Pub Date : 2021-10-01DOI: 10.22038/IJN.2021.55601.2039
A. Bhardwaj, R. Rai
Background Pre-pregnancy body mass index (BMI) during the gestation period is a major factor that predicts fetal weight and development. It is also positively associated with an increase in fetal head circumference and femur length. To assess the impact of pre-pregnancy BMI on neonatal anthropometryMethods This multicenter observational study was conducted from July 2010-July 2011. A total of 1,000 mothers were enrolled, and their antenatal records were screened for pre-pregnancy weight, height, and other details. They were assigned to four categories as per their BMI: underweight: BMI<18.5kg/m2, normal:18.5-24.99kg/m2, overweight: 25-29.9kg/m2, and obese: ≥30kg/m2 group. The neonatal anthropometric measurements and other information were retrieved from the neonate's files. Neonates who were admitted to the neonatal intensive care unit (NICU) were followed till their discharge from hospital or mortality.Results Out of 1,000 cases, 170 (17%) belonged to underweight, 224 (22.4%) to overweight, 86 (8.6%) to obese, and 520 (52%) to the normal group. Overweight and obese women were at a higher risk of developing gestational diabetes mellitus, hypertensive complications during pregnancy, and undergoing cesarean sections. They also had a higher risk of delivering large for gestational age and post-term neonates, whereas underweight women had a significantly higher risk of delivering small for gestational, low birth weight, and premature newborns. Furthermore, a positive correlation was observed between maternal BMI and neonatal anthropometric measurements.Conclusion As evidenced by the obtained results, both low and high pre-pregnancy BMI is associated with adverse maternal and perinatal outcomes.
{"title":"Impact of Pre-pregnancy Body Mass Index on Neonatal Outcome","authors":"A. Bhardwaj, R. Rai","doi":"10.22038/IJN.2021.55601.2039","DOIUrl":"https://doi.org/10.22038/IJN.2021.55601.2039","url":null,"abstract":"Background Pre-pregnancy body mass index (BMI) during the gestation period is a major factor that predicts fetal weight and development. It is also positively associated with an increase in fetal head circumference and femur length. To assess the impact of pre-pregnancy BMI on neonatal anthropometryMethods This multicenter observational study was conducted from July 2010-July 2011. A total of 1,000 mothers were enrolled, and their antenatal records were screened for pre-pregnancy weight, height, and other details. They were assigned to four categories as per their BMI: underweight: BMI<18.5kg/m2, normal:18.5-24.99kg/m2, overweight: 25-29.9kg/m2, and obese: ≥30kg/m2 group. The neonatal anthropometric measurements and other information were retrieved from the neonate's files. Neonates who were admitted to the neonatal intensive care unit (NICU) were followed till their discharge from hospital or mortality.Results Out of 1,000 cases, 170 (17%) belonged to underweight, 224 (22.4%) to overweight, 86 (8.6%) to obese, and 520 (52%) to the normal group. Overweight and obese women were at a higher risk of developing gestational diabetes mellitus, hypertensive complications during pregnancy, and undergoing cesarean sections. They also had a higher risk of delivering large for gestational age and post-term neonates, whereas underweight women had a significantly higher risk of delivering small for gestational, low birth weight, and premature newborns. Furthermore, a positive correlation was observed between maternal BMI and neonatal anthropometric measurements.Conclusion As evidenced by the obtained results, both low and high pre-pregnancy BMI is associated with adverse maternal and perinatal outcomes.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"22 1","pages":"77-84"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86979839","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}
Background: Kangaroo mother care is essential improves outcomes of premature and low birth weight infants. Even though kangaroo mother care is now recognized by global experts as an integral part of essential newborn care, the adoption and implementation of the kangaroo mother care is still challenging. Aim of this study to explore perceived enablers and barriers of kangaroo mother care among mothers and nurses in neonatal intensive care unit.Methods: Descriptive Phenomenological study design was conducted in Tikur Anbessa Specialized referral Hospital at Addis Ababa with 13 mothers and 7 nurses from 10th May -15th July, 2020. In-depth interview used with semi-structured questionnaire and data was collected till saturation of information. Thematic analysis was done with ATLAS.Ti software version 7.5.16 .Results: Major enablers and barriers of practicing kangaroo mother care among mothers and nurses reported that lack of understanding of KMC, family responsibility and workload, lack of awareness of KMC by community, social practice and traditional adaptation were the barriers to practice of KMC. Poor supervision and follow-up, limited resource especially sanitation resource are the major barriers related to health staff and setting. Nurses reported that scale- up of kangaroo mother care was influenced by absence of training, poor attention given by managers and administrative, shortage of rooms and facilities, workload and time shortage.Conclusion: A complex array of barriers and enablers determine a mother’s and nurses ability to provide KMC. Improve the mothers' to practice KMC and to promote the health of preterm infants, supports such as family, community and health professional support needed. Nurses needed in-service education, proper administration and less workload to promote KMC practice.
