Pub Date : 2021-04-01DOI: 10.22038/IJN.2021.49556.1865
F. Mohamed, B. Mesbah, A. Khashana
Background: The value of antenatal corticosteroid regimen in lessening respiratory distress risk in preterm neonates has been well known, and accordingly, antenatal corticosteroid therapy was recommended for any pregnant woman likely to deliver between 24 and 34 weeks of gestation. Therefore, this study aimed to assess the association between the administration of antenatal corticosteroids within the ideal interval of one week before birth and the outcomes of preterm neonates. Methods: This prospective cohort study included 80 preterm neonates admitted to the neonatal intensive care unit with gestational age from 32 to 37 complete weeks at Suez Canal University Hospitals, Ismailia, Egypt. The newborns were then divided into groups A (did not receive antenatal corticosteroids; n=40) and B (received antenatal corticosteroids; n=40). Results: Severe respiratory distress syndrome was significantly less frequent in group B (P<0.05) with lower levels of need for oxygen supplementation (P<0.05). Conclusion: Neonates who received antenatal corticosteroids developed less severe respiratory distress, compared to neonates who did not receive this medication. The results favored the use of antenatal corticosteroids to prevent respiratory distress when administrated within the ideal interval of one week before birth.
{"title":"Antenatal Corticosteroids and Respiratory Distresses Outcome in Preterm Neonates","authors":"F. Mohamed, B. Mesbah, A. Khashana","doi":"10.22038/IJN.2021.49556.1865","DOIUrl":"https://doi.org/10.22038/IJN.2021.49556.1865","url":null,"abstract":"Background: The value of antenatal corticosteroid regimen in lessening respiratory distress risk in preterm neonates has been well known, and accordingly, antenatal corticosteroid therapy was recommended for any pregnant woman likely to deliver between 24 and 34 weeks of gestation. Therefore, this study aimed to assess the association between the administration of antenatal corticosteroids within the ideal interval of one week before birth and the outcomes of preterm neonates. \u0000Methods: This prospective cohort study included 80 preterm neonates admitted to the neonatal intensive care unit with gestational age from 32 to 37 complete weeks at Suez Canal University Hospitals, Ismailia, Egypt. The newborns were then divided into groups A (did not receive antenatal corticosteroids; n=40) and B (received antenatal corticosteroids; n=40). \u0000Results: Severe respiratory distress syndrome was significantly less frequent in group B (P<0.05) with lower levels of need for oxygen supplementation (P<0.05). \u0000Conclusion: Neonates who received antenatal corticosteroids developed less severe respiratory distress, compared to neonates who did not receive this medication. The results favored the use of antenatal corticosteroids to prevent respiratory distress when administrated within the ideal interval of one week before birth.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"132 1","pages":"40-45"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88802115","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 : 2021-04-01DOI: 10.22038/IJN.2020.46861.1798
S. Alamdaran, Soroush Dehghani Dashtabi, Armin Vahabi Sani, Vakili Rahim, S. Hashemian
Background: Congenital Adrenal Hyperplasia (CAH) is one of the main causes of ambiguous genitalia. The unusual appearance of internal genitalia in CAH patients is similar to many other conditions which are classified in Disorders of Sex Development (DSD). This study aimed to accurately describe diagnostic ultrasonic features of the uterus and ovaries in CAH patients in order to distinguish it from other causes of ambiguous genitalia. Methods: This cross-sectional study was performed in Akbar Children Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, from 2017 to 2020. Ultrasound findings of the uterus and ovaries of 22 female infants (2-60 days of age) with CAH due to 21-hydroxylase deficiency and 47 healthy infants with a similar age were recorded and eventually analyzed in this study. Results: All the healthy infants in the control group had a normal prominent cervix, except for two neonates (95%). In the case group, only 9 (41%) infants had a normal prominent cervix, and other 13 newborns had nearly equal sizes of fundus and cervix. There was a significant difference between the two groups in the fundus-to-cervix ratio (P=0.009). The 77% patients had no follicles in both ovaries, while 28% healthy infants in the control group had no follicles, and the rest had unilateral or bilateral multi-follicular ovaries. After two months following treatment, bilateral multi-follicular ovaries were observed in all patients. The sign of non-follicular ovaries (pseudo-testicular appearance) was significantly more prevalent in the case group (P=0.004). Furthermore, half of infants showed normal pelvic lymph node that mimic a testicular-like appearance due to its uniform hyper-echoic texture. Conclusion: The testicular-like appearance of normal pelvic lymph nodes and non-follicular ovaries in a female infant with CAH. Attention to these usual findings can prevent misdiagnoses of cryptorchidism and time loss to perform other laboratory tests and karyotyping.
