Apgar Score and Umbilical Cord pH as Prognostic Predictors in Very Low Birth Weight Premature Neonates

2020 ◽  
Author(s):  
Bernard Barzilay ◽  
Miri Ratner ◽  
Haim Bibi ◽  
Ibrahim Abu-Kishk
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Apgar Score ◽  
Very Low Birth Weight ◽  
Medical Center ◽  
Correlation Coefficients ◽  
Complication Score ◽  
Umbilical Cord Ph

Abstract Objective To estimate the reliability of the Apgar score (AS) and umbilical cord pH (UCP) as prognostic tools among very low birth weight (VLBW) infants. Study Design Retrospective study based on data of 1237 VLBW neonates born between 1997 and 2013 at one tertiary medical center. For each newborn, a complication score (CS) was calculated based on common complications of prematurity. Results The AS at 1 and 5 minutes correlated well with CS (correlation coefficients -0.47 and -0.52, respectively). No significant correlation was found between UCP and CS (correlation coefficient -0.08). Multi regression analysis revealed that the variables with the greatest prognostic contribution were birth weight, gestational age and prenatal steroid administration (beta values 0.277, 0.251 and 0.087, respectively). Conclusion The AS at 1 and 5 minutes, but not UCP, combined with gestational age, birth weight, and prenatal steroids, can be significant parameters for predicting prognosis among VLBW neonates.

scholarly journals Effects of Hypertensive Disorders of Pregnancy On The Mortality and Complications in Very Low Birth Weight Neonates

2021 ◽  
Author(s):  
Baoquan Zhang ◽  
Xiujuan Chen ◽  
Changyi Yang ◽  
Huiying Shi ◽  
Wenlong Xiu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Risk Factor ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Apgar Score ◽  
Very Low Birth Weight ◽  
Fetal Distress ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Abstract Purpose This study was designed to investigate the effects of hypertensive disorders of pregnancy (HDP) on the mortality and complications in very low birth weight neonates. Methods Premature infants at a gestational age of < 37 weeks with a birth weight of < 1,500g were included in this retrospective analysis. Gestational age-matched pregnant women with normal blood pressure giving birth to a very low birth weight neonate served as normal control. HDP neonates were divided into three subgroups based on the disease severity, including gestational hypertension, pre-eclampsia and eclampsia. Then we compared the incidence of complications among three subgroups. We also analyzed the relationship between the subgroups and the neonatal prognosis. Results The incidence of fetal distress, small for gestational age (SGA), mechanical ventilation, neonatal respiratory distress syndrome (RDS), neonatal necrotizing enterocolitis (NEC, ≥ 2 stage), and mortality in HDP group were significantly higher than those of the control. The 1 min Apgar score in HDP group was significantly lower than that of the normal control (P < 0.05). There were significant differences in fetal distress, 1 min Apgar score, mechanical ventilation, RDS and NEC (≥ 2 stage) among HDP, pre-eclampsia and eclampsia subgroups (P < 0.05). Multivariate regression analysis indicated that pre-eclampsia was an independent risk factor for SGA (OR = 4.123, 95%CI: 2.783–6.109) and NEC (OR = 2.493, 95%CI: 1.161–5.351). Eclampsia was a risk factor for SGA (OR = 3.804, 95%CI: 1.239–11.681) and NEC (OR = 7.264, 95%CI: 1.771–29.797). Conclusions HDP may affect the prognosis of very low birth weight neonates. Pre-eclampsia and eclampsia were risk factors for SGA and NEC.

scholarly journals Hypothermia and neonatal morbimortality in very low birth weight preterm infants

2022 ◽  
Vol 40 ◽  
Author(s):  
Rafaelle Cristine Oliveira Cordeiro ◽  
Daniela Marques de Lima Mota Ferreira ◽  
Heloísio dos Reis ◽  
Vivian Mara Gonçalves de Oliveira Azevedo ◽  
Airan dos Santos Protázio ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cesarean Delivery ◽  
Preterm Infants ◽  
Gestational Age ◽  
Apgar Score ◽  
Very Low Birth Weight ◽  
Delivery Room ◽  
Inverse Association ◽  
Axillary Temperature

