scholarly journals Effect of maternal underweight on fetal outcome

Biomedicine ◽  
2020 ◽  
Vol 39 (3) ◽  
pp. 480-483
Author(s):  
Monteiro Geraldin ◽  
N Anupama ◽  
Rekha D. Kini ◽  
Nayanatara A. K. ◽  
Sneha Shetty ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Weight Gain ◽  
Body Mass ◽  
Neonatal Intensive Care ◽  
Fetal Outcome ◽  
Chi Square ◽  
Chi Square Test ◽  
Nicu Admission

Introduction and Aim: Nutritional state of the mother before and during pregnancy is one of the important determinants along with factors like pre-pregnancy BMI, weight gain during pregnancy and gestational age which determines pregnancy outcome. Adequate gestational weight gain contributes for better pregnancy outcomes in both mother and infants for short- and long-term health. Materials and Methods: This is an observational study conducted retrospectively over a year comprised 300 pregnant subjects in their second trimester. Incidence of anemia, preterm labour, intrauterine growth retardation (IUGR) and neonatal intensive care unit (NICU) admission were compared in women with various Body Mass index (BMI). Analysis of the data was done using SPSS version 13 using chi square test and p ? 0.05 was considered statistically significant. Results: Out of 300 subjects, 79 developed anemia, among these 64(81%) were in the underweight category. 49 cases had a preterm delivery, out of these 49 cases, about 37(75.5%) belonged to the underweight BMI category. 39 cases delivered an intra-uterine growth retarded baby. Out of these 39 cases, about 25 (64.1%) belonged to the underweight BMI category. 56 neonates required intensive care unit (NICU) admission, of which 41 (73.2%) neonates born for underweight BMI mothers. Conclusion: The high proportions of underweight pregnancies in this study reflects the poor nutritional status. Adverse effects of maternal low body mass index target the fetus. Adequate weight gain of pregnant woman is an extremely important factor for the fetal outcome.  

scholarly journals The pattern of admission and outcome of neonates managed in the neonatal intensive care unit in a Sudanese hospital

2021 ◽  
Vol 8 (4) ◽  
pp. 616
Author(s):  
Safaa A. M. Ahmed ◽  
Mohammed A. O. Ali ◽  
Esraa A. A. Mahgoub ◽  
Mohammed Nimir ◽  
Elfatih M. Malik
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Binary Logistic Regression ◽  
Neonatal Morbidity ◽  
Chi Square ◽  
Chi Square Test

Background: This study aimed to assess the admission pattern and outcome of neonates managed in the neonatal intensive care unit (NICU) in a Sudanese hospital.Methods: This hospital-based retrospective study was conducted in the NICU of Saad Abu Elella Teaching Hospital in Khartoum, Sudan. Data was collected from medical records of 207 neonates using an extraction form. Chi-square test and binary logistic regression were used in analysis.Results: Most of the neonates were term, and 43% of them had a birth weight less than 2.5 kg. Moreover, the most common morbidities among them were sepsis, respiratory distress syndrome, neonatal jaundice and asphyxia, and the mortality rate was 15%. Additionally, the birth weight, gestational age, the need for resuscitations, direct breast feeding and being beside mother were found to be significantly associated with the studied outcome.Conclusions: Majority of causes of neonatal morbidity and mortality in our study were preventable diseases. Therefore, interventions to improve services in the NICU are highly needed to improve the outcomes.

scholarly journals 481. SARS-CoV-2 Infection in Hospitalized Children: An Elevated Body Mass Index is a Marker of Increased Risk of Acute Respiratory Failure

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S341-S342
Author(s):  
Catherine Foster ◽  
Shelley Kumar ◽  
Elizabeth Tocco ◽  
Galit Holzmann-Pazgal ◽  
Judith R Campbell ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Body Mass ◽  
Polymerase Chain Reaction Test ◽  
P Value ◽  
Hospitalized Children ◽  
Chi Square ◽  
Increased Risk ◽  
Length Of Hospitalization

