scholarly journals Elimination of Intravenous Di-2-Ethylhexyl Phthalate Exposure Abrogates Most Neonatal Hypertension in Premature Infants with Bronchopulmonary Dysplasia

Toxics ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 75
Author(s):  
Randall Jenkins ◽  
Katia Farnbach ◽  
Sandra Iragorri
Keyword(s):  
Risk Factors ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Chi Square ◽  
Neonatal Hypertension ◽  
Vlbw Infants ◽  
Chi Square Analysis ◽  
Ethylhexyl Phthalate ◽  
Current Report

(1) Background: The incidence of hypertension in very low birthweight (VLBW) infants in a single neonatal intensive care unit (NICU) dropped markedly during a 2-year period when the IV fluid (IVF) in both the antenatal unit and the NICU temporarily changed to a di-2-ethylhexyl phthalate (DEHP)-free formulation. The objective of the current report is to document this observation and demonstrate the changes in incidence of hypertension were not associated with the variation in risk factors for hypertension; (2) Methods: The charts of all VLBW infants born in a single NICU during a 7-year span were reviewed. This time includes 32 months of baseline, 20 months of DEHP-free IVF, 20 months of IVF DEHP re-exposure, and two 4-month washout intervals. The group of interest was limited to VLBW infants with bronchopulmonary dysplasia (BPD). Chi-square analysis was used to compare incidence of hypertension among periods. Vermont Oxford NICU Registry data were examined for variation in maternal and neonatal risk factors for hypertension; Results: Incidence of hypertension in VLBW infants with BPD decreased from 7.7% (baseline) to 1.4% when IVF was DEHP-free, rising back to 10.1% when DEHP-containing IVF returned to use. Risk factors for neonatal hypertension were stable across the 3 study periods in the NICU’s group of VLBW infants; (3) Conclusions: Serendipitous removal of IVF containing DEHP resulted in near elimination of hypertension in one NICU—an effect entirely reversed after the same brand of DEHP-containing IVF returned to clinical use. These results suggest that DEHP exposure from IVF plays a major role in neonatal hypertension.

scholarly journals CORRELATION OF EXCLUSIVE BREASTFEEDING AND CIGARETTE SMOKE EXPOSURE WITH PNEUMONIA IN CHILDREN UNDER TWO YEARS

2020 ◽  
Vol 8 (3) ◽  
pp. 228
Author(s):  
Denisca Vanya Almeida ◽  
Fariani Syahrul
Keyword(s):  
Risk Factors ◽  
Cigarette Smoke ◽  
Exclusive Breastfeeding ◽  
Simple Random Sampling ◽  
Observational Research ◽  
Cigarette Smoke Exposure ◽  
Chi Square ◽  
Prevention Education ◽  
Control Research ◽  
Chi Square Analysis

Background: Pneumonia is one of the leading causes of death for children and is caused by pneumococcus, staphylococcus, and streptococcus bacteria. Exclusive breastfeeding and exposure to cigarette smoke are risk factors for pneumonia in children less than two years old. Purpose: The aim of this research was to analyze the relationship between exclusive breastfeeding or exposure to cigarette smoke and pneumonia in children aged less than two years at Public Health Center (PHC) of Wates, Kediri District. Methods: This research employed analytic observational research using a case–control research design. The number of research samples used was 60, consisting of 30 case respondents and 30 control respondents. The samples were taken in the PHC of Wates, Kediri District’s working area in July 2019. The determination of the samples was carried out through simple random sampling. The data were analyzed using chi-square analysis. Results: The research variables related to pneumonia in children less than two years old at PHC of Wates, Kediri District were exclusive breastfeeding with Odds Ratio (OR) = 3.50 (95% Confidence Interval (CI) = 1.20–10.19), the age of the mothers of the two-year-old infants with OR = 0.19 (95% CI = 0.04–0.78), and the education of the mothers of children less than two years old with OR = 3.14 (95% CI = 1.07–9.27). Conclusion: Exclusive breastfeeding, maternal age, and mothers’ level of education are some of the risk factors for pneumonia. The suggestion from this research is to hold socialization in the form of pneumonia prevention, education on exclusive breastfeeding for mothers who have children under two years of age, and the dangers of smoking for children's health.

