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Rashed, Ghader M., Areej A. Al-Omrani, Zahoor A. Mohmmed, and AbdulKarem J. Al-Bahadle. "NEONATAL OUTCOMES IN GESTATIONAL DIABETES MELLITUS." Iraqi Journal of Medical Sciences 20, no. 1 (June 30, 2022): 59–67. http://dx.doi.org/10.22578/ijms.20.1.8.
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Background: Gestational diabetes mellitus (GDM) is a common and serious maternal complication, in which hyperglycemia develops at any time during pregnancy due to progressive insulin resistance. It affects about 14% of pregnancies worldwide. There are many adverse effects of GDM that compromise the fetus and neonate. Objective: To compare neonatal outcomes according to type of treatment for GDM. Methods: A prospective study conducted at the Department of Pediatrics, (Neonatal Intensive Care Unit; NICU) and Obstetric in Al-Imamein Al-Kadhimein Medical City in Baghdad during a period from 1st of march 2019 to 1st of January 2020. The study included 100 neonates delivered by mothers with GDM, divided in to four groups according to their mothers' therapy; (diet group: 18 neonates, metformin group: 36, insulin group: 26, mixed group: 20). Results: Neonates in metformin group had a higher chance of having normal birth weight comparing with others, but neonates in insulin group have higher percent of prematurity, macrosomia, large for gestational age or small for gestational age, hypoglycemia and jaundice among others. No significant statistical difference between metformin and insulin, in mode of delivery, Apgar score, respiratory distress syndrome, hypocalcaemia, anomalies, and NICU admission but can occur more in insulin group. Conclusion: Metformin was able to reduce the risk of neonatal complications, therefore, it can be a good alternative for insulin in the treatment of GDM. Keywords: Gestational diabetes mellitus, macrosomia, metformin, insulin Citation: Rashed GM, Al-Omrani AA, Mohmmed ZA, Al-Bahadle AJ. Neonatal outcomes in gestational diabetes mellitus. Iraqi JMS. 2022; 20(1): 59-67. doi: 10.22578/IJMS.20.1.8
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Saboohi, Erum, Nighat Seema, and Abdulah Hadi Hassan. "Maternal and fetal factors contributing to neonatal outcome in Al-Tibri Medical College and Hospital." Journal of Fatima Jinnah Medical University 15, no. 1 (March 15, 2021): 18–22. http://dx.doi.org/10.37018/qbhp7754.
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Background: The study was done to identify the maternal and fetal factors contributing to neonatal outcome and to evaluate the correlation between risk factors and adverse neonatal outcome.
Subjects and methods: This prospective observational study was conducted on 126 mothers and their neonates fulfilling the selection criteria at Al-Tibri Medical College and Hospital. A self-designed Performa was used to enter data of subjects. Sick neonates were referred to neonatal intensive care unit for admission and management. The results were analyzed by using SPSS version 22. A p-values <0.05 was considered as significant.
Results: Out of 126 enrolled subjects, 81% mothers were multigravidas, 31% were unbooked, 13.5% had gestational comorbidities, 15% were drug addict, 2% were Hepatitis B positive. 22.2% underwent emergency LSCS while 31.7% delivered babies by elective LSCS. Regarding fetal factors contributing to sick babies, IUGR (20%), twin fetuses (15.4%), prematurity (47.7%) were significant. 65 were sick babies. Adverse neonatal outcomes observed were prematurity in 25.4%, IUGR in 11.1%, NICU admission in 33.3%, and neonatal death in 2%. Risk factors associated with adverse neonatal outcomes were positive maternal drug addiction (p-value = 0.028), preterm delivery (p-value<0.001), NICU admission (p-value<0.001) and low birth weight (p-value <0.001).
Conclusion: Compromised maternal antenatal care has profound deleterious effect on fetus and neonate. Obstetricians, perinatologists and neonatologists need to work in concord to improve maternal antenatal care hence improving neonatal outcome. In our study adverse neonatal outcome was associated with unbooked cases, delivery by EmLSCS, addicted mother, preterm delivery, LBW and neonates requiring NICU admission.
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Siddiqui, Muhammad Asif, Sehrish Masood, Tayyaba Khawar Butt, and Shahla Tariq. "Neonatal outcomes of birth asphyxia in tertiary care hospital of low-income country." Journal of Fatima Jinnah Medical University 15, no. 1 (March 15, 2021): 23–26. http://dx.doi.org/10.37018/unkh2664.
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Background: Pakistan has highest neonatal mortality in the region and birth asphyxia is one of the main preventable contributors to this. Objective of this study is to determine the frequency of different neonatal outcomes in neonates with birth asphyxia.
Subjects & Methods: It was descriptive case series study conducted in Department of Pediatrics Medicine, Services Hospital, Lahore in 6 months period during 6th Dec 2016 to 5th June 2017. 150 cases were included using non probability, consecutive sampling with 95% confidence level, 6% margin of error taking an expected percentage of neonate mortality as 15%. Data was analyzed with SPSS version 23. Categorical variables i.e., gender and neonatal outcomes in terms of neonatal mortality, discharge and neurological complications were expressed by frequency and percentage. Post stratification chi square test was applied. A p-value of <0.05 was taken as significant.
Results: The mean age of neonates was 3.09±0.8 hours. Outcomes of these neonates was seen in terms of mortality, discharge and neurological problems. Out of total 150 patients, 51 (34%) neonates expired and 99 (66%) neonates were survived. And neonates 69 (46%) neonates were diagnosed with neurological complications.
Conclusion: We found, birth asphyxia has significant association with neonatal mortality and neurological complications. Prevention of birth asphyxia with appropriate resuscitation at birth may be helpful in reduction of morbidity and mortality due to birth asphyxia.Neonates
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Rasamoelison, Rina J., Setra H. Rambeloson, Hanitriniaina S. C. Samena, and Annick L. Robinson. "Impact of extreme maternal age on neonatal outcomes." International Journal of Contemporary Pediatrics 9, no. 11 (October 27, 2022): 1016. http://dx.doi.org/10.18203/2349-3291.ijcp20222760.
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Background: Pregnancies at extreme ages of reproductive life are considered to be at high risk for mother and neonate. The aim of the study was to determine neonatal risks associated with extreme maternal age.Methods: A retrospective cohort study was conducted at Befelatanana Maternity covering the period from 1 January to 31 December 2018. Data was collected from neonate’s medical files.Results: Of 789 neonates from mothers with extreme age included, 64.7% were from mothers under the age of 18, and 35.3% from mothers aged 40 and over. They were compared to 519 neonates from mothers aged 20-30. Maternal age under 18 was a risk factor for Apgar index below 7 at the 5th minute RR 1.69 (95% CI 1.17, 2.44), preterm birth RR 2.19 (95% CI 1.70, 2.80), low birthweight RR 2.03 (95% CI 1.53, 2.53) and admission to neonatalogy RR 2.64 (95% CI 2.20, 3.16). Also, the neonatal risks of pregnancy after 40 years were fetal death in utero RR 2.97 (95% CI 1.51, 5.85), low birthweight RR 2.47 (95% CI 1.97, 3.10), preterm birth RR 2.85 (95% CI 2.21, 3.68), and admission to Neonatalogy RR 3.06 (95% CI 2.54, 3.68).Conclusions: The extreme age of the mother is therefore a risk of neonatal adverse outcomes. Rigorous prenatal follow-up is needed for these high-risk pregnancies.
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Darcha, Rosina, and Margaret Wekem Kukeba. "Neonatal outcomes of obstetric complications." African Journal of Midwifery and Women's Health 15, no. 3 (October 2, 2021): 1–10. http://dx.doi.org/10.12968/ajmw.2020.0030.
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Background/Aims Neonatal mortality remains a global challenge. In Ghana, neonatal mortality accounts for up to 50% of child mortality. A better understanding of the neonatal outcomes of obstetrics complications could contribute to context-specific evidence-based care to prevent neonatal deaths. This study aimed to describe the relationship between poor neonatal outcomes and obstetric complications in a tertiary health facility in the north of Ghana. Methods This was a cross-sectional quantitative study conducted at a tertiary health facility in northern Ghana. Purposive convenience sampling was used to select 384 mothers who experienced obstetric complications. A structured questionnaire was used to collect data on the participants' neonatal health outcomes. The chi-square test was performed to determine the relationship between neonatal health outcomes and obstetric complications, with significance set at P<0.05. Results A total of 20 obstetric complications were recorded. Overall, 327 participants had a single complication. The three most common obstetric complications resulting in adverse neonatal outcomes were obstructed labour (56.0%), pregnancy-induced hypertension (14.6%) and postpartum haemorrhage (11.6%). The majority (66.7%) of the neonates were healthy at birth, with 21.9% and 11.5% being sick or stillborn respectively. Obstetric complications were significantly associated with both neonatal morbidities and mortalities at P<0.000. Conclusions Preventable maternal obstetric complications continue to cause adverse neonatal outcomes in health facilities in Ghana. Appraisal of maternal and newborn care practices may be necessary to understand context-specific factors.
