scholarly journals Renal function in the third year among very low birth weight infants fed by supplemental proteins

2020 ◽  
Author(s):  
Arash Bordbar ◽  
Azade Noroozi Vahid ◽  
Mandana Kashaki
Keyword(s):  
Renal Function ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Intervention Group ◽  
Protein Supplementation ◽  
Control Group ◽  
P Value ◽  
Mean Values ◽  
Vlbw Infants

Very Low Birth Weight (VLBW) infants have higher nutritional needs than term infants. Energy and protein are two important factors influencing their growth. Breastfeeding is not enough to meet VLBW infants’ needs, for this reason, complementary protein is required by them. Hence, the present study aimed at investigation of renal function among VLBW infants receiving complementary proteins. The study was conducted on two groups of intervention and control (n= 18 in each group) (Case study: VLBW infants born in Akbarabadi hospital of Tehran in 2014 2015). The intervention group includes 3-year-old children who weighting less than 1200 grams at birth and have received protein supplementation at the course of NICU hospitalization, protein was added to maternal milk when the amount of milk reaches to 100 cc/kg/day, at this time parenteral nutrition was discontinued and the volume of feeding was increased 20cc/kg/day until reached to 150-180cc/kg/day. We also added the fortifier to breast milk at this time. The fortification and the protein supplementation were stopped when the weight of the baby reached to 1500 grams. The control group was fed similar to the intervention group but had received no complementary protein . The renal function was evaluated by measuring such criteria as BUN, Cr, ALB and U/A. After data collection, a statistical analysis was performed using SPSS software Ver. 22. Following to BUN evaluation, a significant correlation was seen between BUN and received protein (p-value=0.010). However, there was no significant correlation between Cr and received protein as well as mean values of the two groups (p-value=0.0766). Similarly, an insignificant correlation was found between the two groups following to investigation of ALB (p-value=0/257), while the mean values of the two groups were similar. The both groups were also equal in U/A. The complementary protein increased the BUN with no effect on Cr, ALB and U/A, providing no impact on renal function. Therefore, complementary protein intake made no conflict in renal function.

scholarly journals Renal function in the third year among very low birth weight infants fed by supplemental proteins

2020 ◽  
Vol 30 (2) ◽  
pp. 304-310
Author(s):  
Arash Bordbar ◽  
Azade Noroozi Vahid ◽  
Mandana Kashaki
Keyword(s):  
Renal Function ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Intervention Group ◽  
Protein Supplementation ◽  
Control Group ◽  
P Value ◽  
Mean Values ◽  
Vlbw Infants

Very Low Birth Weight (VLBW) infants have higher nutritional needs than term infants. Energy and protein are two important factors influencing their growth. Breastfeeding is not enough to meet VLBW infants’ needs, for this reason, complementary protein is required by them. Hence, the present study aimed at investigation of renal function among VLBW infants receiving complementary proteins. The study was conducted on two groups of intervention and control (n= 18 in each group) (Case study: VLBW infants born in Akbarabadi hospital of Tehran in 2014 2015). The intervention group includes 3-year-old children who weighting less than 1200 grams at birth and have received protein supplementation at the course of NICU hospitalization, protein was added to maternal milk when the amount of milk reaches to 100 cc/kg/day, at this time parenteral nutrition was discontinued and the volume of feeding was increased 20cc/kg/day until reached to 150-180cc/kg/day. We also added the fortifier to breast milk at this time. The fortification and the protein supplementation were stopped when the weight of the baby reached to 1500 grams. The control group was fed similar to the intervention group but had received no complementary protein . The renal function was evaluated by measuring such criteria as BUN, Cr, ALB and U/A. After data collection, a statistical analysis was performed using SPSS software Ver. 22. Following to BUN evaluation, a significant correlation was seen between BUN and received protein (p-value=0.010). However, there was no significant correlation between Cr and received protein as well as mean values of the two groups (p-value=0.0766). Similarly, an insignificant correlation was found between the two groups following to investigation of ALB (p-value=0/257), while the mean values of the two groups were similar. The both groups were also equal in U/A. The complementary protein increased the BUN with no effect on Cr, ALB and U/A, providing no impact on renal function. Therefore, complementary protein intake made no conflict in renal function.