ABSTRACT Objective: To assess the prevalence of hypothermia in the delivery room, at admission, and 2 to 3 hours after admission in the neonatal intensive care unit (NICU), factors associated and possible relationship with morbidity and mortality in preterm infants with very low birth weight (VLBW). Methods: Cross-sectional study with data collection based on a retrospective review of medical records and including infants born in 2016 and 2017, with birth weights <1500g, and gestational ages <34 weeks. Data about VLBW preterm infants, maternal data and temperature in the delivery room were analyzed. Hypothermia was considered when axillary temperature <36°C. For statistical analysis, the chi-square test or G test, canonical and Spearman correlation, and logistic regression were used. Results: 149 newborns (NB) were included in the study. The prevalence of hypothermia in delivery room, at admission to the NICU and 2 to 3 hours after admission was 25.8%, 41.5% and 40.2%, respectively. The temperature of NBs was directly proportional to gestational age (p<0.010), birth weight (p<0.010), and Apgar score (p<0.050). There was an inverse association with hypothermia in the delivery room and cesarean delivery (OR 0.25; p=0.016). Conclusions: Hypothermia was a prevalent problem in the studied population. The neonatal temperature was directly proportional to gestational age, birth weight and Apgar score. Hypothermia was associated with maternal factors, such as cesarean delivery. It is necessary to implement and improve strategies for its prevention.

scholarly journals PREDICTOR VARIABLES OF NEONATAL MORTALITY IN VERY-LOW-BIRTH-WEIGHT INFANTS

2021 ◽  
Vol 9 (06) ◽  
pp. 163-171
Author(s):  
Cristina Amaral Calixto ◽  
◽  
Nathalia Macedo Marteletto ◽  
Priscila da Silva Azevedo Leite ◽  
Paulo Sergio Leite ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Apgar Score ◽  
Maternal Age ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Kaplan Meier ◽  
Type Of Delivery

The aim of this study is to investigate the mortality profile in very-low-birth-weight infants, as well as model the association of some variables with neonatal mortality, in order to detect possible preventable causes of death. This retrospective cross-sectional study included a total of 109 Very-Low-Weight-Infants admitted to a Neonatal Intensive Care Unit in a municipality in Minas Gerais, Brazil, between January 2012 and December 2016. The neonates were divided into two groups: death and non-death. Frequency distributions were constructed for the variables maternal age, sex, birth weight, gestational age, type of delivery, asphyxia (Apgar at five minutes), administration of antenatal corticosteroids, hypothermia, twinning, and amniotic membrane rupture. The survival curve was plotted using the Kaplan-Meier non-parametric estimator, and theassociation between death and the observed explanatory variables was modeled via Logistic Regression. In the survivor group, most infants exhibited normothermia and weight ≥1,000g. As for the death group, weight below 1,000g and hypothermic infants were predominant. In both groups, maternal age between 18 and 35 years prevailed, as well as the male sex, gestational age of 224 days, cesarean delivery, and fifth minute Apgar scores ≥7. The survival rate, estimated using the Kaplan-Meier method, showed a decrease from 1.0 to 0.55 at the beginning of the observation period. The adjusted logistic regression model included fetal weight and the fifth minute Apgar score. No significant relationship was found between death and the variables type of delivery, hypothermia, and antenatal corticosteroid use.Logistic regression indicated a high probability of death associated with birth weight and the Apgar score at five minutes. The low association with the other variables may be related to the good quality of prenatal, intrapartum, and postpartum care provided in the region and the analyzed hospital.

scholarly journals Single-course antenatal corticosteroids is related to faster growth in very-low-birth-weight infant

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiajia Jing ◽  
Yiheng Dai ◽  
Yanqi Li ◽  
Ping Zhou ◽  
Xiaodong Li ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Postnatal Growth ◽  
Weight Increase ◽  
Antenatal Corticosteroids ◽  
Lung Maturation ◽  
Growth Outcomes

Abstract Background Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants. Methods A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes. Results A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed. Conclusions Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.

scholarly journals Pregnancy Outcome during the First COVID 19 Lockdown in Vienna, Austria

2021 ◽  
Vol 18 (7) ◽  
pp. 3782
Author(s):  
Sylvia Kirchengast ◽  
Beda Hartmann
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Negative Effects ◽  
Gestational Length ◽  
Live Births

The COVID 19 pandemic represents a major stress factor for non-infected pregnant women. Although maternal stress during pregnancy increases the risk of preterm birth and intrauterine growth restriction, an increasing number of studies yielded no negative effects of COVID 19 lockdowns on pregnancy outcome. The present study focused on pregnancy outcome during the first COVID 19 lockdown phase in Austria. In particular, it was hypothesized that the national lockdown had no negative effects on birth weight, low birth weight rate and preterm birth rate. In a retrospective medical record-based single center study, the outcome of 669 singleton live births in Vienna Austria during the lockdown phase between March and July 2020 was compared with the pregnancy outcome of 277 live births at the same hospital during the pre-lockdown months of January and February 2020 and, in addition, with the outcome of 28,807 live births between 2005 and 2019. The rate of very low gestational age was significantly lower during the lockdown phase than during the pre-lockdown phase. The rate of low gestational age, however, was slightly higher during the lockdown phase. Mean birth weight was significantly higher during the lockdown phase; the rates of low birth weight, very low birth weight and extremely low birth weight were significantly lower during the lockdown phase. In contrast, maternal gestational weight gain was significantly higher during the lockdown phase. The stressful lockdown phase in Austria seems to have no negative affect on gestational length and newborn weight among non-infected mothers.