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McPherson, Christopher C. "Neonatal Herpes Simplex Virus: The Long Road to Improved Outcomes." Neonatal Network 39, no. 2 (March 1, 2020): 92–98. http://dx.doi.org/10.1891/0730-0832.39.2.92.
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Herpes simplex virus (HSV) acquired during delivery places the neonate at risk for mortality or long-term neurodevelopmental disability. Exposure generally occurs from recurrent genital herpes infection, although primary infections result in the highest risk of neonatal disease. Neonates generally present in the second or third week of life with lesions. Encephalitis with seizures indicates the presence of central nervous system involvement, and other end organs may also be impacted. Clinical suspicion for neonatal HSV infection warrants immediate initiation of appropriate antiviral therapy. In the last 50 years, antiviral therapy has progressed from agents with prohibitive toxicity or cumbersome administration to herpes virus–specific agents that dramatically improve clinical outcomes with manageable toxicity. Multicenter clinical trials have demonstrated the superiority of high-dose intravenous acyclovir for acute therapy, followed by long-term oral suppressive therapy. This work has dramatically reduced morbidity and mortality from neonatal HSV, representing the benchmark for future clinical trials in neonatal pharmacotherapy.
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liston, Poonguzhali, Gomathy E, and Sudha Reddy V. "Neonatal Outcomes in Women with Isolated Oligohydramnios." Indian Journal of Obstetrics and Gynecology 7, no. 2 (2019): 267–72. http://dx.doi.org/10.21088/ijog.2321.1636.7219.25.
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Gunawardane, Damitha Asanga, Samath D. Dharmaratne, and Dhammica S. Rowel. "Neonatal outcome of term deliveries in Sri Lanka." South East Asia Journal of Public Health 7, no. 2 (November 28, 2018): 34–39. http://dx.doi.org/10.3329/seajph.v7i2.38854.
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Major proportion (40-70%) of neonatal mortality is among ‘term neonates’. Even though, information on neonatal outcomes of term neonates is scarce. The high volume of term neonatal admissions to neonatal care units signify the importance of studying the neonatal outcomes among term neonates. The aim of this study is to describe the neonatal outcomes, of term neonates following term deliveries (37 completed weeks - 41 completed weeks and 6 days) at Teaching Hospital (TH) Kandy, Sri Lanka. A descriptive cross-sectional study was conducted to describe neonatal outcomes of term neonates before the initial hospital discharge point. A sample of 1,105 neonates, delivered at term were studied during the study period. Mean gestational age at delivery is 38.85 weeks and 41% of term neonates are delivered before completion of 39 weeks of Period of Amenorrhoea (POA). The mean birth weight of the term neo-nates is 2925.24 grams. Out of all term neonates, 15.84% (n=175) were admitted to Neonatal Care Unit (NCU) and 23.3% (n=257) had at least one diagnosed neonatal condition. The commonest neonatal condition was bacterial sepsis of newborn (n=138, 12.48%), followed by neonatal jaundice from other and unspecified causes (n=84, 7.6%), and respiratory distress of newborn (n=44, 3.94%). Median hospital stay of term neonates is 3 days. Majority of term neo-nates admitted to NCU are normal weight term neonates. Nearly one-fourth of term neonates had at least one diag-nosed neonatal condition. Prevention and control of infection from the time of birth to the time of discharge from the hospital should be given due attention to reducing bacterial sepsis among term neonates.South East Asia Journal of Public Health Vol.7(2) 2017: 34-39
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Webbe, James, Nicholas Longford, Sabita Uthaya, Neena Modi, and Chris Gale. "Outcomes following early parenteral nutrition use in preterm neonates: protocol for an observational study." BMJ Open 9, no. 7 (July 2019): e029065. http://dx.doi.org/10.1136/bmjopen-2019-029065.
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IntroductionPreterm babies are among the highest users of parenteral nutrition (PN) of any patient group, but there is wide variation in commencement, duration, and composition of PN and uncertainty around which groups will benefit from early introduction. Recent studies in critically unwell adults and children suggest that harms, specifically increased rates of nosocomial infection, outweigh the benefits of early administration of PN. In this study, we will describe early PN use in neonatal units in England, Wales and Scotland. We will also evaluate if this is associated with differences in important neonatal outcomes in neonates born between 30+0and 32+6weeks+daysgestation.Methods and analysisWe will use routinely collected data from all neonatal units in England, Wales and Scotland, available in the National Neonatal Research Database (NNRD). We will describe clinical practice in relation to any use of PN during the first 7 postnatal days among neonates admitted to neonatal care between 1 January 2012 and 31 December 2017. We will compare outcomes in neonates born between 30+0and 32+6weeks+daysgestation who did or did not receive PN in the first week after birth using a propensity score-matched approach. The primary outcome will be survival to discharge home. Secondary outcomes will include components of the neonatal core outcome set: outcomes identified as important by former patients, parents, clinicians and researchers.Ethics and disseminationWe have obtained UK National Research Ethics Committee approval for this study (Ref: 18/NI/0214). The results of this study will be presented at academic conferences; the UK charity Bliss will aid dissemination to former patients and parents.Trial registration numberNCT03767634
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Dwa, Yam Prasad, Sunita Bhandari, Devendra Shrestha, and Ajaya Kumar Dhakal. "Perinatal outcomes in adolescent pregnancy." Journal of Chitwan Medical College 8, no. 2 (June 30, 2018): 27–31. http://dx.doi.org/10.3126/jcmc.v8i2.23734.
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Introduction: Adolescent pregnancy is prevalent in Nepal and bears significant consequences to both mother and newborn.
Methods: All pregnant women aged 19 years or less who were admitted for delivery at KIST Medical College during 14th April 2017 to 15th July 2018 were included in this study. Maternal and immediate neonatal outcomes were analyzed retrospectively from their medical records.
Results: There were 135 pregnant adolescent women out of 1300 deliveries. Preeclampsia was observed in 2 pregnancies. Vaginal delivery (99; 73.3%) was the predominant mode of delivery. Emergency LS CS was performed in 35 (25.9%) deliveries and most frequent indications for LS CS were nonprogress of labor (8/35), breech presentation (8/35) and fetal distress (6/35). 10 (7.4%) babies were born preterm. 23 (17%) babies were born low birth weight. 37 (27.4%) neonates were symptomatic and required neonatal admission. Respiratory distress was the most frequent neonatal problem (29; 21.5%), followed by neonatal sepsis (18; 13.3%) and perinatal asphyxia (9; 6.7%). There were 3 (2.2%) still birth and 2 (1.5%) early neonatal deaths.
Conclusion: Adolescent pregnancy was common and associated with increased early neonatal problems.
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Yilgwan, C. S., V. C. Pam, G. Yilgwan, O. O. Ige, W. N. Golit, S. Anzaku, A. S. Sagay, et al. "Comparing neonatal outcomes in women with preeclampsia and those with normal pregnancy." Nigerian Journal of Paediatrics 47, no. 3 (August 6, 2020): 258–63. http://dx.doi.org/10.4314/njp.v47i3.11.
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Background: Preeclampsia has remained an important public health problem in the developing world where it is associated with a five-fold increase in perinatal morbidity and mortality.
Objective: We set out to compare neonatal outcomes between women with preeclampsia and those with normal pregnancy. We also sought to evaluate factors associated with poor outcome in the neonates.
Materials and Methods: This was a prospective cohort study that enrolled 90 women (45 with preeclampsia and 45 with normal pregnancy) after 20 weeks gestation. Maternal socio-demographic and clinical information was obtained at enrolment and delivery using questionnaire. Neonatalanthropometric and physiologic data was obtained at delivery and used for classifying the birth weight according to the WHO classification. APGAR score was used to evaluate the presence of birth asphyxia. We defined poor outcome as the presence of at least one of low birth weight, prematurity, birth asphyxia and need for admission. SPSS version 25 was used in all analysis. Significance testing was set at p=0.05.
Results: The women with preeclampsia were significantly heavier at booking (BMI 29.0±6.9 Kg/ m2 vs 25.0±5.2. p=0.005), have higher mean booking systolic blood pressure (122.±22.6 mmHg vs 111.5±12.7mmHg, p=0.003) and diastolic blood pressure ( 7 9 . 8 ± 1 4 . 3mm Hgvs 68.8±9.0mmHg, p<0.001). Neonates of women with preeclampsia were significantly more premature ( meangestational age = 36 . 8 ± 3 . 2 week svs 38.7±2.0weeks, p=0.001) and lighter (mean birth weight =2,529±817.5g vs 3,079.2±527.4g, p<0.001). Overall, 22 (49.4%) of the neonates of women with preeclampsiahad significantly poor outcome compared with 12(27.4%) of the neonates of women with normal pregnancy (p=0.01). Univariate logistic analysis showed only being a male neonate, maternal preeclampsia and admission in index pregnancy were significantly associated with poor outcome. Multivariable logistic regression showed only being a male neonate to be 3 times more likely to have a poor outcome (Wald=5.34. OR=3.2, p=0.02)
Conclusions: Intrauterine exposure to preeclampsia is associated with poor neonatal outcomes especially in males
Key words: infant outcome, preeclampsia, Nigeria
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Sura, Mandeep, Alfred Osoti, Onesmus Gachuno, Rachel Musoke, Frank Kagema, George Gwako, Diana Ondieki, Patrick M. Ndavi, and Omondi Ogutu. "Effect of umbilical cord milking versus delayed cord clamping on preterm neonates in Kenya: A randomized controlled trial." PLOS ONE 16, no. 1 (January 26, 2021): e0246109. http://dx.doi.org/10.1371/journal.pone.0246109.