A Single-Center Experience with Very Low Birth Weight Infants and Focal Intestinal Perforation: Comparison of Primary Anastomosis versus Stoma Opening

2017 ◽  
Vol 28 (05) ◽  
pp. 426-432
Author(s):  
Dario Consonni ◽  
Francesco Macchini ◽  
Giovanni Parente ◽  
Andrea Zanini ◽  
Stefania Franzini ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Intestinal Perforation ◽  
Very Low Birth Weight ◽  
Primary Anastomosis ◽  
P Value ◽  
Single Center ◽  
Vlbw Infants ◽  
Single Center Experience ◽  
Focal Intestinal Perforation

Introduction We present a single-center experience with very low birth weight (VLBW) infants with focal intestinal perforation (FIP), comparing the results of primary anastomosis (PA) and stoma opening (SO). Materials and Methods Clinical records of VLBW infants with FIP who underwent surgery between 2006 and 2015 were reviewed. Patients were divided into two groups according to the procedure performed: limited bowel resection and PA or SO. Patients with gastric perforation or patients who underwent clip and drop were excluded. Information regarding birth weight (BW), gestational age (GA), weight at surgery (WS), number of abdominal reoperations, duration of parenteral nutrition (PN), and demise was recorded. Results In this study, 40 patients were included: 22 in PA group and 18 in SO group. BW was 865 g in PA and 778 in SO (p-value: 0.2). GA was 26.1 weeks in PA and 25.6 in SO (p-value: 0.3). WS was 1,014 g in PA and 842 in SO (p-value: 0.09). Duration of surgery was 115 minutes in PA and 122 in SO (p-value: 0.67). Five patients (23%) belonging to PA group developed complications and required SO. Five patients (23%) demised in PA group and six (33%) in SO (p-value: 0.2). Seventeen abdominal reoperations were performed in PA group and 22 in SO group (p-value: 0.08). Conclusion Both procedures appear to be safe. When possible, PA should be performed as it reduces the number of abdominal reinterventions.

scholarly journals 39 Early Higher Parenteral Lipid Intake Decreases Extra-Uterine Growth Restriction in Very Low Birth weight Infants: A Randomized Controlled Trial

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e15-e16
Author(s):  
Wissam Alburaki ◽  
Belal Alshaikh ◽  
Kamran Yusuf
Keyword(s):  
Weight Loss ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Intervention Group ◽  
Excessive Weight Loss ◽  
Vlbw Infants ◽  
Excessive Weight ◽  
Uterine Growth

