Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.42978.1714
Farideh Gharekhanloo
Background: The present study was conducted to compare the efficiency of hydronephrosis index (HI) with those of pelvic anteroposterior (AP) diameter and parenchymal thickness in the diagnosis of fetal hydronephrosis in the prenatal period, as well as 1, 6, and 12 months after birth. Methods: This study was conducted on pregnant women with the pregnancy age of > 30 weeks whose fetus was suspected of hydronephrosis. The study participants were collected via the consecutive sampling method. The HI, pelvic AP diameter, and parenchymal thickness were measured at the baseline and 1, 6, and 12 months after delivery using ultrasound. According to the study design, the study participants were divided into three groups. Group A consisted of cases with decreased HI and higher hydronephrosis severity. Group B was composed of subjects with relatively constant HI, and group C entailed individuals with increased HI and lower hydronephrosis severity. All of the study measurements and analyses were performed on the three study groups. Results: The results revealed a negative association between HI and pelvic AP diameter but a positive association with parenchymal thickness. On the other hand, HI showed a significant correlation with parenchymal thickness in the diagnosis and prognostic assessment of fetal hydronephrosis. Conclusion: The HI correlated with parenchymal thickness and pelvic AP diameter scores in all follow-up stages. Accordingly, HI can be concluded to be a good alternative to parenchymal thickness or pelvic AP diameter as a grading factor for hydronephrosis. It is suggested to perform further studies to carefully assess the efficiency of HI in the diagnosis, prognosis, and clinical outcome of hydronephrosis.
{"title":"Hydronephrosis Index as a New Method for the Evaluation and Follow-up of Fetal Hydronephrosis","authors":"Farideh Gharekhanloo","doi":"10.22038/IJN.2020.42978.1714","DOIUrl":"https://doi.org/10.22038/IJN.2020.42978.1714","url":null,"abstract":"Background: The present study was conducted to compare the efficiency of hydronephrosis index (HI) with those of pelvic anteroposterior (AP) diameter and parenchymal thickness in the diagnosis of fetal hydronephrosis in the prenatal period, as well as 1, 6, and 12 months after birth. Methods: This study was conducted on pregnant women with the pregnancy age of > 30 weeks whose fetus was suspected of hydronephrosis. The study participants were collected via the consecutive sampling method. The HI, pelvic AP diameter, and parenchymal thickness were measured at the baseline and 1, 6, and 12 months after delivery using ultrasound. According to the study design, the study participants were divided into three groups. Group A consisted of cases with decreased HI and higher hydronephrosis severity. Group B was composed of subjects with relatively constant HI, and group C entailed individuals with increased HI and lower hydronephrosis severity. All of the study measurements and analyses were performed on the three study groups. Results: The results revealed a negative association between HI and pelvic AP diameter but a positive association with parenchymal thickness. On the other hand, HI showed a significant correlation with parenchymal thickness in the diagnosis and prognostic assessment of fetal hydronephrosis. Conclusion: The HI correlated with parenchymal thickness and pelvic AP diameter scores in all follow-up stages. Accordingly, HI can be concluded to be a good alternative to parenchymal thickness or pelvic AP diameter as a grading factor for hydronephrosis. It is suggested to perform further studies to carefully assess the efficiency of HI in the diagnosis, prognosis, and clinical outcome of hydronephrosis.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"17 1","pages":"24-30"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86860081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.37500.1691
S. Tabatabaee, Abolfazl Afjeh, M. Radfar, M. Fallahi
Background: There are many known risk factors related to maternal or neonatal problems which can predict the need for resuscitation. In this study, we evaluated the resuscitation process of preterm neonates and analyzed the impact of different risk factors on the level of resuscitation required in the patients.Methods: This cross-sectional descriptive study was conducted on inborn preterm infants with a birth weight of < 1500 g during one year. Moreover, the present study evaluated the resuscitation process of the delivery room and analyzed the association of maternal-neonatal risk factors and requirement for different levels of resuscitation.Results: In the present study, 193 preterm neonates were evaluated. In addition, 82 (42.5%) and 110 (57%) patients were female and male, respectively. The mean values of gestational age and birth weight of the patients were 29.9±2.4 weeks and 1191.6±265.2 g, respectively. The mode of delivery in 159 (82.4%) patients was cesarean section.In the assessment of different levels of resuscitation, 84 (43.5%), 35 (18.1%), 54 (28%), 10 (5.2%), 10 (5.2%), and 9 (4.7%) neonates needed initial steps, free flow of oxygen, positive pressure ventilation, endotracheal intubation, chest compression, and drug administration, respectively. The rate of neonatal mortality was 23.8% (n=46), and hypoxic-ischemic encephalopathy was recorded in 10 (21.7%) subjects. In the evaluation of mothers, 117 (60.6%) subjects had medical problems during pregnancy. The most common problem was preeclampsia in 44 (22.8%) mothers. The lower birth weight (P<0.001), gestational age (P<0.001), Apgar score (P<0.001), and longer duration of resuscitation had a significant effect on the needed level of resuscitation in neonates.Conclusion: According to the obtained results, it was shown that premature neonates needed more advanced resuscitation. Therefore, improving the quality of care for mothers and neonates is necessary to obtain better outcomes. Regarding the need for noninvasive positive pressure ventilation was the second most frequent intervention, the proper use of equipment is necessary for the prevention of advanced resuscitation.
