Factors affecting neonatal birth weight in Sidotopo Wetan Health Centre: A cross-sectional study

Birth weight serves as an indicator of a newborn’s health status. It is associated with mortality rate in the first year, developmental problems in childhood and risk of various diseases in adulthood. Even in modern era, it continues to be a health concern globally, especially in developing countries. In Indonesia, the prevalence of low birth weight has increased from 2013 to 2018, swaying further from the national target. Low birth weight is often caused by insufficient nutrients supplied by the mother to the fetus. In Indonesia, chronic energy deficiency status is diagnosed in the first antenatal care visit by measuring maternal middle-upper arm circumference with a cut-off point of 23.5cm. Meanwhile, iron level is measured via assessing hemoglobin level will be measured in the first antenatal care visit and in trimester III. This study aims to describe the factors that may influence neonatal birth weight. It is a quantitative study with a cross sectional approach conducted at Sidotopo Wetan Public Health Centre. 97 samples are collected from medical records and analysed using bivariate correlative test. Result shows that maternal age (0.20), chronic energy deficiency status (0.026) and antenatal care visit minimal of 4 times (0.49) increase the risk of low-birth-weight incidence. On the other hand, educational level, maternal parity and anemia status does not acts as risks. In conclusion, maternal age, energy status and visits to antenatal care acts as risk factors in causing low birth weight.

Incidence and risk factors of retinopathy of prematurity in extremely low birth weight babies in a tertiary neonatal care unit in northern India

To study the incidence and risk factors of Retinopathy of prematurity in extremely low birth weight babies in a tertiary neonatal care unit in northern India. A prospective cohort study of all neonates born during January 1, 2015 to December 31, 2015, with birth weight less than 1000 grams. Demographic details, risk factors and incidence of ROP were studied. Sixty babies were enrolled for the study with mean birth weight of 892.983±112.933 (560 to 1000) grams and mean gestation age of 29.47±2.258 (25-35) weeks. The incidence of ROP in this cohort was 50% (30 infants), out of which 23% (7 infants) required treatment (laser photocoagulation). The statistical analysis of risk factors on univariate analysis revealed significant association for oxygen exposure, apnoea, surfactant use, anaemia, blood transfusion, intraventricular haemorrhage, sepsis and antibiotic use. On multivariate logistic regression analysis anemia and oxygen exposure > week were found to be independent risk factors for development of ROP. The incidence of ROP was although high in this exclusive cohort of babies born <1000g but there is substantial decrease in incidence as compared to that reported in earlier studies. Gestational age <30 wks, being appropriate for gestation rather than small for gestation, anemia and oxygen exposure>1 week were found to be independent risk factors for development of ROP in this cohort.

Desfechos Adversos Perinatais Associados A Escolaridade Materna

Objective: To compare different levels of education with adverse perinatal outcomes in low-risk patients. Methodology: Cross-sectional study, puerperae were randomly selected, usual risk, attended in the public network, with single gestation. The evaluated puerperae were divided into 3 groups, according to education: primary or less, secondary and higher or more. The outcomes evaluated were cesarean section, neonatal ICU, low 1st minute Apgar, prematurity, and low birth weight. The calculation of the odds ratio had a 95% confidence interval. Results: the population was divided into 3 groups, 187 (52.9%) puerperal women with primary education or less, 437 (60.5%) patients with secondary education and 98 (13.6%) patients with higher education or more. Maternal characteristics differed in terms of age, previous pregnancies, normal deliveries, previous cesarean sections, age of 1st pregnancy, number of prenatal visits, income, number of people living in the household, and tobacco use. In the newborn profile, there was a difference only regarding cesarean sections. After calculating the odds ratio, it was seen that patients with primary education or less had a lower propensity to perform a cesarean section (0.511 95%CI 0.290-0.900), as well as patients with secondary education (0.530 95%CI 0.322-0.873), both compared to the population with higher education or more. In the other outcomes, no significance was observed. Conclusion: Primary and secondary education proved to be protective factors for cesarean section. No difference was found regarding prematurity, low birth weight, need for neonatal ICU and low 1st minute Apgar score.