{"title":"Ultrasonographic Changes of the Uterus and Ovaries in Female Infants with Congenital Adrenal Hyperplasia: Pseudo-Testicular Sign","authors":"S. Alamdaran, Soroush Dehghani Dashtabi, Armin Vahabi Sani, Vakili Rahim, S. Hashemian","doi":"10.22038/IJN.2020.46861.1798","DOIUrl":"https://doi.org/10.22038/IJN.2020.46861.1798","url":null,"abstract":"Background: Congenital Adrenal Hyperplasia (CAH) is one of the main causes of ambiguous genitalia. The unusual appearance of internal genitalia in CAH patients is similar to many other conditions which are classified in Disorders of Sex Development (DSD). This study aimed to accurately describe diagnostic ultrasonic features of the uterus and ovaries in CAH patients in order to distinguish it from other causes of ambiguous genitalia. Methods: This cross-sectional study was performed in Akbar Children Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, from 2017 to 2020. Ultrasound findings of the uterus and ovaries of 22 female infants (2-60 days of age) with CAH due to 21-hydroxylase deficiency and 47 healthy infants with a similar age were recorded and eventually analyzed in this study. Results: All the healthy infants in the control group had a normal prominent cervix, except for two neonates (95%). In the case group, only 9 (41%) infants had a normal prominent cervix, and other 13 newborns had nearly equal sizes of fundus and cervix. There was a significant difference between the two groups in the fundus-to-cervix ratio (P=0.009). The 77% patients had no follicles in both ovaries, while 28% healthy infants in the control group had no follicles, and the rest had unilateral or bilateral multi-follicular ovaries. After two months following treatment, bilateral multi-follicular ovaries were observed in all patients. The sign of non-follicular ovaries (pseudo-testicular appearance) was significantly more prevalent in the case group (P=0.004). Furthermore, half of infants showed normal pelvic lymph node that mimic a testicular-like appearance due to its uniform hyper-echoic texture. Conclusion: The testicular-like appearance of normal pelvic lymph nodes and non-follicular ovaries in a female infant with CAH. Attention to these usual findings can prevent misdiagnoses of cryptorchidism and time loss to perform other laboratory tests and karyotyping.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"28 1","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82735564","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 : 2021-04-01DOI: 10.22038/IJN.2021.51786.1915
S. Akar, Mehmet Göksu
Background: Necrotizing enterocolitis is the leading cause of intestinal perforation and pneumoperitoneum in neonates. In addition, neonatal pneumoperitoneum includes several conditions requiring surgery, such as gastric and duodenal perforation, intestinal atresia, volvulus, meconium ileus, and Hirschsprung’s disease. A type of pneumoperitoneum in which intra-abdominal free air is detected through direct X-ray; however, no cause is found clinically and radiologically during the surgery is named “benign pneumoperitoneum”. Case report: This case report presents a 5-day-old male newborn who is presented with complaints of abdominal color change and vomiting and is diagnosed with Idiopathic Benign Pneumoperitoneum (IBP) during the operation. Neonatal pneumoperitoneum usually occurs as a result of perforation and requires emergency surgery. Rare cases of IBP should also be kept in mind. Unnecessary surgery can be prevented by establishing a differential diagnosis with clinical, laboratory, and imaging methods. Conclusion: This case demonstrated that laparotomy is not a true routine in neonates with IBP if a timely diagnosis is established.
