scholarly journals Small for Gestational Age Babies: Morbidity and Immediate Outcome in a Tertiary Care Hospital - A Prospective Study

Author(s):  
Arjun Chandra Dey ◽  
Farid Uddin Ahmed ◽  
Md Abdul Mannan ◽  
Laxmi Saha ◽  
Chowdhury Chiranjib Barua ◽  
...  

Background: Birth weight is the single most important determinant of survival and subsequent growth and development of the newborn. In Bangladesh there is high prevalence of low birth weight (LBW) babies and most of them are small for gestational age. The study was conducted to identify the proportion and category of the small for gestational age babies and determination of the short-term outcome with the aim to the reduction of neonatal mortality and morbidity by problem-wise intervention. Methods: This cross sectional study was conducted in the Neonatal Unit of Chittagong Medical College Hospital, Chittagong between December 2000 and July 2001. Neonates admitted into this unit weighing less than 10th percentile of weight for gestational age were included. On admission the weight was taken and gestational age was calculated using last menstrual period and Ballard score. The infants were monitored daily till discharge or death. Result: A total of 200 SGA babies were included in the study. Among 200 cases 114 were male and 86 were female. All cases were included within 24 hours of age. The anthropometric analysis of the SGA babies showed more than 80% of the SGA babies were normal in length whereas 19.5% fell below 10th percentile of normal. Seventy three percent of SGA babies were asymmetrically (disproportionate) and 27% of babies were symmetrically (proportionate) growth retarded. The main problems associated with the SGA babies were perinatal asphyxia (65.5%), sepsis (54%), jaundice (42.0%), hypothermia (31%), apnea (29%), hypoglycemia (25%), and bleeding manifestations (9%). Asymmetrical SGA babies were at higher risk of infection and jaundice. Present study revealed the mortality of SGA babies were 17% and mortality was significantly higher among the neonates from low socio-economic status and having very low birth weight, hypothermia, apnea, sepsis, bleeding manifestations, and polycythemia. Conclusion: Findings in this study could be important in identifying the areas requiring attention to improve perinatal care in order to prevent SGA babies and also to manage the problems associated with them. DOI: 10.3329/bjch.v31i1.6066 Bangladesh Journal of Child Health 2007; Vol.31(1-3): 1-7

2019 ◽  
Vol 6 (2) ◽  
pp. 857
Author(s):  
Rajendra Shinde ◽  
Kiran Haridas ◽  
Pritesh Nagar ◽  
Hemant Parakh

Background: Preterm birth is one of the major clinical problems in Obstetrics and Neonatology as it is associated with perinatal mortality, serious neonatal morbidity and in some cases childhood disability. Very low birth weight (VLBW) neonates comprise between 4-8% of live-births but about one-third of deaths during the neonatal period occur in this group of newborns. Data on the probability of survival of infant in high risk pregnancies can be of great value in guiding management. The objective is to study the survival at discharge of VLBW neonates admitted in a tertiary care hospital.Methods: Retrospective observational study of all VLBW infants admitted in Aditya Hospital NICU over 3 years between 1-7-2011 to 30-6-2014. Descriptive and inferential statistical analysis has been carried out in the present study.Results: In the present study maternal PROM was seen in 32.9% of cases, Preeclampsia in 31.7% of cases which constituted the most important antenatal risk factor for VLBW followed by multiple gestations in 25.2%. Common morbidities in VLBW neonates are Neonatal jaundice, Probable sepsis, Apnea of prematurity and RDS. Survival improved with increasing gestational age and weight.Conclusions: Birth weight and gestational age specifically predicts survival of preterm VLBW babies, facilitating decision making for obstetricians, neonatologists and parents. In the present study total survival rate was 86.6% with a mortality of 13.4%.


2017 ◽  
Vol 35 (1) ◽  
pp. 20-23
Author(s):  
Soma Halder ◽  
Md Mahbubul Hoque ◽  
Urmi Rahman ◽  
Sheikh Farjana Sonia ◽  
Sudhangshu Shekhar Biswas

Introduction: Acute kidney injury (AKI) is an important clinical problem in sick neonate. In most patients, AKI accompanies with a predisposing factor such as sepsis, asphyxia and surgery. The aims of this study were to determine the incidence, associated contributing factors and short term outcome of AKI in hospitalized newborn infants.Materials and Methods: This prospective cohort study was done in Dhaka Shishu Hospital from March 2011 to September 2011. This study included 300 sick neonates admitted during the study period. AKI was defined when serum creatinine level >1.5 mg/dl and BUN was >20 mg/dl on two separate occasions at 24 hours apart. Oliguria was defined as urine output <1ml/kg/ hr. Medical records of those patients were reviewed and data were analyzed using SPSS software.Results: Fourteen babies (4.66%) out of 300 sick neonates had AKI, of whom 64.2% were male and 35.7% female. The term and preterm neonates were 71% and 29% respectively. While a normal birth weight was observed in 57% cases, 35% had low birth weight and 7.14% had very low birth weight. Sepsis was the most common (71%) association of AKI, followed by perinatal asphyxia (52%). All patients had more than one predisposing factors. Frequency of oliguric kidney injury was 57% and non-oliguric was 43%. Mortality among the hospitalized neonate with AKI was 21%.Conclusion: This study showed that in a tertiary care hospital AKI is not uncommon (4.66%) in neonatal care unit. It is associated with some preventable conditions such as sepsis, perinatal asphyxia and shock. Outcome is poor in sick neonates with AKI (21% mortality) in comparison to sick neonates without AKI (10.3%).J Bangladesh Coll Phys Surg 2017; 35(1): 20-23


PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 7-17
Author(s):  
Dale L. Phelps ◽  
David R. Brown ◽  
Betty Tung ◽  
George Cassady ◽  
Richard E. McClead ◽  
...  

Survival rates specific for birth weight, gestational age, sex, and race are described for 6676 inborn neonates who weighed less than 1251 g at birth and were born during 1986 through 1987. Overall 28-day survival increased with gestational age and birth weight, from 36.5% at 24 weeks' gestation to 89.9% at 29 weeks' gestation, or from 30.0% for neonates of 500 through 599 g birth weight to 91.3% for neonates of 1200 through 1250 g. The expected birth weight-specific survival advantage for female neonates and black neonates diminished when the data were controlled for gestational age, showing that certain previously reported survival advantages are based on lower birth weight for a given gestational age. Multivariate analysis showed that all tested variables were significant predictors for survival, in order of descending significance: gestational age and birth weight, sex, race, single birth, and small-for-gestational-age status. The powerful effect of gestational age on survival highlights the need for an accurate neonatal tool to assess the gestational age of very low birth weight neonates after birth.


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