Abstract Background Several risk factors are known to increase the severity of coronavirus disease 2019 (COVID-19) illness in adults, including age and obesity. Specific comorbidities affecting COVID-19 outcomes in children are less well defined. Methods We performed a retrospective cohort study of overweight and obese (OW) children compared to underweight and normal weight (NW) children with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Children between 2 and 18 years of age who were admitted to Texas Children’s Hospital from April through December of 2020 with a positive SARS-CoV-2 polymerase chain reaction test were included. Asymptomatic patients undergoing surveillance testing for SARS-CoV-2 were excluded. Body mass index (BMI) was calculated using the Centers for Disease Control definition. Demographic and clinical information was obtained from the electronic medical record. Statistical analyses were performed using SAS 9.0. Results We identified 145 total children who met inclusion criteria. Fifty-five (38%) children were NW and 90 (62%) children were OW. Demographics and characteristics are shown (Figure 1). Underlying asthma or chronic lung disease was present in 13 (24%) vs 31 (34%) in the NW and OW groups respectively (P=0.17). OW children were more likely to have pneumonia than NW children [relative risk1.6 (CI 1.40-2.45)]. An elevated BMI was also associated with an increased risk of requiring oxygen [relative risk 1.4 (CI 1.03-1.96)]. The median length of hospitalization was 4 days for NW versus 5 days for OW children (P=0.6). Admission to the Intensive Care Unit (ICU) was similar between the groups (P=0.7). There was no significant difference in treatments administered to children in the two groups, although there was a trend towards increased steroid (29 (53%) vs 59 (67%), P=0.13) and remdesivir (12 (22%) vs 30 (33%), P=0.14) use in the OW children. Four children in each group died. Characteristics of Hospitalized Children with SARS-CoV-2 Infection by Weight Category Abbreviations: ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit; MIS-C, multisystem inflammatory syndrome in children; MV, mechanical ventilation; NC, nasal cannula *Denotes statistically significant P-value a. Calculated using chi-square or fisher exact unless otherwise noted. a. Calculated using chi-square or fisher exact unless otherwise noted. A P-value <0.05 was considered significant. b. Calculated using Wilcoxon rank sum test. c. Includes patients with home noninvasive MV (2) or tracheostomy and home MV(4). Conclusion For children admitted with symptomatic COVID-19, being overweight or obese was significantly associated with having pneumonia and with requiring oxygen. A difference in ICU admission, length of hospitalization, and mortality was not observed. Obesity prevention along with vaccination efforts may prevent COVID-19 related morbidity in this group. Disclosures All Authors: No reported disclosures

Diagnosis of Auditory Neuropathy Spectrum Disorder in the Neonatal Intensive Care Unit Population

2021 ◽  
pp. 019459982110298
Author(s):  
Chengetai Mahomva ◽  
Yi-Chun Carol Liu ◽  
Nikhila Raol ◽  
Samantha Anne
Keyword(s):  
Intensive Care Unit ◽  
Information System ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Information ◽  
Neonatal Intensive Care ◽  
Health Information System ◽  
Auditory Neuropathy ◽  
Spectrum Disorder ◽  
Nicu Admission

Objective To determine the incidence of auditory neuropathy spectrum disorder (ANSD) and its risk factors among the neonatal intensive care unit (NICU) population from 2009 to 2018 in the Pediatric Health Information System database. Study Design Retrospective national database review. Setting Population-based study. Methods The Pediatric Health Information System database was queried to identify patients ≤18 years old with NICU admission and ANSD diagnosis. Patient demographics, jaundice diagnosis, use of mechanical ventilation, extracorporeal membrane oxygenation, furosemide, and/or aminoglycosides were extracted. Multivariable linear regression was used to assess trends in incidence. Chi-square analysis was used to assess differences between patients with and without ANSD. Logistic regression was used to assess factors associated with ANSD. Results From 2009 to 2018, there was an increase in (1) NICU admissions from 14,079 to 24,851 ( P < .001), (2) total ANSD diagnoses from 92 to 1847 ( P = .001), and (3) annual total number of patients with ANSD and NICU admission increased from 4 to 16 ( P = .005). There was strong correlation between the increases in total number of NICU admissions and total ANSD diagnoses over time ( R = 0.76). The average ANSD incidence was 0.052% with no statistically significant change over 10 years. When compared with all NICU admissions, children with ANSD had a higher association with use of furosemide ( P < .001) and ventilator ( P < .001). Conclusion Despite a statistically significant increase in NICU admissions and total ANSD diagnosis, the incidence of ANSD in the NICU population has not increased from 2009 to 2018. Furosemide and mechanical ventilator use were associated with increased likelihood of ANSD.