scholarly journals Late-Onset Enterobacter cloacae Sepsis in Very-Low-Birth-Weight Neonates: Experience in a Medical Center

2009 ◽  
Vol 50 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Hsiao-Neng Chen ◽  
Meng-Luen Lee ◽  
Wai-Kit Yu ◽  
Yue-Wen Lin ◽  
Lon-Yen Tsao
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Medical Center ◽  
Enterobacter Cloacae

28-Day Survival Rates of 6676 Neonates With Birth Weights of 1250 Grams or Less

PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 7-17
Author(s):  
Dale L. Phelps ◽  
David R. Brown ◽  
Betty Tung ◽  
George Cassady ◽  
Richard E. McClead ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Very Low Birth Weight ◽  
Survival Rates ◽  
Survival Advantage ◽  
Lower Birth Weight ◽  
Single Birth

Survival rates specific for birth weight, gestational age, sex, and race are described for 6676 inborn neonates who weighed less than 1251 g at birth and were born during 1986 through 1987. Overall 28-day survival increased with gestational age and birth weight, from 36.5% at 24 weeks' gestation to 89.9% at 29 weeks' gestation, or from 30.0% for neonates of 500 through 599 g birth weight to 91.3% for neonates of 1200 through 1250 g. The expected birth weight-specific survival advantage for female neonates and black neonates diminished when the data were controlled for gestational age, showing that certain previously reported survival advantages are based on lower birth weight for a given gestational age. Multivariate analysis showed that all tested variables were significant predictors for survival, in order of descending significance: gestational age and birth weight, sex, race, single birth, and small-for-gestational-age status. The powerful effect of gestational age on survival highlights the need for an accurate neonatal tool to assess the gestational age of very low birth weight neonates after birth.

scholarly journals Hypoglycaemia in the Newborn

PRILOZI ◽  
2017 ◽  
Vol 38 (2) ◽  
pp. 79-84
Author(s):  
Orhideja Stomnaroska ◽  
Elizabeta Petkovska ◽  
Sanja Ivanovska ◽  
Snezana Jancevska ◽  
Dragan Danilovski
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Gestational Age ◽  
Apgar Score ◽  
Significant Positive Correlation ◽  
High Birth Weight ◽  
Neonatal Hypoglycaemia ◽  
Maternal Risk ◽  
Positive Correlation

Abstract Aim: Severe neonatal hypoglycaemia (HG) leads to neurologic damage, mental retardation, epilepsy, impaired cardiac performance and muscle weakness. The aim was to assess the frequency and severity of HG in a population of newborns. Patients and methods: We investigated 739 patients with neonatal hypoglycaemia (HG) (M:F=370:369) born at the University Clinic for Gynaecology and Obstetritics in Skopje in the period 2014-2016 and treated at the neonatal intensive care unit (NICU). 1416 babies were treated in the same period in NICU, and HG was observed in 52.18%. The birth weight was dominated by children with low birth weight: very low birth weight (VLBW)(<1500g) 253 children, (34,23%), low birth weight (1500-2500g) 402 (54.39%), appropriate for gestational age (AGA) 78(10.55%), and high birth weight (>4000g) 6 babies (0.81%). The gestational age was also dominated by children with low gestational age: gestational week (GW) 20-25 four children (0.54%), 26-30 GW 133 babies (17.99%), 31-35 GW472 (63.87%), and 36-40 GW130 neonates (17.59 %). 241 mothers (32.61%) have had an infection during pregnancy, 82 preeclampsia or eclampsia (11.09%), 20 diabetes mellitus (2.70%), 78 placental situations (placenta previa, abruption) (10.55%). In this study 47 babies (6.35%) with HG and co-morbidities died. There was a significant positive correlation between HG birth weight (p<0.01), gestational age (p<0.05), and the lowest Apgar score (p<0.01). Neonatal deaths were significantly correlated with GA (р>0,01), co-morbidities of the mothers (р>0,05) but not with the birth weight (р>0,05). In contrast, a significant positive correlation was found between convulsions and body weight (р<0.05). The lowest Apgar score was positively correlated with the gestational age (0.01), but not with the birth weight (0.05). Conclusion: Low birth weight, low gestational age, maternal risk factors, hypoxic-ischemic encephalopathy and neonatal infections are associated with HG and are a significant factor in overall neonatal mortality. Those results indicate that diminishing the frequency of the neonatal HG and the rates of neonatal mortality requires complex interaction of prenatal and postnatal interventions.

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