scholarly journals ASSOCIATION OF THE IMPACT OF POSTNATAL NUTRITION ON THE GROWTH OF PRETERM INFANTS <34 WEEKS GESTATIONAL AGE FROM BIRTH TO DISCHARGE

2020 ◽  
pp. 63-67
Author(s):  
JITENDRA SINGH FAUJDAR ◽  
KALPANA SINGH ◽  
RAJVEER SINGH YADAV ◽  
JITENDRA KUMAR GUPTA ◽  
MUNISH KAKKAR ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Nutritional Supplement ◽  
Preterm Neonates ◽  
Preterm Baby ◽  
Medical College ◽  
Gandhi Medical College ◽  
The Impact

Objectives: The objectives of the study were to measure the actual daily amount of each nutrient (protein, glucose, and fat) energy and fluid as per current ESPGHAN guidelines for preterm infants and to analyze the role of nutrients at different gestational age on growth and weight of preterm infants. Material and Methods: An observational and prospective cohort study was conducted from January 1, 2018, to December 31, 2018. This study included all preterm infants born <34 weeks gestational age admitted in the neonatal intensive care unit during this period at Mahatma Gandhi Medical College and Hospital. A total of 120 preterm neonates were studied. Results: There were mean weight, length, and head circumference continues to rise till the study end. Mean energy at birth was also continues to rise till the end. Conclusion: In the study, proper nutritional supplement as per ESPHAGEN guidelines was used for the development of preterm infant. The study showed that there were statistically significant results with anthropometry parameters with preterm baby growth in all domains.

ACCURACY OF TRANSCUTANEOUS BILIRUBIN MEASUREMENTS DURING PHOTOTHERAPY IN JAUNDICED PRETERM NEONATES

2021 ◽  
pp. 7-9
Author(s):  
Rajveer Singh Yadav ◽  
Nikita Singh ◽  
Gaurav Agrawal ◽  
Madhu Mathur ◽  
Munish Kumar Kakkar
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Preterm Neonates ◽  
Total Serum ◽  
Preterm Baby ◽  
Transcutaneous Bilirubin ◽  
Non Invasive ◽  
Invasive Method

Aim: It is very difcult to nd veins and also seems unethical to withdraw blood daily in a preterm baby for the monitoring of jaundice during the course of phototherapy. So it becomes essential that we nd out a method which is non-invasive and at the same time accurate to assess jaundice. Jaundice is the most common morbidity in the rst week of life, reported in 60% of term, 80% of preterm (1, 2) & also being the commonest cause of readmission. Materials and Method: Study was planned to assess the accuracy of transcutaneous bilirubin in comparison to total serum bilirubin in premature jaundiced neonates of gestational age (28-32 weeks v/s 32-37 weeks) during phototherapy. Result: Study has demonstrated reliability of TCB measurements in preterm infants during phototherapy. Gestational age, comorbidities and risk factors for jaundice did not inuence the correlation. Summary: This study reveals that Transcutaneous Bilirubin Estimation by bilirubin meter can be used as a non-invasive method for monitoring of jaundice treatment during phototherapy in preterm neonates.

scholarly journals Packed Cell Transfusion and Feeding Tolerance in Healthy Preterm Infants: A Randomized Clinical Tria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Minoo Fallahi ◽  
Mohammad Kazemian ◽  
Saeed Hojat Kashani ◽  
Saleheh Tajalli ◽  
Naeeme Taslimi
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Significant Difference ◽  
Packed Cell Transfusion ◽  
Feeding Tolerance

Background: Recently, the correlation between necrotizing enterocolitis (NEC) and packed cell transfusion (PCT) has been identified. Evidence shows that 25 - 35% of NEC cases are associated with PCT. Objectives: this study aimed to determine the association between PCT and feeding tolerance in healthy preterm newborns. Methods: Materials and Methods: This clinical trial was performed on preterm infants, admitted to the neonatal intensive care unit (NICU) of Mofid Children's Hospital, Tehran, Iran, from April 2017 to May 2018. A total of 70 healthy premature infants (birth weight < 1500 g and gestational age < 32 weeks) with enteral feeding, who required PCT, were included in this study. The eligible infants were divided into two groups by simple randomization. In the intervention group (n = 35), breastfeeding was withheld only during PCT and then continued as usual. On the other hand, in the control group (n = 35), feeding was performed as usual, regardless of PCT. Feeding tolerance within the first 72 hours post-transfusion was compared between the two groups. Sick newborns were excluded from the study. Data analysis was performed in SPSS version 20. Results: The mean gestational age, birth weight, and postnatal age of the neonates were 30.13 weeks, 1245.71 g, and 17 days in the intervention group and 29.97 weeks, 1169.43 g, and 15.46 days in the control group, respectively; there was no significant difference between the two groups. Except for pre-transfusion hemoglobin and hematocrit levels, other characteristics of the two groups were similar. Feeding tolerance was reported in 32 (91.2%), 33 (94.73%), and 34 (97.1%) newborns at 24, 48, and 72 hours post-transfusion in both groups, without any significant difference. There was no significant difference between neonates with and without feeding tolerance in either of the groups. Conclusions: According to the present results, withholding feeding during PCT is not necessary in healthy preterm neonates with a good general condition, and continued breastfeeding seems to be a safe option.