Relatedness of Coagulase-Negative Staphylococci Causing Bacteremia in Low-Birthweight Infants

1994 ◽  
Vol 15 (10) ◽  
pp. 658-662 ◽  
Author(s):  
Marilyn A. Kacica ◽  
Michael J. Horgan ◽  
Karen E. Preston ◽  
Martha Lepow ◽  
Richard A. Venezia
Keyword(s):  
Risk Factors ◽  
Restriction Fragment ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Coagulase Negative Staphylococcus ◽  
Coagulase Negative Staphylococci ◽  
Oxacillin Resistance ◽  
Total Dna ◽  
Staphylococcus Hominis ◽  
Multiple Strains

AbstractObjective:To investigate coagulase-negative staphylococcus (CONS) causing bacteremia in a neonatal intensive care unit (NICU).Design:A 14-month retrospective review of 47 infants in the NICU with CONS bacteremia was undertaken to determine CONS glycocalyx production, plasmid pattern, total DNA restriction fragment polymorphism, and clinical risk factors.Results:The isolates included 32Staphylococcusepidermidis, sixStaphylococcus haemolyticus,fourStaphylococcus warneri,four Staphylococcus saprophyticus, and oneStaphylococcus hominis. Sixty-five percent of Sepidermidisproduced glycocalyx; other species did not. Oxacillin resistance (52%) and the antibiograms of the CONS were consistent with other units in the hospital. Five similar CONS plasmid patterns were found among 16 isolates; 31 isolates had unique patterns. Extractions of total DNA from these isolates were digested usingHindIII,HaeIII, and BstEII. Those with similar restriction fragment length patterns could not be linked as nosocomially transmitted among infants with bacteremia.Conclusion:Our observations suggest that multiple strains of CONS infect infants in the NICU who have similar risk factors. Although current infection control practices limit transmission of a pathogen, they do not prevent CONS bacteremias.

Risk Factors for Brain Injury in Newborns Treated with Extracorporeal Membrane Oxygenation

2020 ◽  
Author(s):  
Launice Melbourne ◽  
Michael A. Wien ◽  
Matthew T. Whitehead ◽  
Michelande Ridore ◽  
Yunfei Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Neonatal Intensive Care ◽  
Significant Risk ◽  
Predictive Ability ◽  
Severe Injury ◽  
Free Standing ◽  
Membrane Oxygenation ◽  
Chi Square Analysis

Objective This study aimed to assess the association of clinical risk factors with severity of magnetic resonance imaging (MRI) brain injury in neonatal extracorporeal membrane oxygenation (ECMO) patients. Study Design This is a single-center retrospective study conducted at an outborn level IV neonatal intensive care unit in a free-standing academic children's hospital. Clinical and MRI data from neonates treated with ECMO between 2005 and 2015 were reviewed. MRI injury was graded by two radiologists according to a modified scoring system that assesses parenchymal injury, extra-axial hemorrhage, and cerebrospinal fluid spaces. MRI severity was classified as none (score = 0), mild/moderate (score = 1–13.5), and severe (score ≥ 14). The relationship between selected risk factors and MRI severity was assessed by Chi-square, analysis of variance, and Kruskal–Wallis tests where appropriate. Combinative predictive ability of significant risk factors was assessed by logistic regression analyses. Results MRI data were assessed in 81 neonates treated with ECMO. Veno-arterial (VA) patients had more severe injury compared with veno-venous patients. There was a trend toward less severe injury over time. After controlling for covariates, duration of ECMO remained significantly associated with brain injury, and the risk for severe injury was significantly increased in patients on ECMO beyond 210 hours. Conclusion Risk for brain injury is increased with VA ECMO and with longer duration of ECMO. Improvements in care may be leading to decreasing incidence of brain injury in neonatal ECMO patients. Key Points

scholarly journals Risk factors for intradomiciliary infestation by the Chagas disease vector Triatoma dimidiatain Jutiapa, Guatemala

2009 ◽  
Vol 25 (suppl 1) ◽  
pp. S83-S92 ◽  
Author(s):  
Dulce Maria Bustamante ◽  
Carlota Monroy ◽  
Sandy Pineda ◽  
Antonieta Rodas ◽  
Xochitl Castro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Chagas Disease ◽  
Linear Models ◽  
Control Strategies ◽  
Chi Square ◽  
Disease Vector ◽  
Log Linear ◽  
Chi Square Analysis

