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Amin, Muhammad, Muhammad Saleem, Shamas-un Nisa, Malik Muhammad Naeem, and Hafiz Muhammad Anwar-ul Haq. "BIRTH ASPHYXIA;." Professional Medical Journal 24, no. 06 (June 5, 2017): 796–800. http://dx.doi.org/10.29309/tpmj/2017.24.06.1214.
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Introduction: Out of 130 million births, about four million infants die in the first fourweeks of their life. Birth asphyxia is a major cause of neonatal deaths in developing countries.Birth asphyxia is estimated to account for approximately 25% of neonatal mortality worldwide.Allopurinol is a cheap and freely available medicine whereas other management options arenot widely used. Objectives: To analyze the short-term outcome between allopurinol-treatedand non-allopurinol-treated asphyxiated neonates. Study Design: A randomized controlledstudy. Setting: Pediatric unit 2, Bahawal Victoria Hospital, Bahawalpur. Duration of Study: Thisstudy was conducted from March 2015 to September 2015. Materials and Methods: A totalof 62 (31 in allopurinol and 31 in non allopurinon treated group) infants having admitted within6 hours after birth with gestational age > 36 weeks. All were suffering from stage-2 hypoxicischemic encephalopathy, lethargy, hypotonia, flexion posture. All were having hyperactivetendon reflexes and poor moro reflex. All the admitted neonates were managed and followedup to to 7 days of admission to note the need of anti-convulsants, conscious level and lengthof admission in intensive care unit (< 7 days or > 7 days). Neonates who died during the staywere noted and compared between both the groups. Results: Out of 62 infants, there were 34(54.8%) males and 28 (45.2%) females. Mean gestational age was 37.90 weeks while meanweight of newborn infants was 2.75 kg. Overall Mortality was noted in 6 (9.68%) infants. Whenboth groups were compared, no statistically significant difference was found between the twogroups in terms of sex, gestational age, birth weight or mortality (p value > 0.05). Conclusion:Short-term outcome in terms of mortality between allopurinol-treated and conventional treatmentasphyxiated neonates was found to be 6.5 vs 12.9%.
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Pritchard, Natasha L., Susan P. Walker, Alexandra R. Mitchell, Stephen Tong, and Anthea C. Lindquist. "Adjusting growth standards for fetal sex improves correlation of small babies with stillbirth and adverse perinatal outcomes: A state-wide population study." PLOS ONE 17, no. 10 (October 10, 2022): e0274521. http://dx.doi.org/10.1371/journal.pone.0274521.
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Objectives Sex impacts birthweight, with male babies heavier on average. Birthweight charts are thus sex specific, but ultrasound fetal weights are often reported by sex neutral standards. We aimed to identify what proportion of infants would be re-classified as SGA if sex-specific charts were used, and if this had a measurable impact on perinatal outcomes. Methods Retrospective cohort study including all infants born in Victoria, Australia, from 2005–2015 (529,261 cases). We applied GROW centiles, either adjusted or not adjusted for fetal sex. We compared overall SGA populations, and the populations of males considered small by sex-specific charts only (SGAsex-only), and females considered small by sex-neutral charts only (SGAunadjust-only). Results Of those <10th centile by sex-neutral charts, 39.6% were male and 60.5% female, but using sex-specific charts, 50.3% were male and 49.7% female. 19.2% of SGA females were reclassified as average for gestational age (AGA) using sex-specific charts. These female newborns were not at increased risk of stillbirth, combined perinatal mortality, NICU admissions, low Apgars or emergency CS compared with an AGA infant, but were at greater risk of being iatrogenically delivered on suspicion of growth restriction. 25.0% male infants were reclassified as SGA by sex-specific charts. These male newborns, compared to the AGAall infant, were at greater risk of stillbirth (RR 1.94, 95%CI 1.30–2.90), combined perinatal mortality (RR 1.80, 95%CI 1.26–2.57), NICU admissions (RR 1.38, 95%CI 1.12–1.71), Apgars <7 at 5 minutes (RR 1.40, 95%CI 1.25–1.56) and emergency CS (RR 1.12, 95%CI 1.06–1.18). Conclusions Use of growth centiles not adjusted for fetal sex disproportionately classifies female infants as SGA, increasing their risk of unnecessary intervention, and fails to identify a cohort of male infants at increased risk of adverse outcomes, including stillbirth. Sex-specific charts may help inform decisions and improve outcomes.
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Beebe, Susan A., John R. Britton, Helen L. Britton, Pelly Fan, and Bryan Jepson. "Neonatal Mortality and Length of Newborn Hospital Stay." Pediatrics 98, no. 2 (August 1, 1996): 231–35. http://dx.doi.org/10.1542/peds.98.2.231.
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Objective. To investigate the effect of hospital discharge time on neonatal mortality of term newborns. Design. Infants who were discharged home at 5 days of age or younger and who subsequently died were compared with control infants using a retrospective casecontrol design. Descriptive information was collected from records of infants who were not discharged home from the hospital of birth (because of death or transfer to a tertiary care hospital) to determine the age at which their illnesses presented. Methods. We reviewed death certificates for all infacts with birth weights of 2500 g or greater born at 37 weeks' gestational age or greater who died in the first 28 days of life and who were born in one of four Utah counties (1985 through 1989). Of the 109 256 eligible births, 115 infants were found who had died in the neonatal period. Eighty-four infants had not been discharged home from the hospital of birth, 5 infants had had hospital stays of more than 5 days, 9 records could not be located, 17 presumed healthy infants were discharged from the hospital at 5 days of age or younger. These 17 infants were each matched with 3 control infants. Newborn nursery charts were reviewed to determine hospital discharge times for case and control infants. Descriptive information regarding the time of presentation of illness was collected for the other 89 infants. Results. The mean age of hospital discharge was 43 ± 21 hours for the 17 case infants and 47 ± 25 hours for the 51 control infants. The odds ratio for neonatal mortality for discharge at less than 24 hours was 1.65 (95% confidence interval, 0.42 to 3.34) and for discharge at less than 48 hours was 1.16 (95% confidence interval, 0.4 to 3.34). Of the 84 infants who were not discharged home from the hospital of birth, 93% had been symptomatic by 12 hours of age, and 99% were symptomatic by 18 hours. Conclusions. Most full-term infants who die in the neonatal period are symptomatic within the first 18 hours after birth. We could not demonstrate an association between early hospital discharge and neonatal mortality in those infants who died after discharge home.
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Grandi, Carlos. "Hospital mortality of very low birth weight newborn infants." Jornal de Pediatria 83, no. 3 (June 1, 2007): 287. http://dx.doi.org/10.2223/jped.1640.
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MERCHANT, NAZAKAT, and DENIS AZZOPARDI. "HYPOXIC ISCHAEMIC ENCEPHALOPATHY IN NEWBORN INFANTS." Fetal and Maternal Medicine Review 21, no. 3 (May 19, 2010): 242–62. http://dx.doi.org/10.1017/s0965539510000069.
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Neonatal encephalopathy has been defined as “a clinically defined syndrome of disturbed neurological function in the earliest days of life in the term infant, manifested by difficulty with initiating and maintaining respiration, depression of tone and reflexes, sub normal level of consciousness and often seizures”. It occurs in about 2–3 per 1000 births in developed countries. In developing countries, neonatal encephalopathy accounts for the largest number of deaths in infancy and childhood – approximately 1 million per year worldwide. Neonatal encephalopathy is associated with significant morbidity and mortality and is an important predictor of long term neurodevelopmental disability in near- and full-term newborn infants. Fifteen to 20 percent of infants with neonatal encephalopathy die in the neonatal period, and a further 25 percent have permanent neurologic deficits.
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McKenna, Laura. "Pancreatic Disorders in the Newborn." Neonatal Network 19, no. 4 (June 2000): 13–20. http://dx.doi.org/10.1891/0730-0832.19.4.13.
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Except for the hyperinsulinism associated with the infant of a diabetic mother (accounting for about 5 percent of NICU admissions annually), pancreatic disorders of the newborn are rare. Congenital anomalies (such as annular pancreas) and endocrine disorders (such as hyperinsulinism of nesidioblastosis or hyperglycemia of neonatal diabetes mellitus) present many challenges to the personnel caring for these infants and their families. The potential mortality and morbidity of these disorders make it imperative for nurses and nurse practitioners working with infants to recognize and understand pancreatic dysfunction so that appropriate and timely intervention can prevent complications of brain injury and developmental delay. The home care needs of these infants and the extensive teaching needs of their parents require skilled nursing care to ensure a safe discharge.
