Burden and consequence of birth defects in Nepal-evidence from prospective cohort study

Abstract Background-Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal.Method-This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results-Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age <20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18-2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46-2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41-2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12-2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93-4.69). Conclusion- Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted.

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Burden and consequence of birth defects in Nepal-evidence from prospective cohort study

BMC Pediatrics ◽

10.1186/s12887-021-02525-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Prajwal Paudel ◽

Avinash K. Sunny ◽

Rejina Gurung ◽

Abhishek Gurung ◽

Honey Malla ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cohort Study ◽

Prospective Cohort Study ◽

Birth Defects ◽

Prospective Cohort ◽

Birth Defect ◽

Cleft Lip ◽

Birth Asphyxia ◽

Neonatal Infection

Abstract Background Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal. Method This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age < 20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18–2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46–2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41–2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12–2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93–4.69). Conclusion Maternal age younger than 20 years and advantaged ethnicity were risk factors of birth defects. Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted. Funding Swedish Research Council (VR).

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Burden and consequence of birth defects in Nepal-evidence from prospective observational study

10.21203/rs.3.rs-41322/v1 ◽

2020 ◽

Author(s):

Prajwal Paudel ◽

Avinash K Sunny ◽

Rejina Gurung ◽

Abhishek Gurung ◽

Honey Malla ◽

...

Keyword(s):

Risk Factors ◽

Observational Study ◽

Birth Defects ◽

Birth Defect ◽

Cleft Lip ◽

Prospective Observational Study ◽

Cleft Lip And Palate ◽

Birth Outcome ◽

Birth Asphyxia ◽

Neonatal Infection

Abstract Background-Every year an estimated 7.9 million babies are born with birth defects. Of these, more than 3 million die and a further 3.2 million suffer from a disability. In order to address this, countries require data to enable better resource allocation for prevention, management and rehabilitation of babies born with birth defects. This paper contributes to this evidence base, assessing the prevalence of birth defects, associated risk factors and health consequences in Nepal. Method-This is a prospective observational study conducted in 12 hospitals in Nepal for 18 months. All the women who delivered in the hospitals during the study period were enrolled. Independent researchers collected social and demographic data using semi-structured questionnaires at the time of discharge. Clinical events and birth outcome information were extracted from clinical case notes. Data were analysed to determine the prevalence and type of birth defect. Logistic regression was performed to assess risk factors and health outcomes of babies born with a birth defect. Results-Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The most common birth defects observed were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of having a baby with a birth defect was higher for mothers younger than 20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18-2.28) and those from disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46-2.18). The odds of birth asphyxia was almost double for babies with birth defect (aOR 1.88; 95% CI, 1.41-2.51) when compared to babies without a birth defect. The odds of neonatal infection was nearly double for babies with birth defect (aOR 1.82; 95% CI, 1.12-2.96) compared to babies without a defect. Babies with a birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93-4.69). Conclusion- Babies with birth defect have a higher risk of birth asphyxia, neonatal infection and pre-discharge mortality at birth. A portion of birth defect could have been prevented through micro-nutrient supplementation, a portion can be managed through surgery and rehabilitation. Funding-Swedish Research Council (VR)

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The Effect Of Honey Give As Oral Drops In Precipitating Epithelialization Of Lateral Palatal Defects Post TwoFlap Palatoplasty

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i5.105 ◽

1970 ◽

Vol 1 (5) ◽

Cited By ~ 1

Author(s):

Prasetyanugraheni Kreshanti ◽

Gentur Sudjatmiko ◽

Kristaninta Bangun

Keyword(s):

Cohort Study ◽

Retrospective Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Wound Contraction ◽

Long Run ◽

Common Technique ◽

Maxillary Growth

Background : Two-flap palatoplasty, which is a very common technique used including in our institution, will result in lateral palatal defects without any periosteal coverage. Faster epithelialization is expected to decrease wound contraction thus reducing scar formation, and in the long run will result in good maxillary growth. In our institution, the retrospective study showed a fair maxillary growth (mean GOSLON score=3.5). Thus, we explore possibilities to precipitate the epithelialization process in pursuit of good maxillary growth in the future.Method :This is a prospective cohort study conducted in Cipto Mangunkusumo Hospital, on consecutive patients who underwent two-flap palatopasty from October 2010-February 2011. We followed up these patients weekly for 4 consecutive weeks to observe the rate of epithelialization of the lateral palatal defects.Result : Two-flap palatoplasty was performed in 48 patients, 23 among them were given honey as oral drops. Eighty-seven point five percent had unilateral complete cleft lip and palate and 12.5% had bilateral complete cleft lip and palate. Faster epithelialization of the lateral palatal defects post two-flap palatoplasty was significantly in!uenced by intraoral honey application on the wound as oral drops (RR 2.1, 95% CI 1.314 - 3.391, p < 0.001).Conclusion: Honey given as oral drops significantly precipitates the epithelialization process of the lateral palatal defects post two flap palatoplasty 2.1 times faster.