scholarly journals Efficacy of prophylactic parenteral paracetamol to decrease rate of ductus patency in preterm infants.

2021 ◽  
Vol 29 (01) ◽  
pp. 126-130
Author(s):  
Bushra Madni ◽  
Muhammad Imran ◽  
Muhammad Naveed ◽  
Fazal ur Rehman ◽  
Khurram Shahnawaz ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Case Control Study ◽  
Preterm Neonates ◽  
Case Group ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Duration Of Hospitalization ◽  
Study Setting ◽  
Control Study

Objective: To find out the effectiveness of prophylactic parenteral paracetamol to minimize rates of ductus patency among preterm infants. Study Design: Case-control study. Setting: Department of Pediatrics, Sughra Shafi Medical Complex, Sahara Medical College, Narowal, Pakistan. Period: March 2020 to February 2021. Material & Methods: A total of 70 neonates (35 cases and 35 controls) having gestational age less than or equal to 34 weeks were enrolled. All 35 cases were administered prophylactic parenteral paracetamol as 20 mg per kg stat and 7.5 mg per kg 6 hourly for 1st 3 days of life while all controls were given no drugs. Echocardiography was performed in all 70 neonates after 1st three post-natal days to identify PDA. Data was analyzed using SPSS 26.0. Results: In a total of 70 neonates, 37 (52.9%) were male and 33 (47.1%) female. Overall, mean gestational age was noted to be 32.1+1.47 weeks while mean body weight was recorded to be 1424.6+229.7 grams. There were 6 neonates (17.1%) among cases who were found to have PDA in comparison to 23 (65.7%) in controls (p<0.0001). Four (11.4%) neonates died in case group in comparison to 7 (20.0%) among controls (p=0.3245). Mean duration of hospitalization was recorded to be 20.52+8.2 days in case group in comparison to 24.81+4.6 days among controls (p=0.0088). Conclusion: Prophylactic parenteral paracetamol was found to prevent ductus patency among preterm neonates. In comparison to controls, duration of hospital stay was significantly short among neonates who were administered prophylactic parenteral paracetamol.

scholarly journals Role of neurosonography in neonates with clinically suspected intracranial pathology

2019 ◽  
Vol 7 (6) ◽  
pp. 2302
Author(s):  
Abhishek Gahlot ◽  
Anil Joshi
Keyword(s):  
Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Periventricular Leukomalacia ◽  
Preterm Neonates ◽  
Neurodevelopmental Outcomes ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Grade 3 ◽  
Ischemic Encephalopathy

Background: Preterm neonates have a higher mortality and morbidity because of their greater risk for intracranial hemorrhage (ICH), hypoxic ischemic encephalopathy(HIE) which can lead to poor neurodevelopmental outcomes. The present study was conducted to evaluate neonates with clinically suspected intracranial pathology by neurosonography.Methods: Included neonates were those with clinically suspected intracranial pathology admitted to neonatal intensive care unit of the Bharati Vidyapeeth Medical College and Hospital (Deemed to be University), Sangli from October 2018 till December 2018. First cranial neurosonography was done between first and third day, second between 7th and 10th day of birth. HIE also known as Periventricular leukomalacia (PVL) grading was done using the De Varies et al, grading. Severity of ICH was graded according to Papile and Burstein classification(1978).Results: Of the total 60 neonates, 61.7% were preterm and rest at term. Mean APGAR score at 1 minute was 8.6 (range 5 to 10) and at 5 minutes was 9.58 (range 8 to 10). Mean ventricular index at the first assessment was 26.78% and 26.89% at the second assessment. Grade 1 HIE was found in 17 neonates on first assessment, and two had grade 2 HIE. Second assessment revealed grade 1 HIE in 20 neonates and grade 2 in two. First assessment revealed two neonates with grade 1 and grade 2 ICH, out of which one grade 2 ICH worsened to grade 3. Two neonates were found to have corpus callosal agenesis.Conclusions: Transcranial neurosonography stands as an excellent and reliable investigation of choice for neonates to detect HIE,ICH and intracranial congenital anomalies.