Seventeen variables were evaluated as possible risk factors for the intradomiciliary infestation with Triatoma dimidiata in 644 houses in Jutiapa, Guatemala. During 2004 the houses were assessed for vector presence and evaluated for hygiene, cluttering, material comfort, construction conditions and number of inhabitants, among other factors. Chi-square analysis detected significant associations between vector presence and eight variables related to domestic sanitary and construction conditions. Log-linear models showed that regardless of the age of the house, the odds of vector presence were 4.3 and 10 times lower in houses with a good socioeconomic status compared with poor and very poor houses respectively. Log-linear models also pointed to a greater chance of vector presence when walls lacked plastering (3.85 times) or walls had low quality-incomplete plastering (4.56 times), compared with walls that were completely plastered. Control strategies against T. dimidiata should include the introduction of better-quality but inexpensive plastering formulations and better sanitation practices should also be promoted among the population. Such control strategies should not only reduce or eliminate infestation, but also prevent vector reinfestation.

Perinatal risk factors for bronchopulmonary dysplasia in a national cohort of very-low-birthweight infants

2013 ◽  
Vol 208 (2) ◽  
pp. 115.e1-115.e9 ◽  
Author(s):  
Gil Klinger ◽  
Nir Sokolover ◽  
Valentina Boyko ◽  
Lea Sirota ◽  
Liat Lerner-Geva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bronchopulmonary Dysplasia ◽  
Low Birthweight ◽  
Very Low Birthweight ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
National Cohort ◽  
Very Low Birthweight Infants

scholarly journals Blood pressure changes during the first 24 hours of life and the association with the persistence of a patent ductus arteriosus and occurrence of intraventricular haemorrhage

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260377
Author(s):  
Robert Boldt ◽  
Pauliina M. Mäkelä ◽  
Lotta Immeli ◽  
Reijo Sund ◽  
Markus Leskinen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Patent Ductus Arteriosus ◽  
Gestational Age ◽  
Odds Ratio ◽  
Low Birthweight ◽  
Ductus Arteriosus ◽  
Intraventricular Haemorrhage ◽  
Vlbw Infants ◽  
Patent Ductus

Very low birthweight (VLBW) infants are at risk of intraventricular haemorrhage (IVH) and delayed closure of ductus arteriosus. We investigated mean arterially recorded blood pressure (MAP) changes during the first day of life in VLBW infants as potential risk factors for a patent ductus arteriosus (PDA) and IVH. This retrospective cohort study exploring MAP changes during adaption and risk factors for a PDA and IVH comprised 844 VLBW infants admitted to the Helsinki University Children’s Hospital during 2005–2013. For each infant, we investigated 600 time-points of MAP recorded 4–24 hours after birth. Based on blood pressure patterns revealed by a data-driven method, we divided the infants into two groups. Group 1 (n = 327, mean birthweight = 1019 g, mean gestational age = 28 + 1/7 weeks) consisted of infants whose mean MAP was lower at 18–24 hours than at 4–10 hours after birth. Group 2 (n = 517, mean birthweight = 1070 g, mean gestational age = 28 + 5/7 weeks) included infants with a higher mean MAP at 18–24 hours than at 4–10 hours after birth. We used the group assignments, MAP, gestational age at birth, relative size for gestational age, surfactant administration, inotrope usage, invasive ventilation, presence of respiratory distress syndrome or sepsis, fluid intake, and administration of antenatal steroids to predict the occurrence of IVH and use of pharmacological or surgical therapy for a PDA before 42 weeks of gestational age. Infants whose mean MAP is lower at 18–24 hours than at 4–10 hours after birth are more likely to undergo surgical ligation of a PDA (odds ratio = 2.1; CI 1.14–3.89; p = 0.018) and to suffer from IVH (odds ratio = 1.83; CI 1.23–2.72; p = 0.003).