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Substance-induced psychosis as a risk factor for unipolar depression or anxiety disorders: A nationwide register-based prospective cohort study

Journal of Affective Disorders ◽

10.1016/j.jad.2021.09.004 ◽

2021 ◽

Author(s):

Carsten Hjorthøj ◽

Benjamin Arnfred ◽

Silke Behrendt ◽

Stine Bjerrum Møller ◽

Merete Nordentoft

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Anxiety Disorders ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Unipolar Depression

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Rapid Weight Change Over Time Is a Risk Factor for Adverse Outcomes in Patients With Predialysis Chronic Kidney Disease: A Prospective Cohort Study

Journal of Renal Nutrition ◽

10.1053/j.jrn.2021.01.026 ◽

2021 ◽

Author(s):

Hyunjin Ryu ◽

Yeji Hong ◽

Eunjeong Kang ◽

Minjung Kang ◽

Jayoun Kim ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Risk Factor ◽

Cohort Study ◽

Kidney Disease ◽

Prospective Cohort Study ◽

Weight Change ◽

Prospective Cohort ◽

Adverse Outcomes ◽

Change Over Time ◽

Over Time

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Travel style is a major risk factor for diarrhoea in India: a prospective cohort study

Clinical Microbiology and Infection ◽

10.1016/j.cmi.2015.03.005 ◽

2015 ◽

Vol 21 (7) ◽

pp. 676.e1-676.e4 ◽

Cited By ~ 6

Author(s):

V.M. Schindler ◽

V.K. Jaeger ◽

L. Held ◽

C. Hatz ◽

S. Bühler

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Major Risk Factor

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Risk Factors for the Occurrence and Protraction of Anterior Knee Pain in Children and Adolescents: a Prospective Cohort Study of 3 Years

10.21203/rs.3.rs-1095827/v1 ◽

2021 ◽

Author(s):

Manato Horii ◽

Ryuichiro Akagi ◽

Sho Takahashi ◽

Shotaro Watanabe ◽

Yuya Ogawa ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cohort Study ◽

Children And Adolescents ◽

Knee Pain ◽

Prospective Cohort Study ◽

Anterior Knee Pain ◽

Prospective Cohort ◽

Activity Level ◽

Anterior Knee

Abstract Background: Anterior knee pain (AKP) is a common limitation to children’s participation in social and physical activities. Therefore, to prevent the occurrence and protraction of AKP, it is crucial to identify risk factors. The purpose of this study was to clarify the factors associated with the occurrence and protraction of AKP in children and adolescents. Method: A three-year prospective cohort study was conducted with children and adolescents aged 8–14 in Japan. We recorded the occurrence of AKP, heel buttock distance, straight leg raising angle (SLRA), dorsiflexion angle of the ankle joint, and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS). Logistic regression analysis was performed to calculate the odds ratio (OR) for each predicted risk factor for the occurrence and protraction of AKP among subjects without AKP at baseline. Results: We recruited 1,254 children and adolescents for the present study, and 1,133 children and adolescents who did not have AKP at baseline were included in the analysis. Six to nine percent of the subjects developed AKP annually. A high HSS Pedi-FABS score significantly predicted AKP occurrence (in 2017, OR 1.07, 95% CI 1.02−1.12, p = 0.003; in 2018, OR 1.05, 95% CI 1.01−1.10, p = 0.025). Of the participants, 32.9% developed chronic AKP during the follow-up period. When 8-year-old was used as a reference age, 13-year-old subjects (right side, OR 2.37, 95% CI, 1.00−5.61, p = 0.05) and 14-year-old subjects (right side, OR 2.57, 95% CI, 1.00−6.60, p = 0.049; left side, OR 6.32; 95% CI 1.33−30.00, p = 0.020) were at a significantly higher risk of AKP protraction. Conclusions: This study showed that a greater physical activity level was a risk factor for the onset of anterior knee pain in childhood. In addition, one-third of the children and adolescents developed chronic knee pain, and elderly adolescents were at a higher risk of protraction.

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