{"title":"Assessment of Delivery Room Resuscitation with Different Levels and Its Related Factors in Preterm Neonates","authors":"S. Tabatabaee, Abolfazl Afjeh, M. Radfar, M. Fallahi","doi":"10.22038/IJN.2020.37500.1691","DOIUrl":"https://doi.org/10.22038/IJN.2020.37500.1691","url":null,"abstract":"Background: There are many known risk factors related to maternal or neonatal problems which can predict the need for resuscitation. In this study, we evaluated the resuscitation process of preterm neonates and analyzed the impact of different risk factors on the level of resuscitation required in the patients.Methods: This cross-sectional descriptive study was conducted on inborn preterm infants with a birth weight of < 1500 g during one year. Moreover, the present study evaluated the resuscitation process of the delivery room and analyzed the association of maternal-neonatal risk factors and requirement for different levels of resuscitation.Results: In the present study, 193 preterm neonates were evaluated. In addition, 82 (42.5%) and 110 (57%) patients were female and male, respectively. The mean values of gestational age and birth weight of the patients were 29.9±2.4 weeks and 1191.6±265.2 g, respectively. The mode of delivery in 159 (82.4%) patients was cesarean section.In the assessment of different levels of resuscitation, 84 (43.5%), 35 (18.1%), 54 (28%), 10 (5.2%), 10 (5.2%), and 9 (4.7%) neonates needed initial steps, free flow of oxygen, positive pressure ventilation, endotracheal intubation, chest compression, and drug administration, respectively. The rate of neonatal mortality was 23.8% (n=46), and hypoxic-ischemic encephalopathy was recorded in 10 (21.7%) subjects. In the evaluation of mothers, 117 (60.6%) subjects had medical problems during pregnancy. The most common problem was preeclampsia in 44 (22.8%) mothers. The lower birth weight (P<0.001), gestational age (P<0.001), Apgar score (P<0.001), and longer duration of resuscitation had a significant effect on the needed level of resuscitation in neonates.Conclusion: According to the obtained results, it was shown that premature neonates needed more advanced resuscitation. Therefore, improving the quality of care for mothers and neonates is necessary to obtain better outcomes. Regarding the need for noninvasive positive pressure ventilation was the second most frequent intervention, the proper use of equipment is necessary for the prevention of advanced resuscitation.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"47 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81560623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.39859.1644
H. Boskabadi, M. Sadeghian, Zahra Abroshan
Background: Intraventricular hemorrhage (IVH) is one of the most serious complications of premature deliveries, especially in very low birth weight (VLBW) newborns. The current study compared the number of nucleated red blood cells (NRBCs) in newborns with and without IVH.Methods: This cross-sectional study was carried out on 109 VLBW neonates who were referred to the Neonatal Intensive Care Unit (NICU) Department of Ghaem Hospital in Mashhad, Iran. They were investigated to evaluate the predictive value of cord NRBC in the diagnosis of IVH. To this end, 77 neonates who had normal brain ultrasonographywere assigned to the control group and 32 newborns with IVH were allocated to the case group. The percentage of NRBC per 100 white blood cells was determined by a blood sample. These neonates underwent brain ultrasonography3-5 days after the birth; thereafter, mean NRBC/100 WBC and the absolute number of NRBC swere compared in both groups.Results: In the current study, the mean scores of NRBC/100 WBC and the absolute number of NRBCs in neonates with IVH were obtained as 15.19 and 2272.38/μl. In the group without IVH, these values were reported as 40.95% and 5459.17/μl, respectively (P>0.05). Based on receiver operating characteristic (ROC) curve, the NRBC value does not have a diagnostic value in predicting the incidence of IVH.Conclusion: As illustrated by the obtained results, the number of absolute NRBCs and the percentage of NRBC/100 WBC cannot help to predict the probability of neonatal IVH. Nonetheless, further studies are recommended in this regard.
