Perinatal Risk Factors for Retinopathy of Prematurity in Preterm and Low Birth Weight Neonates

2020 ◽  
Vol 12 (1) ◽  
pp. 32-38
Author(s):  
Reena Yadav ◽  
Sharad Gupta ◽  
Jyoti Baba Shrestha ◽  
Raveena Yadav ◽  
Tushar Bikram Sipaliya Yadav

Background: Retinopathy of prematurity (ROP) is emerging as a leading cause of childhood blindness. The incidence of ROP is likely to increase after improvement in neonatal care unit in premature neonates. This study is conducted to determine the perinatal risk factors for ROP in preterm and low birth weight neonates. Methods: This is a prospective, descriptive and clinical; hospital based study. A total of 92 preterm neonates with gestational age of 36 weeks or less and birth weight of 2000 grams or less admitted in Neonatal Intensive Care Unit (NICU) were screened. Detailed antenatal, perinatal and neonatal history; birth asphyxia and subsequent oxygen support records were noted. All the neonates underwent detailed anterior and posterior segment eye examination with indirect binocular ophthalmoscope after pupil dilatation within 4 weeks of life. Retinal vascular changes were classified according to the International Classification of Retinopathy of Prematurity. The Chi-square test with odds ratio was performed to derive the association between ROP and antenatal, perinatal and neonatal factors. A p-value was considered significant at 0.05. Result: Out of 92 neonates, 21(22.8%) developed ROP. Twelve neonates (13%) had stage-1 ROP, 6(6.5%) had stage-2 and 3(3.3%) had stage-3 ROP. Birth weight (OR=2.9; p=0.04; 95% CI=1.0-8.3), gestational age (OR=3.9; p=0.01; 95% CI=1.3-11.8) and time span of oxygen exposure (OR=2.9; p=0.05; 95% CI=1.0-8.4) had a strong association with ROP. Conclusion: The incidence of ROP is significantly high among preterm low birth weight neonates. The risk of developing ROP becomes even greater with lower gestational age and more duration of oxygen exposure.

2019 ◽  
Vol 26 (04) ◽  
Author(s):  
Muhammad Asghar Ali ◽  
Muhammad Anwar ◽  
Malik Muhammad Naeem

Objectives: To find out Association with risk factors of retinopathy of prematurity (ROP) of in-hospital newborns of low birth weight (LBW). Study Design: Cross sectional study. Setting: Department of Paediatrics, Civil Hospital Bahawalpur. Period: March 2017 to May 2018. Material and Methods: Sixty infants having birth weight 800 gram to 2500 gram, gestational age from 28 weeks to 40 weeks, either male or female were selected. Retinopathy of prematurity (ROP) was assessed in selected patients. Results: Mean gestational age was 32.67 ± 3.8 weeks, mean weight was 1484.17 ± 532.9 gram and mean duration of hospital stay was 14.52 ± 6.6 days. ROP was noted in 20 (33%) patients. Grade I ROP was noted in 11 (55%) patients followed by grade II 7 (35%) and grade III in 2 (10%) patients. Very low birth weight (VLBW), longer duration of oxygen supplementation and male gender were found to be significantly associated (p value < 0.05) with ROP while other variables turned out to be insignificant. Conclusion: Association and risk factors of ROP in LBW infants is high and most of the cases were found with grade I ROP. ROP developed in all very premature infants. Significant association of ROP was noted with VLBW, prolonged duration of oxygen supplementation and male gender.