{"title":"A Case of Idiopathic Diffuse Pneumoperitoneum Presented with Neonatal Abdominal Color Change","authors":"S. Akar, Mehmet Göksu","doi":"10.22038/IJN.2021.51786.1915","DOIUrl":"https://doi.org/10.22038/IJN.2021.51786.1915","url":null,"abstract":"Background: Necrotizing enterocolitis is the leading cause of intestinal perforation and pneumoperitoneum in neonates. In addition, neonatal pneumoperitoneum includes several conditions requiring surgery, such as gastric and duodenal perforation, intestinal atresia, volvulus, meconium ileus, and Hirschsprung’s disease. A type of pneumoperitoneum in which intra-abdominal free air is detected through direct X-ray; however, no cause is found clinically and radiologically during the surgery is named “benign pneumoperitoneum”. \u0000Case report: This case report presents a 5-day-old male newborn who is presented with complaints of abdominal color change and vomiting and is diagnosed with Idiopathic Benign Pneumoperitoneum (IBP) during the operation. Neonatal pneumoperitoneum usually occurs as a result of perforation and requires emergency surgery. Rare cases of IBP should also be kept in mind. Unnecessary surgery can be prevented by establishing a differential diagnosis with clinical, laboratory, and imaging methods. \u0000Conclusion: This case demonstrated that laparotomy is not a true routine in neonates with IBP if a timely diagnosis is established.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"24 1","pages":"105-107"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89505145","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 : 2021-04-01DOI: 10.22038/IJN.2021.51449.1910
Ahmadshah Farhat, A. Mohamadzadeh, R. Saeidi, Negar Yeganeh Khorasani
Background: Personal protective equipment (PPE) is one of the protective equipment that health workers can use to protect themselves against coronavirus disease 2019(COVID-19); however, it is accompanied by some problems for medical staff. Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not transmitted through healthy skin, the hypothesis was examined as to whether the cotton gown could be used instead of PPE. Methods: The medical staff of the Neonatal Care Unit took care of 51 patients with 1180 shifts. During the first and a half months, the medical personnel used a special PPE package for providing care of patients, which included an air-impermeable plastic gown with a head-to-toe cover, an N95 mask, gloves, and a face shield. However, from the beginning of the epidemic, doctors used cotton surgical gowns instead of the ones in the package. Following that, the nursing team gradually replaced the air-impermeable plastic gowns with cotton surgical gowns, and finally, all the staff used the cotton gowns. Results: After three months, all medical staff was evaluated for clinical signs of COVID-19, such as fever, cough, nausea, and headache. During these three months, no symptoms or absence due to illness were observed in the staff. It should be mentioned that the antibody titer was not evaluated at the end of the study. Conclusion: A retrospective review of the staff showed that the cotton surgical gown protected the staff against COVID-19. Accordingly, the cotton surgical gown can be used in medical centers to replace PPE sets containing an air-impermeable plastic gown with a head-to-toe cover. The result of this study can improve some of the problems of the medical staff.