{"title":"Does the Umbilical Cord Nucleated Red Blood Cellcan Help Predict Intraventricular Hemorrhage","authors":"H. Boskabadi, M. Sadeghian, Zahra Abroshan","doi":"10.22038/IJN.2020.39859.1644","DOIUrl":"https://doi.org/10.22038/IJN.2020.39859.1644","url":null,"abstract":"Background: Intraventricular hemorrhage (IVH) is one of the most serious complications of premature deliveries, especially in very low birth weight (VLBW) newborns. The current study compared the number of nucleated red blood cells (NRBCs) in newborns with and without IVH.Methods: This cross-sectional study was carried out on 109 VLBW neonates who were referred to the Neonatal Intensive Care Unit (NICU) Department of Ghaem Hospital in Mashhad, Iran. They were investigated to evaluate the predictive value of cord NRBC in the diagnosis of IVH. To this end, 77 neonates who had normal brain ultrasonographywere assigned to the control group and 32 newborns with IVH were allocated to the case group. The percentage of NRBC per 100 white blood cells was determined by a blood sample. These neonates underwent brain ultrasonography3-5 days after the birth; thereafter, mean NRBC/100 WBC and the absolute number of NRBC swere compared in both groups.Results: In the current study, the mean scores of NRBC/100 WBC and the absolute number of NRBCs in neonates with IVH were obtained as 15.19 and 2272.38/μl. In the group without IVH, these values were reported as 40.95% and 5459.17/μl, respectively (P>0.05). Based on receiver operating characteristic (ROC) curve, the NRBC value does not have a diagnostic value in predicting the incidence of IVH.Conclusion: As illustrated by the obtained results, the number of absolute NRBCs and the percentage of NRBC/100 WBC cannot help to predict the probability of neonatal IVH. Nonetheless, further studies are recommended in this regard.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"22 1","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88881930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.42296.1702
Raid M R Umran, J. Hashim, Husam Jameel
Background: Sepsis in neonates presents itself with non-specific clinical features which makes early diagnosis difficult. However, procalcitonin (PCT) and other inflammatory markers have recently been considered as sensitive markers for the early detection of neonatal sepsis. Therefore, the present study aimed to determine the diagnostic value of PCT in the early detection of neonatal sepsis and compare it with C-reactive protein (CRP) and white blood cells count.Methods: This case-control study was conducted on 40 neonates who were divided into two groups. The case or sepsis group consisted of 18 neonates with the clinical symptoms of sepsis and positive culture. On the other hand, the control group contained 22 healthy neonates with negative culture. Demographic characteristic of all the participants was recorded during the clinical follow-up. Moreover, blood samples were collected from each neonate for hematological analysis, blood culture, serum CRP measurement, and PCT analysis. Finally, all the collected data were statistically analyzed in SPSS software (version 17).Results: Based on the findings, the mean value of the procalcitonin level was significantly higher in the sepsis group (866.60±480.51 pg/ml), compared with that of the control group (P<0.001). Moreover, the CRP was positive in 66.7% of sepsis patients and 22.7% of the control group (P=0.006). The procalcitonin level shows higher sensitivity (94%) than CRP (66%) with the same specificity but a higher positive and negative predictive value.Conclusion: Procalcitonin level was elevated in neonates with sepsis in comparison to normal neonates and it is more sensitive than CRP. The PCT could be used as a routine test for the early diagnosis of neonatal sepsis which also leads to a reduction in the use of antibiotics.
{"title":"Significance of Serum Procalcitonin Level in the Early Diagnosis of Neonatal Sepsis","authors":"Raid M R Umran, J. Hashim, Husam Jameel","doi":"10.22038/IJN.2020.42296.1702","DOIUrl":"https://doi.org/10.22038/IJN.2020.42296.1702","url":null,"abstract":"Background: Sepsis in neonates presents itself with non-specific clinical features which makes early diagnosis difficult. However, procalcitonin (PCT) and other inflammatory markers have recently been considered as sensitive markers for the early detection of neonatal sepsis. Therefore, the present study aimed to determine the diagnostic value of PCT in the early detection of neonatal sepsis and compare it with C-reactive protein (CRP) and white blood cells count.Methods: This case-control study was conducted on 40 neonates who were divided into two groups. The case or sepsis group consisted of 18 neonates with the clinical symptoms of sepsis and positive culture. On the other hand, the control group contained 22 healthy neonates with negative culture. Demographic characteristic of all the participants was recorded during the clinical follow-up. Moreover, blood samples were collected from each neonate for hematological analysis, blood culture, serum CRP measurement, and PCT analysis. Finally, all the collected data were statistically analyzed in SPSS software (version 17).Results: Based on the findings, the mean value of the procalcitonin level was significantly higher in the sepsis group (866.60±480.51 pg/ml), compared with that of the control group (P<0.001). Moreover, the CRP was positive in 66.7% of sepsis patients and 22.7% of the control group (P=0.006). The procalcitonin level shows higher sensitivity (94%) than CRP (66%) with the same specificity but a higher positive and negative predictive value.Conclusion: Procalcitonin level was elevated in neonates with sepsis in comparison to normal neonates and it is more sensitive than CRP. The PCT could be used as a routine test for the early diagnosis of neonatal sepsis which also leads to a reduction in the use of antibiotics.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"17 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76555018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.41505.1682
M. Khosravi, K. Khazaeel, M. K. Mahabady, M. Behmanesh
Background: This study evaluated the effects of the maternal immune system stimulation or suppression during the pregnancy on the development of the neonate’s immune system.Methods: A total of 20 female rats were divided into four groups. The groups were treated using Leishmania major, Salmonella typhimurium, Tacrolimus, and sterilized normal saline. The animals were mated after 3-time treatments. The neonate’s humoral immune response, total body, thymus, liver, spleen weight, and histology were determined in this study.Results: The spleen’s mean weight of the two-month-old samples showed a significant reduction in the Salmonella group; in addition, the Tacrolimus group had a significant reduction in liver mean weight. The Salmonella and Tacrolimus groups showed a significant reduction (P≤0.05) in the anti-sheep red blood cells antibody titer.Conclusion: Stimulation or suppression of the immune responses during the pregnancy has significant effects on the neonate’s immune responses, spleen, liver, and thymus development.