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Background Delayed cord clamping (DCC) is a placental to new-born transfusion strategy recommended by obstetric and gynaecological societies. Though not widely adopted, umbilical cord milking (UCM) may achieve faster transfusion when DCC cannot be performed such as when a neonate requires resuscitation. Methods Pragmatic, two-arm, randomized clinical trial in which consenting women in spontaneous labour or provider-initiated delivery at 28 to less than 37 weeks at Kenyatta National Hospital in Nairobi, Kenya, were enrolled. At delivery, stable preterm infants were randomized to UCM (4 times) or DCC (60 seconds). Neonatal samples were collected for analysis at 24 hours after delivery. Maternal primary PPH (within 24 hours) and neonatal jaundice (within 1 week) were evaluated clinically. The primary outcome was the mean neonatal haemoglobin level at 24 hours after birth. Modified Intention to treat analysis was used for all outcomes. P-value was significant at p<0.05. Results Between March 2018 to March 2019, 344 pregnant women underwent screening, and 280 eligible participants were randomized when delivery was imminent. The intervention was not performed on 19 ineligible neonates. Of the remaining 260 neonates, 133 underwent UCM while 128 underwent DCC. Maternal and neonatal baseline characteristics were similar. The mean neonatal haemoglobin (17.1 vs 17.5 grams per decilitre, p = 0.191), haematocrit (49.6% vs 50.3%, p = 0.362), anaemia (9.8% vs 11.7%, p = 0.627), maternal PPH (2.3% vs 3.1%, p = 0.719) were similar between UCM and DCC respectfully. However, neonatal polycythaemia (2.3% vs 8.6%, p = 0.024) and neonatal jaundice (6.8% vs 15.6%, p = 0.024) were statistically significantly lower in UCM compared to DCC. Conclusion UCM compared to DCC for preterm neonates resulted in similar outcomes for neonatal haemoglobin, haematocrit, anaemia and maternal primary PPH and a lower proportion of neonatal polycythaemia and clinical jaundice. UCM offers a comparable method of placental transfusion compared to DCC and may be considered as an alternative to DCC in preterm neonates at 28 to <37 weeks’ gestation.
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McCormick, Marie. "Predicting Neonatal Outcomes." American Journal of Perinatology 13, no. 02 (February 1996): 125–26. http://dx.doi.org/10.1055/s-2007-994306.
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Workineh, Yeneneh Ayalew, and Hailemariam Mekonnen Workie. "Adverse Neonatal Outcomes and Associated Risk Factors: A Case-Control Study." Global Pediatric Health 9 (January 2022): 2333794X2210840. http://dx.doi.org/10.1177/2333794x221084070.
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Background Adverse neonatal outcomes have a significant effect on perinatal and neonatal survival and the risk of developmental disabilities and illnesses throughout future lives. Hence, the objective of this study was to identify adverse neonatal outcomes and associated risk factors. Method Institutional based unmatched case-control study was conducted among 206 neonates. Neonates who had adverse outcomes were cases with their index mothers and those neonates who hadn’t had adverse outcomes were controls with their index mothers. Sociodemographic, potential neonatal risk factors, and clinical data were taken from the mothers and medical records. Data were entered into Epi Info v7 and analyzed using SPSS v23. Bivariate and multivariable logistic regression analyses were used to adjust for confounding factors of adverse neonatal outcomes. Frequencies, means, standard deviations, percentages, and cross-tabulations were used to summarize the descriptive statistics of the data. Results In this study, low birth weight (61.5%), preterm birth (57.7%), and low Apgar score at fifth minutes (53.9%) were the major identified adverse neonatal outcomes. Based on the multivariable logistic regression analysis, rural place of residence (AOR = 5.992 to 95% CI [1.011-35.809]), low monthly income (AOR = 4.364), middle monthly income (AOR = 4.364), and emergency cesarean section (AOR = 9.969) were the potential risk factors for adverse neonatal outcomes. Conclusions The adverse neonatal outcomes & the risk factors identified in this research have the potential to harm the health of the neonates. Thus, it needs emphasis to tackle the problems and save the life of the newborn through better and strengthened ANC follow-up, accesses to health care.
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Rodriguez, Christina E., Torri D. Metz, Shrena Patel, Minda Abbaszadeh, Bradley A. Yoder, Tyler Bardsley, and Erin A. S. Clark. "Neonatal Outcomes Associated with Umbilical Cord Milking in Preterm Multiple Gestations." American Journal of Perinatology 36, no. 10 (March 1, 2019): 990–96. http://dx.doi.org/10.1055/s-0039-1679915.
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Objective Our aim was to evaluate the effect of umbilical cord milking on outcomes for preterm multiples. Study Design We implemented a policy of cord milking in neonates born at less than 30 weeks' gestation in September 2011. We compared cord milking in multiples with a historical cohort. Multivariable logistic regression models estimated the effect of cord milking on a composite neonatal adverse outcome. Secondary outcomes were hematocrit at birth, need for blood transfusion, and inotrope use. Results We identified 149 neonates (120 twins, 29 triplets), 51 historical controls, and 98 neonates with cord milking. Cord milking was associated with a lower rate of adverse composite neonatal outcome in univariable analysis (odds ratio [OR]: 0.36; 95% confidence interval [CI]: 0.15–0.84). However, in multivariable modeling, the effect was not significant (adjusted OR [aOR]: 0.54, 95% CI: 0.23–1.28). Hematocrit was 4.6 unit % (95% CI: 2–7.3) higher in the cord milking group, and cord milking was associated with a lower rate of blood transfusion (aOR: 0.28; 95% CI: 0.1–0.74; p = 0.01). There was no difference in inotrope administration. Conclusion Umbilical cord milking was not associated with a decrease in composite neonatal adverse outcome. However, we observed an increase in hematocrit and decreased need for blood transfusion in neonates with cord milking.
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Selvanathan, T., V. Chau, R. Brant, A. Synnes, R. Grunau, and S. Miller. "A.07 Head circumference in preterm neonates: size at birth and postnatal growth predict neurodevelopment at 18 months." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 43, S2 (June 2016): S8—S9. http://dx.doi.org/10.1017/cjn.2016.111.
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Background: We determined the association between head circumference (HC) at birth and through neonatal intensive care with neurodevelopmental outcome in preterm neonates, accounting for brain injury on MRI. Methods: 169 neonates born 24-32 weeks gestation were studied prospectively with serial MRI. HC was measured at birth and discharge from neonatal intensive care. Outcome was assessed at 18 months corrected age using Bayley Scales of Infant & Toddler Development III motor and cognitive scores. Using multivariate linear regressions we evaluated the association between HC and outcomes, accounting for severity of brain injury and postnatal infection. Results: 46 neonates had HC <10th percentile at birth (SHC) which predicted poorer motor (~4 points; p=0.001) and cognitive (~4 points; p=0.005) outcomes, relative to those with normal HC at birth. In 9 of these neonates, SHC persisted to discharge; they had dramatically lower motor scores (15 points; p=0.004) and cognitive scores (12 points; p<0.001), even after adjusting for known risk factors Those born with SHC whose HC normalized by discharge did not show significantly poorer outcomes than those born with normal HC. Conclusions: The relationship between small HC at birth and adverse neurodevelopmental outcomes can be attenuated with normalization of head growth through the period of neonatal intensive care.
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Demaree, Devyn, Emily Merfeld, Methodius Tuuli, Jennifer Wambach, F. Cole, Alison Cahill, and Molly Stout. "Neonatal Outcomes Differ after Spontaneous and Indicated Preterm Birth." American Journal of Perinatology 35, no. 05 (November 28, 2017): 494–502. http://dx.doi.org/10.1055/s-0037-1608804.