Toxoplasmosis impact on prematurity and low birth weight

Background Toxoplasma gondii, one of the most common parasites, causes toxoplasmosis, one of the most frequent zoonotic diseases worldwide. T. gondii infects about one-third of the world’s population. T. gondii infection is generally considered a major risk for spontaneous abortion, prematurity and low birth weight in the animal sphere. Less commonly, a toxoplasma serological profile is correlated with the particular data of delivery. Acute T. gondii infection during pregnancy often leads to spontaneous abortion and/or a severe injury of the eyes, brain, and other structures of the foetus. Latent T. gondii infection of pregnant women could lead to less obvious but important changes during pregnancy, including the end product of pregnancy and the timing of labour. This study aimed to contribute to the current knowledge by comparing serological T. gondii profiles of pregnant women with prematurity and low birth weights of newborns. Material and methods A retrospective study design was adopted. The study participants included a cohort of 1733 pregnant women who consecutively gave birth to their children and underwent regular antenatal biochemical screening between the 14th and 16th weeks of pregnancy. Prematurity was defined as the liveborn preterm delivery in gestational age of pregnancy <37 weeks. Low birth weight was defined as weight at birth of ≤2499 grams. The complement-fixation test (CFT) provided serological profiles for toxoplasmosis that expresses the overall levels of toxoplasma immunoglobulins of all classes. Enzyme-linked immunosorbent assay (ELISA) tests for IgG and IgM were used simultaneously. IgM positivity helped to differentiate acute from the latent stage of toxoplasmosis. Birth data, especially the week of delivery and fetal weight, were evaluated accordingly. Results Of the 1733 pregnant women, 25% were diagnosed as latent toxoplasma positive, and 75% as toxoplasma negative. There were 87 premature deliveries versus 1646 timely births. We observed 88 low birth weights and 1645 normal fetal weights. We found a statistically significant association between latent toxoplasmosis and prematurity, χ2(1) = 5.471, p = .019 and between latent toxoplasmosis and low birth weight of newborns, χ2(1) = 7.663, p = .006. There was a 1.707 times higher risk of prematurity for toxoplasma-positive women, while the risk for low birth weight was 1.861 times higher. The strength of both tests of association was mild. We tested the correlation between the levels of CFT titres and week of delivery and weight of newborns. No association was found between the level of latent toxoplasmosis and the week of delivery and fetal weight. Conclusion Latent toxoplasmosis was associated with premature birth rate and lower birth weight of newborns. The odds of premature delivery was 1.7 and low birth weight 1.9 times higher in women with latent toxoplasmosis compared to toxoplasma negative women. Even though the strength of the association in our large sample is relatively mild, the combination of latent toxoplasmosis with other adverse factors could cause serious harm. Whole CFT and specific IgG levels of latent toxoplasmosis are not linked to the severity of prematurity or low birth weight in newborns.

Maternal Health Services as Determinant Factors for Low Birth Weight in public hospitals of Addis Ababa, Ethiopia: a Case-control Study.

Background: The birth weight of a newborn has a substantial impact on infant mortality, morbidity, development, and long-term health. It is determined by the mother's overall health status. More than 20 million babies are born with low birth weight across the world. In developing countries, almost 17% of all newborns are born with low birth weights, with no exception in Ethiopia. Alleviating this problem, needs a clear understanding of the determinants. Thus, this study was done in Addis Ababa, the most populous city in the country, where the lifestyles of mothers might be affected by the dynamic city life.Method: An unmatched case-control study was applied to assess the risk factors of low birth weight in three randomly selected public hospitals in Addis Ababa, Ethiopia. Data was collected through interviewer-administered structured questionnaires. Data analysis was done using SPSS version 24. Descriptive statistics using frequencies and percentages were used to describe the socio-demographic characteristics of the study participants. Bi-variable and multi-variable logistic regression analyses were used to assess the possible effect of determinant factors on low birth weight, with their respective odds ratios and 95% confidence intervals. P-values of less than 0.05 were considered statistically significant.Result: We enrolled 168 cases and 336 controls; all completed the study with no refusal. Of all pregnancies, 90 (17.8%) were unplanned and unwanted. And, 153 (30.3%) of mothers have a history of prior abortion. Among the factors we studied, maternal age below 18 years (AOR: 2.69, 95% CI: 1.24, 5.84), unwanted and unplanned pregnancy (AOR: 1.25, 95% CI: 1.09, 2.66), ANC visit in the last pregnancy below three (AOR: 3.23, 95% CI: 1.61, 6.49), female neonate (AOR: 1.09, 95% CI: 2.04, 3.20), not supplemented with iron and folic acid (AOR: 3.11, 95% CI: 1.36, 7.11) and hematocrit level of < 30 (AOR: 2.29, 95% CI: 1.00, 5.22) showed a statistically significant association with low birth weight.Conclusion: This study demonstrates that the age of mothers below 18 years, unwanted and unplanned pregnancy, low ANC visits, lack of iron and folic acid supplements, and low maternal hemoglobin level were the significant determinants of low birth weight among term babies. Thus, women of childbearing age should be screened and educated about the risks of pregnancy and should get the necessary care and support when they get pregnant.