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Aminullah, Asril, Jonardi Sarmili, and Sudigdo Sastroasmoro. "Factors associated with mortality in newborn infants with meconium aspiration syndrome." Paediatrica Indonesiana 41, no. 1 (February 8, 2017): 6. http://dx.doi.org/10.14238/pi41.1.2001.6-10.
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Meconium aspiration syndrome (MAS) is still one of the common causes of morbidity and mortality in neonatal period. A retrospective study was conducted from January 1993 to December 1999, to identify factors associated with mortality in MAS. Univariate analysis disclosed that preeclampsia/eclampsia, sex, Apgar scores, consistency of meconium, and use of mechanical ventilation were significantly associated with mortality in MAS, while gestational age, mode of delivery, hypertension, birth weight, tracheal suctioning, blood cultures, and complications were not. Logistic regression analysis showed that mode of delivery, preeclampsia/eclampsia, Apgar scores, consistency of meconium, and use of mechanical ventilation were associated with mortality in MAS, while other variables were not.
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Sakelo, Amanuel Nuramo, Nega Assefa, Lemessa Oljira, and Zebene Mekonnen Assefa. "Newborn Care Practice and Associated Factors among Mothers of One-Month-Old Infants in Southwest Ethiopia." International Journal of Pediatrics 2020 (October 20, 2020): 1–7. http://dx.doi.org/10.1155/2020/3897427.
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Newborn care refers to the care that is provided to the baby from birth to one-month-old by a caregiver or by the mothers including thermal care, hygienic care, cord care, eye care, breastfeeding, immunization, and identification of newborn danger signs. According to Ethiopian Demographic and Health Survey (EDHS) 2016, the neonatal mortality rate was 29 deaths per 1000 live births, and the postneonatal mortality rate was 19 deaths per 1000 live births with neonates contributing 48 deaths per 1000 of the infant mortality. Neonatal mortality accounts for approximately two-thirds of all infant mortality worldwide. Objective. The objective of this study was to assess newborn care practice and associated factors among mothers with babies of one-month-old in Hossana town, Southern Nations, Nationalities, and Peoples’ Region, Ethiopia, 2018. Methods. A community-based cross-sectional study was conducted among randomly selected 422 mothers with babies of one-month-old in Hossana town, southwest Ethiopia. The data were entered to EpiData 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 22. Bivariate and multivariate analyses were applied, and frequencies and odds ratios were calculated to determine the prevalence and associated factors, respectively. Results. In this study, 31% of participants had good newborn care practice based on three composite variables such as 84% who have done early breastfeeding initiation, 32.9% who have done safe cord care, and 30.6% who have done thermal care. Educational status of the mother’s, primary ( AOR = 2.80 , 95% CI: 1.027-7.637), secondary ( AOR = 2.596 , 95% CI: 0.921-7.316), and college and above ( AOR = 3.63 , 95% CI: 1.056-12.492); mothers who practiced handwashing (hygiene) before touching a newborn ( AOR = 2.552 , 95% CI: 1.092-5.963); and mothers who had good knowledge on newborn care practice ( AOR = 15.638 , 95% CI: 3.599-67.943) were significantly associated with newborn care practice. Conclusion and Recommendation. The present study indicated that the level of comprehensive newborn care practice was unsatisfactory; all responsible bodies were giving attention and intervene on the predictors to improve newborn care practice and provide health education regarding newborn care practice. Education level, health education (counseling) on hygiene, and knowledge of mother on newborn care practice were independent predictors of newborn care practice.
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McIntire, Donald D., Steven L. Bloom, Brian M. Casey, and Kenneth J. Leveno. "Birth Weight in Relation to Morbidity and Mortality among Newborn Infants." New England Journal of Medicine 340, no. 16 (April 22, 1999): 1234–38. http://dx.doi.org/10.1056/nejm199904223401603.
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Kaya, Ayla. "The Significance and Effectiveness of Kangaroo Care for Premature Infants." New Trends and Issues Proceedings on Advances in Pure and Applied Sciences, no. 8 (December 22, 2017): 92–97. http://dx.doi.org/10.18844/gjapas.v0i8.2821.
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Kangaroo care maintains thermoregulation between infants and their mothers. This technique can also be called the human incubator method, reducing newborn morbidity and mortality at considerably lower costs of infrastructure or safe and reliable practicality for both health professionals and mothers. It has recently been revealed that kangaroo care helps to reduce mortality rates in preterm infants, stabilises heart rate, maintains body temperature, reduces the need for oxygen, positively affects weight gain and sleep duration, and assures early discharge. Kangaroo care also guarantees mother–infant commitment in the postnatal period. Despite the evidence for its reliability and efficiency, its practice still remains limited due to lack of qualified medical personnel and an inadequate care environment. Consequently, it can be suggested that primary care providers in newborn intensive care units promote kangaroo care practices by establishing an efficient care environment in order to improve medical results and enhance the care quality. Keywords: Kangaroo care, premature newborn, neonatal intensive care unit, primary care, providers.
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Yang, Gaoji, Tong Jin, Shuhua Yin, Du Guo, Chunling Zhang, Xiaodong Xia, and Chao Shi. "trans-Cinnamaldehyde mitigated intestinal inflammation induced by Cronobacter sakazakii in newborn mice." Food & Function 10, no. 5 (2019): 2986–96. http://dx.doi.org/10.1039/c9fo00410f.
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Pejic, Katarina, Borisav Jankovic, Zeljko Mikovic, Zorica Rakonjac, Jelena Martic, and Natasa Stajic. "Non-immune hydrops fetalis: Clinical experience in newborn infants." Medical review 64, no. 9-10 (2011): 507–10. http://dx.doi.org/10.2298/mpns1110507p.
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Introduction. Non-immune hydrops fetalis is a condition of excessive accumulation of extravascular fluid without identifiable circulating antibody to erythrocytes membrane antigens. In newborn infants it is characterized by skin oedema and pleural, pericardial or peritoneal effusion. In the era of routine Rh immunization for the prevention of foetal erythroblastosis, non-immune pathophysiologic mechanisms are presented in 76-87% of all hydropic newborns. Non-immune hydrops fetalis can be associated with numerous and various disorders. The mortality rate may exceed 50%. This study was aimed at presenting our clinical experience in treating newborn infants with non-immune hydrops fetalis. Material and methods. A retrospective-prospective study included newborn infants with non-immune hydrops fetalis, who were treated in the Neonatal Intensive Care Unit of Mother and Child Health Institute of Serbia between January 1, 2001 and October 31, 2010. All valid data about aetiology, diagnosis, clinical course and outcome were recorded. Results. The diagnosis of non-immune hydrops fetalis was made in 11 newborns. The etiologic diagnosis was established in 8 patients: anaemia due to fetomaternal transfusion in 4 patients and conatal cytomegalovirus infection, intracranial haemorrhage, isolated pulmonary lymphangiectasia and diffuse skin and mediastinal lymphangiomatosis in the remaining 4 patients. Conclusion. Non-immune hydrops of newborn infant is associated with a high mortality rate and requires complex diagnostic and therapeutic procedures. An optimal management of neonates with non-immune hydrops fetalis demands a multidisciplinary approach to the treatment in a neonatal intensive care unit.
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Hewish, Alexandra, Michael Dibley, and Tanvir Huda. "The Neonatal Mortality Risk of Different Types of Vulnerable Newborns in Rural Bangladesh: A Prospective Cohort Study Within the Shonjibon Trial." Current Developments in Nutrition 6, Supplement_1 (June 2022): 663. http://dx.doi.org/10.1093/cdn/nzac061.047.
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Abstract Objectives We aimed to estimate the prevalence and neonatal mortality risks associated with mutually exclusive vulnerable newborn phenotypes in rural Bangladesh. Methods We conducted a prospective cohort study in five rural districts in Bangladesh using data collected on births in the Shonjibon Trial from 2013–2015. We estimated the prevalence of preterm birth, low birth weight (LBW), small-for-gestational-age (SGA), and large-for-gestational-age (LGA) individually and for mutually exclusive phenotypes using a combination of these characteristics. We calculated the neonatal mortality associated with preterm birth, LBW, SGA, LGA, and mutually exclusive phenotypes using Kaplan-Meier survival analysis for neonatal mortality rates and Poisson regression for adjusted relative risks (aRR) with 95% confidence intervals (CI). Results We analyzed 24,314 live births and found the prevalence of preterm birth was 26.2%, LBW 22.9%, SGA 41.7%, and LGA 8.2%. The neonatal mortality risk was approximately 3-fold for preterm birth, LBW, and LGA, and 1.5-fold higher for SGA compared to newborns with appropriate-for-gestational-age (AGA), with term gestation (≥37 weeks) and normal birth weight (NBW, ≥2500g). The risk of neonatal mortality was highest in infants born SGA, preterm, and LBW (aRR = 6.3 95% CI 4.1–9.6) relative to AGA, term, and NBW infants. There was an increased mortality risk for vulnerable newborns whose households had any iron in their drinking water. Conclusions In rural Bangladesh, most infants are born with one or more vulnerable newborn characteristics associated with an increased risk of neonatal mortality. Groundwater iron may exacerbate this risk. Our findings highlight the value of categorizing infants using mutually exclusive vulnerable newborn phenotypes and their different neonatal mortality risks, which will help to target nutrition interventions to improve child survival. Funding Sources National Health and Medical Research Council, Australia.