{"title":"Effects of Maternal Immune System Status on Neonate’s Immune System","authors":"M. Khosravi, K. Khazaeel, M. K. Mahabady, M. Behmanesh","doi":"10.22038/IJN.2020.41505.1682","DOIUrl":"https://doi.org/10.22038/IJN.2020.41505.1682","url":null,"abstract":"Background: This study evaluated the effects of the maternal immune system stimulation or suppression during the pregnancy on the development of the neonate’s immune system.Methods: A total of 20 female rats were divided into four groups. The groups were treated using Leishmania major, Salmonella typhimurium, Tacrolimus, and sterilized normal saline. The animals were mated after 3-time treatments. The neonate’s humoral immune response, total body, thymus, liver, spleen weight, and histology were determined in this study.Results: The spleen’s mean weight of the two-month-old samples showed a significant reduction in the Salmonella group; in addition, the Tacrolimus group had a significant reduction in liver mean weight. The Salmonella and Tacrolimus groups showed a significant reduction (P≤0.05) in the anti-sheep red blood cells antibody titer.Conclusion: Stimulation or suppression of the immune responses during the pregnancy has significant effects on the neonate’s immune responses, spleen, liver, and thymus development.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"73 1","pages":"31-37"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75077459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.43670.1726
Alireza Jashni Motlagh, A. Elsagh
Background: Today, preterm birth is well known as the major risk factor for intraventricular hemorrhage (IVH). In the first week of life, some preterm infants may have grade 1 IVH extending to severe (grade 3 or 4) IVH by transfusion one or more units. Several previous studies have found that blood and blood product transfusions lead to adverse clinical outcomes in neonates. Therefore, this study aimed to explore the relationship between Red blood cell (RBC) transfusion and extension of IVH in preterm infants.Methods: For the purposes of the study, an observational retrospective case-control design was utilized. Moreover, all the neonates with grade 1 IVH in our referral hospital were identified in the past 5 years. Afterward, the subjects with extended IVH were compared with those who had resolved IVH.Results: In total, 1050, 36, and 24 neonates were diagnosed with grade 1, grade 3, and grade 4 IVH, respectively. The mean values of the birth weight of extended IVH and resolved IVH groups were 1285±615 g and 1361±348 g, respectively (P=0.05). Moreover, extended IVH and resolved IVH groups were 29±3 weeks and 30±2 weeks premature, respectively (P=0.36). The low 5-minute Apgar scores of the extended IVH and resolved IVH groups were 5±2 and 7±2, respectively (P=0.000). In addition, the low cord pH of the extended IVH and resolved IVH groups were 7.29±0.1 and 7.37±0.1, respectively (P=0.005). Administration of packed RBC transfusion before and on the day of the diagnosis of grade 1 IVH had the most significant relationship with the extension of IVH (IR, 10.602; 95% CI, 2.81-39.92). The obtained results confirmed that criteria to order the transfusions were similar in both groups, based on which they did not have any proportion of the transfusions of compliance with the guidelines.Conclusion: Based on the results, there was a great association between restrictive RBC transfusion and extension of a low-grade IVH into a higher grade (3 or 4) IVH. However, the statistical explanation is unclear and more studies are needed to discover the causality of this relationship.