scholarly journals Accuracy of Pulse Oximetry in the Presence of Fetal Hemoglobin—A Systematic Review

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 361
Author(s):  
Ena Pritišanac ◽  
Berndt Urlesberger ◽  
Bernhard Schwaberger ◽  
Gerhard Pichler
Keyword(s):  
Pulse Oximetry ◽  
Neonatal Intensive Care ◽  
English Language ◽  
Arterial Oxygen Saturation ◽  
Fetal Hemoglobin ◽  
Arterial Oxygen ◽  
Cochrane Library ◽  
Preterm Neonates ◽  
Neonatal Blood ◽  
The Impact

Continuous monitoring of arterial oxygen saturation by pulse oximetry (SpO2) is the main method to guide respiratory and oxygen support in neonates during postnatal stabilization and after admission to neonatal intensive care unit. The accuracy of these devices is therefore crucial. The presence of fetal hemoglobin (HbF) in neonatal blood might affect SpO2 readings. We performed a systematic qualitative review to investigate the impact of HbF on SpO2 accuracy in neonates. PubMed/Medline, Embase, Cumulative Index to Nursing & Allied Health database (CINAHL) and Cochrane library databases were searched from inception to January 2021 for human studies in the English language, which compared arterial oxygen saturations (SaO2) from neonatal blood with SpO2 readings and included HbF measurements in their reports. Ten observational studies were included. Eight studies reported SpO2-SaO2 bias that ranged from −3.6%, standard deviation (SD) 2.3%, to +4.2% (SD 2.4). However, it remains unclear to what extent this depends on HbF. Five studies showed that an increase in HbF changes the relation of partial oxygen pressure (paO2) to SpO2, which is physiologically explained by the leftward shift in oxygen dissociation curve. It is important to be aware of this shift when treating a neonate, especially for the lower SpO2 limits in preterm neonates to avoid undetected hypoxia.

scholarly journals Regional variation in cost of neonatal intensive care for extremely preterm infants

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asaph Rolnitsky ◽  
David Urbach ◽  
Sharon Unger ◽  
Chaim M. Bell
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Preterm Infants ◽  
Gestational Age ◽  
Regional Variation ◽  
Neonatal Intensive Care ◽  
Cost Optimization ◽  
Program Cost ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract Background Regional variation in cost of neonatal intensive care for extremely preterm infant is not documented. We sought to evaluate regional variation that may lead to benchmarking and cost saving. Methods An analysis of a Canadian national costing data from the payor perspective. We included all liveborn 23–28-week preterm infants in 2011–2015. We calculated variation in costs between provinces using non-parametric tests and a generalized linear model to evaluate cost variation after adjustment for gestational age, survival, and length of stay. Results We analysed 6932 infant records. The median total cost for all infants was $66,668 (Inter-Quartile Range (IQR): $4920–$125,551). Medians for the regions varied more than two-fold and ranged from $48,144 in Ontario to $122,526 in Saskatchewan. Median cost for infants who survived the first 3 days of life was $91,000 (IQR: $56,500–$188,757). Median daily cost for all infants was $1940 (IQR: $1518–$2619). Regional variation was significant after adjusting for survival more than 3 days, length of stay, gestational age, and year (pseudo-R2 = 0.9, p < 0.01). Applying the model on the second lowest-cost region to the rest of the regions resulted in a total savings of $71,768,361(95%CI: $65,527,634–$81,129,451) over the 5-year period ($14,353,672 annually), or over 11% savings for the total program cost of $643,837,303 over the study period. Conclusion Costs of neonatal intensive care are high. There is large regional variation that persists after adjustment for length of stay and survival. Our results can be used for benchmarking and as a target for focused cost optimization, savings, and investment in healthcare.

scholarly journals Birth-weight centiles and the risk of serious adverse neonatal outcomes at term