Risk factors for diabetes mellitus and hypertension among artisans in Ogun state, Nigeria

2019 ◽  
Vol 50 (4) ◽  
pp. 695-710 ◽  
Author(s):  
Cathrine A. Oladoyinbo ◽  
Adenike Mercy Abiodun ◽  
Mariam Oluwatoyin Oyalowo ◽  
Irene Obaji ◽  
Abisola Margaret Oyelere ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Abdominal Obesity ◽  
Dietary Habits ◽  
Activity Level ◽  
Chi Square ◽  
Content Type ◽  
Factors Associated ◽  
Ogun State ◽  
Chi Square Analysis

Purpose This study was designed to assess the risk factors associated with hypertension (HTN) and diabetes among artisans in Ogun State, Nigeria. Evidences suggest increasing prevalence, incidences and morbidity of diabetes and HTN in Nigeria. However, the purpose of this study is to plan and prioritize effective intervention programs, there is need to provide data on the prevalence and risk factors for HTN and diabetes among local groups. Design/methodology/approach In total 300 apparently healthy artisans who have never been diagnosed of diabetes or HTN were randomly selected from five communities. A structured questionnaire was used in obtaining information on the personal characteristics of the respondents. An adapted dietary habit and lifestyle questionnaire were used to assess the dietary habits and lifestyle of the respondents. The WHO global activity questionnaire was adapted and used to gather information on the physical activity level of the respondents. Random blood glucose, blood pressure and anthropometric measurements were assessed using standard instruments. Chi-square (χ2), correlations and multinomial logistic regression analysis were performed to identify significant determinants of diabetes and HTN. Findings Mean age was 34.8 ± 9.9 and prevalence of diabetes and pre-diabetes were 1 and 4.7 per cent, respectively, while HTN and pre-HTN were 48.0 and 30.3 per cent, respectively. About half (55.7 per cent) of the respondents skip at least a meal daily and 31 per cent snack daily. Most (61.4 per cent) consume alcohol and 65.7 per cent engage in high physical activity. Abdominal obesity was significantly higher among women (p = 0.004). Using the chi-square analysis, age, abdominal obesity and educational status were factors found to be significantly associated with diabetes (p = 0.002; p = 0.007; p = 0.004) while age, gender, abdominal obesity and alcohol consumption had significant association with HTN. Although not statistically significant, respondents were 0.8, 1.0 and 1.1 times more likely to be diabetic with increasing body mass index, waist circumference (WC) and age (odd ratio (OR) = 0.78; confidence intervals (CI): 0.51-1.18; OR = 1.04; CI: 0.89-1.21; OR = 1.06; CI: 0.96-1.18, respectively). Abdominal obesity was significantly associated with HTN (OR = 1.08; CI: 1.03-1.13; p = 0.001). Also, older respondents were 1.1 times more likely of becoming hypertensive (OR = 1.07; CI: 1.02-1.11; p = 0.003). Increased risk of diabetes and HTN was found among respondents with increasing age and WC. Research limitations/implications This study was cross-sectional in design; it cannot be used to establish a cause-effect relationship between diabetes, HTN and the observed variables (anthropometric characteristics, dietary habits and lifestyle risk factors). Because of the few numbers (1 per cent) of respondents identified to be diabetic several important risk factors could not be included in the model. Practical implications An understanding of the risk factors associated with diabetes and HTN among sub-groups in the population will help to plan effective interventions targeted at specific groups. Originality/value The findings of this study show the associated risk factors for diabetes and HTN among artisans in Ogun State.

Abstract P387: Risk Factors for Neonatal Intensive Care Unit Admission; Project Watch, 2012-2017

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Ksheeraja Sriram ◽  
Amna Umer ◽  
Candice Hamilton ◽  
Collin C John ◽  
Christa LILLY
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Maternal Smoking ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Insurance Status ◽  
Nicu Admission

Background: Neonatal intensive care unit (NICU) admission is often due to specific cardiovascular conditions. Low birthweight, another common reason for NICU admission, is also linked to later cardiovascular risk. Within the past decade, the rate of NICU admissions in the United States has significantly increased. Identification of emerging risk factors for NICU admission will help inform efforts to reduce the number of newborns requiring intensive care. Methods: The objective of this study was to identify risk factors for NICU admission in all infants born in West Virginia (WV), 2012-2017, via Project WATCH. Fifteen exposure variables including demographics, maternal and infant characteristics, were included in multivariable logistic regression analyses, stratified by preterm and term births. Results: Of 120,894 neonates, 6,393 (5.3%) were admitted to NICU. Among preterm infants (Table 1), predictors included male sex (OR: 1.11), insurance status (OR: 1.29), APGAR scores less than or equal to 3 (OR: 2.57), maternal diabetes (OR: 1.68 and 2.01), residence outside WV (OR: 1.27), intrauterine substance exposure (OR: 1.94), congenital abnormalities (OR: 2.58), and low birthweight (OR: 1.73 and 6.64). Risk factors in term infants included all factors identified for preterm infants, as well as maternal smoking, maternal age, and number of previous pregnancies. Conclusions: In addition to infant characteristics predictive of NICU admission (e.g., birthweight and APGAR score), socioeconomic factors (e.g., insurance status and rurality) and preventable risk factors (e.g., maternal smoking and substance use) provide an opportunity for intervention during pregnancy, with the goal to decrease the number of newborns requiring intensive care.