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Objective Preterm birth (PTB) at <37 weeks of gestation complicates 10% of pregnancies and requires accurate counseling regarding anticipated neonatal outcomes. PTB classification as spontaneous or indicated is commonly used to cluster PTB into subtypes, but whether neonatal outcomes differ by PTB subtype is unknown. We tested the hypothesis that neonatal morbidity differs based on subtype of PTB. Methods We performed a retrospective cohort study of live-born, non-anomalous preterm infants from 2004 to 2008. Spontaneous PTB was defined as PTB from spontaneous preterm labor or preterm rupture of membranes. Indicated PTB was defined as PTB from any maternal or fetal medical complication necessitating delivery. The primary outcome was a composite of early respiratory morbidity. Secondary outcomes included late composite respiratory morbidity and other neonatal morbidities. Results Of 1,223 preterm neonates, 60.9% were born after spontaneous PTB and 30.1% after indicated PTB. Composite early respiratory morbidity was significantly higher after indicated PTB versus spontaneous PTB (1.3, 95% confidence interval [CI] 1.2–1.4). Composite late respiratory morbidity (1.8, 95% CI 1.3–2.3) and neonatal death (2.8, 95% CI 1.5–5.1) were also significantly higher after indicated PTB versus spontaneous PTB. Conclusion Neonatal respiratory outcomes and death differ according to PTB subtype. PTB subtype should be considered while counseling families and anticipating neonatal outcomes after PTB.
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Patel, Saumil M., Kinjal Patel, Karan Patel, and Rekha Thaddanee. "Comparison of outcomes of thrombocytopenic and non-thrombocytopenic culture proven neonatal sepsis." International Journal of Contemporary Pediatrics 8, no. 3 (February 23, 2021): 512. http://dx.doi.org/10.18203/2349-3291.ijcp20210656.
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Background: Due to high incidence of sepsis as a main cause of neonatal mortality, early detection and proper treatment are important in reducing neonatal mortality. Thrombocytopenia is a common hematological problem encountered during neonatal period, particularly in neonatal sepsis. This study was done to know the incidence of thrombocytopenia in neonatal sepsis and to compare clinical outcome in patients with thrombocytopenic and non-thrombocytopenic neonatal sepsis.Methods: This was a prospective study carried out at neonatal intensive care unit of a tertiary care teaching hospital of western Gujarat, India, from October 2018 to August 2020. 2739 neonates were admitted with probable sepsis during study period. 299 neonates with positive blood cultures were recruited for the study. They were divided into two groups; group-1 had patients with thrombocytopenia, while group-2 included patients without thrombocytopenia. Severity of thrombocytopenia was assessed in group-1. Micro-organisms isolated and outcome of sepsis were compared in both the groups. Results: There were 208 neonates in group-1 (thrombocytopenic) and 91 in group-2 (non-thrombocytopenic). There was no significant difference in demographic profiles of neonates in both groups. Klebsiella pneumonia was the most common organism isolated from 79 patients of group-1 and 19 patients of group-2 (p=0.033). Coagulase negative Staphylococci and Candida were the second and third most common micro-organisms isolated from 30.2% and 15.1% of blood cultures respectively. In group-1, 85 (40.8%), 72 (34.6%) and 51 (24.5%) neonates had severe, moderate and mild thrombocytopenia respectively. Klebsiella pneumoniae (45.9%) was the commonest organism isolated in severe thrombocytopenic neonates, followed by Candia (22.4%) and Enterococcus (14.1%).Conclusions: Thrombocytopenia is a specific marker of neonatal sepsis. The platelet count is a simple test that facilitates diagnostic orientation and the establishment of an early empirical treatment. Klebsiella pneumoniae was the commonest organism isolated in severe thrombocytopenic neonates.
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Sharma, Sanjay Kumar, and Madhusudan Dey. "Maternal and neonatal outcome in cases of premature rupture of membranes beyond 34 weeks of gestation." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 4 (March 30, 2017): 1302. http://dx.doi.org/10.18203/2320-1770.ijrcog20171382.
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Background: Preterm premature rupture of membrane (PPROM) and premature rupture of membrane (PROM) are associated with various maternal and neonatal complications. Management guidelines regarding rupture of membrane before labour is still controversial. The study was carried out to determine the various maternal and neonatal outcomes associated with rupture of membranes beyond 34 weeks of gestation.Methods: It was a prospective observational study carried out in a tertiary care teaching hospital for a period of one year. All the pregnant women with rupture of membrane beyond 34 weeks are included in the study. After establishment of diagnosis of rupture of membranes, antibiotics were started and all of them were induced after 6 hours if they did not have spontaneous labour. Various maternal and neonatal outcomes were noted and statistical analysis carried out.Results: Incidence of rupture of membrane in our study was 4.2%. 92% of patients delivered within 24 hours of rupture of membrane and 18% of them required caesarean section. 5 neonates had respiratory distress syndrome and 1 neonate had sepsis.Conclusions: Induction of labour and delivery within 24 hours of rupture of membranes associated with low incidence of maternal and neonatal adverse outcome.
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Konnur, Dr Harsha. "Neonatal Outcomes in Pre-eclampsia: An Institutional Study." Journal of Medical Science And clinical Research 05, no. 05 (May 28, 2017): 22393–96. http://dx.doi.org/10.18535/jmscr/v5i5.181.
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Dreher, Melanie C., Kevin Nugent, and Rebekah Hudgins. "Prenatal Marijuana Exposure and Neonatal Outcomes in Jamaica: An Ethnographic Study." Pediatrics 93, no. 2 (February 1, 1994): 254–60. http://dx.doi.org/10.1542/peds.93.2.254.
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Objective. To identify neurobehavioral effects of prenatal marijuana exposure on neonates in rural Jamaica. Design. Ethnographic field studies and standardized neurobehavior assessments during the neonatal period. Setting. Rural Jamaica in heavy-marijuana-using population. Participants. Twenty-four Jamaican neonates exposed to marijuana prenatally and 20 nonexposed neonates. Measurements and main results. Exposed and nonexposed neonates were compared at 3 days and 1 month old, using the Brazelton Neonatal Assessment Scale, including supplementary items to capture possible subtle effects. There were no significant differences between exposed and nonexposed neonates on day 3. At 1 month, the exposed neonates showed better physiological stability and required less examiner facilitation to reach organized states. The neonates of heavy-marijuana-using mothers had better scores on autonomic stability, quality of alertness, irritability, and self-regulation and were judged to be more rewarding for caregivers. Conclusions. The absence of any differences between the exposed on nonexposed groups in the early neonatal period suggest that the better scores of exposed neonates at 1 month are traceable to the cultural positioning and social and economic characteristics of mothers using marijuana that select for the use of marijuana but also promote neonatal development.
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Torfs, Marlien, Titia Hompes, Michael Ceulemans, Kristel Van Calsteren, Christine Vanhole, and Anne Smits. "Early Postnatal Outcome and Care after in Utero Exposure to Lithium: A Single Center Analysis of a Belgian Tertiary University Hospital." International Journal of Environmental Research and Public Health 19, no. 16 (August 16, 2022): 10111. http://dx.doi.org/10.3390/ijerph191610111.
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Knowledge of the impact of in utero exposure to lithium during the postnatal period is limited. Besides a possible teratogenic effect during the first trimester, exposure during the second and third trimesters might lead to neonatal effects. Uniform guidelines for postnatal management of these neonates are lacking. The aim was to retrospectively describe all neonates admitted to the University Hospitals Leuven after in utero exposure to lithium (January 2010 to April 2020), and to propose a postnatal care protocol. Descriptive statistics were performed. For continuous parameters with serial measurements, median population values were calculated. In total, 10 mother-neonate pairs were included. The median gestational age was 37 (interquartile range, IQR, 36–39) weeks. Neonatal plasma lithium concentration at birth was 0.65 (IQR 0.56–0.83) mmol/L with a median neonate/mother ratio of 1.02 (IQR 0.87–1.08). Three neonates needed respiratory support, 7/10 started full enteral (formula) feeding on day 1. The median length of neonatal stay was 8.5 (IQR 8–12) days. One neonate developed nephrogenic diabetes insipidus. This study reported in detail the postnatal characteristics and short-term neonatal outcomes. A postnatal care protocol was proposed, to enhance the quality of care for future neonates, and to guide parental counselling. Future prospective protocol evaluation is needed.
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Clive, Breanna, Michael Vincer, Tahani Ahmad, Naeem Khan, Jehier Afifi, and Walid El-Naggar. "Epidemiology of neonatal stroke: A population-based study." Paediatrics & Child Health 25, no. 1 (February 11, 2019): 20–25. http://dx.doi.org/10.1093/pch/pxy194.
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Abstract Objective The goal of this study was to obtain population-based data on the incidence, clinical presentation, management, imaging features, and long-term outcomes of patients with all types of neonatal stroke (NS). Methods Full-term neonates with NS born between January 2007 and December 2013 were identified through the Nova Scotia Provincial Perinatal Follow-up Program Database. Perinatal data and neonatal course were reviewed. Neurodevelopmental outcomes were assessed at 18 and 36 months of age using standardized testing. Results Twenty-nine neonates with NS were identified during the study period, giving an incidence of 47 per 100,000 live births in Nova Scotia. Arterial ischemic stroke was the most common stroke type (76%), followed by neonatal hemorrhagic stroke (17%), then cerebral sinovenous thrombosis (7%). The majority of neonates presented with seizures (86%) on the first day of life (76%). At 36 months of age, 23 (79%) of the children had a normal outcome, while 3 (10%) were diagnosed with cerebral palsy (2 with neonatal arterial stroke and one with neonatal hemorrhagic stroke) and 3 (10%) had recurrent seizures (1 patient from each stroke subtype group). Conclusion The incidence of NS in Nova Scotia is higher than what has been reported internationally in the literature. However, the neurodevelopmental outcomes at 3 years of age are better. Further studies are required to better understand the reasons for these findings.