Abstract Background Approximately 43-65% of very low birth weight (VLBW) infants develop extra-uterine growth restriction (EUGR). EUGR is associated with a significant increase in the risk of neurodevelopmental impairment. Inadequate early postnatal nutrition results in excessive weight loss that cannot be explained by the physiologic contraction of body water alone. EUGR and postnatal growth failure are usually associated with negative early energy and nitrogen balance in the first week of life. Growth trajectories after initial weight loss have similar slopes regardless of gestational age, which indicates that the early excessive weight loss is a lead cause for EUGR. Objectives To study whether an early and higher parenteral lipid intake in the first week after birth would decrease the percentage of weight loss and subsequently the incidence of EUGR. Design/Methods This was a randomized, open-label, control trial of appropriate-for-gestational age VLBW infants admitted to our level III NICU. Lipid intake in the control group started at 0.5-1 g/kg/day and was increased daily by 0.5-1 g/kg/day until 3 g/kg/day was reached. The intervention group was started on 2 g/kg/day then increased to 3 g/kg/day the following day. Triglyceride levels were measured the day after the start and after each increase in lipid intake. Results Among the 176 infants assessed for eligibility, eighty-three were included in the trial. There were no significant differences between the control and the intervention group in mean gestational age (27.3 ± 2.4 vs. 27.1 ± 2.3 weeks respectively) or birth weight (1011 ± 250 vs. 1019 ± 271 g respectively). Infants in the intervention group were started on lipid earlier (13.8±7.8 vs. 17.5±7.8 h; p=0.03) and had higher cumulative lipid intake in the first 7 days of age (13.5±4.2 vs. 10.9±3.5 g/kg; p=0.004) that led to a protein to energy ratio; closer to the recommended values. Total fluid intake was similar between the two groups. Infants in the intervention group had a lower percentage of weight loss (10.4±3.6 vs. 12.7±4.6; p=0.02). The mean triglyceride level was higher in the intervention group (1.91± 0.79 vs. 1.49±0.54 mmol/L; p= 0.01), however, hypertriglyceridemia was similar between the two groups at 2 and 3 g/kg/day of lipid intake. Enteral energy and protein intake calculated weekly between the time of parenteral nutrition discontinuation and 36 weeks corrected gestational age (CGA) were similar between the 2 groups. EUGR at 36 weeks CGA was significantly lower in the intervention group (38.6% vs. 67.6%; p=0.01). Conclusion In VLBW infants, the provision of an early and higher dose of parenteral lipid in the first week of life results in less weight loss and lower incidence of EUGR.

scholarly journals Oropharyngeal Administration of Colostrum Increases Salivary Secretory IgA Levels in Very Low-Birth-Weight Infants

2017 ◽  
Vol 34 (14) ◽  
pp. 1389-1395 ◽  
Author(s):  
Coleen Greecher ◽  
Kim Doheny ◽  
Kristen Glass
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Multicenter Trial ◽  
Secretory Iga ◽  
Control Group ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Late Onset Sepsis

Aim Oropharyngeal administration of colostrum (OAC) has been proposed to provide mother's early milk to very low-birth-weight (VLBW) infants in the first few days of life. The aim of this study was to test the hypothesis that OAC would increase salivary secretory IgA (SsIgA). Patients and Methods Overall, 30 VLBW infants randomized to receive OAC or sterile water had salivary sampling for SsIgA on the day of life (DOL) 2, 7, and 14. The incidence of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) was determined prospectively. Within and between-group comparisons were made by paired and independent samples t-tests. Results Baseline characteristics were similar between groups. SsIgA was higher in OAC versus the control group (p < 0.05) on DOL 7, but not subsequently on DOL 14. There was no difference in LOS or NEC. Conclusion OAC increased SsIgA at DOL 7. A large, multicenter trial is needed to determine if OAC decreases LOS or NEC in VLBW infants.

The Effect of Breast Milk Cells on the Clinical Outcomes of Neonates With Birth Weight Equal to or Less Than 1800 Grams: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Minoo Fallahi ◽  
Seyed Masoud Shafiei ◽  
Naeeme Taslimi Taleghani ◽  
Maryam Khoshnood Shariati ◽  
Shamsollah Noripour ◽  
...  
Keyword(s):  
Birth Weight ◽  
Breast Milk ◽  
Clinical Outcomes ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Low Birth Weight Infants ◽  
Randomized Controlled

