scholarly journals Early Neonatal Morbidity after Term Delivery: How should We respond?

Author(s):  
Milan Stanojevic ◽  
Lana Leko

ABSTRACT Aim The aim of this retrospective study was to investigate the influence of gestational age and mode of delivery at term on early neonatal morbidity and mortality in a tertiary maternity center in a 10-year period. Materials and methods The data were derived from the medical records between January 1, 2005, and December 31, 2014, from the University Hospital “Sveti Duh,” Zagreb, Croatia. There were 30,363 live born term infants included in the study. The data from the medical records have been used to analyze their mode of delivery, morbidity, and mortality. Results Term newborn infants delivered by cesarean section (CS) had increased prevalence of lower Apgar scores, resuscitation, neonatal convulsions, and neonatal encephalopathy, respiratory pathology (except for amniotic fluid aspiration), and mechanical ventilation. Early and late neonatal deaths were more prevalent in term infants delivered by CS. The prevalence of birth trauma (except for facial nerve palsy) and hyperbilirubinemia was significantly increased in vaginally born neonates. The prevalence of perinatal infections was equal in both groups of infants. Morbidity and mortality of term newborn infants presented as prevalence per 1,000 live born, regardless of the mode of a delivery week by week from 37 through 41 weeks of gestation, were also investigated. The highest prevalence for most of the observed parameters were at 37 to 41 weeks of gestation, while the lowest prevalence was observed at a gestational age between 39 and 40 weeks. This was not the case for the 1st and the 5th minute 4 to 7 Apgar scores, birth injuries, respiratory pathology, and late neonatal deaths. Conclusion Early-term delivery was connected with more morbidity and mortality in the early neonatal period. It seems that the best gestational age to be born is at 39 to 40 weeks of gestation. Mode of delivery at term counts as well, showing that vaginal delivery at term had the lowest risk of morbidity and mortality. How to cite this article Stanojevic M, Leko L. Early Neonatal Morbidity after Term Delivery: How should We respond? Donald School J Ultrasound Obstet Gynecol 2016;10(2):180-184.

2019 ◽  
Vol 6 (4) ◽  
pp. 1582
Author(s):  
Jayalakshmi Pabbati ◽  
Preethi Subramanian ◽  
Mahesh Renikuntla

Background: A baby’s weight at birth is a strong indicator of newborn health and nutrition. Low birth weight (LBW) babies are more susceptible to morbidities and mortality in early neonatal period than normal birth weight (NBW) babies. Among neonatal deaths, 80% occurs in LBW / preterm babies and 75% of total neonatal deaths occur in early neonatal period. The present study was undertaken to know the incidence and early neonatal outcome of LBW babies in rural area.Methods: Prospective observational study was conducted in babies born with <2.5 kg (LBW) birth weight.Results: The incidence of LBW babies was 25.07% with almost an equal contribution from preterm (50.46%) and Term Intra Uterine Growth Restricted (IUGR) (49.53%) babies. The most common morbidity found in LBW babies was Jaundice (40.09%) followed by respiratory distress (18.16%), sepsis (8.72%) and apnea (4.48%). Preterm-LBW babies had more morbidities in terms of apnea (100%), birth asphyxia (88.88%), respiratory distress (87.01%%), sepsis (80.55%) and jaundice (67.64%). Early neonatal mortality was 21.22 per 1000 live births. Mortality was 100% for babies <1 kg in birth weight, 16% in 1-1.499 kg group and 0.75% in 1.5-2.499 kg group in early neonatal period. According to gestational age, mortality in preterm-LBW babies was 88.88% and 11.11% in Term IUGR-LBW babies. The most common cause of death in LBW babies was birth asphyxia (44.44%) followed by hyaline membrane disease (HMD) (33.33%).Conclusions: The present study revealed that preterm babies contributed 50% to incidence of LBW babies. Morbidity and mortality in LBW babies were inversely related to birth weight and gestational age.


2004 ◽  
Vol 191 (3) ◽  
pp. 773-777 ◽  
Author(s):  
Shi Wu Wen ◽  
Fung Karen Fung Kee ◽  
Oppenheimer Lawrence ◽  
Demissie Kitaw ◽  
Yang Qiuying ◽  
...  

2018 ◽  
Vol 5 (3) ◽  
pp. 1036
Author(s):  
Satheesh Kumar D. ◽  
Thenmozhi M. ◽  
Kumar .

Background: Perinatal asphyxia is the most common cause of neonatal morbidity and mortality in worldwide. It accounts for 23% of all neonatal deaths. Electrolyte abnormalities are more common in the immediate post asphyxiated period and influence neonatal the outcome effectively. Aim of this study was to measure the serum sodium, potassium and calcium levels in immediate postnatal period of asphyxiated newborns and assess the correlation with different degree of birth asphyxia.Methods: The serum sodium, potassium and calcium levels were measured in asphyxiated newborns in the early post-natal period. Both intramural and extramural newborns were included irrespective of their mode of delivery but according to the Apgar score. The measured electrolyte values were compared with the different severity of asphyxia. Results: Out of 100 newborns 53 had hyponatremia, 10 had hyperkalemia and 3 had hypocalcemia. The serum sodium and potassium levels showed significant P value (<0.00) with the different degree of both asphyxia but calcium levels were not significant (p valve = 0.06). There was a negative linear correlation with sodium and calcium levels and positive correlation with the serum potassium levels.Conclusions: Hyponatremia was significant in all stages of birth asphyxia, hyperkalemia was significant with increased severity of birth asphyxia and hypocalcemia was only weakly significant even in severe birth asphyxia.


