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 Intraventricular hemorrhage in very low birth weight infants: associated risk factors and outcome in the neonatal period

1999 ◽  
Vol 54 (5) ◽  
pp. 151-154 ◽  
Author(s):  
Monique Catache Mancini ◽  
Naila Elias Barbosa ◽  
Débora Banwart ◽  
Sandra Silveira ◽  
José Luiz Guerpelli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Periventricular Leukomalacia ◽  
Associated Risk Factors ◽  
Length Of Hospitalization

Intraventricular hemorrhage (IVH) is a severe complication in very low birth weight (VLBW) newborns (NB). With the purpose of studying the incidence of IVH, the associated risk factors, and the outcomes for these neonates, we studied all the VLBW infants born in our neonatal unit. Birth weight, gestational age, presence of perinatal asphyxia, mechanical ventilation, length of hospitalization, apnea crisis, hydrocephalus, and periventricular leukomalacia were analyzed. The diagnosis of IVH was based on ultrasound scan studies (Papile's classification) performed until the tenth day of life and repeated weekly in the presence of abnormalities. Sixty-seven/101 neonates were studied. The mortality rate was 30.6% (31/101) and the incidence of IVH was 29.8% (20/67) : 70% grade I, 20% grade III and 10% grade IV. The incidence of IVH in NB <1,000 g was 53.8% (p = 0.035) and for gestational age <30 weeks was 47.3% (p = 0.04), both considered risk factors for IVH. The length of hospitalization (p = 0.00015) and mechanical ventilation (p = 0.038) were longer in IHV NB. The IVH NB had a relative risk of 2.3 of developing apnea (p = 0.02), 3.7 of hydrocephalus (p = 0.0007), and 7.7 of periventricular leukomalacia (p < 0.00001). The authors emphasize the importance of knowing the risk factors related to IVH so as to introduce prevention schemes to reduce IVH and to improve outcomes of affected newborns.

A Retrospective Cohort Study on Mortality and Neurodevelopmental Outcomes of Preterm Very Low Birth Weight Infants Born to Mothers with Hypertensive Disorders of Pregnancy

2021 ◽  
Author(s):  
Yumi Kono ◽  
Naohiro Yonemoto ◽  
Hidehiko Nakanishi ◽  
Shigeharu Hosono ◽  
Shinya Hirano ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Research Network ◽  
Hypertensive Disorders Of Pregnancy ◽  
Neurodevelopmental Outcomes ◽  
Vlbw Infants ◽  
Growth Status ◽  
Intrauterine Growth ◽  
Hypertensive Disorders

Objective We examined the effects of maternal hypertensive disorders of pregnancy (HDP) on the mortality and neurodevelopmental outcomes in preterm very low birth weight (VLBW) infants (BW ≤1,500 g) based on their intrauterine growth status and gestational age (GA). Study Design We included singleton VLBW infants born at <32 weeks' gestation registered in the Neonatal Research Network Japan database. The composite outcomes including death, cerebral palsy (CP), and developmental delay (DD) at 3 years of age were retrospectively compared among three groups: appropriate for GA (AGA) infants of mothers with and without HDP (H-AGA and N-AGA) and small for GA (SGA) infants of mothers with HDP (H-SGA). The adjusted odds ratios (AOR) and 95% confidence intervals (CI) stratified by the groups of every two gestational weeks were calculated after adjusting for the center, year of birth, sex, maternal age, maternal diabetes, antenatal steroid use, clinical chorioamnionitis, premature rupture of membranes, non-life-threatening congenital anomalies, and GA. Results Of 19,323 eligible infants, outcomes were evaluated in 10,192 infants: 683 were H-AGA, 1,719 were H-SGA, and 7,790 were N-AGA. Between H-AGA and N-AGA, no significant difference was observed in the risk for death, CP, or DD in any GA groups. H-AGA had a lower risk for death, CP, or DD than H-SGA in the 24 to 25 weeks group (AOR: 0.434, 95% CI: 0.202–0.930). The odds for death, CP, or DD of H-SGA against N-AGA were found to be higher in the 24 to 25 weeks (AOR: 2.558, 95% CI: 1.558–3.272) and 26 to 27 weeks (AOR: 1.898, 95% CI: 1.427–2.526) groups, but lower in the 30 to 31 weeks group (AOR: 0.518, 95% CI: 0.335–0.800). Conclusion There was a lack of follow-up data; however, the outcomes of liveborn preterm VLBW infants of mothers with HDP depended on their intrauterine growth status and GA at birth. Key Points

scholarly journals Morbidity and mortality pattern of very low birth weight infants admitted in SNCU in a South Asian tertiary care centre

2018 ◽  
Vol 5 (3) ◽  
pp. 720 ◽  
Author(s):  
Kabilan S. ◽  
Mekalai Suresh Kumar
Keyword(s):  
Mechanical Ventilation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Normal Vaginal Delivery ◽  
Vlbw Infants ◽  
The Mean

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.

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 Is being small for gestational age a risk factor for retinopathy of prematurity? A study with 345 very low birth weight preterm infants

2009 ◽  
Vol 85 (1) ◽  
pp. 48-54 ◽  
Author(s):  
João Borges Fortes Filho ◽  
Fabiana Borba Valiatti ◽  
Gabriela Unchalo Eckert ◽  
Marlene Coelho da Costa ◽  
Rita C. Silveira ◽  
...  
Keyword(s):  
Risk Factor ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Small For Gestational Age ◽  
Very Low Birth Weight

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.

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 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.

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