The Survival Rate of Extremely Low Birth Weight Infants Improved in Guangdong Province, China

Background With the increase in extremely low birth weight (ELBW) infants, their outcomes received special attention. However, in China, studies of the outcomes of ELBW infants are rare. Methods The hospitalized records of ELBW infants discharged from twenty-six neonatal intensive care units were reviewed and analyzed. Results A total of 2575 ELBW infants were enrolled and the overall survival rate was 55.11%. From 2008 to 2017, the number of ELBW infants increased rapidly from 91 to 466, and the survival rate improved steadily from 41.76–62.02%. The survival rate rose with increasing BW, the ascending level of regional economic development and specialist hospitals. The incidence of complications was neonatal respiratory distress syndrome (85.2%), bronchopulmonary dysplasia (63.7%), retinopathy of prematurity (39.3%), intraventricular hemorrhage (29.4%), necrotizing enterocolitis (12.0%), and periventricular leukomalacia (8.0%). Among the 1156 nonsurvivors, 90.0% of infants died during the neonatal period (≤ 28 days), and the other died after the neonatal period. A total of 768 ELBW infants died after medical care withdrawal, with economic factors and expected outcome being important causes. Conclusion The number of ELBW infants is increasing in China, and the overall survival rate is still low but is improving steadily.

Preconception Hemoglobin Concentration and Risk of Low Birth Weight and Small-for-Gestational-Age: A Large Prospective Cohort Study in China

Less is known about the impact of maternal preconception anemia on birth outcomes. We aimed to examine associations between preconception hemoglobin (Hb) concentrations with risk of low birth weight (LBW) and small-for-gestational-age (SGA). This study was from a large population-based prospective cohort in China and included 124,725 women with singleton live births delivered at gestational ages of 28–45 weeks who were registered before pregnancy. Maternal Hb concentrations were measured during registration, and other health-related information was recorded prospectively. Logistic regression was used to evaluate the associations between preconception Hb concentrations with risk of LBW and SGA, adjusting for potential confounders. The results showed women with preconception anemia accounted for 22.28%. The incidences of LBW/SGA were 2.37%/6.30% among anemic women, and 2.01%/5.48% among non-anemic women, respectively. Preconception mild anemia increased by 17% (95% confidence interval (CI): 1.06, 1.28) and 14% (95% CI: 1.07, 1.21) the risk for LBW and SGA, while moderate-to-severe anemia had no significant association with LBW and SGA. Compared with the 120–129 g/L group, a U-shaped association was observed between preconception Hb concentrations with LBW and SGA. In conclusion, not only maternal anemia but also elevated Hb concentrations before pregnancy contribute to an increased risk of LBW and SGA.

Association between the number of visits during prenatal care and the occurrence of low birth weight in the United States

BackgroundLow birth weight (LBW) is one of the major child and infant health issues in the United States, standing as one of the main causes of child and infant mortality. While the importance of prenatal visits regarding pregnancy outcomes is recognized, its relationship with birth weight is still a matter of debate.ObjectivesThis study examines the relationship between the number of prenatal visits and low birth weight among children born in the United States in 2017.Study designData from the CDCs Online Birth Databases are used for this study. 3,864,754 registered children born in the U.S. in 2017 are included in the analyses. The databases also include information on maternal characteristics, pregnancy history and prenatal care characteristics, pregnancy risk factors, delivery characteristics, and infant characteristics. The outcome variable is low birth weight, defined as weight at birth lower than 2500 grams. The independent variable is the number of prenatal visits grouped in three categories (no visit, 10 visits or less, and more than 10 visits. Confounding and covariates include prematurity and plurality among others. Multiple logistic regression modeling was used, reporting unadjusted and adjusted odds ratios with corresponding 95% confidence intervals.ResultsData from the CDCs Online Birth Databases are used for this study. 3,864,754 registered children born in the U.S. in 2017 are included in the analyses. The databases also include information on maternal characteristics, pregnancy history and prenatal care characteristics, pregnancy risk factors, delivery characteristics, and infant characteristics. The outcome variable is low birth weight, defined as weight at birth lower than 2500 grams. The independent variable is the number of prenatal visits grouped in three categories (no visit, 10 visits or less, and more than 10 visits. Confounding and covariates include prematurity and plurality among others. Multiple logistic regression modeling was used, reporting unadjusted and adjusted odds ratios with corresponding 95% confidence intervals. ConclusionThis study reveals that the number of prenatal visits has an inverse relationship with low birth weight, even when confounding and other factors are accounted for. These findings are compatible with the notion that the more a woman goes for prenatal visits, the more likely it is to detect risks of negative pregnancy outcomes.