背景:今天，早产是众所周知的脑室内出血(IVH)的主要危险因素。在生命的第一周，一些早产儿通过输血一个或多个单位，可能从1级IVH扩展到严重(3或4级)IVH。先前的几项研究发现，血液和血液制品输血会导致新生儿不良的临床结果。因此，本研究旨在探讨红细胞(RBC)输注与早产儿IVH延长的关系。方法:本研究采用观察性回顾性病例对照设计。此外，我们转诊医院的所有1级IVH新生儿均为近5年内发现的。之后，将延长IVH的受试者与解决IVH的受试者进行比较。结果:共有1050名、36名和24名新生儿被诊断为1级、3级和4级IVH。延长IVH组和消退IVH组新生儿出生体重平均值分别为1285±615 g和1361±348 g (P=0.05)。延长IVH组和缓解IVH组早产儿分别为29±3周和30±2周(P=0.36)。延长IVH组和消退IVH组低5分钟Apgar评分分别为5±2分和7±2分(P=0.000)。延长IVH组和溶解IVH组脐带低pH值分别为7.29±0.1和7.37±0.1 (P=0.005)。1级IVH诊断前及诊断当日输注红细胞与IVH延长的关系最为显著(IR, 10.602;95% ci, 2.81-39.92)。所获得的结果证实，两组订购输血的标准相似，基于此，他们没有任何比例的输血符合指南。结论:基于结果，限制性红细胞输血与低级别IVH扩展到更高级别(3或4)IVH之间存在很大关联。然而，统计解释尚不清楚，需要更多的研究来发现这种关系的因果关系。
{"title":"Effect of Transfusion on the Extension of IVH in Preterm Neonates","authors":"Alireza Jashni Motlagh, A. Elsagh","doi":"10.22038/IJN.2020.43670.1726","DOIUrl":"https://doi.org/10.22038/IJN.2020.43670.1726","url":null,"abstract":"Background: Today, preterm birth is well known as the major risk factor for intraventricular hemorrhage (IVH). In the first week of life, some preterm infants may have grade 1 IVH extending to severe (grade 3 or 4) IVH by transfusion one or more units. Several previous studies have found that blood and blood product transfusions lead to adverse clinical outcomes in neonates. Therefore, this study aimed to explore the relationship between Red blood cell (RBC) transfusion and extension of IVH in preterm infants.Methods: For the purposes of the study, an observational retrospective case-control design was utilized. Moreover, all the neonates with grade 1 IVH in our referral hospital were identified in the past 5 years. Afterward, the subjects with extended IVH were compared with those who had resolved IVH.Results: In total, 1050, 36, and 24 neonates were diagnosed with grade 1, grade 3, and grade 4 IVH, respectively. The mean values of the birth weight of extended IVH and resolved IVH groups were 1285±615 g and 1361±348 g, respectively (P=0.05). Moreover, extended IVH and resolved IVH groups were 29±3 weeks and 30±2 weeks premature, respectively (P=0.36). The low 5-minute Apgar scores of the extended IVH and resolved IVH groups were 5±2 and 7±2, respectively (P=0.000). In addition, the low cord pH of the extended IVH and resolved IVH groups were 7.29±0.1 and 7.37±0.1, respectively (P=0.005). Administration of packed RBC transfusion before and on the day of the diagnosis of grade 1 IVH had the most significant relationship with the extension of IVH (IR, 10.602; 95% CI, 2.81-39.92). The obtained results confirmed that criteria to order the transfusions were similar in both groups, based on which they did not have any proportion of the transfusions of compliance with the guidelines.Conclusion: Based on the results, there was a great association between restrictive RBC transfusion and extension of a low-grade IVH into a higher grade (3 or 4) IVH. However, the statistical explanation is unclear and more studies are needed to discover the causality of this relationship.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"13 1","pages":"92-99"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77945264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.44317.1733
Ebissa Bayana, Debela Gela, Tigistu Gebreyohannis
Background: Neonatal period is a susceptible time in which the newborn has to adapt to a new environment and is vulnerable to many problems. This study aimed to assess the disease outcome and associated factors among neonates.Methods: This retrospective cross-sectional study was conducted from March 15, 2018, to March 30, 2018, on neonates (n=341) admitted to the Neonatal Intensive Care Unit for two years. The systematic sampling technique was employed to perform the sampling. The data were entered the Epi-data (version 3.1) and analyzed in SPSS software (version 23). A p-value less than 0.05 at a 95% confidence interval (CI) was considered statistically significant. Finally, statements, tables, charts, and graphs were used for data presentation.Results: Regarding the outcome, 81.52% of the admitted neonates were improved and the others (18.48%) died. Prematurity and perinatal asphyxia (PNA) were factors associated with increased risk of death (P<0.001, Adjusted Odds Ratio (AOR) =0.26, 95% CI: [0.14, 0.46]) and (P<0.05, AOR=0.44, 95% CI: [0.21, 0.91]), respectively.Conclusion: Prematurity, PNA, and place of delivery (i.e., outborn) were predictors of death. Therefore, the adequate resource should be put in place to improve neonatal outcomes.