{"title":"Perceived Enablers and Barriers of Kangaroo Mother Care among Mothers and Nurses in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Qualitative Study","authors":"Mekuriyaw Gashaw Asmare, Rajalakshimi Murugan, Mekonen Adimasu","doi":"10.22038/IJN.2021.53431.1976","DOIUrl":"https://doi.org/10.22038/IJN.2021.53431.1976","url":null,"abstract":"Background: Kangaroo mother care is essential improves outcomes of premature and low birth weight infants. Even though kangaroo mother care is now recognized by global experts as an integral part of essential newborn care, the adoption and implementation of the kangaroo mother care is still challenging. Aim of this study to explore perceived enablers and barriers of kangaroo mother care among mothers and nurses in neonatal intensive care unit.Methods: Descriptive Phenomenological study design was conducted in Tikur Anbessa Specialized referral Hospital at Addis Ababa with 13 mothers and 7 nurses from 10th May -15th July, 2020. In-depth interview used with semi-structured questionnaire and data was collected till saturation of information. Thematic analysis was done with ATLAS.Ti software version 7.5.16 .Results: Major enablers and barriers of practicing kangaroo mother care among mothers and nurses reported that lack of understanding of KMC, family responsibility and workload, lack of awareness of KMC by community, social practice and traditional adaptation were the barriers to practice of KMC. Poor supervision and follow-up, limited resource especially sanitation resource are the major barriers related to health staff and setting. Nurses reported that scale- up of kangaroo mother care was influenced by absence of training, poor attention given by managers and administrative, shortage of rooms and facilities, workload and time shortage.Conclusion: A complex array of barriers and enablers determine a mother’s and nurses ability to provide KMC. Improve the mothers' to practice KMC and to promote the health of preterm infants, supports such as family, community and health professional support needed. Nurses needed in-service education, proper administration and less workload to promote KMC practice.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"135 1","pages":"63-69"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88439981","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 : 2021-08-07DOI: 10.22038/IJN.2021.53668.1983
Ivan Aivasovsky-Trotta, Sergio Vergara-Cardenas, A. Ferrer-Marcano, Lorena Rincones-Rojas, Carolina Prieto-Soler, Ana Isabel Bracho-Fernández, I. Fernández-González, L. Celis
Cantrell's pentalogy (CP) is an orphan congenital disease resulting from embryological alterations of the mesoderm, characterized by a defect in the lower sternal portion, supraumbilical abdominal wall, anterior diaphragm as well as the diaphragmatic pericardium, and cardiac alterations. We report the case of a male newborn with a prenatal diagnosis of abdominal wall defect, in whom a class 1 or complete phenotype of Cantrell's Pentalogy was diagnosed and early measures were taken to prevent adverse outcomes related to this disease. It is known that congenital syndromic disease, such as CP, may be timely addressed with primary prevention strategies and adequate prenatal controls, also, early diagnosis will permit an effective clinical and surgical management of the patient thus leading to a positive prognosis. Finally, it has been established that in this population, proper decision-taking of therapeutic possibilities during the patient’s early years may improve their quality of life and their lifespan.