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Amin, Tahsinul, and Mohammod Shahidullah. "Surfactant Replacement Therapy for Respiratory Distress Syndrome in the Newborn: A Review." Bangladesh Journal of Child Health 40, no. 1 (February 13, 2017): 26–30. http://dx.doi.org/10.3329/bjch.v40i1.31552.
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Respiratory failure secondary to surfactant deficiency is a major cause of morbidity and mortality in low birth weight premature infants. Surfactant therapy substantially reduces mortality and respiratory morbidity for this population. Exogenous surfactant therapy has become well established in newborn infants with respiratory distress. Many aspects of its use have been well evaluated in high-quality trials and systematic reviews. Secondary surfactant deficiency also contributes to acute respiratory morbidity in late-preterm and term neonates with meconium aspiration syndrome, pneumonia/ sepsis, and perhaps pulmonary hemorrhage; surfactant replacement may be beneficial for these infants. This article summarizes the evidence and gives recommendations for the use of surfactant therapy for respiratory distress syndrome (RDS) in newborn.Bangladesh J Child Health 2016; VOL 40 (1) :26-30
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Yablon, O., T. Bondarenko, V. Vlasenko, N. Bedriy, and N. Shovkoplyas. "BRAIN INJURY IN PRETERM INFANTS - PATIENTS OF THE DEPARTMENT OF INTENSIVE THERAPY OF NEWBORN." Neonatology, surgery and perinatal medicine 12, no. 1(43) (May 8, 2022): 4–8. http://dx.doi.org/10.24061/2413-4260.xii.1.43.2022.1.
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Introduction. Advances in reproductive and perinatal technologies have led not only to an increase in the number of premature babies and an increase in survival rates, but also to an increase in the incidence of complications. Nervous system diseases play a leading role in the structure of pathologies of premature infants. Early onset of extrauterine life contributes to the disruption of physiological processes of brain maturation, increasing the risk of neurological complications.Objective. To establish the frequency and structure of brain damage in premature infants-patients of the intensive care unit. Materials and methods. The mortality and morbidity rates of premature infants-patients of the intensive care unit who were born in 2019-2020 and the first 3 quarters of 2021 were estimated. The frequency of lesions of the nervous system in premature infants, namely the presence of intraventricular hemorrhages of varying severity, hypoxic-ischemic encephalopathy, periventricular leukomalacia, hydrocephalus. Statistical processing of the obtained results was performed using the software system Microsoft Excel 2010 (14.0.6024.1000) SP 1 MSO (14.0.6023.1000).Results. In 2021, the number of premature babies weighing <1,500 g increased compared to 2019. The decrease in mortality rates of premature infants-patients of the intensive care unit was revealed. The most common pathologies of premature infants are respiratory distress syndrome and lesions of the nervous system. Analysis of the obtained data showed that the structure of neurological pathology in premature infants is dominated by hypoxic-ischemic encephalopathy and intraventricular hemorrhage.Conclusions. Against the background of declining mortality rates, the number and severity of HSV in premature infants are increasing.
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Kumar, Aarti, Shambhavi Mishra, Shambhavi Singh, Sana Ashraf, Peiyi Kan, Amit Kumar Ghosh, Alok Kumar, et al. "Effect of sunflower seed oil emollient therapy on newborn infant survival in Uttar Pradesh, India: A community-based, cluster randomized, open-label controlled trial." PLOS Medicine 18, no. 9 (September 28, 2021): e1003680. http://dx.doi.org/10.1371/journal.pmed.1003680.
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Background Hospitalized preterm infants with compromised skin barrier function treated topically with sunflower seed oil (SSO) have shown reductions in sepsis and neonatal mortality rate (NMR). Mustard oil and products commonly used in high-mortality settings may possibly harm skin barrier integrity and enhance risk of infection and mortality in newborn infants. We hypothesized that SSO therapy may reduce NMR in such settings. Methods and findings This was a population-based, cluster randomized, controlled trial in 276 clusters in rural Uttar Pradesh, India. All newborn infants identified through population-based surveillance in the study clusters within 7 days of delivery were enrolled from November 2014 to October 2016. Exclusive, 3 times daily, gentle applications of 10 ml of SSO to newborn infants by families throughout the neonatal period were recommended in intervention clusters (n = 138 clusters); infants in comparison clusters (n = 138 clusters) received usual care, such as massage practice typically with mustard oil. Primary analysis was by intention-to-treat with NMR and post-24-hour NMR as the primary outcomes. Secondary analysis included per-protocol analysis and subgroup analyses for NMR. Regression analysis was adjusted for caste, first-visit weight, delivery attendant, gravidity, maternal age, maternal education, sex of the infant, and multiple births. We enrolled 13,478 (52.2% male, mean weight: 2,575.0 grams ± standard deviation [SD] 521.0) and 13,109 (52.0% male, mean weight: 2,607.0 grams ± SD 509.0) newborn infants in the intervention and comparison clusters, respectively. We found no overall difference in NMR in the intervention versus the comparison clusters [adjusted odds ratio (aOR) 0.96, 95% confidence interval (CI) 0.84 to 1.11, p = 0.61]. Acceptance of SSO in the intervention arm was high at 89.3%, but adherence to exclusive applications of SSO was 30.4%. Per-protocol analysis showed a significant 58% (95% CI 42% to 69%, p < 0.01) reduction in mortality among infants in the intervention group who were treated exclusively with SSO as intended versus infants in the comparison group who received exclusive applications of mustard oil. A significant 52% (95% CI 12% to 74%, p = 0.02) reduction in NMR was observed in the subgroup of infants weighing ≤1,500 g (n = 589); there were no statistically significant differences in other prespecified subgroup comparisons by low birth weight (LBW), birthplace, and wealth. No severe adverse events (SAEs) were attributable to the intervention. The study was limited by inability to mask allocation to study workers or participants and by measurement of emollient use based on caregiver responses and not actual observation. Conclusions In this trial, we observed that promotion of SSO therapy universally for all newborn infants was not effective in reducing NMR. However, this result may not necessarily establish equivalence between SSO and mustard oil massage in light of our secondary findings. Mortality reduction in the subgroup of infants ≤1,500 g was consistent with previous hospital-based efficacy studies, potentially extending the applicability of emollient therapy in very low-birth-weight (VLBW) infants along the facility–community continuum. Further research is recommended to develop and evaluate therapeutic regimens and continuum of care delivery strategies for emollient therapy for newborn infants at highest risk of compromised skin barrier function. Trial registration ISRCTN Registry ISRCTN38965585 and Clinical Trials Registry—India (CTRI/2014/12/005282) with WHO UTN # U1111-1158-4665.
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Vinogradova, I. V., and D. O. Ivanov. "TRANSIENT MYOCARDIAL ISCHEMIA IN NEWBORN." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 19, no. 4 (August 28, 2013): 343–47. http://dx.doi.org/10.18705/1607-419x-2013-19-4-343-347.
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Objective. To study the transient myocardial ischemia in newborn of different gestational age survived after severe perinatal pathology.Design and methods. A total of 110 newborn were examined. One group included newborns weighed 2000–2500 g at birth, group 2 was formed by children with extremely low birth weight (ELBW). In both groups the frequency of transient myocardial ischemia was assessed. Results and conclusion. As a result, the comparative study showed that transient myocardial ischemia is more common in infants with ELBW. It is associated with the worsening of the underlying disease and increased mortality in the group of newborns with ELBW.
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Burton, Barbara K., Rachel Hickey, and Lauren Hitchins. "Newborn Screening for Mucopolysaccharidosis Type II in Illinois: An Update." International Journal of Neonatal Screening 6, no. 3 (September 3, 2020): 73. http://dx.doi.org/10.3390/ijns6030073.