{"title":"Disease Outcome and Associated Factors among Neonates Admitted to Neonatal Intensive Care Unit at Jimma University Medical Center, Jimma, Southwest Ethiopia","authors":"Ebissa Bayana, Debela Gela, Tigistu Gebreyohannis","doi":"10.22038/IJN.2020.44317.1733","DOIUrl":"https://doi.org/10.22038/IJN.2020.44317.1733","url":null,"abstract":"Background: Neonatal period is a susceptible time in which the newborn has to adapt to a new environment and is vulnerable to many problems. This study aimed to assess the disease outcome and associated factors among neonates.Methods: This retrospective cross-sectional study was conducted from March 15, 2018, to March 30, 2018, on neonates (n=341) admitted to the Neonatal Intensive Care Unit for two years. The systematic sampling technique was employed to perform the sampling. The data were entered the Epi-data (version 3.1) and analyzed in SPSS software (version 23). A p-value less than 0.05 at a 95% confidence interval (CI) was considered statistically significant. Finally, statements, tables, charts, and graphs were used for data presentation.Results: Regarding the outcome, 81.52% of the admitted neonates were improved and the others (18.48%) died. Prematurity and perinatal asphyxia (PNA) were factors associated with increased risk of death (P<0.001, Adjusted Odds Ratio (AOR) =0.26, 95% CI: [0.14, 0.46]) and (P<0.05, AOR=0.44, 95% CI: [0.21, 0.91]), respectively.Conclusion: Prematurity, PNA, and place of delivery (i.e., outborn) were predictors of death. Therefore, the adequate resource should be put in place to improve neonatal outcomes.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"6 1","pages":"80-85"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84359221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.42523.1705
Azam Ghehsareh Ardastani, E. Hashemi, Mohadeseh Beheshtinejad, Rezvan Dorostkar
Background: The 25-hydroxyvitamin D3(25-OH D3)deficiency is a common problem worldwide, and it is aprevalent incidence in neonates. Different studies investigated the relationship of vitamin D deficiency with neonatal mortality and morbidity. This study aimed to evaluate the relationship between vitamin D deficiency and respiratory distress in preterm neonates.Methods: A prospective cohort study was conducted in Alzahra Hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. In total, 160 preterm neonates with>1000 g birth weight were evaluated for the manifestation of respiratory distress during the first 6 h of life. The neonates were divided into two groups of A (n=80) with respiratory symptoms and B (n=80) without respiratory symptoms. The level of 25-OH D3 was measured in the first h of the neonate's life. All neonates were followed to reach 36 weeks of gestational age or 28th day of life. Subsequently, the two groups were compared in terms of vitamin D levels. There was a relationship between vitamin D deficiency and respiratory morbidities in group A.Results: The mean vitamin D level was obtained at 27.42±11.25 ng/mL, and it was categorized into adequate level (n=53, 33.1%), inadequate level (n=62,38.8%), and vitamin D deficiency (n=45, 28.1%).According to the results, vitamin D level correlated significantly with birth weight and gestational age (P<0.05). Moreover, respiratory distress correlated with birth weight, gestational age, and the use of corticosteroids during pregnancy (P<0.001). The mean vitamin D level in group A (with respiratory distress syndrome [RDS]) was significantly lower than that in group B (without RDS, P<0.001).Furthermore, vitamin Dcorrelated with RDS, a need for intubation surfactant extubation, and duration of continuous positive airway pressure (P<0.05).Conclusion: Neonates with a low level of vitamin D are prone to manifest respiratory distress, and vitamin D deficiency is a risk factor for presenting RDS.