{"title":"Prenatal diagnosis of Cantrell's Pentalogy with an unusual complete phenotype, a case report, and a literature review.","authors":"Ivan Aivasovsky-Trotta, Sergio Vergara-Cardenas, A. Ferrer-Marcano, Lorena Rincones-Rojas, Carolina Prieto-Soler, Ana Isabel Bracho-Fernández, I. Fernández-González, L. Celis","doi":"10.22038/IJN.2021.53668.1983","DOIUrl":"https://doi.org/10.22038/IJN.2021.53668.1983","url":null,"abstract":"Cantrell's pentalogy (CP) is an orphan congenital disease resulting from embryological alterations of the mesoderm, characterized by a defect in the lower sternal portion, supraumbilical abdominal wall, anterior diaphragm as well as the diaphragmatic pericardium, and cardiac alterations. We report the case of a male newborn with a prenatal diagnosis of abdominal wall defect, in whom a class 1 or complete phenotype of Cantrell's Pentalogy was diagnosed and early measures were taken to prevent adverse outcomes related to this disease. It is known that congenital syndromic disease, such as CP, may be timely addressed with primary prevention strategies and adequate prenatal controls, also, early diagnosis will permit an effective clinical and surgical management of the patient thus leading to a positive prognosis. Finally, it has been established that in this population, proper decision-taking of therapeutic possibilities during the patient’s early years may improve their quality of life and their lifespan.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74969668","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 : 2021-07-01DOI: 10.22038/ijn.2021.50271.1878
Kamran Dehghan, Sakineh Aghazadeh
Background: Coronavirus disease 2019 (COVID-19) is an emerging viral disease with a high rate of transmissibility that has spread and become the first pandemic of the century. There are limited data available regarding COVID-19 during pregnancy. An important question is whether pregnant mothers transmit the virus to their fetuses or newborns. Case report: This study was conducted to investigate the vertical transmission of the COVID-19 virus from pregnant mothers to fetuses. This study reported the case of a preterm newborn admitted to the neonatal intensive care unit of Imam Khomeini Hospital Urmia, Iran, from a COVID-19- positive mother with severe respiratory illness. A preterm female newborn with a gestational age of 34 weeks, 1,800 g weight, and 1-minute and 5-minute Apgar scores of 4 and 5, respectively, was born through the emergency cesarean section from a 39-year-old gravid 1 mother. She was positive for COVID-19, in two consecutive reverse transcription polymerase chain reaction tests which were performed 48 h apart from each other. Conclusion: According to the limited available documents of our case, the researchers claimed that vertical transmission of COVID-19 was possible at this time.
{"title":"Vertical Transmission of Coronavirus Disease 2019: A Case Report","authors":"Kamran Dehghan, Sakineh Aghazadeh","doi":"10.22038/ijn.2021.50271.1878","DOIUrl":"https://doi.org/10.22038/ijn.2021.50271.1878","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) is an emerging viral disease with a high rate of transmissibility that has spread and become the first pandemic of the century. There are limited data available regarding COVID-19 during pregnancy. An important question is whether pregnant mothers transmit the virus to their fetuses or newborns. Case report: This study was conducted to investigate the vertical transmission of the COVID-19 virus from pregnant mothers to fetuses. This study reported the case of a preterm newborn admitted to the neonatal intensive care unit of Imam Khomeini Hospital Urmia, Iran, from a COVID-19- positive mother with severe respiratory illness. A preterm female newborn with a gestational age of 34 weeks, 1,800 g weight, and 1-minute and 5-minute Apgar scores of 4 and 5, respectively, was born through the emergency cesarean section from a 39-year-old gravid 1 mother. She was positive for COVID-19, in two consecutive reverse transcription polymerase chain reaction tests which were performed 48 h apart from each other. Conclusion: According to the limited available documents of our case, the researchers claimed that vertical transmission of COVID-19 was possible at this time.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"23 1","pages":"96-99"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81824093","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 : 2021-07-01DOI: 10.22038/IJN.2021.52072.1927
F. Eghbalian, E. Jenabi, Elham Hatami, B. Basiri, K. Derakhshandeh, N. Pezeshki, E. Khanlarzadeh
Background: No studies, to the best of our knowledge, have been conducted on the effect of Clofibrate in reducing hyperbilirubinemia in preterm infants. Therefore, this study aimed at investigating the therapeutic effect of Clofibrate in treating hyperbilirubinemia of preterm neonates. Methods: This clinical trial was performed from April 4 to December 20, 2019, on neonates in Hamadan in western Iran. The allocation remained concealed to the researcher, neonates’ parents, and analyzer during the study. A dose of Clofibrate of 25 kg/mg was given on the first day of hospitalization. The neonates in the placebo group received the oral placebo 25 kg/mg in the same way as the oral Clofibrate. The data were analyzed using SPSS 16 with P-value < 0.05. Results: No statistically significant difference was observed in the baseline characteristics of the two groups based on the neonate’s age and gender, delivery method, and gestational age. The prescription of Clofibrate significantly reduced the duration of hospitalization (p= 0.002) and phototherapy (p= 0.001). Prescribing a single oral dose of Clofibrate (25 mg/Kg) along with phototherapy in preterm neonates significantly reduced total serum bilirubin levels at 24 and 48 hours after treatment compared with phototherapy alone (p= 0.001). However, this association was not significant in admission (p= 0.095). Conclusion: The findings of this study showed the effect of Clofibrate in treating hyperbilirubinemia of preterm neonates. In addition, prescribing Clofibrate significantly reduced the duration of hospitalization and phototherapy.