Abstract Background: Most premature and very low birth weight infants cannot tolerate feedings in the first few days of life and are deprived of breast milk's beneficial effects. This study aims to evaluate the breast milk cells' effects on neonates' clinical outcomes with a birth weight of ≤1800 grams.Methods: This research is a randomized controlled trial conducted on 156 infants in the neonatal intensive care unit of Mahdieh maternity Hospital in Tehran, Iran, from May 2019 to April 2020. All neonates with a birth weight of ≤1800 grams were enrolled and randomly divided into intervention and control groups. During the first 6-12 hours of delivery, neonates in the intervention group received the extracted breast milk cells (BMCs) provided by centrifuging their own mothers' breast milk for one time. Demographic data and clinical outcomes were compared between the two groups. We also had a subgroup analysis in neonates with birth weight less than 1500 grams.Results: A total of 156 neonates entered the final analysis. We divided participants into two groups by using a computer-generated block randomization sequence, including 75 patients in the intervention group and 81 neonates in the control group. The mean birth weight of neonates was 1390.1±314.4 grams, with a total mortality rate of 12.2% (n=19). We found that in-hospital mortality was significantly lower in neonates who received BMCs (6.7% vs. 17.3%; P-value: 0.043) compared to the control group, and it was more prominent in neonates with birth weight less than 1500 grams (9.5% vs. 30.2%; P-value: 0.017). We did not find any other significant differences in major complications such as retinopathy of prematurity, necrotizing enterocolitis, and bronchopulmonary dysplasia between the two groups.Conclusion: Our research demonstrated a significantly lower mortality rate in neonates (with a birth weight of ≤1800 grams) who received breast milk cells on the first day of life. Since this is a novel method with minimal intervention, we are looking forward to developing and evaluating this method in larger studies, with more frequent use of BMCs in very low birth weight infants.Trial registration: Iranian Registry of Clinical Trials, IRCT20190228042868N1. Registered 25 May 2019, https://irct.ir/trial/38230.

scholarly journals Application of Diffusion Tensor Imaging in the Evaluation of Brain Injury in Premature Infants with Low and Very Low Birth Weight

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Dalin Zhu ◽  
Manxia Wang ◽  
Fan Feng ◽  
Nan Nan ◽  
Yuefen Liu ◽  
...  
Keyword(s):  
Birth Weight ◽  
White Matter ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Very Low Birth Weight ◽  
Diffusion Tensor ◽  
Occipital Lobe ◽  
Control Group ◽  
Vlbw Infants ◽  
Adc Values

Background: Brain injury in premature infants (BIPI) is a severe brain damage in premature infants, resulting in a series of neurological sequelae. Diffusion tensor imaging (DTI), as a magnetic resonance imaging (MRI) technique, is more widely used for premature infants. It is of paramount importance to improve the early diagnosis, treatment, and intervention for this population by using DTI. There are few reports on the application of DTI for the evaluation of BIPI in low-birth-weight (LBW) and very-low-birth-weight (VLBW) infants. Objectives: To analyze the clinical characteristics of BIPI in LBW and VLBW infants and to explore the value of MRI-based DTI in the evaluation of BIPI in LBW infants. Patients and Methods: This prospective study was conducted on 31 cases of BIPI (16 LBW and 15 VLBW infants) and 20 normal control premature infants, undergoing MRI-based DTI at the postmenstrual age (PMA). Differences in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) between the BIPI and control groups and also between the LBW and VLBW groups with BIPI were analyzed. Also, differences with normal controls in terms of the FA and ADC values were investigated in different brain regions. Results: The FA values in the central white matter of the frontal lobe, central white matter of the occipital lobe, centrum semiovale, posterior limb of the internal capsule (PLIC), and ventral thalamus were significantly lower in the BIPI group as compared to the control group (P < 0.05). The ADCs were lower in the BIPI group compared to the control group, and there was a significant difference (P < 0.05). Comparison of FA and ADC values in the central white matter of the frontal lobe, central white matter of the occipital lobe, centrum semiovale, PLIC, and ventral thalamus did not show any significant differences between the LBW and VLBW groups with BIPI (P > 0.05). Conclusion: The FA and ADC values of DTI can be used for the quantitative evaluation of BIPI in LBW and VLBW infants. The FA value was found to be more accurate than the ADC. Overall, different FA values in different brain areas reflect differences in the brain development of normal premature infants.

scholarly journals Oral Nystatin Prophylaxis to Prevent Systemic Fungal Infection in Very Low Birth Weight Preterm Infants : A Randomized Controlled Trial

2019 ◽  
Author(s):  
Lily Rundjan ◽  
Retno Wahyuningsih ◽  
Chrissela Anindita Oeswadi ◽  
Miske Marsogi ◽  
Ayu Purnamasari
Keyword(s):  
Birth Weight ◽  
Fungal Infection ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Intervention Group ◽  
Fungal Colonization ◽  
Control Group ◽  
P Value ◽  
Systemic Fungal Infection