{"title":"Comparison of 25- Hydroxy Vitamin D Levels in Premature Infants with and without Respiratory Distress","authors":"Azam Ghehsareh Ardastani, E. Hashemi, Mohadeseh Beheshtinejad, Rezvan Dorostkar","doi":"10.22038/IJN.2020.42523.1705","DOIUrl":"https://doi.org/10.22038/IJN.2020.42523.1705","url":null,"abstract":"Background: The 25-hydroxyvitamin D3(25-OH D3)deficiency is a common problem worldwide, and it is aprevalent incidence in neonates. Different studies investigated the relationship of vitamin D deficiency with neonatal mortality and morbidity. This study aimed to evaluate the relationship between vitamin D deficiency and respiratory distress in preterm neonates.Methods: A prospective cohort study was conducted in Alzahra Hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. In total, 160 preterm neonates with>1000 g birth weight were evaluated for the manifestation of respiratory distress during the first 6 h of life. The neonates were divided into two groups of A (n=80) with respiratory symptoms and B (n=80) without respiratory symptoms. The level of 25-OH D3 was measured in the first h of the neonate's life. All neonates were followed to reach 36 weeks of gestational age or 28th day of life. Subsequently, the two groups were compared in terms of vitamin D levels. There was a relationship between vitamin D deficiency and respiratory morbidities in group A.Results: The mean vitamin D level was obtained at 27.42±11.25 ng/mL, and it was categorized into adequate level (n=53, 33.1%), inadequate level (n=62,38.8%), and vitamin D deficiency (n=45, 28.1%).According to the results, vitamin D level correlated significantly with birth weight and gestational age (P<0.05). Moreover, respiratory distress correlated with birth weight, gestational age, and the use of corticosteroids during pregnancy (P<0.001). The mean vitamin D level in group A (with respiratory distress syndrome [RDS]) was significantly lower than that in group B (without RDS, P<0.001).Furthermore, vitamin Dcorrelated with RDS, a need for intubation surfactant extubation, and duration of continuous positive airway pressure (P<0.05).Conclusion: Neonates with a low level of vitamin D are prone to manifest respiratory distress, and vitamin D deficiency is a risk factor for presenting RDS.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"2 1","pages":"109-114"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89197952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.40131.1651
Mazyar Vakiliamini, H. Babaei, M. Mohammadi, R. Habibi, Hajar Motamed
Background: The present study aimed to evaluate the effect of synbiotics on the intestinal colonization rate of Candida albicans in low birth weight neonates (i.e., under 2,500 g), which is one of the most important events for necrotizing enterocolitis (NEC).Methods: During one year, 106 preterm neonates with a birth weight of less than 2,500 g, admitted to the Neonatal Intensive Care Unit (NICU) of Imam Reza Hospital, affiliated to Kermanshah University of Medical Sciences, Kermanshah, Iran, were randomly selected and investigated in two groups of case and control. In the case group, 5 drops of synbiotics (under the trade name of Pedilact in which 5 drops are equivalent to 2.5×108 CFU), containing three probiotics of Bifidobacterium infantis, Lactobacillus rhamnosus, and Lactobacillus reuteri, as well as the prebiotic of fructooligosaccharide, were administered. On the other hand, 5 drops of distilled water were used for the control group. In the present single-blind study, the subjects were divided into two groups using a random number table. The stool cultures were obtained on the 1st and 10th days of admission. Then, the two groups were compared in terms of the amount of positive stool culture for Candida albicans, time of feeding initiation and full nutrition, duration of hospitalization, and time of discharge.Results: The incidence rate of positive stool culture for Candida albicans was 6.6%. A significant relationship was observed between gestational age and positive culture (P=0.009). However, there was no significant difference between the two groups in terms of the duration of hospitalization, time of feeding initiation and full feeding, good physical examination results, and wellbeing. In addition, the relationship between positive culture and birth weight was statistically significant (P=0.045) since the rates of positive culture were 57.1% and 42.9% in cases with the birth weight of ≤ 1,500 and > 1,500 g, respectively.Conclusion: Based on the results, synbiotic use showed no significant relationship with enteral positive cultures for Candida albicans, time of enteral feeding initiation and full feeding, and hospitalization duration.
{"title":"Intestinal Colonization Rate of Candida albicans among Low Birth Weight Neonates after Using Oral Synbiotic Supplementation: A Randomized Placebo-controlled Trial","authors":"Mazyar Vakiliamini, H. Babaei, M. Mohammadi, R. Habibi, Hajar Motamed","doi":"10.22038/IJN.2020.40131.1651","DOIUrl":"https://doi.org/10.22038/IJN.2020.40131.1651","url":null,"abstract":"Background: The present study aimed to evaluate the effect of synbiotics on the intestinal colonization rate of Candida albicans in low birth weight neonates (i.e., under 2,500 g), which is one of the most important events for necrotizing enterocolitis (NEC).Methods: During one year, 106 preterm neonates with a birth weight of less than 2,500 g, admitted to the Neonatal Intensive Care Unit (NICU) of Imam Reza Hospital, affiliated to Kermanshah University of Medical Sciences, Kermanshah, Iran, were randomly selected and investigated in two groups of case and control. In the case group, 5 drops of synbiotics (under the trade name of Pedilact in which 5 drops are equivalent to 2.5×108 CFU), containing three probiotics of Bifidobacterium infantis, Lactobacillus rhamnosus, and Lactobacillus reuteri, as well as the prebiotic of fructooligosaccharide, were administered. On