early Onset Preeclampsia ◽  
A Prospective Study

Abstract Background: The purpose of this study was to investigate the risk factors for elevating homocysteine during pregnancy and the relative effects on preeclampsia, so as to further understand whether Hcy had predictive value for PE.Method: This is a prospective study that only covers pregnant women with singleton who received regular prenatal care from July to September 2018 exclusively at IPMCH (N=1142). Homocysteine, folic acid and vitamin B12 were tested in the 1st trimester (10-14 weeks), 2nd trimester (24-28 weeks), and 3rd trimester (30-34 weeks), respectively, and MTHFR genes (rs1801133, rs1801131, rs17367504) were detected. Therefore, the analysis of this case includes the variation in Hcy levels during pregnancy, risk factors for elevating homocysteine and the risk factors on preeclampsia.Results: (1) Homocysteine was lowest in the 1st trimester. (2) Homocysteine was negatively correlated with folic acid (r=-0.17, p<0.001) and vitamin B12 (r=-0.15, p<0.001) in the same trimester. (3) Both of heterozygous CT (p=0.025, 95% CI 0.018, 0.275) and homozygous TT (p<0.001, 95% CI 0.185, 0.501) in MTHFR rs1801133 might be risk factors that caused an increase in Hcy. G-spot mutations in MTHFR rs17367504 might be a risk factor that caused a decline in homocysteine. (4) Homocysteine in the 3rd trimester might be significantly correlated with increasing risk of preeclampsia (OR = 1.2, 95% CI 1.01,1.42), particularly early-onset preeclampsia (OR = 3.63, 95% CI 1.71,7.71) and severe preeclampsia (OR = 3.63, 95% CI 1.71,7.71).Conclusions: The variation in homocysteine level in the third trimester might be associated with preeclampsia, especially early-onset preeclampsia and severe preeclampsia, and MTHFR, folic acid and vitamin B12 might be the three critical factors responsible for the changing homocysteine levels during pregnancy.

scholarly journals Homocysteine During the Third Trimester is a Risk Factor for Preeclampsia: A Prospective Study

2020 ◽  
Author(s):  
Sha Chen ◽  
Hong Shen ◽  
Weiwei Cheng ◽  
Xueya Zhao ◽  
Jun Luo
Keyword(s):  
Risk Factors ◽  
Folic Acid ◽  
Prospective Study ◽  
Vitamin B12 ◽  
Early Onset ◽  
Severe Preeclampsia ◽  
Third Trimester ◽  
Pregnancy Risk ◽  
Early Onset Preeclampsia ◽  
A Prospective Study

Abstract Background: The purpose of this study was to investigate the risk factors for elevating homocysteine during pregnancy and the relative effects on preeclampsia.Method: This is a prospective study that only covers pregnant women withsingletonwho received regular prenatal care from July to September 2018 exclusively at IPMCH(N=1142). Homocysteine, folic acid and vitamin B12 were tested in the 1st trimester (10-14 weeks), 2nd trimester (24-28 weeks), and 3rd trimester(30-34 weeks), respectively, and MTHFR genes (rs1801133, rs1801131, rs17367504) were detected. Therefore, the analysis of this case includesthe variation in Hcylevels during pregnancy, risk factors for elevating homocysteine and the risk factors on preeclampsia.Results: (1) Homocysteinewas lowest in the 1st trimester. (2) Homocysteine was negatively correlated with folic acid (r=-0.17, p<0.001) and vitamin B12 (r=-0.15, p<0.001) in the same trimester. (3) Heterozygous CT (p=0.025, 95% CI 0.018,0.275) and homozygous TT (p<0.001, 95% CI 0.185,0.501) in MTHFR rs1801133 both caused an increase inHcy. G-spot mutations in MTHFR rs17367504 caused a decline inhomocysteine. (4) Homocysteine in the 3rd trimester significantly increased the risk of preeclampsia (OR = 1.2, 95% CI 1.01,1.42), particularly early-onset preeclampsia (OR = 3.63, 95% CI 1.71,7.71) and severe preeclampsia (OR = 3.63, 95% CI 1.71,7.71).Conclusions: The variation inhomocysteine level has a direct impact on preeclampsia,especially early-onset preeclampsia and severe preeclampsia, in the3rd trimester, and MTHFR, folic acid and vitamin B12 were the three most critical factors responsible for the changing homocysteine levelsduring pregnancy.

scholarly journals BIOFACE: A prospective study of risk factors, cognition and biomarkers in a cohort of individuals with early‐onset mild cognitive impairment at Fundació ACE

2021 ◽  
Vol 17 (S5) ◽  
Author(s):  
Ester Esteban‐De Antonio ◽  
Alba Pérez‐Cordón ◽  
Silvia Gil ◽  
Amanda Cano ◽  
Adelina Orellana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Prospective Study ◽  
Early Onset ◽  
A Prospective Study

NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Pramod P. Singhavi
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Premature Rupture ◽  
Maternal Risk ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

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