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Mucopolysaccharidosis type II (MPS II, Hunter syndrome) is a rare, progressive multisystemic lysosomal storage disorder with significant morbidity and premature mortality. Infants with MPS II develop signs and symptoms of the disorder in the early years of life, yet diagnostic delays are very common. Enzyme replacement therapy is an effective treatment option. It has been shown to prolong survival and improve or stabilize many somatic manifestations of the disorder. Our initial experience with newborn screening in 162,000 infants was previously reported. Here, we update that experience with the findings in 339,269 infants. Measurement of iduronate-2-sulfatase (I2S) activity was performed on dried blood spot samples submitted for other newborn screening disorders. A positive screen was defined as I2S activity less than or equal to 10% of the daily median. In this series, 28 infants had a positive screening test result, and four other infants had a borderline result. Three positive diagnoses of MPS II were established, and 25 were diagnosed as having I2S pseudodeficiency. The natural history and the clinical features of MPS II make it an ideal target for newborn screening. Newborn screening was effective in identifying affected infants in our population with an acceptable rate of false positive results.
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Saugstad, Ola D. "Oxygenation of the Newborn." Donald School Journal of Ultrasound in Obstetrics and Gynecology 10, no. 2 (2016): 170–71. http://dx.doi.org/10.5005/jp-journals-10009-1462.
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ABSTRACT Newborn infants in need of positive pressure ventilation at birth should initially be given 21% O2 from term to gestational age 33 weeks. Gestational ages 29-32 weeks could be given initially FiO2 of 0.21-0.30. For ≤ 28 weeks FiO2 of 0.30 or more should be given initially. FiO2 should then be adjusted according to the oxygen saturation response assessed by pulse oximetry. After delivery room stabilisation oxygen saturation targets of 85-89% increases the risk of mortality and necrotizing enterocolitis. In spite an oxygen target of 90-95% increases the risk of ROP this is presently the recommended range. How to cite this article Saugstad OD. Oxygenation of the Newborn. Donald School J Ultrasound Obstet Gynecol 2016;10(2):170-171.
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Daga, Subhashchandra. "Scalability of the Basic Care Model for Very Low Birth Weight Infants and Implementation Research Considerations." European Journal of Clinical Medicine 2, no. 6 (December 7, 2021): 41–44. http://dx.doi.org/10.24018/clinicmed.2021.2.6.150.
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Objectives: To study the scalability of the rural hospital (RH) model of basic newborn care in a general hospital (GH) by including very low birth weight (VLBW) infants, and to assess the implementation aspects.
Study design: Observational
Settings: RH (1988-1992) and General Hospital, (GH) (2010-2013).
Subjects: VLBW infants with birth weight ranging from 1000 g to 1500 g.
Interventions: (1) RH: Basic care including warmth, feeding, antibiotics, and oxygen (2) GH: Basic plus circulatory care (2010-12), and continuous positive airway pressure (CPAP) support (2013). Mechanical ventilation and surfactant therapy were not available.
Main outcome measure: Mortality
Results: The cumulative mortality (38.5%) with basic neonatal care in the RH model declined to 26.6% at the GH with the addition of circulatory support and a “home-made” CPAP system.
Conclusions: The RH package may be scaled up by adding CPAP and circulatory support to reduce the mortality among VLBW infants. The RH model is scalable horizontally and vertically.
What is already known about this subject?
Implementation research constitutes a relatively new and underdeveloped field,
One of the facets of health system research is the implementation research.
Implementation research aims at bridging the gaps between knowledge and action.
What does this study add?
Tertiary care center can help in developing basic newborn care at a rural hospital.
The rural hospital model can be upscaled vertically as well as horizontally.
Addition of circulatory support and CPAP to basic newborn care can significantly lower neonatal mortality.
How might it impact on clinical practice in the foreseeable future?
The study may encourage tertiary care centers to facilitate the development of basic newborn care centers at the rural hospitals. These centers, in turn, can spread horizontally.
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Visvanathan, Vicky, and Rasika Jayasekara. "Respiratory function monitoring to reduce mortality and morbidity in newborn infants receiving resuscitation." International Journal of Evidence-Based Healthcare 9, no. 1 (March 2011): 73. http://dx.doi.org/10.1111/j.1744-1609.2010.00205.x.
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Poole, Claudette L., and David W. Kimberlin. "Antiviral Approaches for the Treatment of Herpes Simplex Virus Infections in Newborn Infants." Annual Review of Virology 5, no. 1 (September 29, 2018): 407–25. http://dx.doi.org/10.1146/annurev-virology-092917-043457.
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Herpes simplex virus (HSV) infections in newborns are associated with severe disease and death. Trials conducted by the Collaborative Antiviral Study Group have established the standard of care for the treatment of neonatal HSV disease with marked improvements in morbidity and mortality. We review the studies that have contributed to our understanding of the epidemiology and clinical course of neonatal HSV disease and discuss the landmark trials that have resulted in safe and effective treatment together with improved diagnostics. Although significant advances have been made, neonatal HSV disease continues to have an unacceptably high mortality rate with significant sequelae in survivors. Further research is urgently needed for prevention.
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Brown, Audrey K., Scott T. Miller, and Patricia Agatisa. "CARE OF INFANTS WITH DISEASE: THE ULTIMATE OBJECTIVE OF NEWBORN SCREENING." Pediatrics 83, no. 5 (May 1, 1989): 897–900. http://dx.doi.org/10.1542/peds.83.5.897.
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We conclude that newborn screening with a comprehensive follow-up program, emphasizing parental education and the use of penicillin prophylaxis, is effective in reducing morbidity and mortality from pneumococcal infections in infants with sickle cell disease. One of the 159 infants followed-up during 1981 to 1986 died as a result of overwhelming sepsis. This compares with an anticipated mortality rate at that time of 10%. Penicillin prophylaxis should be started at 3 months of age in infants with Hb SS and should also be given to infants with hemoglobin SC and S- β-thalassemia. The duration for which prophylaxis must be given is not known, but it should be continued at least through the age of 5 years. Monthly injections of benzathine penicillin is an inadequate regimen; we recommend that, if penicillin is to be administered by the intramuscular route, it should be given every 3 weeks and supplemented in the last week with oral penicillin. However, we now emphasize that the daily oral administration of penicillin is the preferred method of administration for prophylaxis. Pneumococcal vaccine continues to be given at 2 years of age, with a booster dose recommended at 4 to 5 years of age. H influenzae vaccine conjugates are immunogenic when given at 18 months, and newer vaccines may soon be available that can be given much earlier. Finally, and most important, the program must be structured in such a way as to thoroughly involve the parents in assuming responsibility for their child's continued health and well being.
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Rasul, Noreen, Madeeha Rashid, Aqeela Abbas, and Rubina Sohail. "First Experience of Implementation of Kangaroo Mother Care in Punjab- Pakistan to Reduce Morbidity and Mortality in Preterm Infants." Annals of King Edward Medical University 23, no. 4 (February 21, 2018): 496–502. http://dx.doi.org/10.21649/akemu.v23i4.2197.
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The study was planned to assess the effect of Kangaroo Mother Care on preterm and stable neonates in reducing neonatal morbidity and mortality. This is a case series design of 121preterm and low birth weight neonates, weighing less than 2500 gram, enrolled from 1 August 2016 till31 January 2017.Kangaroo Mother Care is initiated after birth, after performing early essential newborn care practices. Weight gain of 20-30 gram for three consecutive days, establishment of breast-feeding for 20-30 minutes every two hourly and maintenance of body temperature at 37 degree centigrade is the discharge criteria. During the periodof six months, total number of deliveries was 6459, out of them spontaneous vaginal deliveries were 52.2% (3372) and caesarean sections were 47.7% (3087). In 55.4%neonate’s(both preterm and term)early essential newborn care was practiced.Total preterm were 290 (4.5%), out of them 121 (2%) neonates were kept inKangaroo Mother Care position and 129 (44%) were shifted to neonatal intensive care unit. 14% parents refused for KMC position and discharged. Mortality in preterm newborn in neonatal unit was 29.4% (without KMC) but no mortality occurred after 3 months follow up in KMC babies. All the neonates from KMC unitwere discharged in satisfactory condition and called for follow up investigations. All Kangaroo Mother Care babies had exclusive breast-feeding. Taken together, the results indicate that prolonged skin-to-skin contact and exclusive breast feeding reduces neonatal mortality and morbidity in birth weight 1.5 to 2.5 kg in stable neonates in hospital. However KMC is limited to SHL at present. Workshops are being conducted to teach other doctors and nurses for early essential newborn care and kangaroo mother care. They are still facing controversies and challenges in initiation of KMC in many hospitals. However it is essential to strengthen KMC services in healthcare facilities as it significantly reduces neonatal mortality.