2018 ◽  
Vol 46 (9) ◽  
pp. 1048-1056 ◽  
Author(s):  
Joanna Yu ◽  
Christopher Flatley ◽  
Ristan M. Greer ◽  
Sailesh Kumar
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Neonatal Outcomes ◽  
Predicted Probability ◽  
Exposure Variable ◽  
Adverse Neonatal Outcomes ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Age At Birth

Abstract Background: Birth-weight is an important determinant of perinatal outcome with low birth-weight being a particular risk factor for adverse consequences. Aim: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies. Materials and methods: This was a retrospective cohort study of singleton term births at the Mater Mother’s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤−12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile. Results: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06–4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30–1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60–7.75). Conclusions: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.

scholarly journals Confounders for Neonatal Intensive Care Unit Admission ın Neonates of Mothers with Preeclampsia

2018 ◽  
Vol 24 (3) ◽  
pp. 162
Author(s):  
Cetin Kilicci ◽  
Cigdem Yayla Abide ◽  
Enis Ozkaya ◽  
Evrim Bostancı Ergen ◽  
İlter Yenidede ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Intensive Care Unit Admission ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Apgar Scores ◽  
Gestational Age At Delivery

<p><strong>Objective:</strong> The aim of this study was to investigate the effect of some maternal and neonatal clinical parameters on the neonatal intensive care unit admission rates of neonates born to mothers who had preeclampsia. </p><p><strong>Study Design:</strong> Study included 402 singleton pregnant women with preeclampsia who admitted to Maternal-Fetal Medicine Unit of Zeynep Kamil Children and Women’s Health Training and Research Hospital. Pregnancies with uterine rupture, chorioamnionitis and congenital malformations were excluded. Some maternal and neonatal clinical characteristics were assessed to predict neonatal intensive care unit admission.</p><p><strong>Results:</strong> Among 402 neonates, 140 (35%) of them had an indication for neonatal intensive care unit admission, among 140 neonates, 136 (97%) of them were preterm neonates. Comparison of groups with and without neonatal intensive care unit admission indicated significant differences between groups in terms of gestational age, Apgar scores at 1st and 5th minutes, birth weight, some maternal laboratory parameters (Hemoglobin, hematocrit, alanine aminotransferase, aspartate aminotransferase, albumin). In multivariate analysis, among all study population, gestational age at delivery, birth weight and Apgar scores were found to be significantly associated with neonatal intensive care unit admission. On the other hand, in subgroup of term neonates, none of the variables was shown to be associated with neonatal intensive care unit admission.</p><p><strong>Conclusion:</strong> Gestational age at delivery and the birth weight are the main risk factors for neonatal intensive care unit admission of neonates born to mothers who had preeclampsia.</p>

scholarly journals Cranial ultrasound in detection of neurological lesions in preterm neonates in a tertiary center in North Kerala, India

2017 ◽  
Vol 4 (3) ◽  
pp. 804 ◽  
Author(s):  
Kavya M. K. ◽  
Radhamani K. V. ◽  
Mahesh P.
Keyword(s):  
Gestational Age ◽  
Brain Injuries ◽  
Radiology Department ◽  
Preterm Neonates ◽  
Cranial Ultrasound ◽  
Medical College ◽  
Non Invasive ◽  
Tertiary Center ◽  
The Central Nervous System ◽  
Neurodevelopmental Abnormalities

Background: Incomplete formation and maturation of the central nervous system makes it extremely vulnerable to injury, in the case of premature neonates. This can result in a broad range of neurodevelopmental abnormalities. Cranial ultrasound is a sensitive tool for the early detection of these. Hence the present study was undertaken to assess the prevalence of neurosonological abnormality in preterm infants. The aims of the study were to identify and enumerate the neurosonographic features, to assess the severity of brain injuries by grading the neurosonographic findings and to correlate the clinical presentations with the neurosonographic findings.Methods: The present study was conducted in Department of Radiodiagnosis, Pariyaram Medical College. It consisted of all preterm neonates (less than 37 weeks of gestational age) referred to the Radiology department. The initial scan will be done as soon as possible (within 2 weeks of birth) followed by a repeat scan of the same infants at 36 weeks of corrected age, and at 8weeks post-partum.Results: A total of 100 neonates with gestational age varying from 29 to 37 weeks were studied, with the birth weight varying from 1.5 to 1.9 kg. The most common abnormality found on neurosonogram was germinal-matrix haemorrhage, followed by periventricular leukomalacia.Conclusions: Real time sonography is a sensitive non-invasive initial investigation for the detection of various brain lesions in the preterm neonates.

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