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Cambell, Shelly. "Prenatal Cocaine Exposure and Neonatal/Infant Outcomes." Neonatal Network 22, no. 1 (January 2003): 19–21. http://dx.doi.org/10.1891/0730-0832.22.1.19.
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Illegal drug use throughout the nation is a problem of epidemic proportion. Of particular concern is drug use among pregnant women. In most cases, these women have little hope of achieving a better life for themselves or their children. Illegal drugs, cocaine in particular, can have devastating effects on the neonate. These effects can last well into childhood and can exhibit themselves in academic, social, and family situations. Challenges for the neonatal nurse include early identification of these infants and use of available resources. This article addresses prenatal cocaine use and support services for drug-dependent women, effects of cocaine during the neonatal period, possible neonatal and infant outcomes, and implications for nursing practice.
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Garg, Ashish, Renu Suthar, Venkataseshan Sundaram, Praveen Kumar, and Suresh K. Angurana. "Clinical profile, aetiology, short-term outcome and predictors of poor outcome of neonatal seizures among out-born neonates admitted to a neonatal unit in Paediatric emergency of a tertiary care hospital in North India: A prospective observational study." Tropical Doctor 51, no. 3 (May 21, 2021): 365–71. http://dx.doi.org/10.1177/00494755211016226.
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Neonatal seizures are common manifestations of several neurological or systemic disorders and associated with high morbidity, mortality and poor short- and long-term developmental outcomes. It is important to determine the aetiology and factors that determine the poor outcome, more so in a newly developed setting. The early detection of predictors of poor outcome will help in planning acute management, counselling, follow-up and rehabilitation services. In this prospective observational study, we looked at the clinical profile, aetiology, short-term outcomes and predictors of poor outcome of neonatal seizures among out-born neonates. The common causes were hypoxic ischaemic encephalopathy, sepsis and metabolic disturbances. One-third of neonates had poor outcome. Abnormal neurological and cardiorespiratory examination at admission; low oxygen saturation, glucose and pH; and hypoxic ischemic encephalopathy-III were predictors of poor outcome.
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Šušak, Ivona, Vedran Bjelanović, Dejan Tirić, and Vajdana Tomić. "Preterm Births: Obstetric Features and Neonatal Outcomes at University Hospital Mostar." Annals of Biomedical and Clinical Research 1, no. 1 (July 25, 2022): 50–55. http://dx.doi.org/10.47960/2744-2470.2022.1.1.50.
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Background: The aim of this study was to determine and analyze the frequency and obstetric features of preterm birth and neonatal outcomes of infants born before 37 completed weeks of pregnancy. Methods: The retrospective study included 470 premature births. The following data on preterm births were collected from hospital records and analyzed: gestational age, type of preterm birth, multiple pregnancy and maternal parity. The parameters of preterm infants were: Apgar score, intrauterine growth restriction (IUGR), perinatal asphyxia, respiratory distress syndrome (RDS), sepsis, necrotizing enterocolitis, intracranial hemorrhage, neonatal convulsions, hypoglycemia, blood transfusion, the need for surfactant, the need for mechanical ventilation, the length of stay in an Intensive Care Unit and early and late neonatal mortality.Main findings: The frequency of preterm births was 6.48%. The most common type of premature birth was spontaneous premature birth. Most complications occurred in neonates with a gestational age of 28-34 weeks. The most common respiratory complication was RDS (8.1%). Early neonatal mortality was 1.49% and late neonatal mortality was 0.85%.Principal conclusion: Neonatal outcomes of premature infants are directly proportional to their gestational age. The neonatal mortality rate of premature infants at Clinical Hospital Center Mostar (CHC) Mostar is comparable to other developing countries.Key words: preterm birth, gestational age neonatal outcome, perinatal care, neonatal mortality
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Nakahara, Mariko, Shunji Goto, Eiji Kato, Atsuo Itakura, and Satoru Takeda. "Respiratory Distress Syndrome in Infants Delivered via Cesarean from Mothers with Preterm Premature Rupture of Membranes: A Propensity Score Analysis." Journal of Pregnancy 2020 (July 31, 2020): 1–6. http://dx.doi.org/10.1155/2020/5658327.
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Objective. This study aimed to clarify the effects of cesarean delivery on neonatal respiratory morbidity when women had preterm premature rupture of membranes. Methods. This retrospective study included women with preterm premature rupture of membranes who delivered from 23 weeks to 33 weeks of gestation between January 2009 and December 2014. Neonatal outcomes were compared between infants delivered by cesarean section and those delivered vaginally. The primary outcome was respiratory distress syndrome (RDS). Neonatal intubation and mechanical ventilation periods were secondary outcomes. Propensity score matching was used to compare outcomes between cesarean and vaginal delivery cases. Results. There were 101 cesarean deliveries and 89 vaginal deliveries. A comparison of the presence or absence of neonatal complications based on the delivery type indicated a higher occurrence of RDS with cesarean deliveries (P=0.025). The intubation and mechanical ventilation periods were not significantly longer in neonates delivered via cesarean section. Conclusions. Cesarean delivery is a risk factor for neonatal RDS in women with preterm premature rupture of membranes. Trials identifying long-term neonatal prognoses are needed to further develop optimal management strategies in such cases.
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Yu, Joanna, Christopher Flatley, Ristan M. Greer, and Sailesh Kumar. "Birth-weight centiles and the risk of serious adverse neonatal outcomes at term." Journal of Perinatal Medicine 46, no. 9 (November 27, 2018): 1048–56. http://dx.doi.org/10.1515/jpm-2017-0176.
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Abstract Background: Birth-weight is an important determinant of perinatal outcome with low birth-weight being a particular risk factor for adverse consequences. Aim: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies. Materials and methods: This was a retrospective cohort study of singleton term births at the Mater Mother’s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤−12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile. Results: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06–4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30–1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60–7.75). Conclusions: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.
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Appannagiri, Vrunda, Divya K., Beena Kingsbury, Swati Rathore, Jiji E. Mathews, and Mahasampath Gowri. "Maternal and neonatal outcome in pregnancy at 40 years and beyond in a tertiary care center: a retrospective case control study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 8 (July 26, 2019): 3129. http://dx.doi.org/10.18203/2320-1770.ijrcog20193523.
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Background: Obstetric outcome in women with advanced maternal age (AMA) is not usually studied especially in India.Methods: This study was a case control study. The cases were pregnancy in 100 women at 40 years of age and beyond and there were two control arms of 100 each of ages 20-29 years and 30-39 years. The demography, maternal complications, delivery outcomes and neonatal outcomes were compared.Results: Women with AMA were mostly multipavrous and had higher Body Mass Index (BMI). Hypertensive disease in pregnancy was more common in AMA but the difference was statistically significant. Women with AMA were more likely to have gestational diabetes (p ≤ 0.011), more likely to have anemia (p = 0.038), more likely to have preterm birth (p = 0.001), other medical complications compare to the control group (p = 0.005). They were also more likely to have Lower Segment Caesarean Section (LSCS) (p ≤ 0.001) and have postpartum complications. The birth weight of the neonate was significantly decreased in the AMA group (p < 0.001). The neonates were also more likely to be admitted to Neonatal Intensive Care Unit (NICU) (p ≤ 0.006).Conclusions: Adverse maternal and neonatal outcomes were seen despite individualized and optimal obstetric care. Thus, these women need preconceptional counselling.
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Ge, W. J., L. Mirea, J. Yang, K. L. Bassil, S. K. Lee, and P. S. Shah. "Prediction of Neonatal Outcomes in Extremely Preterm Neonates." PEDIATRICS 132, no. 4 (September 23, 2013): e876-e885. http://dx.doi.org/10.1542/peds.2013-0702.
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Elimian, A., R. Verma, P. Ogburn, V. Wiencek, A. Spitzer, and J. G. Quirk. "Magnesium sulfate and neonatal outcomes of preterm neonates." Journal of Maternal-Fetal & Neonatal Medicine 12, no. 2 (January 2002): 118–22. http://dx.doi.org/10.1080/jmf.12.2.118.122.
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Iwami, Hiroko, Tetsuya Isayama, Abhay Lodha, Rody Canning, Ayman Abou Mehrem, Shoo Lee, Anne Synnes, and Prakesh Shah. "Outcomes after Neonatal Seizures in Infants Less Than 29 Weeks' Gestation: A Population-Based Cohort Study." American Journal of Perinatology 36, no. 02 (July 17, 2018): 191–99. http://dx.doi.org/10.1055/s-0038-1667107.