{"title":"Clofibrate in the Treatment of the Non-hemolytic Hyperbilirubinemia in Preterm Neonates in Western Iran","authors":"F. Eghbalian, E. Jenabi, Elham Hatami, B. Basiri, K. Derakhshandeh, N. Pezeshki, E. Khanlarzadeh","doi":"10.22038/IJN.2021.52072.1927","DOIUrl":"https://doi.org/10.22038/IJN.2021.52072.1927","url":null,"abstract":"Background: No studies, to the best of our knowledge, have been conducted on the effect of Clofibrate in reducing hyperbilirubinemia in preterm infants. Therefore, this study aimed at investigating the therapeutic effect of Clofibrate in treating hyperbilirubinemia of preterm neonates. Methods: This clinical trial was performed from April 4 to December 20, 2019, on neonates in Hamadan in western Iran. The allocation remained concealed to the researcher, neonates’ parents, and analyzer during the study. A dose of Clofibrate of 25 kg/mg was given on the first day of hospitalization. The neonates in the placebo group received the oral placebo 25 kg/mg in the same way as the oral Clofibrate. The data were analyzed using SPSS 16 with P-value < 0.05. Results: No statistically significant difference was observed in the baseline characteristics of the two groups based on the neonate’s age and gender, delivery method, and gestational age. The prescription of Clofibrate significantly reduced the duration of hospitalization (p= 0.002) and phototherapy (p= 0.001). Prescribing a single oral dose of Clofibrate (25 mg/Kg) along with phototherapy in preterm neonates significantly reduced total serum bilirubin levels at 24 and 48 hours after treatment compared with phototherapy alone (p= 0.001). However, this association was not significant in admission (p= 0.095). Conclusion: The findings of this study showed the effect of Clofibrate in treating hyperbilirubinemia of preterm neonates. In addition, prescribing Clofibrate significantly reduced the duration of hospitalization and phototherapy.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"33 1","pages":"48-52"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87289381","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 : 2021-07-01DOI: 10.22038/IJN.2021.54350.2001
Melike Ersoy, Ozgul Salihoğlu, T. Çetin
Background: Hyperammonaemia is a serious cause of mortality and morbidity duringin the neonatal period, regardless of the aetiology. Quickly differentiatingon between inherited metabolic diseases (IMDs) and other causes is important in terms of for treatment and prognosis. We This study aimed to determine the diagnostic and prognostic differences between IMD- and non-IMD-related causes with based on a literature review. Methods: Clinical and laboratory data of newborns treated for hyperammonaemia between 2016 and 2019 were evaluated retrospectively. Results: Hyperammonaemia was detected in 60 out of 1963 (3%) patients, and 25% of these patients were diagnosed with IMD. The most common non-IMD etiologies were sepsis (31.6%) and prematurity (31.6%). Significant differences were detected between the two groups inregarding gestational age (P=0.001) and birth weight (P=0.005)were detected (p=0.001 and p=0.005, respectively). Moreover, another significant difference was observed between the two groups in terms of glutamine (P=0.004), alanine (P=0.004), and citrulline (P=0.001) levels and as well as the proportions of glutamine to arginine (G/A)P=0.001), citrulline (G/CP=0.0001), ornithine (G/OP=0.003), and alanine (G/A) (P=0.003). Conclusion: Metabolic screening tests should be performed to rapidly diagnose hyperammonaemia. In addition to the diagnosing diagnosis of IMDs, it can promptly differentiate non-metabolic causes.