Clinical Outcomes among Diagnostic Subgroups of Infants with Severe Bronchopulmonary Dysplasia through 2 Years of Age

2018 ◽  
Vol 35 (14) ◽  
pp. 1376-1387 ◽  
Author(s):  
Gangaram Akangire ◽  
Winston Manimtim ◽  
Michael Nyp ◽  
Janelle Noel-MacDonnell ◽  
Allyssa Kays ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Ventilatory Support ◽  
Retrospective Chart Review ◽  
Assisted Ventilation ◽  
Entire Cohort ◽  
Significant Difference ◽  
Group B ◽  
Over Time

Objective This article aimed to identify readmission risk factors through 2 years of life for infants with severe bronchopulmonary dysplasia (BPD) who do not require tracheostomy and ventilatory support after neonatal intensive care unit (NICU) discharge. It also aimed to identify if clinical differences exist between the subcategories of severe BPD. Study Design A retrospective chart review was performed on 182 infants with severe BPD born between 2010 and 2015. A total of 130 infants met the inclusion criteria and were stratified into three groups based on their respiratory status at 36 weeks of gestational age: group A—oxygen (O2), group B—assisted ventilation (AV), group C—both O2 and AV. NICU clinical risk factors for readmission were assessed at set time points (6/12/18/24 months). Reasons for readmission were assessed for the entire cohort and severe BPD subgroups. Conclusion An NICU diagnosis of neurologic abnormality, necrotizing enterocolitis, invasive NICU infection, dysphagia, and O2 at NICU discharge differed between the three subgroups of severe BPD. The most common cause of readmission was viral respiratory tract infection. Inhaled steroid use remained stable over time, while oxygen use and diuretic use declined over time. Risk factors for readmission in the entire cohort included g-tube, O2 use, and diuretic use at 12 months. There was no significant difference in readmission rates between the three BPD subgroups.

scholarly journals Evaluation of Heart Rate Assessment Timing, Communication, Accuracy, and Clinical Decision-Making during High Fidelity Simulation of Neonatal Resuscitation

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Win Boon ◽  
Jennifer McAllister ◽  
Mohammad A. Attar ◽  
Rachel L. Chapman ◽  
Patricia B. Mullan ◽  
...  
Keyword(s):  
Decision Making ◽  
Heart Rate ◽  
Neonatal Intensive Care ◽  
Clinical Decision Making ◽  
Neonatal Resuscitation ◽  
Clinical Decision ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Chi Square ◽  
Chi Square Analysis

Objective. Accurate heart rate (HR) determination during neonatal resuscitation (NR) informs subsequent NR actions. This study’s objective was to evaluate HR determination timeliness, communication, and accuracy during high fidelity NR simulations that house officers completed during neonatal intensive care unit (NICU) rotations.Methods. In 2010, house officers in NICU rotations completed high fidelity NR simulation. We reviewed 80 house officers’ videotaped performance on their initial high fidelity simulation session, prior to training and performance debriefing. We calculated the proportion of cases congruent with NR guidelines, using chi square analysis to evaluate performance across HR ranges relevant to NR decision-making: <60, 60–99, and ≥100 beats per minute (bpm).Results. 87% used umbilical cord palpation, 57% initiated HR assessment within 30 seconds, 70% were accurate, and 74% were communicated appropriately. HR determination accuracy varied significantly across HR ranges, with 87%, 57%, and 68% for HR <60, 60–99, and ≥100 bpm, respectively (P<0.001).Conclusions. Timeliness, communication, and accuracy of house officers’ HR determination are suboptimal, particularly for HR 60–100 bpm, which might lead to inappropriate decision-making and NR care. Training implications include emphasizing more accurate HR determination methods, better communication, and improved HR interpretation during NR.

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