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Objective The aim of this study was to evaluate the association between neonatal seizure and neurodevelopmental impairment (NDI) at 18 to 24 months in extremely preterm neonates. The association between anticonvulsants use and NDI was also assessed. Study Design In this retrospective cohort study of infants born at <29 weeks' gestation from the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network databases, we compared mortality and neurodevelopmental outcomes in infants who had neonatal seizures with those without seizures after adjusting for confounders. Results Of the 2,762 eligible neonates, 133 (4.8%) had seizures. Infants who had seizures were of lower gestation (25.2 vs. 26.2 weeks) and birth weight (819 vs. 920 g) and had higher rates of adverse outcomes. Neonatal seizure was associated with higher odds of composite outcome of death or significant NDI (74 vs. 27%; adjusted odds ratio [OR]: 3.4; 95% confidence interval [CI]: 2.2–5.4). Death or significant NDI was higher in infants with seizures treated with anticonvulsants than those without treatment (89 vs. 70%); however, when adjusted for confounders, it was not significantly different (adjusted OR: 3.5; 95% CI: 0.83–14.6). Conclusion Neonatal seizures were independently associated with higher odds of death or significant NDI at 18 to 24 months of age. Relationship of anticonvulsant and neurodevelopmental outcomes needs further studies.
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Jones, Michael James, Asma Lotfi, Amber Lin, Ladawna L. Gievers, Robert Hendrickson, and David C. Sheridan. "Prenatal marijuana exposure and neonatal outcomes: a retrospective cohort study." BMJ Open 12, no. 9 (September 2022): e061167. http://dx.doi.org/10.1136/bmjopen-2022-061167.
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ObjectivesPrevious literature on the effects of marijuana exposure on neonatal outcomes has been limited by the reliance on maternal self-report. The objective of this study was to examine the relationship of prenatal marijuana exposure on neonatal outcomes in infants with marijuana exposure confirmed with meconium drug testing.DesignRetrospective cohort study.Setting and participantsMeconium drug screens obtained on infants born in a hospital system in the Pacific Northwest in the USA over a 2.5-year period. 1804 meconium drug screens were initially obtained, with 1540 drug screens included in the analysis.Primary and secondary outcome measuresNeonates with meconium drug screens positive for delta-9-tetrahydrocannabinol (THC) only were compared with neonates with negative drug screens. The following neonatal outcomes were examined: gestational age, preterm birth (<37 weeks), birth weight, low birth weight (defined as birth weight <2.5 kg), length, head circumference, Apgar scores and admission to the neonatal intensive care unit (NICU). Using multivariable logistical and linear regression, we controlled for confounding variables.Results1540 meconium drug screens were included in the analysis, with 483 positive for delta-9-THC only. Neonates exposed to delta-9-THC had significantly lower birth weight, head circumference and length (p<0.001). Neonates with THC exposure had 1.9 times the odds (95% CI 1.3 to 2.7, p=0.001) of being defined as low birth weight. Birth weight was on average 0.16 kg lower (95% CI 0.10 to 0.22, p<0.001) in those exposed to THC.ConclusionsPrenatal marijuana exposure was significantly associated with decreases in birth weight, length and head circumference, and an increased risk of being defined as low birth weight. These findings add to the previous literature demonstrating possible negative effects of prenatal marijuana use on neonatal outcomes.
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Sharma, Parul, Bani Sarkar, and Bangali Majhi. "Fetal and neonatal outcomes in intrahepatic cholestasis of pregnancy." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 10 (September 26, 2018): 4056. http://dx.doi.org/10.18203/2320-1770.ijrcog20184128.
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Background: Intrahepatic cholestasis of pregnancy has been associated with adverse fetal and neonatal outcomes. The objective of this study was to assess the improvement in fetal and neonatal outcomes with timely intervention in pregnant females with intrahepatic cholestasis of pregnancyMethods: This prospective observational study included 50 patients attending antenatal clinic of the Department of Obstetrics and Gynecology of Dr. RML Hospital, from 1st November 2015 to 31st March 2017, using inclusion and exclusion criteria. History, examination, blood investigations, with ultrasound upper abdomen was done for all the patients. Diagnosed patients were treated accordingly and fetal and neonatal outcomes were studied. The data was analyzed using STATA (version 13.1, Stata Corp 4905 Lakeway Drive College Station, Texas 77845 USA). Comparisons were analyzed using Chi-Square, Student’s t-tests.Results: In the present study, in view of timely diagnosis and intervention, 82% of the neonates had birth weight >2.5kg. 94% of the total neonates had >7 APGAR at 1min, and 100% of the neonates had >7 APGAR at 5min. No stillbirth was observed in present study group. No NICU admission was observed in the present study.Conclusions: Patients with intrahepatic cholestasis of pregnancy should be taken with utmost care. With early intervention, the adverse effects on fetus and neonates can be reduced to a significant amount.
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Valent, Amy M., Eric S. Hall, and Emily A. DeFranco. "The influence of obesity on perinatal outcomes in pregnancies achieved with assisted reproductive technology: A population-based retrospective cohort study." Obstetric Medicine 9, no. 1 (January 31, 2016): 34–39. http://dx.doi.org/10.1177/1753495x15621152.
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Objective To determine the influence of obesity on neonatal outcomes of pregnancies resulting from assisted reproductive technology. Methods Population-based retrospective cohort study of all non-anomalous, live births in Ohio from 2007 to 2011, comparing differences in the frequency of adverse neonatal outcomes of women who conceived with assisted reproductive technology versus spontaneously conceived pregnancies and stratified by obesity status. Primary outcome was a composite of neonatal morbidities defined as ≥1 of the following: neonatal death, Apgar score of <7 at 5 min, assisted ventilation, neonatal intensive care unit admission, or transport to a tertiary care facility. Results Rates of adverse neonatal outcomes were significantly higher for assisted reproductive technology pregnancies than spontaneously conceived neonates; non-obese 25% versus 8% and obese 27% versus 10%, p < 0.001. Assisted reproductive technology was associated with a similar increased risk for adverse outcomes in both obese (adjusted odds ratio (aOR): 1.33, 95% confidence interval (CI): 1.11–1.59) and non-obese women (aOR: 1.34, 95% CI: 1.18–1.51) even after adjustment for coexisting risk factors. This increased risk was driven by higher preterm births in assisted reproductive technology pregnancies; obese (aOR: 1.06, 95% CI: 0.86–1.31) and non-obese (aOR: 1.15, 95% CI: 1.00–1.32). Discussion Assisted reproductive technology is associated with a higher risk of adverse neonatal outcomes. Obesity does not appear to adversely modify perinatal risks associated with assisted reproductive technology.
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Kalish, Brian T., and Christopher McPherson. "Management of Neonatal Hypotension." Neonatal Network 36, no. 1 (2017): 40–47. http://dx.doi.org/10.1891/0730-0832.36.1.40.
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AbstractHypotension is a common problem in neonates with complex underlying pathophysiology. Although treatment of low blood pressure is common, clinicians must use all available information to target neonates with compromised perfusion. Pharmacotherapy should be tailored to the specific physiologic perturbations of the individual neonate. Dopamine is the most commonly utilized agent and may be the most appropriate agent for septic shock with low diastolic blood pressure. However, alternative therapies should be considered for other etiologies of hypotension, including milrinone and vasopressin for persistent pulmonary hypertension of the newborn and dobutamine for patent ductus arteriosus. Additional studies are required to refine the approach to neonatal hypotension and document the long-term outcomes of treated neonates.
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Wood, Tara, Margret Johnson, Taryn Temples, and Curry Bordelon. "Thermoneutral Environment for Neonates: Back to the Basics." Neonatal Network 41, no. 5 (August 1, 2022): 289–96. http://dx.doi.org/10.1891/nn-2022-0003.
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Thermoregulation is an essential component to the stability and long-term outcomes of newborns and critically-ill neonates. A thermoneutral environment (TNE) is an environment in which a neonate maintains a normal body temperature while minimizing energy expenditure and oxygen consumption. Neonates who experience thermal stability within a TNE demonstrate enhanced growth, decreased respiratory support, decreased oxygen requirements, increased glucose stability, reduced mortality, and reduced morbidities associated with hyperthermia and hypothermia. Heat exchange occurs between the neonate and surrounding environment through four mechanisms: evaporation, conduction, convection, and radiation. By recognizing the methods by which heat is lost or gained, the neonatal provider can prevent adverse conditions related to abnormal thermal control and support a thermoneutral neonatal environment.
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BOWMAN, E. D., and R. N. D. ROY. "Comparison of neonatal outcomes." Journal of Paediatrics and Child Health 30, no. 5 (October 1994): 382–83. http://dx.doi.org/10.1111/j.1440-1754.1994.tb00681.x.