scholarly journals Neonatal and Maternal Outcomes in Spontaneously-Conceived Twin Pregnancies According to Mode of Delivery

Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 468-476
Author(s):  
Samantha Mc Kenzie Stancu ◽  
Manuela Cristina Russu
Keyword(s):  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Mode Of Delivery ◽  
Statistical Correlation ◽  
P Value ◽  
Maternal Outcomes ◽  
Chi Square ◽  
Chi Square Test ◽  
Nicu Admission ◽  
Twin Pregnancies

Introduction: Appropriate intrapartum conduct in a twin delivery remains a challenging aspect of obstetric practice. The objective of this study was to compare neonatal and maternal outcomes in twin pregnancies according to mode of delivery.&nbsp; Materials and methods: This is a single centre retrospective cohort study of all consecutive spontaneously-conceived twin deliver-ies (&ge; 24 weeks, estimated fetal weight &ge; 500 grams) over a nine-year period between 01/01/2007 - 31/12/2016 at a tertiary-level centre. Neonatal outcomes included survival, APGAR score, prematurity-associated pathology (PAP), admission to the neonatal intensive care unit (NICU) and length of stay (LOS). Maternal outcomes included postpartum complications and LOS. Statistical analysis comprised Chi-square test with subsequent p-value and odds-ratio with 95% confidence interval. Statistical significance was set at p<0.05. Results: A total of 173 consecutive women with spontaneously-conceived twin deliveries were enrolled in this study, 129 (74.6%) women delivered by caesarean section (CS). The success rate of vaginal delivery (VD) was 93.6% (44/47). A strong statistical correlation was identified between CS and NICU admission; 53.2% vs. 1.5% (p=0.0001). Neonatal LOS in the NICU was significantly longer in the CS group. Prematurity-associated pathology (PAP) was noted in 75 pairs of twins (75/173); 61 pairs were delivered by CS, bearing strong statistical significance (p<0.0001). Postpartum complications occurred in 14.7% of CS compared to 13.6% of VDs.&nbsp; Conclusion: Neonates delivered by CS had a higher rate of PAP, NICU admission, lower birth weight and longer LOS. This study showed that VD is safe, especially when the first twin is in cephalic presentation

Labor and Delivery Outcomes with the Sequential Use of Misoprostol Followed by Cervical Foley Catheter

2020 ◽  
Author(s):  
Maeve K. Hopkins ◽  
Rebecca F. Hamm ◽  
Sindhu K. Srinivas ◽  
Lisa D. Levine
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Maternal Morbidity ◽  
Neonatal Intensive Care ◽  
Foley Catheter ◽  
Catheter Placement ◽  
Increased Risk ◽  
Nicu Admission ◽  
Time To Delivery

Objective Studies demonstrate shorter time to delivery with concurrent use of misoprostol and cervical Foley catheter. However, concurrent placement may not be feasible. If misoprostol is used to start an induction, little is known regarding the benefit of sequentially using Foley catheter. We examine obstetrical outcomes in women with Foley catheter placed after misoprostol compared with those only requiring misoprostol. Study design Retrospective cohort study of singleton pregnancies, intact membranes, and an unfavorable cervix (Bishop score of ≤6 and dilation ≤2 cm) undergoing term induction May 2013 to June 2015. We compared obstetrical outcomes between women receiving misoprostol alone versus those that had a Foley catheter placed after misoprostol. Outcomes are mode of delivery, time to delivery, chorioamnionitis, admission to neonatal intensive care unit, and maternal morbidity. Chi-square and Fisher's exact tests were used for categorical variables, Mann–Whitney U-tests compared continuous variables. Results Among 364 women, 281 began induction with misoprostol alone. A total of 135 (48%) subsequently had a Foley catheter placed. Characteristics were similar between the groups, although nulliparity and cervical dilation <1 cm at start of induction were more likely to have subsequent Foley catheter. Women with Foley catheter placement after misoprostol had a longer median time to delivery (15 vs. 11 hours, p < 0.001), twofold higher rate of cesarean (42 vs. 26%, odds ratio: 2.1, 95% confidence interval: 1.26–3.44, p = 0.004), and increased risk of neonatal intensive care unit (NICU) admission (21 vs. 11%, p = 0.024). There was a nonsignificant increased risk of chorioamnionitis (12 vs. 7%, p = 0.1) and maternal morbidity (15 vs. 8%, p = 0.08) in the misoprostol followed by Foley catheter group. Conclusion In women receiving misoprostol for induction, nulliparas and those with dilation <1 cm are more likely to have subsequent Foley catheter placement. Sequential use of cervical Foley catheter after misoprostol is associated with longer labor, higher cesarean rate, and increased NICU admission. Requirement of Foley catheter after misoprostol confers higher risk and may guide counseling. Key Points