2016 ◽  
Vol 44 (5) ◽  
pp. 197
Author(s):  
Ahmad Faisal ◽  
Guslihan D Tjipta ◽  
Bidasari Lubis ◽  
Dachrul Aldy

Background Neutrophils are very important in the body defenseagainst bacterial infection. Absolute neutrophil count (ANC) couldbe used for the recognition of early-onset bacterial sepsis inneonates.Objective The aim of this study was to compare the value of ANCbetween premature and term infants, to assess the prevalence ofearly-onset neutropenia in premature infants and its relationshipwith prematurity, and to find out the correlation between gesta-tional age and ANC.Methods A cross-sectional study was conducted during Februaryto May 2003. Subjects were newborn infants with gestational ageof less than 37 weeks who were born in Adam Malik and PirngadiHospitals, Medan. Newborn infants with severe asphyxia (5-minuteApgar score of less than 4), fever, seizure, and maternalhypertension were excluded. Complete blood count was done bymeans of automatic cell counter (Micros (R) , Germany). Term healthyinfants were used as control subjects.Results ANC differed significantly between both groups (p=0.0001).The prevalence of early-onset neutropenia in premature infantswas 9% (95%CI 0.065;0.21). Prematurity was related with theincidence of neutropenia with a prevalence ratio of 1.1. Therewas a weak positive correlation between gestational age andANC with an r-value of 0.49 (p=0.0001).Conclusions ANC in premature infants differs from that in terminfants. The prevalence of early-onset neutropenia in prematureinfants was 9% (95%CI 0.065;0.21). Prematurity is related with theincidence of early-onset neutropenia in newborn infants. There isa correlation between gestational age and ANC


2018 ◽  
Vol 5 (2) ◽  
pp. 448
Author(s):  
Sharwari J. Bhutada ◽  
Chandrakant M. Bokade

Background: Neonatal sepsis can cause multiorgan involvement causing neonatal morbidity and mortality. The kidneys are an important organ affected in septicemic newborns. In this study we evaluated the renal functions and its association with various risk factors along with outcome in septicemic neonates.Methods: This study was a prospective observational study conducted in a tertiary care teaching hospital. The sample size was 276 cases of septicemic new-borns and study duration was 2 years. The profile of acute renal failure (ARF) and various risk factors were studied in a sample of 276 septicemic neonates. Detailed clinical examination and investigations were done to confirm the diagnosis of neonatal sepsis and the occurrence of ARF was studied among these septicemic newborns. Risk factors like birth weight, gestational age, shock, etiological agents, DIC were studied for the occurrence of ARF and mortality in ARF patients among septicemic neonates.Results: 30.07% of septicemic neonates developed ARF. DIC (p value=0.014), shock (p value=<0.0001), gestational age (p value=0.005), birth weight (p value=0.003), were found to be analytically significant for the occurrence of ARF. Birth weight (p value=0.006), age of onset of sepsis (p value=0.019), shock (p value =<0.0001), oliguria (p value =<0.0001), and DIC (p value=0.015) were significant predictors of mortality in ARF among septicemic neonates.Conclusions: Awareness and early identification of various risk factors and ARF in septicemic neonates can prevent morbidity and mortality among neonates. 


Author(s):  
Bianca Haase ◽  
Ana Maria Badinska ◽  
Bernd Koos ◽  
Christian F Poets ◽  
Laila Lorenz

ObjectiveWith inappropriately large facemasks, it is more difficult to create a seal on the face, potentially leading to ineffective ventilation during neonatal stabilisation. We investigated whether commonly available round facemasks are of appropriate size by measuring facial dimensions in near-term and term infants using two-dimensional (2D) and three-dimensional (3D) images.DesignProspective single-centre observational study.SettingInfants born in our centre at 34–41 weeks’ gestation were eligible.InterventionPatients were photographed with 2D and 3D technique.Main outcome measuresDistances between nasion and gnathion were measured and compared with the outer diameter of various round facemasks.Methods2D and 3D images were performed using standard equipment. Correlations between gestational age and the above-mentioned distances were assessed using Pearson’s r.ResultsImages were taken from 102 infants with a mean (SD) gestational age of 37.9 (2.3) weeks. Mean distance between nasion and gnathion was 46.9 mm (5.1) in 2D and 49.9 mm (4.1) in 3D images, that is, on average 3 mm smaller in 2D than with 3D (p<0.01). Based on these measurements, round facemasks with an external diameter of 50 mm seemed fitting for most (61%) term infants and 42 mm masks for most (72%) near-term infants (GA 34–36 weeks).ConclusionsRound facemasks with an external diameter of 60 mm are too large for almost all newborn infants, while 42/50 mm round facemasks are well fitting. Important anatomical structures were only visible using 3D images.Clinical trial registration numberNCT03369028


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