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Falciglia, Horacio S. "Selenium and neonatal outcomes." Journal of Perinatology 38, no. 10 (July 24, 2018): 1428. http://dx.doi.org/10.1038/s41372-018-0163-2.
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Allegaert, Karel, and Ju-Lee Oei. "Neonatal Abstinence Syndrome: Prevention, Management and Outcomes: From Birth to Adulthood." Children 9, no. 8 (July 30, 2022): 1151. http://dx.doi.org/10.3390/children9081151.
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Neonatal abstinence syndrome (NAS), or—when specifically focused on opioids—neonatal opioid withdrawal syndrome (NOWS) is a withdrawal syndrome in neonates after birth causally related to the in utero exposure to drugs of dependence, and the subsequent acute interruption at delivery [...]
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Elias, Solomon, Zenebe Wolde, Temesgen Tantu, Muluken Gunta, and Dereje Zewudu. "Determinants of early neonatal outcomes after emergency cesarean delivery at Hawassa University comprehensive specialised hospital, Hawassa, Ethiopia." PLOS ONE 17, no. 3 (March 24, 2022): e0263837. http://dx.doi.org/10.1371/journal.pone.0263837.
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Background Neonatal mortality after cesarean delivery is three folds higher than mortality after vaginal births. Post cesarean early neonatal outcomes are associated with preoperative and intraoperative fetomaternal factors which are preventable in the majority of cases. Objective To identify determinants of early neonatal outcomes after emergency cesarean delivery at Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia. Method Institution based cross sectional study was conducted on 270 emergency cesarean deliveries. Data were collected by using a pretested questionnaire by trained data collectors. Descriptive analysis was used to see the nature of the characteristics of interests. Pearson chi-square-test was used to check presence of association between independent and outcome variables. Bivariate analysis was used to sort out variables at p values less than 0.05 for multivariate logistic regression. Significance level was obtained using odds ratio with 95% CI and p value < 0.05. Results The prevalence of adverse early neonatal outcome after emergency cesarean delivery was 26.7%. Around 11% of newborns had low (<7) fifth minute Apgar score and more than one-third (34.8%) of them admitted to neonatal intensive care unit for more than 24 hours. Fifteen (5.6%) newborns died within their first seven days of life. Neonates with a preoperative meconium-stained amniotic fluid and low birth weight (< 2500 grams) had greater odds of having adverse early neonatal outcome with (AOR = 6.37; 95% CI: 2.64, 15.34) and (AOR = 14.00; 95% CI: 3.64, 53.84) respectively. Conclusion The prevalence of adverse early neonatal outcome is high in this study and meconium-stained amniotic fluid during labor as well as low birth weight were the leading predictors of adverse early neonatal outcome during emergency cesarean delivery.
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Witwicki, Jacek, Katarzyna Chaberek, Natalia Szymecka-Samaha, Adam Krysiak, Paweł Pietruski, and Katarzyna Kosińska-Kaczyńska. "sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates." Children 8, no. 8 (August 23, 2021): 718. http://dx.doi.org/10.3390/children8080718.
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Background: Small for gestational age is a pregnancy complication associated with a variety of adverse perinatal outcomes. The aim of the study was to investigate if sFlt-1/PlGF ratio is related to adverse short-term neonatal outcome in neonates small for gestational age in normotensive pregnancy. Methods: A prospective observational study was conducted. Serum sFlt-1/PlGF ratio was measured in women in singleton gestation diagnosed with fetus small for gestational age. Short-term neonatal outcome analyzed in the period between birth and discharge home. Results: Eighty-two women were included. Women with sFlt-1/PlGF ratio ≥33 gave birth to neonates with lower birthweight at lower gestational age. Neonates from high ratio group suffered from respiratory disorders and NEC significantly more often. They were hospitalized at NICU more often and were discharged home significantly later. sFlt-1/PlGF ratio predicted combined neonatal outcome with sensitivity of 73% and specificity of 82.2%. Conclusions: sFlt-1/PlGF ratio is a useful toll in prediction of short-term adverse neonatal outcome in SGA pregnancies.
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Upadhyay, Kirtikumar, and Ajay Talati. "Neonatal Immune Responses during Group B Streptococcal Infections." Journal of Pediatric Infectious Diseases 12, no. 03 (June 7, 2017): 164–70. http://dx.doi.org/10.1055/s-0037-1603657.
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AbstractGroup B streptococcus (GBS) still remains an important cause of neonatal sepsis in spite of various preventive strategies. The immune response of a neonate varies from an adult human immune system and makes a newborn more vulnerable to illness not typically manifested by adults. Microbial virulence, bacterial load, and immaturity of immune response system may explain the variation in severity of illness in term and preterm neonates. In this review, the mechanisms of GBS invasion and infection in a neonate are described. We also try to identify the host immune response to various bacterial components of GBS and possible future strategies to mitigate this immune response to improve neonatal outcomes after GBS sepsis.
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Lyu, Yanyu, Xiang Ye, Tetsuya Isayama, Ruben Alvaro, Chuks Nwaesei, Keith Barrington, Shoo Lee, and Prakesh Shah. "Admission Systolic Blood Pressure and Outcomes in Preterm Infants of ≤ 26 Weeks' Gestation." American Journal of Perinatology 34, no. 13 (May 12, 2017): 1271–78. http://dx.doi.org/10.1055/s-0037-1603342.
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Objective To examine the relationship between admission systolic blood pressure (SBP) and adverse neonatal outcomes. Specifically, we aimed to identify the optimal SBP that is associated with the lowest rates of adverse outcomes in extremely preterm infants of ≤ 26 weeks' gestation. Methods In this retrospective study, inborn neonates born at ≤ 26 weeks' gestational age and admitted to tertiary neonatal units participating in the Canadian Neonatal Network between 2003 and 2009 were included. The primary outcome was early mortality (≤ 7 days). Secondary outcomes included severe brain injury, late mortality, and a composite outcome defined as early mortality or severe brain injury. Nonlinear multivariable logistic regression models examined the relationship between admission SBP and outcomes. Results Admission SBP demonstrated a U-shaped relationship with early mortality, severe brain injury, and composite outcome after adjustment for confounders (p < 0.01). The lowest risks of early mortality, severe brain injury, and composite outcome occurred at admission SBPs of 51, 55, and 54 mm Hg, respectively. Conclusion In extremely preterm infants of ≤ 26 weeks' gestational age, the relationship between admission SBP, and early mortality and severe brain injury was “U-shaped.” The optimal admission SBP associated with lowest rates of adverse outcome was between 51 and 55 mm Hg.
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Tousty, Piotr, Magda Fraszczyk-Tousty, Joanna Ksel-Hryciów, Beata Łoniewska, Joanna Tousty, Sylwia Dzidek, Kaja Michalczyk, et al. "Adverse Neonatal Outcome of Pregnancies Complicated by Preeclampsia." Biomedicines 10, no. 8 (August 22, 2022): 2048. http://dx.doi.org/10.3390/biomedicines10082048.
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Despite many available treatments, infants born to preeclamptic mothers continue to pose a serious clinical problem. The present study focuses on the evaluation of infants born to preeclamptic mothers for the occurrence of early-onset complications and attempts to link the clinical status of such infants to the angiogenesis markers in maternal blood (sFlt-1, PlGF). The study included 77 newborns and their mothers diagnosed with preeclampsia. The infants were assessed for their perinatal outcomes, with an emphasis on adverse neonatal outcomes such us infections, RDS, PDA, NEC, IVH, ROP, or BPD during the hospitalization period. The cutoff point was established using the ROC curve for the occurrence of any adverse neonatal outcome and it was 204 for the sFlt-1/PlGF and 32 birth week with AOC 0.644 and 0.91, respectively. The newborns born to mothers with high ratios had longer hospitalization times and, generally, were more frequently diagnosed with any of the aforementioned adverse neonatal outcomes. Also, the neonates born prior to or at 32 wkGA with higher sFlt-1/PlGF ratios were statistically significantly more common to be diagnosed with any of the adverse neonatal outcomes compared to those with lower ratio born prior to or at 32 wkGA. The sFlt-1/PlGF ratio can be a useful tool in predicting short-term adverse neonatal outcomes. Infants born after a full 33 weeks gestation developed almost no severe neonatal complications. Appropriate screening and preventive healthcare for preeclampsia can contribute significantly to reducing the incidence of neonatal complications.
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Bello, Maria Ronallaine, and Shirley Kwong-Buizon. "Maternal and Neonatal Clinico-Demographic Profile and Outcomes During the Covid-19 Pandemic at the Chinese General Hospital and Medical Center." Pediatric Infectious Disease Society of the Philippines Journal 22, no. 2 (September 7, 2021): 46–54. http://dx.doi.org/10.56964/pidspj20212202007.
