Early Morbidities and Mortality among SGA and AGA Preterm Neonates in South India

Madhu Nadagouda, S. SiddarameshwarKalyanshettar, Patil Sv
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Abstract

Introduction: Pre-term birth is the main determinant of neonatal morbidity and mortality with long-term adverse health consequences. Infants born pre-term compared to term infants experience more difficulty with temperature instability, feeding intolerance, blood glucose regulation, jaundice, apnea, respiratory distress (RDS) and sepsis. Aim: To study the early neonatal morbidities of all pre-term neonates admitted in NICU and to know the immediate outcome during their stay. Also to compare rate of early morbidities and mortality among SGA and AGA pre-term neonates. Material and methods: It’s a prospective observational study carried out in a NICU of a Medical college in South India, for a period of 18 months. Preterm babies (less than 37 weeks gestation using Modified Ballard score) divided into SGA and AGA using growth charts. Total 100 preterm babies included of which SGA and AGA were 50 each. Neonates with TTN (Transient Tachypnea of the Newborn), Birth asphyxia, Neonatal sepsis, Hypoglycemia, Hypothermia, Neonatal hyperbilirubinemia, Respiratory insufficiency, Feed intolerance were included in present study. Results: Hyperbilirubinemia constituted 61% of morbidities, among which 47.5% are AGA neonates and 52.5% are SGA neonates. 24 newborns presented with sepsis, 15 newborns with feed intolerance. 80 newborns had hypoxia at admission. RDS was commonly seen in AGA neonates when compared to SGA neonates. 6 babies among AGA and 8 among SGA had mortality. One baby was discharged AGAinst medical advice. Conclusion: Most common morbidities among the SGA neonates were sepsis, hyperbilirubinemia, feed intolerance, hypoglycemia, Apnea, PDA, hypoxia. AGA neonates had metabolic disorders and RDS.
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南印度SGA和AGA早产儿的早期发病率和死亡率
前言:早产是新生儿发病率和死亡率的主要决定因素,具有长期的不良健康后果。与足月婴儿相比,早产婴儿在体温不稳定、喂养不耐受、血糖调节、黄疸、呼吸暂停、呼吸窘迫(RDS)和败血症方面遇到更多困难。目的:了解新生儿重症监护病房收治的所有早产儿的早期新生儿发病率,并了解其住院期间的直接预后。同时比较SGA和AGA早产儿的早期发病率和死亡率。材料和方法:这是一项前瞻性观察性研究,在南印度一所医学院的新生儿重症监护病房进行,为期18个月。早产儿(小于37周妊娠,使用改良巴拉德评分)使用生长图分为SGA和AGA。共纳入100例早产儿,其中SGA和AGA各50例。新生儿短暂性呼吸急促(TTN)、新生儿窒息、新生儿败血症、低血糖、低体温、新生儿高胆红素血症、呼吸功能不全、饲料不耐受均纳入本研究。结果:高胆红素血症占总发病率的61%,其中AGA新生儿占47.5%,SGA新生儿占52.5%。24名新生儿出现败血症,15名新生儿出现饲料不耐受。80例新生儿入院时出现缺氧。与SGA新生儿相比,RDS常见于AGA新生儿。AGA组6例死亡,SGA组8例死亡。一名婴儿违背医嘱出院。结论:SGA新生儿最常见的发病为败血症、高胆红素血症、饲料不耐受、低血糖、呼吸暂停、PDA、缺氧。AGA新生儿有代谢紊乱和RDS。
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