Abstract Background Systemic fungal infection (SFI) is one of leading causes of morbidity and mortality in very low birth weight (VLBW) preterm infants. Because early diagnosis of SFI is challenging due to nonspecific manifestations, prophylaxis becomes crucial. This study aimed to assess effectiveness of oral nystatin as an antifungal prophylaxis to prevent SFI in VLBW preterm infants.Methods A prospective, open-labelled, randomized controlled trial was performed in a neonatal intensive care unit (NICU) of an academic hospital in Indonesia. Infants with a gestational age < 32 weeks and/or birth weight of < 1500 grams with risk factors of fungal infection were assessed for eligibility and randomized to either an intervention group (nystatin) or control group. The intervention group received 1 ml of oral nystatin three times a day, and the control group received a dose of 1ml of sterile water three times a day. The incidence of fungal colonization and SFI were observed and evaluated during the six-week study period. Overall, mortality rates and nystatin-related adverse drug reactions during the study period were also documented.Results A total of 95 patients were enrolled. The incidence of fungal colonization was lower among infants in nystatin group compared to those in control group (29.79% and 56.25%, respectively; relative risk 0.559; 95% confidence interval 0.357-0.899; p-value=0.009). There were five cases of SFI, all of which were found in the control group (p-value=0.056). There was no difference in overall mortality between the two groups. No adverse drug reactions were noted during the study period.Conclusions Nystatin is effective and safe as an antifungal prophylactic medication in reducing colonization rates in the study population. Whilst the use of nystatin showed a potential protective effect against SFI among VLBW preterm infants, there was no statistical significant difference in SFI rates between groups.

scholarly journals Oral Nystatin Prophylaxis To Prevent Systemic Fungal Infection In Very Low Birth Weight Preterm Infants : A Randomized Controlled Trial

2020 ◽  
Author(s):  
Lily Rundjan ◽  
Retno Wahyuningsih ◽  
Chrissela Anindita Oeswadi ◽  
Miske Marsogi ◽  
Ayu Purnamasari
Keyword(s):  
Birth Weight ◽  
Fungal Infection ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Intervention Group ◽  
Fungal Colonization ◽  
Control Group ◽  
P Value ◽  
Systemic Fungal Infection

Abstract Background Systemic fungal infection (SFI) is one of leading causes of morbidity and mortality in very low birth weight (VLBW) preterm infants. Because early diagnosis of SFI is challenging due to nonspecific manifestations, prophylaxis becomes crucial. This study aimed to assess effectiveness of oral nystatin as an antifungal prophylaxis to prevent SFI in VLBW preterm infants. Methods A prospective, open-labelled, randomized controlled trial was performed in a neonatal intensive care unit (NICU) of an academic hospital in Indonesia. Infants with a gestational age < 32 weeks and/or birth weight of < 1500 grams with risk factors of fungal infection were assessed for eligibility and randomized to either an intervention group (nystatin) or control group. The intervention group received 1 ml of oral nystatin three times a day, and the control group received a dose of 1ml of sterile water three times a day. The incidence of fungal colonization and SFI were observed and evaluated during the six-week study period. Overall, mortality rates and nystatin-related adverse drug reactions during the study period were also documented. Results A total of 95 patients were enrolled. The incidence of fungal colonization was lower among infants in nystatin group compared to those in control group (29.79% and 56.25%, respectively; relative risk 0.559; 95% confidence interval 0.357-0.899; p-value=0.009). There were five cases of SFI, all of which were found in the control group (p-value=0.056). There was no difference in overall mortality between the two groups. No adverse drug reactions were noted during the study period. Conclusions Nystatin is effective and safe as an antifungal prophylactic medication in reducing colonization rates in the study population. Whilst the use of nystatin showed a potential protective effect against SFI among VLBW preterm infants, there was no statistical significant difference in SFI rates between groups.