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Background: COVID-19 is an ongoing health concern that hospitals have struggled to keep up with, given its increasing burden with the passage of time. Considerations for the management of COVID-19 should be made especially for pregnant patients and their neonates. Objectives: To determine COVID-19 prevalence and the clinical profile of mothers admitted for childbirth at Chinese General Hospital and Medical Center from May 2020 to July 2020. The profile and outcomes of neonates born to these mothers were likewise studied. Materials and Method: A descriptive cross-sectional study was done that included mothers admitted for childbirth who had SARS-CoV-2 RT PCR swab test and their neonates. A total of 408 medical records of mother and neonate dyads were reviewed. Relevant variables such as the patients’ demographic profile, clinical characteristics, co-morbidities and the maternal and neonatal outcomes were obtained. Frequency distributions were made to assess the prevalence of COVID-19 among the patients, as well as maternal and neonatal outcomes. Results: Twenty-two (5.39%) mothers tested positive for COVID-19, while all neonates (n = 22) that underwent RT-PCR swab at the 24th hour of life had negative results. Of the 22 COVID-19 positive mothers, 2 (9.09%) were symptomatic upon admission while 20 (90.09%) were asymptomatic. The following were the key trends among those mothers who tested positive for COVID-19: (1) 81.82% were from ages 20-39 years old, (2) 72.73% were multigravida mothers, (3) 54.55% had normal spontaneous delivery, (4) diabetes mellitus was the only noted comorbidity. Key findings on the neonatal outcomes observed in the study population of both COVID-19 positive and negative cases, include: (1) majority of neonates had an APGAR score of greater than 7 at 1st and 5th minute of life; (2) higher frequency of neonates with Ballard’s score of more than 37 weeks AOG; (3) more male neonates as compared to female neonates; (4) a normal birth weight for majority of cases; (5) 45.45% of neonates born to COVID positive mothers had a length of stay of <48 hours as compared to 72.8% of neonates born to COVID negative mothers; and (6) neonatal pneumonia as the most common comorbid condition in both cases. Conclusion: This study noted a prevalence of 5.39% COVID-19 positive mothers. SARS-CoV-2 virus was not detected in all of the neonates born to COVID-19 affected mothers. Neonates delivered to COVID-19 positive mothers had similar trends in the neonatal outcomes when compared to neonates delivered to mother who were COVID-19 negative.
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Sarvi, Jyoti B., and Sandeep V. H. "A neonatal morbidities and outcomes among late preterm infants." International Journal of Contemporary Pediatrics 7, no. 2 (January 23, 2020): 248. http://dx.doi.org/10.18203/2349-3291.ijcp20200017.
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Background: Late preterm birth (34-36 weeks) infants are at greater risk of (2-3 fold) compared to near term or term babies. The present study was done with the purpose to examine related morbidities and outcomes among late preterm infants.Methods: The study included all late preterm babies (34 0/7 weeks-36 6/7 weeks) admitted to the Basaveshwar Teaching and General Hospital and Sangameshwar Hospital for a period of one and half year (December 2013-May 2015). Short term outcome was assessed in the form of neonatal morbidities and mortality during the study period.Results: A total of 203 late Preterm neonates comprised the study group. Male preponderance was noticed with a ratio of 1.5:1. This study confirmed that late-preterm infants are a population at risk of increased neonatal morbidity. Neonatal hyperbilirubinemia requiring phototherapy forms the major one followed by sepsis, respiratory distress, and feed intolerance. Majority of late preterm neonates required more than 7 days hospital duration.Conclusions: Late preterm infants suffer a large number of intercurrent medical problems during the neonatal period, especially increased likelihood of resuscitation in the delivery room, hypothermia, hypoglycemia, jaundice requiring phototherapy, respiratory pathologies, sepsis and feeding intolerance. Prolonging pregnancy to the maximum safest gestation will result in decrease in such morbidities.
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Horbar, Jeffrey D., Elizabeth C. Wright, and Lynn Onstad. "Decreasing Mortality Associated With the Introduction of Surfactant Therapy: An Observational Study of Neonates Weighing 601 to 1300 Grams at Birth." Pediatrics 92, no. 2 (August 1, 1993): 191–96. http://dx.doi.org/10.1542/peds.92.2.191.
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Objective. To determine whether the introduction of surfactant therapy was associated with decreased mortality for high-risk preterm neonates weighing 601 to 1300 g at birth. Design. Before-after observational study. Setting. Eight tertiary care neonatal intensive care units participating in the National Institute of Child Health and Human Development Neonatal Research Network. Patients. The outcomes for neonates with birth weight 601 to 1300 g admitted in the 2 years before surfactants became available (n = 2780) were compared with those of neonates admitted in the year beginning 2 months after surfactants became available (n = 1413). Main outcome measures. The primary outcome measure was in-hospital mortality; secondary outcome measures included durations of assisted ventilation, length of hospitalization, and neonatal morbidity. Results. Forty percent of neonates in the postsurfactant group received surfactant (range 28% to 69% at the centers). Mortality decreased from 27.8% before to 19.9% after surfactant therapy was introduced (Mantel-Haenszel x2 = 31.4, P = .001). The adjusted odds ratio for mortality after surfactants became available was 0.73 (95% confidence interval 0.55 to 0.95). The duration of assisted ventilation and length of hospitalization increased after surfactants were introduced (P = .0001 for both outcomes). Conclusion. Mortality for neonates weighing 601 to 1300 g decreased after surfactant therapy was introduced, suggesting that the efficacy of surfactants demonstrated in randomized controlled trials will translate into effectiveness in routine clinical care.
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Kumar, Pardeep, Bakhtiar Ahmed Bhanbhro, Asif Ali Khuhro, Iftikhar Haider, Mumtaz Ali Bharo, and Ubedullah Bahalkani. "Evaluation of the Relationship Between Vitamin D Deficiency and Early-Onset Neonatal Sepsis in Neonates: A Cross-Sectional Analytical Study." Pakistan Journal of Medical and Health Sciences 16, no. 1 (January 30, 2022): 1092–95. http://dx.doi.org/10.53350/pjmhs221611092.
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Aims: To evaluate the relationship between vitamin D deficiency and early-onset neonatal sepsis in neonates Study design: A cross-sectional analytical study Place and duration: This study was conducted at Pir Abdul Qadir Shah Jilani Institute of Medical Science Gambat Khairpur Pakistan from March 2020 to March 2021 Methodology: Samples were taken from the neonatal department that met the inclusion criteria. All neonates with proven or suspected sepsis were included. We used the Chi-square test to identify the relationship between vitamin D levels and neonate sepsis. However, Fisher exact test was applied where Chi-square was not fitted well. Mann Whitney analysis was also performed. Results: We recruited 41 cases of preterm and full-term neonates with sepsis. Out of these 41 cases, 46.3% (19/41) were male and 53.7% (22/41) were females. An insignificant correlation was observed between mortality, length of hospital stay, and blood culture with Vitamin D levels. However, we observed a positive correlation between Vitamin D levels and the need for respiratory support. Conclusion: Our study concluded that vitamin D deficiency is associated with the need for respiratory support in neonates with sepsis. However, no correlation with other outcomes was observed in the current study. Keywords: Neonatal sepsis, Vitamin D deficiency, outcome, respiratory support
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Nepal, Deepeshwara, Sumit Agrawal, Sushan Shrestha, and Ajit Rayamajhi. "Morbidity Pattern and Hospital Outcome of Neonates Admitted in Tertiary Care Hospital, Nepal." Journal of Nepal Paediatric Society 40, no. 2 (September 11, 2020): 107–13. http://dx.doi.org/10.3126/jnps.v40i2.29469.
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Introduction: The first 28 days of life, neonatal period is crucial as neonates are susceptible to sepsis, birth asphyxia, hypoxic injuries and its consequences which may lead to lifelong morbidity. Knowing the causes of morbidity and mortality is an essential step to improve neonatal health. The aim of this study is to describe the pattern and causes of neonatal admission, immediate hospital outcome in the form of improved, died or left against medical advice and factors associated with its outcome.
Methods: This was a retrospective hospital based study carried out in Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital, Kathmandu, Nepal over a period of six months (February 2019 to July 2019 AD). Neonatal details including age, sex, gestational age, birth weight, and maternal age and parity, mode of delivery, place of delivery, neonatal morbidities and neonatal outcomes were recorded in a predesigned performa. Results were expressed as mean, percentage and p value. P- value was calculated by using chi-square test.
Results: A total of 163 neonates were admitted during the study period, among which 106 (65%) were males. The mean birth weight was 2483.96 ± 812.63 gm. Among admitted newborns 130 (79.8%) had good outcome, babies born to young mothers (< 20 years of age) had poor outcome which is statistically significant with p value of 0.002. Neonates whose birth weight were < 1000 gram had significantly poor outcome (0.001).
Conclusion: Common causes of NICU admission were neonatal sepsis, neonatal hyperbilirubinemia, prematurity and perinatal asphyxia. Babies born to young primipara mothers, extremely low birth weight, extremely premature babies and babies undergoing mechanical ventilation had poor outcome.