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Berkelhamer, Sara K., Douglas D. McMillan, Erick Amick, Nalini Singhal, and Carl L. Bose. "Beyond Newborn Resuscitation: Essential Care for Every Baby and Small Babies." Pediatrics 146, Supplement_2 (October 1, 2020): S112—S122. http://dx.doi.org/10.1542/peds.2020-016915d.
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Helping Babies Breathe (HBB) addresses a major cause of newborn mortality by teaching basic steps of neonatal resuscitation and improving survival rates of infants affected by intrapartum-related events or asphyxia. Addressing the additional top causes of mortality (infection and prematurity) requires more comprehensive education, including content on thermal and nutritional support, breastfeeding, and alternative feeding strategies, as well as recognition and treatment of infection. Essential Care for Every Baby (ECEB) and Essential Care for Small Babies (ECSB) use educational principles developed with HBB as a model for teaching basic newborn care. These programs complement the content provided with HBB, further integrate counseling of families, and advance the agenda of providing quality care to all infants at birth. ECEB and ECSB have further demonstrated that engagement of individuals through active participation in their education empowers providers at all levels. With added experience teaching and implementing ECEB and ECSB, the next generation of newborn educational programs will likely incorporate bedside teaching and clinical exposure, multimedia platforms for demonstrating clinical content, and added efforts toward quality improvement. Through ECEB and ECSB, the attention brought to the newborn health agenda with HBB has only grown. Although current global health issues pose new challenges in implementing this agenda, these programs together provide a critical framework to both educate and advocate for optimal care of every newborn.
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Willim, Herick Alvenus, Cristianto, and Alice Inda Supit. "Critical Congenital Heart Disease in Newborn: Early Detection, Diagnosis, and Management." Bioscientia Medicina : Journal of Biomedicine and Translational Research 5, no. 1 (December 15, 2020): 107–16. http://dx.doi.org/10.32539/bsm.v5i1.180.
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Critical congenital heart disease (CHD) is a type of CHD that requires early intervention in the first year of life to survive. Morbidity and mortality increases significantly if newborns with critical CHD experience delay in the initial diagnosis and management. The infants may develop cyanosis, systemic hypoperfusion, or respiratory distress as the main manifestations of critical CHD. Pulse oximetry screening for early detection of critical CHD must be performed in newborns after 24 hours of age or before discharge from hospital. Generally, infants with critical CHD require patency of the ductus arteriosus with infusion of prostaglandin to maintain pulmonary or systemic blood flow. After initial management, the infants must be immediately referred to tertiary care center for definitive intervention.
Keywords: congenital heart disease, duct-dependent circulation, ductus arteriosus, prostaglandin
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Verloove-Vanhorick, S. Pauline, Robert A. Verwey, Marij C. A. Ebeling, Ronald Brand, and Jan H. Ruys. "Mortality in Very Preterm and Very Low Birth Weight Infants According to Place of Birth and Level of Care: Results of a National Collaborative Survey of Preterm and Very Low Birth Weight Infants in the Netherlands." Pediatrics 81, no. 3 (March 1, 1988): 404–11. http://dx.doi.org/10.1542/peds.81.3.404.
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As part of a collaborative project in the Netherlands in 1983, for which data were collected on 1,338 newborn infants (<32 weeks' gestation and/or <1,500 g birth weight), all infants were assigned to one of three levels of care according to hospital of birth. Considerable centralization was achieved by antenatal and neonatal transport. Although the uncorrected mortality rates were similar, the mortality odds (adjusted for four and 22 potential confounding perinatal factors, respectively) were significantly higher in level 1 and level 2 hospitals compared with level 3 hospitals (tertiary perinatal care centers). By extending the facilities for full perinatal intensive care in level 3 centers and thus providing optimal care for all such infants, the overall mortality rate is expected to decrease further.
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Paneth, Nigel, Sylvan Wallenstein, John L. Kiely, Curtis P. Snook, and Mervyn Susser. "Medical Care and Preterm Infants of Normal Birth Weight." Pediatrics 77, no. 2 (February 1, 1986): 158–66. http://dx.doi.org/10.1542/peds.77.2.158.
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Preterm infants of normal birth weight (born before 37 completed weeks of gestation and weighing more than 2,250 g) experience a neonatal mortality risk almost four times higher than do term infants in the same weight range. In an analysis of the effect of hospital level of birth on neonatal mortality, such preterm normal weight infants were found to experience higher mortality if born outside of a Level 3 (tertiary care) center. For all singleton infants in this weight-gestation category born in New York City maternity services during a 3-year period (N = 23,257), the relative mortality risk for Level 1 births (compared with Level 3) was 1.72 (P < .01) and for Level 2 births 1.47 (P < .05). The excess mortality at Level 1 and Level 2 units was almost entirely due to a more than twofold higher death rate in black infants born in these units. Several potentially confounding socioeconomic, demographic, and biologic variables entered into a logistic regression model could not account for the higher mortality rates for black infants born in Level 1 and Level 2 units. Among black infants born at Level 1 units, deaths in preterm normal birth weight infants were less likely to occur in a receiving tertiary care center than were either deaths in low birth weight infants or deaths in term normal weight infants, suggesting that the need for special care of preterm normal birth weight infants is underestimated in some hospitals without newborn intensive care units.
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Klyukhina, Yuliya Borisovna, Lyudmila Aleksandrovna Zhelenina, and Dmitriy Olegovich Ivanov. "Pulmonary Catamnesis in Children on Artificial Lung Ventilation in the Neonatal Period." Pediatrician (St. Petersburg) 5, no. 3 (September 15, 2014): 16–21. http://dx.doi.org/10.17816/ped5316-21.
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Bronchopulmonary pathology is the most frequent cause of morbidity and mortality among newborn infants. Emergency aid and inten-sive care to newborn infants decrease death rate among children; at the same time, they cause an increase in pulmonary morbidity. The article deals with data concerning generation of bronchopulmonary diseases in children who underwent resuscitation in neonatal period, tracks pulmonary catamnesis, and analyzes hereditary load. The article confirms the adverse effect of artificial lung ventilation on lungs of both mature and premature babies. Neonatal pneumonia, together with iatrogenic factors of emergency care, is a dominating factor in formation of chronic non-specific pulmonary diseases in catamnesis.
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Gupta, N., C. Kamlin, M. Stewart, M. Cheung, and N. Patel. "1143 Predictors of Duct Dependent Congenital Heart Disease in Infants Transferred by Newborn Emergency Transport Service (NETS) Victoria." Archives of Disease in Childhood 97, Suppl 2 (October 1, 2012): A327—A328. http://dx.doi.org/10.1136/archdischild-2012-302724.1143.
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Vesel, Linda, Lauren Spigel, Jnanindra Nath Behera, Roopa M. Bellad, Leena Das, Sangappa Dhaded, Shivaprasad S. Goudar, et al. "Mixed-methods, descriptive and observational cohort study examining feeding and growth patterns among low birthweight infants in India, Malawi and Tanzania: the LIFE study protocol." BMJ Open 11, no. 12 (December 2021): e048216. http://dx.doi.org/10.1136/bmjopen-2020-048216.
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IntroductionEnding preventable deaths of newborns and children under 5 will not be possible without evidence-based strategies addressing the health and care of low birthweight (LBW, <2.5 kg) infants. The majority of LBW infants are born in low- and middle-income countries (LMICs) and account for more than 60%–80% of newborn deaths. Feeding promotion tailored to meet the nutritional needs of LBW infants in LMICs may serve a crucial role in curbing newborn mortality rates and promoting growth. The Low Birthweight Infant Feeding Exploration (LIFE) study aims to establish foundational knowledge regarding optimal feeding options for LBW infants in low-resource settings throughout infancy.Methods and analysisLIFE is a formative, multisite, observational cohort study involving 12 study facilities in India, Malawi and Tanzania, and using a convergent parallel, mixed-methods design. We assess feeding patterns, growth indicators, morbidity, mortality, child development and health system inputs that facilitate or hinder care and survival of LBW infants.Ethics and disseminationThis study was approved by 11 ethics committees in India, Malawi, Tanzania and the USA. The results will be disseminated through peer-reviewed publications and presentations targeting the global and local research, clinical, programme implementation and policy communities.Trial registration numbersNCT04002908 and CTRI/2019/02/017475.
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Casaccia, Germana, Francesco Crescenzi, Andrea Dotta, Irma Capolupo, Annabella Braguglia, Olivier Danhaive, L. Pasquini, et al. "Birth weight and McGoon Index predict mortality in newborn infants with congenital diaphragmatic hernia." Journal of Pediatric Surgery 41, no. 1 (January 2006): 25–28. http://dx.doi.org/10.1016/j.jpedsurg.2005.10.002.