scholarly journals The Effect of Health Education on Mother's Knowledge Attitudes and Behavior in Giving Care to Low Birth Weight Babies

2021 ◽  
Vol 19 (2) ◽  
pp. 97-109
Author(s):  
Dian Pratiwi ◽  
Djauhar Ismail ◽  
Mufdlilah Mufdlilah ◽  
Panyada Cholsakhon
Keyword(s):  
Birth Weight ◽  
Health Education ◽  
Low Birth Weight ◽  
Intervention Group ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Inclusion Criteria ◽  
Significant Difference ◽  
Low Birth Weight Babies

The number of low-birth-weight babies (LBW) who returned to the hospital after returning home had increased from 2015 to 2016. The results of the interview revealed that mothers who had LBW did not thoroughly understand providing care for LBW after returning from the hospital. This study aims to determine the effect of health education on a mother's knowledge, attitude and behaviour in providing care to LBW. This study is quasi-experimental with a pre-posttest approach non-equivalent to the control group, with 66 respondents fulfilling the inclusion criteria. The inclusion criteria in this study were post-partum mothers on the second day who had babies with a birth weight of 1500 grams-2499 grams and were willing to be respondents. The sampling technique was purposive sampling. The statistical test employed independent t-test, paired t-test, and chi-square. Knowledge scores before and after treatment were significantly different in the intervention group and control group, with a p-value in the intervention group 0.00, while the knowledge and attitude scores in the control group were 0.00 and the behavioural scores were 0.11. There was a significant difference in the increase in knowledge, attitudes and behaviour scores in both groups. The p-value of knowledge and attitudes is 0.00, and the p-value of behaviour is 0.01. Hence, there is an increase in mothers' knowledge, attitudes, and behaviour after being provided with health education using a booklet.

scholarly journals Oral Nystatin Prophylaxis to Prevent Systemic Fungal Infection in Very Low Birth Weight Preterm Infants : A Randomized Controlled Trial

2020 ◽  
Author(s):  
Lily Rundjan ◽  
Retno Wahyuningsih ◽  
Chrissela Anindita Oeswadi ◽  
Miske Marsogi ◽  
Ayu Purnamasari
Keyword(s):  
Birth Weight ◽  
Fungal Infection ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Intervention Group ◽  
Fungal Colonization ◽  
Control Group ◽  
P Value ◽  
Systemic Fungal Infection

Abstract Background Systemic fungal infection (SFI) is one of leading causes of morbidity and mortality in very low birth weight (VLBW) preterm infants. Because early diagnosis of SFI is challenging due to nonspecific manifestations, prophylaxis becomes crucial. This study aimed to assess effectiveness of oral nystatin as an antifungal prophylaxis to prevent SFI in VLBW preterm infants. Methods A prospective, open-labelled, randomized controlled trial was performed in a neonatal intensive care unit (NICU) of an academic hospital in Indonesia. Infants with a gestational age < 32 weeks and/or birth weight of < 1500 grams with risk factors of fungal infection were assessed for eligibility and randomized to either an intervention group (nystatin) or control group. The intervention group received 1 ml of oral nystatin three times a day, and the control group received a dose of 1ml of sterile water three times a day. The incidence of fungal colonization and SFI were observed and evaluated during the six-week study period. Overall, mortality rates and nystatin-related adverse drug reactions during the study period were also documented. Results A total of 95 patients were enrolled. The incidence of fungal colonization was lower among infants in nystatin group compared to those in control group (29.79% and 56.25%, respectively; relative risk 0.559; 95% confidence interval 0.357-0.899; p-value=0.009). There were five cases of SFI, all of which were found in the control group (p-value=0.056). There was no difference in overall mortality between the two groups. No adverse drug reactions were noted during the study period. Conclusions Nystatin is effective and safe as an antifungal prophylactic medication in reducing colonization rates in the study population. Whilst the use of nystatin showed a potential protective effect against SFI among VLBW preterm infants, there was no statistical significant difference in SFI rates between groups.

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