the other hand, 5 drops of distilled water were used for the control group. In the present single-blind study, the subjects were divided into two groups using a random number table. The stool cultures were obtained on the 1st and 10th days of admission. Then, the two groups were compared in terms of the amount of positive stool culture for Candida albicans, time of feeding initiation and full nutrition, duration of hospitalization, and time of discharge.Results: The incidence rate of positive stool culture for Candida albicans was 6.6%. A significant relationship was observed between gestational age and positive culture (P=0.009). However, there was no significant difference between the two groups in terms of the duration of hospitalization, time of feeding initiation and full feeding, good physical examination results, and wellbeing. In addition, the relationship between positive culture and birth weight was statistically significant (P=0.045) since the rates of positive culture were 57.1% and 42.9% in cases with the birth weight of ≤ 1,500 and > 1,500 g, respectively.Conclusion: Based on the results, synbiotic use showed no significant relationship with enteral positive cultures for Candida albicans, time of enteral feeding initiation and full feeding, and hospitalization duration.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"1 1","pages":"51-56"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78510795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.22038/IJN.2020.42619.1708
N. Khalesi, N. Hooman, M. Kashaki, R. Bayat, Asma Javid, S. Shojaee, A. Safaeiasl, Soheila Mahdavynia
Background: Blood pressure (BP) is an important vital sign and indicator of clinical stability. Therefore, the accurate measurement and interpretation of this physiological signal is essential for the optimal management of ill newborns. In this regard, the present study aimed to determine BP values and percentiles in stable newborns in the first weeks of life and evaluate the relevant factors.Methods: This prospective observational study was conducted on 320 term and preterm newborns between 26 and 42 weeks gestational age (GA) within 2015-2017. The exclusion criteria entailed: 1) birth asphyxia,2) preeclampsia, 3) gestational diabetes mellitus (GDM) type I, 4) illicit substance use, and 5) major congenital anomaly. The oscillometric technique was used for BP measurement and systolic and diastolic BPs were analyzed by regression analysis for various percentiles (5th to 95th).Results: The neonates in the current study consisted of 185 (57.8%) males and 135 (42.2%) females with mean (SD) birth weight of 2058.3±582.5grams. Mean (SD) gestational age was reported as 32.95(3.97) weeks. 69.1 % of neonates were delivered via cesarean section. Percentile charts (5th- 95th values) which were developed for systolic (SBP) and diastolic (DBP) demonstrated a steady rise on the respective days that were comparable between different groups. Term neonates were found to have higher BPs, compared to their preterm counterparts on the respective days. Moreover, the neonates who were delivered vaginally had higher mean BP values than neonates delivered via cesarean section.Conclusion: The current study provided normative BP values among neonates, especially in the first two weeks of life. Data presented in this study which include delivery-mode-specific BP percentile curves using an oscillometric method serve as a valuable reference for physicians in the management of newborns in the neonatal unit.
{"title":"Percentile Charts of Neonatal Blood Pressure Values at a Tertiary Iranian Hospital","authors":"N. Khalesi, N. Hooman, M. Kashaki, R. Bayat, Asma Javid, S. Shojaee, A. Safaeiasl, Soheila Mahdavynia","doi":"10.22038/IJN.2020.42619.1708","DOIUrl":"https://doi.org/10.22038/IJN.2020.42619.1708","url":null,"abstract":"Background: Blood pressure (BP) is an important vital sign and indicator of clinical stability. Therefore, the accurate measurement and interpretation of this physiological signal is essential for the optimal management of ill newborns. In this regard, the present study aimed to determine BP values and percentiles in stable newborns in the first weeks of life and evaluate the relevant factors.Methods: This prospective observational study was conducted on 320 term and preterm newborns between 26 and 42 weeks gestational age (GA) within 2015-2017. The exclusion criteria entailed: 1) birth asphyxia,2) preeclampsia, 3) gestational diabetes mellitus (GDM) type I, 4) illicit substance use, and 5) major congenital anomaly. The oscillometric technique was used for BP measurement and systolic and diastolic BPs were analyzed by regression analysis for various percentiles (5th to 95th).Results: The neonates in the current study consisted of 185 (57.8%) males and 135 (42.2%) females with mean (SD) birth weight of 2058.3±582.5grams. Mean (SD) gestational age was reported as 32.95(3.97) weeks. 69.1 % of neonates were delivered via cesarean section. Percentile charts (5th- 95th values) which were developed for systolic (SBP) and diastolic (DBP) demonstrated a steady rise on the respective days that were comparable between different groups. Term neonates were found to have higher BPs, compared to their preterm counterparts on the respective days. Moreover, the neonates who were delivered vaginally had higher mean BP values than neonates delivered via cesarean section.Conclusion: The current study provided normative BP values among neonates, especially in the first two weeks of life. Data presented in this study which include delivery-mode-specific BP percentile curves using an oscillometric method serve as a valuable reference for physicians in the management of newborns in the neonatal unit.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"58 1","pages":"15-23"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85066509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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