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Kiely, John L., Nigel Paneth, Zena Stein, and Mervyn Susser. "CEREBRAL PALSY AND NEWBORN CARE. II: MORTALITY AND NEUROLOGICAL IMPAIRMENT IN LOW-BIRTHWEIGHT INFANTS." Developmental Medicine & Child Neurology 23, no. 6 (November 12, 2008): 650–59. http://dx.doi.org/10.1111/j.1469-8749.1981.tb02048.x.
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Charney, Edward B., Susan C. Weller, Leslie N. Sutton, Derek A. Bruce, and Luis B. Schut. "Management of the Newborn with Myelomeningocele: Time for a Decision-Making Process." Pediatrics 75, no. 1 (January 1, 1985): 58–64. http://dx.doi.org/10.1542/peds.75.1.58.
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The relationship between time of surgical intervention and eventual outcome was examined in 110 newborns with myelomeningocele. Numerous earlier reports have cited a significant increase in mortality and morbidity associated with delay of surgery beyond 48 hours. Within the study population of infants, 52 infants (47%) had "early" surgery within the first 48 hours of life, 32 infants (29%) had "delayed" surgery between 3 and 7 days of age, 12 infants (11%) had "late" surgery between 1 week and 10 months of age, and 14 infants (13%) never had surgery by parental decision. Survival rates were similar between those with early, delayed, or late surgery as 92%, 94%, and 100%, respectively, were alive at age 10 months. Also, no significant association existed between time of surgery and development of ventriculitis, developmental delay, or worsening of paralysis. From these observations, it is concluded that there is no urgency in surgical intervention for the initial management of newborns with myelomeningocele. Rather, there is time for comprehensive discussions, counseling, and emotional support for those parents in need of a decision-making process before establishing consent for or against surgical management of their newborn.
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Aboayesh, Said, and Dimitrie Nanu. "Associated factors of survival in premature infants." Romanian Medical Journal 68, no. 4 (December 31, 2021): 500–507. http://dx.doi.org/10.37897/rmj.2021.4.17.
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The particular interest of the study of the evolution of children with very low birth weight is constantly growing because it has the highest percentage in perinatal mortality. The medical care of premature newborn with low birth weight is meticulous, long, very pretentious and expensive, and the prognosis is frequently burdened by complications and neuropsychic sequelae. The defining characteristic of these children – their biological immaturity that has a wide and complex impact on the functioning of metabolic apparatus, systems and pathways –is both a factor with profound implications on adaptation to mechanical and hypoxic aggression imposed by labor and premature birth and a disability of adaptation postnatal development and further development.
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SOFATZIS, JOHN, and VASSO IOAKIMIDOU. "Perinatal Statistics." Pediatrics 80, no. 2 (August 1, 1987): 301–2. http://dx.doi.org/10.1542/peds.80.2.301.
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To the Editor.— Evaluation of the effect of good medical care of pregnant women and newborn infants and/or the impact of birth weight distribution on crude perinatal mortality rates is based upon the use of birth weight-specific mortality rates and standardized perinatal mortality rates.1-4 We agree with the suggestion made by Hermansen and Hasan5 that all future reports on perinatal statistics should comply with the recommendations made by WHO. Moreover, meaningful comparisons of standardized perinatal mortality rates over time and place require the use of a standard birth weight distribution.
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Daga, S. R. "Reduction in neonatal mortality by simple interventions." Journal of Biosocial Science 21, S10 (1989): 127–36. http://dx.doi.org/10.1017/s0021932000025335.
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Newborn infants are among those which generate the highest health care costs. For instance, the cost of hospital care until discharge was assessed at US $ 14,200 (Boyle et al., 1983) for babies weighing 1000–1499g at birth. The average hospital stay for a baby weighing less than 1500g at birth in 1981 was 100 days at an average daily cost of US$ 898 (Stahlman, 1984). Achievements in neonatal survival, especially of extremely low birth weight babies, have necessitated frequent revision of the definition of viability. However, modern neonatal intensive care cannot be regarded as appropriate for developing countries as it cannot be made accessible to all at an affordable cost.
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Ade-Ajayi, Niyi, Edward Kiely, David Drake, Rob Wheeler, and Lewis Spitz. "Resection and Primary Anastomosis in Necrotizing Enterocolitis." Journal of the Royal Society of Medicine 89, no. 7 (July 1996): 385–88. http://dx.doi.org/10.1177/014107689608900708.
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Necrotizing enterocolitis (NEC) is the most common surgical emergency in the newborn. Up to half of babies with NEC develop advanced disease requiring surgical intervention. Options include peritoneal drainage under local anaesthetic, enterostomy only, resection and enterostomies, and resection with primary anastomosis. Resection with enterostomies is favoured by many paediatric surgeons but management of neonatal enterostomies can be difficult. The outcome of 26 infants undergoing surgery for advanced NEC over a 2-year period is reviewed. Resection and primary anastomosis was possible in 18 infants of whom two (11%) died. Recurrent NEC developed in four (22%) and strictures in three (17%) of these infants. An initial enterostomy was fashioned in eight infants, three following resection of necrotic intestine and five as a proximal diverting stoma in infants with pan-intestinal involvement. Five of these eight infants died (63%), giving an overall mortality of 27%. Primary anastomosis is an effective procedure following resection of grossly involved intestine in infants with NEC. The mortality and morbidity in this series compared well with those reported for staged procedures.
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Panigrahy, Nalinikanta, Dinesh Kumar Chirla, Rakshay Shetty, Farhan A. R. Shaikh, Poddutoor Preetham Kumar, Rajeshwari Madappa, Anand Lingan, and Satyan Lakshminrusimha. "Thiamine-Responsive Acute Pulmonary Hypertension of Early Infancy (TRAPHEI)—A Case Series and Clinical Review." Children 7, no. 11 (October 28, 2020): 199. http://dx.doi.org/10.3390/children7110199.
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Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome of high pulmonary vascular resistance (PVR) commonly seen all over the world in the immediate newborn period. Several case reports from India have recently described severe pulmonary hypertension among infants in the postneonatal period. These cases typically present with respiratory distress in 1–6-month-old infants, breastfed by mothers on a polished rice-based diet. Predisposing factors include respiratory tract infection such as acute laryngotracheobronchitis with change in voice, leading to pulmonary hypertension, right atrial and ventricular dilation, pulmonary edema and hepatomegaly. Mortality is high without specific therapy. Respiratory support, pulmonary vasodilator therapy, inotropes, diuretics and thiamine infusion have improved the outcome of these infants. This review outlines four typical patients with thiamine-responsive acute pulmonary hypertension of early infancy (TRAPHEI) due to thiamine deficiency and discusses pathophysiology, clinical features, diagnostic criteria and therapeutic options.
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Putra, Putu Junara. "Characteristics and outcomes of low birth weight infants in Bali." Paediatrica Indonesiana 52, no. 5 (October 31, 2012): 300. http://dx.doi.org/10.14238/pi52.5.2012.300-3.
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Background The prevalence and the mortality of low birthweight infants are still high. Low birth weight (LBW) births areresponsible for newborn death. LBW infants are easier to sufferserious health problems and death. Lower infant body weightand younger gestational age are determinants of greater risk ofmortality.Objective To determine the characteristics of LBW infants andtheir outcomes in Sanglah Hospital, Denpasar.Methods This prospective study was conducted on all LBWinfants in the nursery from their time of admission until dischargefor the year of 20 11..Results There were 120 LBW infants admitted to SanglahHospital fromJanuary 2011 to December 2011. The prevalenceofLBW was 8.9%. The birth weight group of 15002499 gramshad the highest number of infants (79.2%). The gestational agegroup of 3336 weeks had 53.3% of the infants, while 68.3% ofthe LBW infants were of the appropriate gestational age. Themost common method of delivery was normal spontaneousdelivery (70%). Moderate asphyxia was observed in 25% of thesubjects, while severe asphyxia was observed in 22.5% of subjects.The mortality rate was 24.2%.Conclusions The prevalence of LBW of all newborns in ourhospital was 8.9%. Severe asphyxia was observed in 22.5% ofsubjects. The mortality rate of the LBW infants was 24.2%. OurLBW infants were most cormnonly in the categories of birth weightof 15002499 grams, gestational age was between 3336 weeks,appropriate for gestational age, as well as delivered spontaneously.[Paediatr lndanes. 2012,52:30003].