{"title":"Diagnosis and Management of Hyperammonemia in Newborns: Is It Still a Challenge?","authors":"Melike Ersoy, Ozgul Salihoğlu, T. Çetin","doi":"10.22038/IJN.2021.54350.2001","DOIUrl":"https://doi.org/10.22038/IJN.2021.54350.2001","url":null,"abstract":"Background: Hyperammonaemia is a serious cause of mortality and morbidity duringin the neonatal period, regardless of the aetiology. Quickly differentiatingon between inherited metabolic diseases (IMDs) and other causes is important in terms of for treatment and prognosis. We This study aimed to determine the diagnostic and prognostic differences between IMD- and non-IMD-related causes with based on a literature review. \u0000Methods: Clinical and laboratory data of newborns treated for hyperammonaemia between 2016 and 2019 were evaluated retrospectively. \u0000Results: Hyperammonaemia was detected in 60 out of 1963 (3%) patients, and 25% of these patients were diagnosed with IMD. The most common non-IMD etiologies were sepsis (31.6%) and prematurity (31.6%). Significant differences were detected between the two groups inregarding gestational age (P=0.001) and birth weight (P=0.005)were detected (p=0.001 and p=0.005, respectively). Moreover, another significant difference was observed between the two groups in terms of glutamine (P=0.004), alanine (P=0.004), and citrulline (P=0.001) levels and as well as the proportions of glutamine to arginine (G/A)P=0.001), citrulline (G/CP=0.0001), ornithine (G/OP=0.003), and alanine (G/A) (P=0.003). \u0000Conclusion: Metabolic screening tests should be performed to rapidly diagnose hyperammonaemia. In addition to the diagnosing diagnosis of IMDs, it can promptly differentiate non-metabolic causes.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"38 1","pages":"40-47"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80362395","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 : 2021-07-01DOI: 10.22038/IJN.2021.53483.1977
Nasrin Zamiri-Miandoab, Reyhane Montazeri, Shirin Hassanpour, M. Mirghafourvand
Background: Jaundice is one of the most common neonatal complications. Therefore, promptly diagnosing and treating it is vital. This study aimed to determine the effect of Fenofibrate and phototherapy compared to the phototherapy alone on total serum bilirubin (TSB) at 24 and 48 h (primary outcome) and side effects (secondary outcome). Methods: English (Cochrane Library, Web of Science, Medline, CINAHL, PsycINFO, PubMed, and Google Scholar) and Persian (SID and Magiran) databases were searched using verified keywords (MeSH library) without time constraint. The risk of bias was assessed using the Cochrane Handbook. RevMan software (version 5.3) was used for meta-analysis and the mean difference was calculated as effect size. In heterogeneous cases, the random effect was reported instead of the fixed one. Results: The total number of studies found in all databases was 5482. Six articles were included in the present study. The results of the meta-analysis showed no statistically significant difference in TSB levels within 24 (Mean difference: -5.56; 95% Confidence Interval (95% CI): 4.53 to -16.05; P = 0.27) and 48 h (-4.77; 2.57 to -12.10; P= 0.20) between Fenofibrate with phototherapy group and the phototherapy alone group. No side effects have been reported in included studies. Conclusion: Although the results of the five studies showed the significant effect of Fenofibrate as adjuvant therapy on reducing TSB level, the meta-analysis failed to show the same result in the study groups. It is recommended to perform more trials following all principles of randomized controlled trials to find an effective treatment for hyperbilirubinemia.
背景:黄疸是最常见的新生儿并发症之一。因此，及时诊断和治疗是至关重要的。本研究旨在确定非诺贝特联合光疗与单独光疗相比对24和48小时血清总胆红素(TSB)(主要结局)和副作用(次要结局)的影响。方法:检索英文(Cochrane Library, Web of Science, Medline, CINAHL, PsycINFO, PubMed, Google Scholar)和波斯语(SID和Magiran)数据库，使用验证关键词(MeSH库)，不受时间限制。使用Cochrane手册评估偏倚风险。采用RevMan软件(5.3版)进行meta分析，计算平均差异为效应量。在异质情况下，报告了随机效应而不是固定效应。结果:在所有数据库中发现的研究总数为5482项。本研究共纳入6篇文章。meta分析结果显示，24组患者的TSB水平差异无统计学意义(平均差异:-5.56;95%置信区间(95% CI): 4.53 ~ -16.05;P = 0.27)和48 h (-4.77;2.57 ~ -12.10;非诺贝特联合光疗组与单独光疗组比较P= 0.20)。在纳入的研究中没有副作用的报道。结论:虽然5项研究结果均显示非诺贝特辅助治疗对降低TSB水平有显著作用，但meta分析未能在研究组中显示相同的结果。建议遵循随机对照试验的所有原则进行更多的试验，以寻找高胆红素血症的有效治疗方法。