2020 ◽  
Vol 7 (7) ◽  
pp. 1534
Author(s):  
Kiran C. Pankaj ◽  
Sristi Ganguly ◽  
Manas R. Upadhyay

Background: Neonatal sepsis remains a leading cause of neonatal mortality and morbidity, diagnosis of which remains difficult due to variable presentations. With the increasing threat of antimicrobial resistance, it is important to identify perinatal risk factors which are associated with higher incidence of definite sepsis, to initiate empirical antibiotics, while awaiting blood culture reports.Methods: This was hospital based cross-sectional study done in SVPPGIP, Cuttack, Odisha during January 2019 to April 2019, enrolling all neonates  ≥37 weeks gestation and aged less than 72 hours, with suspected early onset sepsis. Neonates with TORCH infections, congenital anomalies, syndromic baby or with surgical conditions were excluded. After obtaining informed consent, blood culture was sent for all and their perinatal risk factors noted. Blood culture positive newborns were considered to have definite sepsis. Data was analysed with Chi-square test and percentages, using SPSS 18.Results: Among the 200 cases, incidence of definite sepsis was 26%. The most common risk factor was low birth weight and birth asphyxia. Majority (67%) had single or lesser risk factor and number of risk factors was significantly associated with definite sepsis. A significant association was seen between blood culture positivity with low birth weight (p=0.003), foul smelling liquor (p= 0.025), birth asphyxia (p 0.018) and premature rupture of membranes (p= 0.016). The combination of maternal fever and unclean vaginal examination was also significantly associated with the same.Conclusions: Protocols for initiating empiric antibiotics need to be formulated, taking into account the significant risk factors, in resource limited settings, to avoid resource and time wastage.


2021 ◽  
Vol 8 ◽  
pp. 2333794X2110317
Author(s):  
Faisal A. Nawaz ◽  
Meshal A. Sultan

The aim of this study is to evaluate the prevalence of low birth weight and other perinatal risk factors in children diagnosed with neurodevelopmental disorders. This is one of the first studies in the Arabian Gulf region focused on the contribution of these factors toward the development of various disorders such as attention-deficit/hyperactivity disorder, autism spectrum disorder, and other mental disorders. This descriptive study was based on qualitative data analysis. We reviewed retrospective information from the electronic medical records of 692 patients in Dubai, United Arab Emirates. The prevalence of low birth weight in children with mental disorders was significantly higher as compared to the general population (16% vs 6% respectively). Furthermore, other risk factors, including high birth weight and preterm birth were noted to have a significant association with neurodevelopmental disorders. Future research on the impact of perinatal risk factors will contribute to advancement of early intervention guidelines.


2020 ◽  
Vol 24 (3) ◽  
pp. 229-234
Author(s):  
Hira Arif ◽  
Nadeem Ikram ◽  
Shangraf Riaz ◽  
Asma Nafisa

Introduction: About 30% of neonates develop thrombocytopenia during hospital admission. Inevitable and irreversible complications can be prevented by determining the risk factors of neonatal thrombocytopenia. The present study was undertaken to determine the risk factors and outcome of neonatal thrombocytopenia in neonates admitted to Neonatal Intensive Care Unit Benazir Bhutto Hospital Rawalpindi. Materials and Methods: A prospective study was conducted to evaluate the risk factors for neonatal thrombocytopenia (NT) in 160 neonates. Neonatal and maternal risk factors were recorded and neonates were categorized into three groups based on the severity of thrombocytopenia. Results: A higher percentage of the neonates 89 (55.6%) were male. The majority (61.9%) had moderate neonatal thrombocytopenia while 21.9% had severe neonatal thrombocytopenia. A highly significant difference was observed for the distribution of gestational age, platelet count, birth weight, and age at admission (for all p-value ≥0.0001) among different groups. Multivariate logistic regression revealed a significant independent association of prematurity, birth asphyxia, and low birth weight with neonatal thrombocytopenia. Conclusion: Prematurity, low birth weight, and birth asphyxia were the significant causes of Neonatal thrombocytopenia. The mortality rate increased significantly with the severity of thrombocytopenia.


2016 ◽  
Vol 30 (22) ◽  
pp. 2679-2685 ◽  
Author(s):  
Fermín García-Muñoz Rodrigo ◽  
Lourdes Urquía Martí ◽  
Gloria Galán Henríquez ◽  
Sonia Rivero Rodríguez ◽  
Patricia Tejera Carreño ◽  
...  