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Хетагурова, Yuliana Khetagurova, Ревазова, Asya Revazova, Бораева, Tatyana Boraeva, Павловская, et al. "Clinical and neurosonographic signs of c entral nervous system in newborns." Vladikavkaz Medico-Biological Bulletin 20, no. 30 (November 1, 2014): 97–100. http://dx.doi.org/10.12737/11808.
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Despite of significant progress in the development of technologies of clinical monitoring and the fetus and newborn pathology study, perinatal asphyxia or, more accurately – cerebral ischemia (CI) remain serious condition, causing significant mortality and long-term morbidity. Chi-acquired syndrome characterized by clinical and laboratory signs of acute brain injury due to asphyxia (ie, hypoxia, acidosis). The paper reflects the main clinical signs and neurosonographic lesion of the Central nervous system (CNS) in neonatal newborn infants with different gestational age who underwent CI mild to moderate severity.
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Liamputtong Rice, Pranee. "Childhood Health and Illness: Cultural Beliefs and Practices among the Hmong in Victoria." Australian Journal of Primary Health 4, no. 4 (1998): 44. http://dx.doi.org/10.1071/py98060.
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This paper examines the cultural construction of childhood illness among Hmong refugees from Laos who are living in Australia. It focuses on traditional patterns of beliefs and practices related to health and illness of newborn infants and young children. The Hmong treat childhood health and illness seriously, and for them there are several causes of childhood illness, including nature, souls, supernatural beings and human aggression. The roles of traditional healers who play an important part in childhood health and illness are also discussed. Lastly, the paper attempts to make clear some implications for child health services for immigrants such as the Hmong in Australia and elsewhere. The paper intends to contribute an anthropological perspective on child health which is particularly important in a multicultural society. A clear understanding by health professionals of cultural beliefs and expectations is essential if misunderstanding is to be avoided, and culturally appropriate and sensitive health care for immigrant children, such as the Hmong to be available.
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Gaur, Ajay, and Prakash Petchimuthu. "Growth outcome, feeding practices and co morbidities in follow up of discharged newborns from special newborn care unit Gwalior, India." International Journal of Contemporary Pediatrics 6, no. 6 (October 21, 2019): 2296. http://dx.doi.org/10.18203/2349-3291.ijcp20194189.
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Background: In spite of advances in neonatal care, infant mortality is still high in India. Regular follow up of discharged newborns could bring down infant mortality and reduce long term disability by early identification and intervention. The primary objective of the study is evaluating the Special Newborn Care Unit(SNCU) graduates for Comorbidities, feeding and immunization practices, growth assessment and outcome during follow up.Methods: The discharged neonates from SNCU, GRMC were examined for their morbidity and growth monitoring done. Feeding and immunization practices were observed.Results: Among 100 neonates observed, 2 neonates were excluded and 41(41.8%) were females and 57(58.1%) were males. Major causes of indication of admission were prematurity (25.5%) and birth asphyxia (22.4%). During follow up, 23(23.4%) neonates had respiratory infections followed by 19 cases (19.3%) of diarrhea. Around 45(45.9%) infants’ weight fall between -1 to +1 SD which was around 55 infants during admission. Length monitoring showed that around 68(69.3%) infants length fall between -1 to +1 SD which was 72 during admission. Exclusive breast feeding was observed in 68(69.3%) infants, 7 infants (7.1%) were exclusively top fed, and 19 infants (19.3%) were mixed fed. Immunization was appropriately done in only 51 infants (52%). Retinopathy of prematurity was observed in 2 infants during follow up. Hearing difficulty was observed in 1 infant.Conclusions: Most common indication of admission in SNCU was prematurity. Most common comorbidity during follow up was respiratory infection. Weight monitoring of infants showed the reduction in weight during follow up than admission whereas length and head circumference was relatively static during admission and follow up.
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WETHERS, DORIS, HOWARD PEARSON, and MARILYN GASTON. "Newborn Screening for Sickle Cell Disease and Other Hemoglobinopathies." Pediatrics 83, no. 5 (May 1, 1989): 813–14. http://dx.doi.org/10.1542/peds.83.5.813.
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Hemoglobinopathies represent one of the major health problems in the United States and constitute the most common genetic disorders in some populations. Sickle cell disease (SS, SC, S-β-thalassemia) alone affects about one in 400 American black newborns, as well as persons of African, Mediterranean, Asian, Caribbean, Middle Eastern, and South and Central American origins. For the past 20 years, the medical profession has known that children with sickle cell anemia have an increased susceptibility to severe bacterial infection, particularly due to Streptococcus pneumoniae. The risk of major infection and death posed by this organism is greatest in the first 3 years of life and can occur as early as 3 months of age. In fact, this infection may be the first clinical manifestation of disease. The infection can be fulminant, progressing from the onset of fever to death in a matter of hours, and the case fatality rate is reported as high as 30%. In addition, acute splenic sequestration, another acute catastrophic event, contributes to early mortality in children with sickle cell anemia and may occur as early as 5 months of age. It has been proposed that early diagnosis to identify infants with major sickle hemoglobinopathies, who have a high risk of early mortality and morbidity, is essential to institute appropriate ongoing care and effective measures of prophylaxis and intervention. Early diagnosis of hemoglobinopathies should be in the newborn period. Even though the technology to screen infants in the newborn period has been available for the past 15 to 20 years, screening has not received widespread acceptance.
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Flannery, Dustin D., and Karen M. Puopolo. "Neonatal Early-Onset Sepsis." NeoReviews 23, no. 11 (November 1, 2022): 756–70. http://dx.doi.org/10.1542/neo.23-10-e756.
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Early-onset sepsis (EOS) is a significant cause of morbidity and mortality among newborn infants, particularly among those born premature. The epidemiology of EOS is changing over time. Here, we highlight the most contemporary data informing the epidemiology of neonatal EOS, including incidence, microbiology, risk factors, and associated outcomes, with a focus on infants born in high-income countries during their birth hospitalization. We discuss approaches to risk assessment for EOS, summarizing national guidelines and comparing key differences between approaches for term and preterm infants. Lastly, we analyze contemporary antibiotic resistance data for EOS pathogens to inform optimal empiric treatment for EOS.
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Elahi, Shokrollah, Rachelle M. Buchanan, Lorne A. Babiuk, and Volker Gerdts. "Maternal Immunity Provides Protection against Pertussis in Newborn Piglets." Infection and Immunity 74, no. 5 (May 2006): 2619–27. http://dx.doi.org/10.1128/iai.74.5.2619-2627.2006.
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ABSTRACT Pertussis continues to be a significant cause of morbidity and mortality in infants and young children worldwide. Methods to control the disease are based on vaccination with either whole-cell or acellular vaccines or treatment with antibiotics. However, despite worldwide vaccination infants are still at the highest risk for the disease. Here we used our newly developed newborn-piglet model to investigate whether transfer of maternal immunity can protect newborn piglets against infection with Bordetella pertussis. Pregnant sows were vaccinated with heat-inactivated B. pertussis or treated with saline (controls). Newborn piglets were allowed to suckle colostrum and milk for 4 to 5 days before they were challenged with 5 × 109 CFU of bacteria intrapulmonarily. Elevated levels of B. pertussis-specific secretory immunoglobulin A (S-IgA) and IgG antibodies were found in the colostrum and serum of vaccinated sows but not in those of control sows. Subsequently, significant levels of specific IgG and S-IgA were detected in the serum and bronchoalveolar lavage fluid of piglets born to vaccinated sows. Following infection with 5 × 109 CFU of B. pertussis, clinical symptoms, pathological alterations, and bacterial shedding were significantly reduced in piglets that had received passively transferred immunity. Thus, our results demonstrate that maternal immunization might represent an alternative approach to provide protection against pertussis in young infants.
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Guzzetta, Franco, Gary D. Shackelford, Sara Volpe, Jeffrey M. Perlman, and Joseph J. Volpe. "Periventricular Intraparenchymal Echodensities in the Premature Newborn: Critical Determinant of Neurologic Outcome." Pediatrics 78, no. 6 (December 1, 1986): 995–1006. http://dx.doi.org/10.1542/peds.78.6.995.
