Prevalence and predictors of adverse outcomes in neonatal seizures

OBJECTIVES: Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors. METHODS: This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated. RESULTS: Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57–2.84)], microcephaly [OR 5.93 (CI 0.55–64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18–30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43–14.78)], meningitis [OR 2.63(CI 0.08–6.39)], septicemia [OR1.22(CI 0.45–3.31)] and abnormal cranial USG [OR 7.95(CI 12.61–24.22)] were significant predictors of adverse outcomes in neonates with seizures. CONCLUSION: Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.

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FREQUENT BLOOD SAMPLING LEADS TO SIGNIFICANT IATROGENIC BLOOD LOSS IN VERY LOW BIRTH WEIGHT BABIES

10.36106/ijsr/3004641 ◽

2020 ◽

pp. 32-34

Author(s):

Prabodh Chandra Mondal ◽

Dhruba Kumar Mahata ◽

Rincy Mathew ◽

Debarshi Jana

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Blood Loss ◽

Critically Ill ◽

Very Low Birth Weight ◽

Birth Asphyxia ◽

Neonatal Unit ◽

Blood Sampling ◽

Study Results ◽

Low Birth Weight Babies

INTRODUCTION Newborns receiving intensive care require frequent determination of hematologic status, blood chemistry and arterial gas analysis. Anemia of prematurity (AoP) is common in preterm very low birth weight babies (<1.5 kg body weight).Nearly all extremely preterm infants develop AoP and up to 90% require atleast one red blood cell transfusion during their NICU stay. However, anotherim[ortant cause for AoP seems to be related to iatrogenic blood loss due to frequent laboratory investigations. Recently, several small studies reported that newborns especially preterm VLBW infants may lose more than half of their blood volume due to cumulative laboratory blood sampling in the first weeks after birth. OBJECTIVES To determine the total amount of blood sampled in VLBW new-borns during the stay in the neonatal unit (SNCU& NICU). The number and total amount of blood transfused in VLBW new-borns during the stay. The relationship between blood loss due to blood sampling and blood transfusion in VLBW. MATERIALS AND METHODS A prospective observational study is being planned to perform in all VLBW new-borns admitted in the neonatal unit of a tertiary care centre in eastern India. This study will be conducted for 6 months in all VLBW. Subjects will be subdivided into 1000gm (500gm to 999gm) and >- 1000gm- < 1500gm. Each group will be subdivided into critically ill or not. Babies with RDS requiring surfactant and/or ventilator treatment, birth asphyxia with HIE and/or in whom infection is strongly suspected or verified by blood investigation and culture will be considered as critically ill. Those babies with duration of stay more than 5 days will be considered for the study. RESULTS Our study showed that total of 214 babies (both VLBW, ELBW) admitted from 1/11/2019 to 30/4/2020.Among these, 130 babies admitted in the SNCU for more than 5 days. Out of this, 86 babies were eligible in the study satisfying all inclusion criteria. Baseline characteristics are mentioned in table 1.Table 2 presents the comorbidities like respiratory distress, birth asphyxia, sepsis. The total iatrogenic blood loss was 3ml (0.90- 11.89). The average blood loss was 3.4 ml/kg. CONCLUSION From our study we found that sampling related blood loss is higher among lower birth weight babies. As birth weight decreases, sampling related blood loss increases and further need for transfusion increase.

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Mortality and morbidity of very low birth weight and extremely low birth weight babies in neonatal period

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20190704 ◽

2019 ◽

Vol 6 (2) ◽

pp. 645

Author(s):

Saroj Kumar Tripathy ◽

Kripasindhu Chatterjee ◽

Narendra Behera

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Neonatal Morbidity ◽

Hyaline Membrane Disease ◽

Extremely Low Birth Weight ◽

Childhood Disability ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Low Birth Weight Babies

Background: Preterm birth is one of the major clinical problems in neonatology as it is commonly associated with perinatal mortality, serious neonatal morbidity and in some cases, it leads to childhood disability. The objective of this study was to find out the outcomes of VLBW and ELBW babies in the form of mortality and morbidity in neonatal period.Methods: A cross sectional study was conducted in SNCU, MKCG Medical College, Berhampur, Odisha between 2011 to 2013. All babies with birth weight less than 1500gm, admitted between days 1 to day 7 of life were enrolled in the study. Babies were broadly divided in to two groups i.e.VLBW group (weight 1000-1499gm) and ELBW group (weight<1000gm). Details of antenatal history, sociodemographic profile and birth history including significant events were noted. Outcome measures included were death, cured and with sequelae.Results: Total number of babies enrolled in this study were two hundred twelve (n=212) and following observations were made. Mortality of ELBW babies was 61.11% and that of VLBW babies was 26.41%. Death rate in babies with weight range 500-749gm, 750-999gm, 1000-1249gm and 125-1499gm was 87.50%, 53.57%, 30.76% and 20.97% respectively. It was found that morbidities such as RDS, HIE, shock and hypoglycemia are significantly higher in ELBW babies as compared to VLBW babies.Conclusions: Extremely low birth weight babies have shown high mortality and morbidity compared to very low birth weight babies and its related death multiply when associated with complications like hyaline membrane disease, hypoxic ischemic encephalopathy, and sepsis.

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