2018 ◽  
Vol 5 (3) ◽  
pp. 726
Author(s):  
Ravi Garg ◽  
Rupesh Masand ◽  
Chaman Ram Verma ◽  
Girdhari Lal Sharma ◽  
Suman Ankit Yadav

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.


Author(s):  
Shantisena Mishra ◽  
Anjali Saji ◽  
Saiprasanna Behera ◽  
Sridhar Mohanty

Background: Retinopathy of prematurity is a multifactorial vasoproliferative retinal disease that increases in incidence with decreasing gestational age and is one of the leading causes of preventable childhood blindness in India. Advances in neonatology have led to dramatic increase in survival of preterm neonates and in turn, to the risk of developing ROP. Since most of the risk factors associated with ROP mentioned above arise in the neonatal intensive care unit (NICU) itself and most of them are avoidable, cautious monitoring of the risk factors, early screening, follow up and surgical intervention have been shown to reduce the incidence and improve the outcome of ROP.Methods: This was a prospective observational study conducted for a period of 2 years. A total of 151 infants admitted in NICU /SNCU who satisfied the inclusion criteria were enrolled in this study. Initial and follow up screening was conducted in three phases the results were documented in proforma after ethical clearance.Results: Comparison of risk factors between eyes with and without ROP was done using Chi-square test. A p-value of<0.05 was considered to be statistically significant. Incidence of ROP in centre is found to be 33.8%. Among maternal risk factors, multiple gestation and PROM/PPROM is found to be significant in the development of ROP from this study. However, mode of delivery and gestational hypertension, were found to be not significant in ROP. Among neonatal risk factors, low birth weight, lower gestational age, prolonged oxygen exposure, blood transfusion, mechanical ventilation, sepsis, phototherapy was found to be significant in this study.Conclusions: ROP, being an emerging cause for potentially blinding visual disability, needs to be diagnosed early. Due to the advancements in neonatology and better survival of preterm babies, timely screening, regular follow up, early detection and intervention is mandatory. A multidisciplinary approach is required in diagnosis and treatment of the disease. Proper counselling and motivation for parents of preterm and low birth weight babies for regular follow up is also essential.


Author(s):  
V. Soumya ◽  
K. V. Phani Madhavi ◽  
B. Devi Madhavi

Background: Cerebral palsy (CP) is a disorder of movement and posture, defined as an “umbrella term covering a group of non-progressive, but often changing, motor impairment syndromes secondary to lesions or anomalies of the brain arising in the early stages of its development”. Risk factors for CP include maternal infection, placental insufficiency, gestational diabetes, pregnancy induced hypertension, instrumental delivery, low birth weight, hypoxic ischemic injury, hyperbilirubinemia, metabolic abnormalities (hypoglycemia). The families are affected psychologically, financially and socially. It also imposes burden on national health system. The objective of the study was to study the distribution of maternal and perinatal risk factors of cerebral palsy among children attending a cerebral palsy clinic in Visakhapatnam.Methods: A retrospective cohort study was conducted by eliciting history from the mothers of 90 cerebral palsy children who were treated in cerebral palsy clinic, Visakhapatnam, Andhra Pradesh, India for a period of 6 months in 2016. After taking consent, data was collected using a pretested questionnaire. Detailed history was taken from the mothers of 90 cerebral palsy children regarding the period of gestation at which the child was born (preterm or full term), any previous history of pre-term delivery or abortions and neonatal complications was obtained from the care givers. Data was entered into MS-excel sheet and analysed by using SPSS Trial Version 20.Results: Total numbers of study subjects were 90, out of which 58 were boys and 32 were girls. Around 38% of study subjects were born out of consanguineous marriage. As per the records available, only 7% of mothers had gestational diabetes. It was found that 13% study subjects were preterm, 22% had low birth weight, 24% had perinatal hypoglycaemia, 33% had neonatal jaundice and 33% had birth asphyxia.Conclusions: Consanguinity, birth asphyxia, neonatal jaundice are found to be the important risk factors for Cerebral Palsy in our study which can be avoided by improving maternal and paediatric health services. 


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