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Controversy exists concerning the degree of importance of periventricular intraparenchymal echodensities (IPE) observed on neonatal ultrasound scans in the determination of subsequent neurologic disability in premature infants. In this report, IPE was studied in 75 infants weighing less than 2,000 g at birth to determine the basic characteristics of the lesion, the likely pathogenesis, the outcome, and the aspects of the ultrasonographic appearance in the acute period of neonatal illness that are important for prediction of outcome. IPE was defined as any periventricular echodensity greater than 1 cm in at least one dimension. IPE was strikingly associated with large areas of intraventricular hemorrhage (IVH) (81% of cases). IPE was distinctly asymmetric. Thus, the lesion was either exclusively unilateral (67%) or bilateral with marked predominance on one side. The associated IVH was asymmetric in approximately 80% of cases, and in all 50 cases of large asymmetric IVH, IPE occurred on the same side as the larger amount of intraventricular blood. Moreover, more than 50% of such cases of IPE associated with large asymmetric IVH were progressive. Neuropathologic correlation showed that IPE represented hemorrhagic necrosis of periventricular tissue. Concerning pathogenesis, these data raise the possibility that large asymmetric IVH is related etiologically to IPE. Outcome varied with the severity of the IPE. Thus, the mortality rate among the 38 infants with extensive IPE was 79%. Of the survivors with extensive IPE, all had subsequent major motor deficits and all but one exhibited cognitive function less than 80% of normal. Among the 37 infants with localized IPE, the mortality rate was 38%. Of the survivors, although 79% had major motor deficits, 43% had cognitive function greater than 80% of normal. Thus, the findings demonstrate that with extensive IPE there is little or no chance for survival with normal neurologic and cognitive outcome, but with localized IPE, although major motor deficits are common, an appreciable proportion of infants have cognitive function in the normal range. Careful, quantitative assessment of the ultrasonographic features of IPE in the acute period of illness in the premature infant is of major value in estimating outcome.
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Fidanovski, Dusko, Vladislav Milev, Aleksandar Sajkovski, Antoni Hristovski, Aspasija Sofijanova, Ljiljana Kojic, and Mica Kimovska. "Mortality risk factors in premature infants with respiratory distress syndrome treated by mechanical ventilation." Srpski arhiv za celokupno lekarstvo 133, no. 1-2 (2005): 29–35. http://dx.doi.org/10.2298/sarh0502029f.
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Respiratory distress syndrome (RDS) is the most common cause of respiratory failure and requirement for mechanical ventilation (MV) of newborns. RDS is also common cause of mortality and severe morbidity in premature infants. In developing countries, despite facilities for respiratory care of newborn infants, RDS mortality rate and percentage of complications still remain high in comparison to the developed countries. Survival rates of RDS infants requiring MV ranged from 25% in those newborns with birth weight <1000 grams up to 53% in those with birth weight >2500 grams. There have been limited data about causes of high mortality rate in infants with RDS from developing countries. AIM The objectives of the study were to determine (I) the incidence of severe RDS at Pediatric Intensive Care Unit (PICU), University Children's Hospital Skopje (UCHS) and main characteristics of infants with RDS, as well as (II) the survival rate and mortality risk factors of these infants. MATERIAL AND METHODS The study included 126 premature infants with clinical and radiological signs of RDS requiring mechanical ventilation who were admitted to PICU, UCHS between January 1996 and December 2003. The mean gestational age (GA) of the infants was 31.5+2.5 weeks, and the mean birth weight (BW) was 1663+489 grams. The management of newborns with RDS at PICU, UCHS, follows the standard protocol, with emphasis on minimal manipulation, maintenance of thermo neutral environment, administration of humidified oxygen and non-invasive cardio respiratory monitoring. Pressure-limited time-cycled mechanical ventilation with pediatric/neonatal ventilators was performed in all infants. In those newborn infants with clinical and radiological signs of RDS and need for MV with FiO2>0.4, synthetic (Exosurf) or natural (Survanta) surfactants were administered. Out of all newborns, 43 infants (34%) were not treated with surfactant, because it was not available at that time. RESULTS In the period 1996-2003, out of 1722 consecutive admissions to PICU, 693 hospitalized infants had neonatal RDS (40.2%). A total of 210 (30.3%) infants with RDS required intubation and PPV, and 126 met the inclusion criteria for this study. Surfactant replacement therapy (up to two doses) was given to 83 (65.8%) infants. Most of neonates (80 or 634%) were born at two maternity hospitals in Skopje, and others were transferred from regional maternity hospitals in Macedonia. The relation between perinatal characteristics, disease severity and outcome was illustrated in Table 2. There was higher risk of mortality in infants with lower birth weight, lower Apgar score (minutes 1 and 5), and shorter gestational age. Expected admission values of VI as well as other parameters of illness severity were not significantly associated with higher risk of mortality. The newborns with air-leak sy (any form) and pulmonary hemorrhage had significantly higher risk of dying, while the risk of mortality was significantly lower in infants with sepsis and BPD as complications in studied cohort. The findings of logistic regression analysis for mortality risk factors were presented in Table 3. The minimal model identified a number of factors as independently associated with significantly higher risk of mortality. Infant birth weight ?1500 grams, admission VI ?0.2 mmHg and air leak sy (any form) as complication significantly increased the risk of dying in infants with RDS. BPD was significantly associated with survival in studied cohort. CONCLUSION In spite of the implementation of high technology in Neonatal Intensive Care in our country, the mortality rate of the infants with RDS is high, but is not different from that in developing countries. The improvement of perinatal care and diminution of risk factors, common use of surfactant as well as antenatal steroids could most probably result in better outcome of neonatal RDS.
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Pietravalle, Andrea, Luca Brasili, Francesco Cavallin, Margherita Piquè, Chiara Zavattero, Gaetano Azzimonti, Donald Micah Maziku, Dionis Erasto Leluko, Giovanni Putoto, and Daniele Trevisanuto. "Impact of Quality Improvement Bundle on Neonatal Mortality in a District Hospital in Tanzania." Children 9, no. 7 (July 15, 2022): 1060. http://dx.doi.org/10.3390/children9071060.
Full textAbstract:
Background: The poor quality of care received by mothers and neonates in many limited-resource countries represents a main determinant of newborn mortality. Small and sick hospitalized newborns are the highest-risk population, and they should be one of the prime beneficiaries of quality-of-care interventions. This study aimed to evaluate the impact on neonatal mortality of quality improvement interventions which were implemented at Tosamaganga Council Designated Hospital, Iringa, Tanzania, between 2016 and 2020. Methods: A retrospective comparison between pre- and post-intervention periods was performed using the chi-square test and Fisher’s exact test. Effect sizes were reported as odds ratios with 95% confidence intervals. Results: The analysis included 5742 neonates admitted to the Special Care Unit (2952 in the pre-intervention period and 2790 in the post-intervention period). A decrease in mortality among infants with birth weight between 1500 and 2499 g (overall: odds ratio 0.49, 95% confidence interval 0.27–0.87; inborn: odds ratio 0.50, 95% confidence interval 0.27–0.93) was found. The analysis of cause-specific mortality showed a decrease in mortality for asphyxia (odds ratio 0.33, 95% confidence interval 0.12–0.87) among inborn infants with birth weight between 1500 and 2499 g. Conclusions: A quality improvement intervention was associated with decreased mortality among infants with birth weight between 1500 and 2499 g. Further efforts are needed to improve prognosis in very-low-birth-weight infants.
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Ebela, Inguna, Irisa Zile, Aleksandrs Zakis, Valdis Folkmanis, and Ingrida Rumba-Rozenfelde. "Mortality of Children Under Five and Prevalence of Newborn Congenital Anomalies in Relation to Macroeconomic and Socioeconomic Factors in Latvia." Medicina 47, no. 12 (January 3, 2012): 98. http://dx.doi.org/10.3390/medicina47120098.
Full textAbstract:
Background. Mortality of infants and children younger than 5 years is a globally recognized and broad national welfare indicator. Scientific literature has data on the correlation of mortality indicators with macroeconomic indicators. It is important to study the associations between prevalence and mortality indicators and socioeconomic factors, since deaths from congenital anomalies account for approximately 25%–30% of all deaths in infancy. The aim of the study was to analyze the overall trend in mortality of infants and young children aged 0 to 4 years in relation to macroeconomic factors in Latvia and prevalence of congenital anomalies in newborns in relation to socioeconomic factors. Material and Methods. The Newborns’ Register and Causes of Death Register were used as data sources; data on specific socioeconomic factors were retrieved from the Central Statistics Office. Results. The results of the study show a strong correlation between mortality in children younger than 5 years and gross domestic product, as well as health budget in LVL per capita and the national unemployment level. The average decrease in infant mortality from congenital anomalies in Latvia was found to be 6.8 cases per 100 000 live births. Conclusions. There is a strong correlation between child mortality and socioeconomic situation in the country. There is a need to analyze the data on child mortality in a transnational context on a regular basis and studying the correlations between child mortality indicators and socioeconomic indicators and health care management parameters.