{"title":"Effect of Fenofibrate on Neonatal Hyperbilirubinemia: A Systematic Review and Meta-analysis","authors":"Nasrin Zamiri-Miandoab, Reyhane Montazeri, Shirin Hassanpour, M. Mirghafourvand","doi":"10.22038/IJN.2021.53483.1977","DOIUrl":"https://doi.org/10.22038/IJN.2021.53483.1977","url":null,"abstract":"Background: Jaundice is one of the most common neonatal complications. Therefore, promptly diagnosing and treating it is vital. This study aimed to determine the effect of Fenofibrate and phototherapy compared to the phototherapy alone on total serum bilirubin (TSB) at 24 and 48 h (primary outcome) and side effects (secondary outcome). \u0000Methods: English (Cochrane Library, Web of Science, Medline, CINAHL, PsycINFO, PubMed, and Google Scholar) and Persian (SID and Magiran) databases were searched using verified keywords (MeSH library) without time constraint. The risk of bias was assessed using the Cochrane Handbook. RevMan software (version 5.3) was used for meta-analysis and the mean difference was calculated as effect size. In heterogeneous cases, the random effect was reported instead of the fixed one. \u0000Results: The total number of studies found in all databases was 5482. Six articles were included in the present study. The results of the meta-analysis showed no statistically significant difference in TSB levels within 24 (Mean difference: -5.56; 95% Confidence Interval (95% CI): 4.53 to -16.05; P = 0.27) and 48 h (-4.77; 2.57 to -12.10; P= 0.20) between Fenofibrate with phototherapy group and the phototherapy alone group. No side effects have been reported in included studies. \u0000Conclusion: Although the results of the five studies showed the significant effect of Fenofibrate as adjuvant therapy on reducing TSB level, the meta-analysis failed to show the same result in the study groups. It is recommended to perform more trials following all principles of randomized controlled trials to find an effective treatment for hyperbilirubinemia.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"26 1","pages":"76-84"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85604453","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 : 2021-07-01DOI: 10.22038/IJN.2021.55404.2061
L. Mohsen, Mourad Alfy Ramzy, Nermin Mohamed, A. Youssef, A. A. Hegazy, D. Akmal
Background This study aimed to evaluate the competence of the score for neonatal acute physiology (SNAP-II) as a tool to anticipate morbidity and mortality of neonates with early or late sepsis in neonatal intensive care units (NICUs).Methods This prospective cohort study was conducted on all neonates of > 32 weeks with sepsis in tertiary NICUs at Cairo University Children Hospital and El Galaa Hospital For Armed Forces Officers Families, Cairo, Egypt, within May-October 2019. The eligible samples consisted of 100 neonates with septicemia who met inclusion and exclusion criteria and were enrolled. the score for neonatal acute physiology-II was calculated within 24 h of sepsis onset and followed up for 2 weeks for mortality and organ dysfunction (OD). The collected data were analyzed in SPSS software (version 25).Results It was revealed thatSNAP-II was significantly higher in neonates who passed away, compared to the survived neonates (46±17 vs. 12±10, respectively; P<0.001). Moreover, SNAP-II was significantly higher in neonates who developed OD within 14 days of sepsis onset, compared to those without OD (37±17 vs. 9±7, respectively; P<0.001). The score for neonatal acute physiology-II at 14.5 was considered the best cut-off point in predicting OD with a sensitivity of 100%, positive predictive value of 70.4%, specificity of 81.2%, and negative predictive value of 100%. In addition, SNAP-II at 23.5 was considered the best cut-off point in predicting overall mortality with 100% sensitivity, 58.6% PPV, 85.5% specificity, and 100% NPV.Conclusion Higher SNAP-II within 24 h of the early- or late-onset neonatal sepsis was a reliable predictor of OD and death.