Liberal versus Indicated Maternal Oxygen Supplementation in Labor: A Before-and-After Trial

2018 ◽  
Vol 35 (11) ◽  
pp. 1057-1064 ◽  
Author(s):  
Sean Blackwell ◽  
Mesk Alrais ◽  
Farah Amro ◽  
Rachel Wiley ◽  
Patricia Heale ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Supplemental Oxygen ◽  
Oxygen Supplementation ◽  
Before And After ◽  
Clinically Significant ◽  
Nicu Admission ◽  
Singleton Pregnancies

Background Although supplemental oxygen (SO2) is routinely administered to laboring gravidas, benefits and harms are not well studied. Objective This article compares strategies of liberal versus indicated SO2 therapy during labor on cesarean delivery (CD) rate and neonatal outcomes. Study Design A controlled, before-and-after trial of laboring women with term, singleton pregnancies. During an initial 8-week period, maternal SO2 was administered at the discretion of the provider followed by an 8-week period where SO2 was to be given only for protocol indications. Results Our study included 844 women. There was no difference in number of women receiving SO2 (53% liberal vs. 50% indicated; p = 0.33). For those receiving SO2, there was no difference in SO2 duration (median, 89 minutes [interquartile range, 42–172] vs. 87 minutes [36–152]; p = 0.42). There were no differences in overall CD rate (20% vs. 17%; p = 0.70), CD for nonreassuring fetal status, or use of intrauterine resuscitative measures. There were more 5-minute APGAR < 7 in the indicated group, but no difference in umbilical artery pH < 7.1 or neonatal intensive care unit (NICU) admission. Conclusion Approximately half of women receive SO2 intrapartum regardless of a strategy of liberal or indicated oxygen use. There were no clinically significant differences in outcomes between strategies.

Prenatal Care Adherence and Neonatal Intensive Care Unit Admission or Stillbirth among Women with Gestational and Preexisting Diabetes Mellitus

2017 ◽  
Vol 35 (02) ◽  
pp. 103-109 ◽  
Author(s):  
Jeffrey Sperling ◽  
Lindsay Maggio ◽  
Phinnara Has ◽  
Julie Daley ◽  
Amrin Khander ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Prenatal Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Outcomes ◽  
Nicu Admission ◽  
Glycemic Monitoring ◽  
Lower Adherence

Objective To determine if there was an association between prenatal care adherence and neonatal intensive care unit (NICU) admission or stillbirth, and adverse perinatal outcomes in women with preexisting diabetes mellitus (DM) and gestational DM (GDM). Materials and Methods This is a retrospective cohort study among women with DM and GDM at a Diabetes in Pregnancy Program at an academic institution between 2006 and 2014. Adherence with prenatal care was the percentage of prenatal appointments attended divided by those scheduled. Adherence was divided into quartiles, with the first quartile defined as lower adherence and compared with the other quartiles. Results There were 443 women with DM and 499 with GDM. Neonates of women with DM and lower adherence had higher rates of NICU admission or stillbirth (55 vs. 39%; p = 0.003). A multivariable logistic regression showed that the lower adherence group had higher likelihood of NICU admission (adjusted odds ratio: 1.61 [1.03–2.5]; p = 0.035). Those with lower adherence had worse glycemic monitoring and more hospitalizations. Among those with GDM, most outcomes were similar between groups including NICU admission or stillbirth. Conclusion Women with DM with lower adherence had higher rates of NICU admission and worse glycemic control. Most outcomes among women with GDM with lower adherence were similar.

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