{"title":"Severity Index of Neonatal Septicemia in Neonatal Intensive Care units Using Score for Neonatal Acute Physiology-II","authors":"L. Mohsen, Mourad Alfy Ramzy, Nermin Mohamed, A. Youssef, A. A. Hegazy, D. Akmal","doi":"10.22038/IJN.2021.55404.2061","DOIUrl":"https://doi.org/10.22038/IJN.2021.55404.2061","url":null,"abstract":"Background This study aimed to evaluate the competence of the score for neonatal acute physiology (SNAP-II) as a tool to anticipate morbidity and mortality of neonates with early or late sepsis in neonatal intensive care units (NICUs).Methods This prospective cohort study was conducted on all neonates of > 32 weeks with sepsis in tertiary NICUs at Cairo University Children Hospital and El Galaa Hospital For Armed Forces Officers Families, Cairo, Egypt, within May-October 2019. The eligible samples consisted of 100 neonates with septicemia who met inclusion and exclusion criteria and were enrolled. the score for neonatal acute physiology-II was calculated within 24 h of sepsis onset and followed up for 2 weeks for mortality and organ dysfunction (OD). The collected data were analyzed in SPSS software (version 25).Results It was revealed thatSNAP-II was significantly higher in neonates who passed away, compared to the survived neonates (46±17 vs. 12±10, respectively; P<0.001). Moreover, SNAP-II was significantly higher in neonates who developed OD within 14 days of sepsis onset, compared to those without OD (37±17 vs. 9±7, respectively; P<0.001). The score for neonatal acute physiology-II at 14.5 was considered the best cut-off point in predicting OD with a sensitivity of 100%, positive predictive value of 70.4%, specificity of 81.2%, and negative predictive value of 100%. In addition, SNAP-II at 23.5 was considered the best cut-off point in predicting overall mortality with 100% sensitivity, 58.6% PPV, 85.5% specificity, and 100% NPV.Conclusion Higher SNAP-II within 24 h of the early- or late-onset neonatal sepsis was a reliable predictor of OD and death.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"61 1","pages":"32-39"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90445974","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 : 2021-07-01DOI: 10.22038/IJN.2021.52430.1937
S. Patel, P. Padhi, T. Naik, R. Nanda, E. Mohapatra, S. Agrawal
Background: Recent surge in the diagnoses of congenital hypothyroidism (CH) has necessitated the measurement of newborn TSH levels and understanding of the way various antenatal and perinatal factors influence its dynamicity. It is a cross-sectional study on newborns delivered or admitted to the All India Institute of Medical Sciences Raipur (AIIMS Raipur), Chhattisgarh, India. Methods: Dried blood spot analysis of newborn thyroid-stimulating hormone (nTSH) was carried out on 1,216 newborns after ethical clearance. The TSH levels were presented in percentage to determine the distribution in the study population. The mean values were compared within the groups categorized under each variable. The newborns' variables in this study included birth weight, Ponderal index, and neonatal complications. The studied maternal variables included antenatal visits, maternal age, gestational age, anemia, and mode of delivery. Results: The mean (standard error of the mean) for nTSH was obtained at 3.37 (0.12) mIU/L and 97% of newborns were below 8 mIU/L. Mean nTSH was significantly high in mothers older than 30 years (P=0.019) and those with anemia during the antenatal period (p <0.001). It was significantly raised in babies with complications (P=0.004). Besides, higher values were also observed in low birth weight babies and those with low Ponderal Index. Higher nTSH was observed among newborns born to mothers with a thyroid disorder, those delivered prematurely and/or by cesarean section, and those with no antenatal visits. Conclusion: It is highly essential to take a precautionary note on the antenatal status of mothers in terms of advanced age, premature delivery, associated maternal diseases, mode of delivery, newborn’s birth weight, and complications which are supposed to influence the dynamicity of thyroid hormones in newborns and result in CH.
{"title":"Newborn Thyroid-Stimulating Hormone Dynamicity as per the Antenatal and Perinatal Factors","authors":"S. Patel, P. Padhi, T. Naik, R. Nanda, E. Mohapatra, S. Agrawal","doi":"10.22038/IJN.2021.52430.1937","DOIUrl":"https://doi.org/10.22038/IJN.2021.52430.1937","url":null,"abstract":"Background: Recent surge in the diagnoses of congenital hypothyroidism (CH) has necessitated the measurement of newborn TSH levels and understanding of the way various antenatal and perinatal factors influence its dynamicity. It is a cross-sectional study on newborns delivered or admitted to the All India Institute of Medical Sciences Raipur (AIIMS Raipur), Chhattisgarh, India. Methods: Dried blood spot analysis of newborn thyroid-stimulating hormone (nTSH) was carried out on 1,216 newborns after ethical clearance. The TSH levels were presented in percentage to determine the distribution in the study population. The mean values were compared within the groups categorized under each variable. The newborns' variables in this study included birth weight, Ponderal index, and neonatal complications. The studied maternal variables included antenatal visits, maternal age, gestational age, anemia, and mode of delivery. Results: The mean (standard error of the mean) for nTSH was obtained at 3.37 (0.12) mIU/L and 97% of newborns were below 8 mIU/L. Mean nTSH was significantly high in mothers older than 30 years (P=0.019) and those with anemia during the antenatal period (p <0.001). It was significantly raised in babies with complications (P=0.004). Besides, higher values were also observed in low birth weight babies and those with low Ponderal Index. Higher nTSH was observed among newborns born to mothers with a thyroid disorder, those delivered prematurely and/or by cesarean section, and those with no antenatal visits. Conclusion: It is highly essential to take a precautionary note on the antenatal status of mothers in terms of advanced age, premature delivery, associated maternal diseases, mode of delivery, newborn’s birth weight, and complications which are supposed to influence the dynamicity of thyroid hormones in newborns and result in CH.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"115 1","pages":"58-67"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79356475","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 : 2021-07-01DOI: 10.22038/IJN.2021.53108.1968
N. Naseri, L. Nikfarid, M. Nourian, M. Abdolkhaleghi
Background: Reduction of stress in mothers of neonates with congenital anomalies is necessary to improve their coping behaviors and attachment to their neonates. In this regard, the present study aimed to determine the effect of mindfulness-based stress reduction (MBSR) program on “coping behaviors” and attachment of mothers of neonates with congenital anomalies. Methods: This randomized clinical trial (code: IRCT20190123042471N1) was conducted on 70 mothers of neonates with congenital anomalies under medical treatment in two medical-education centers of Shahid Beheshti University of Medical Sciences, Tehran, Iran in 2019. The subjects were selected based on the inclusion criteria and were randomly assigned to two groups of intervention and control (n=35 per group). The intervention group, which included 10 subgroups of 1-3 subjects, received a modified four-session MBSR program (once a week, 1-1.5 h per session). The control group received routine care in the hospital during their hospitalization. The Coping Health Inventory for Parents questionnaire and Maternal Postnatal Attachment Scale tool were completed by the intervention and control groups, both before and after the intervention. The data were analyzed in SPSS (version 25.0) using multivariate analysis of variance. Results: The MBSR program affected the pattern of coping behaviors and maternal-neonatal attachment. There was an increase in the mean scores of coping behaviors and maternal-neonatal attachment in the intervention group, compared to the control group (p <0.05). Conclusion: The MBSR program is recommended as a cost-effective and reliable method for promoting coping behaviors and attachment of mothers to their neonates hospitalized in neonatal intensive care units.
{"title":"Effect of Mindfulness-Based Stress Reduction Program on “Coping Behaviors” and “Attachment” of Mothers of Neonates with Congenital Anomalies: A Randomized Clinical Trial","authors":"N. Naseri, L. Nikfarid, M. Nourian, M. Abdolkhaleghi","doi":"10.22038/IJN.2021.53108.1968","DOIUrl":"https://doi.org/10.22038/IJN.2021.53108.1968","url":null,"abstract":"Background: Reduction of stress in mothers of neonates with congenital anomalies is necessary to improve their coping behaviors and attachment to their neonates. In this regard, the present study aimed to determine the effect of mindfulness-based stress reduction (MBSR) program on “coping behaviors” and attachment of mothers of neonates with congenital anomalies. Methods: This randomized clinical trial (code: IRCT20190123042471N1) was conducted on 70 mothers of neonates with congenital anomalies under medical treatment in two medical-education centers of Shahid Beheshti University of Medical Sciences, Tehran, Iran in 2019. The subjects were selected based on the inclusion criteria and were randomly assigned to two groups of intervention and control (n=35 per group). The intervention group, which included 10 subgroups of 1-3 subjects, received a modified four-session MBSR program (once a week, 1-1.5 h per session). The control group received routine care in the hospital during their hospitalization. The Coping Health Inventory for Parents questionnaire and Maternal Postnatal Attachment Scale tool were completed by the intervention and control groups, both before and after the intervention. The data were analyzed in SPSS (version 25.0) using multivariate analysis of variance. Results: The MBSR program affected the pattern of coping behaviors and maternal-neonatal attachment. There was an increase in the mean scores of coping behaviors and maternal-neonatal attachment in the intervention group, compared to the control group (p <0.05). Conclusion: The MBSR program is recommended as a cost-effective and reliable method for promoting coping behaviors and attachment of mothers to their neonates hospitalized in neonatal intensive care units.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"37 1","pages":"85-95"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80723974","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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