{"title":"Does the Use of Personal Protection Equipment for the Medical Staff Working with Patients with Coronavirus Disease 2019 Need to be Revised","authors":"Ahmadshah Farhat, A. Mohamadzadeh, R. Saeidi, Negar Yeganeh Khorasani","doi":"10.22038/IJN.2021.51449.1910","DOIUrl":"https://doi.org/10.22038/IJN.2021.51449.1910","url":null,"abstract":"Background: Personal protective equipment (PPE) is one of the protective equipment that health workers can use to protect themselves against coronavirus disease 2019(COVID-19); however, it is accompanied by some problems for medical staff. Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not transmitted through healthy skin, the hypothesis was examined as to whether the cotton gown could be used instead of PPE. Methods: The medical staff of the Neonatal Care Unit took care of 51 patients with 1180 shifts. During the first and a half months, the medical personnel used a special PPE package for providing care of patients, which included an air-impermeable plastic gown with a head-to-toe cover, an N95 mask, gloves, and a face shield. However, from the beginning of the epidemic, doctors used cotton surgical gowns instead of the ones in the package. Following that, the nursing team gradually replaced the air-impermeable plastic gowns with cotton surgical gowns, and finally, all the staff used the cotton gowns. Results: After three months, all medical staff was evaluated for clinical signs of COVID-19, such as fever, cough, nausea, and headache. During these three months, no symptoms or absence due to illness were observed in the staff. It should be mentioned that the antibody titer was not evaluated at the end of the study. Conclusion: A retrospective review of the staff showed that the cotton surgical gown protected the staff against COVID-19. Accordingly, the cotton surgical gown can be used in medical centers to replace PPE sets containing an air-impermeable plastic gown with a head-to-toe cover. The result of this study can improve some of the problems of the medical staff.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"42 1","pages":"102-104"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87554118","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 : 2021-04-01DOI: 10.22038/IJN.2021.51371.1907
S. Bazmi, Mina Forouzandeh
Background: Extremely premature infants are at greater risks of cognitive, behavioral, growth, and developmental problems, compared to the term infants. In addition to physical problems, these infants also incur a lot of emotional costs, stress, and financial burden to the family. This study aimed to explore ethical challenges and factors affecting decisions about initiation, sustain, and termination of the life of extremely premature infants that neonatologists face every day in the clinics. Methods: The present qualitative study was conducted based on a grounded theory. The participants were 21 practitioners who were interviewed after giving consent and being briefed about the study. All interviews were recorded, transcribed, and then analyzed in this study. The data were then analyzed using Strauss-Corbin (1998) method in three phases of open, axial, and selective coding. Results: During analysis, 1420 initial (open) codes, 19 subcategories, and two specific categories were obtained to explain the ethical challenges of decision-making on the sustaining or terminating the life of extremely premature infants. These categories included 1) Independent decision-making of physicians, followed by two subcategories of "professional decision-making based on knowledge and clinical experience" and "uncertainty about the consequences of consulting with parents", and 2) Improper conditions and facilities, followed by three subcategories of "lack of local scientific resources on medical ethics", "inefficient neonatal intensive care units", and "lack of efficient rules and guidelines". According to the obtained results, factors leading to ethical challenges included the lack of ethical and legal guidelines tailored to clinical conditions, lack of local scientific documentation in accordance with clinical conditions and health facilities available in the Neonatal Intensive Care Unit (NICU), conflicts between the current law on life preservation and moral guidelines, and lack of facilities, manpower, and equipment in the NICU. Conclusion: A physician’s decision is based on personal scientific and clinical experiences according to the conditions of the wards.
{"title":"Ethical Challenges of Saving Extremely Premature Infants Using a Grounded Theory: Iranian Neonatologists’ Perception","authors":"S. Bazmi, Mina Forouzandeh","doi":"10.22038/IJN.2021.51371.1907","DOIUrl":"https://doi.org/10.22038/IJN.2021.51371.1907","url":null,"abstract":"Background: Extremely premature infants are at greater risks of cognitive, behavioral, growth, and developmental problems, compared to the term infants. In addition to physical problems, these infants also incur a lot of emotional costs, stress, and financial burden to the family. This study aimed to explore ethical challenges and factors affecting decisions about initiation, sustain, and termination of the life of extremely premature infants that neonatologists face every day in the clinics. \u0000Methods: The present qualitative study was conducted based on a grounded theory. The participants were 21 practitioners who were interviewed after giving consent and being briefed about the study. All interviews were recorded, transcribed, and then analyzed in this study. The data were then analyzed using Strauss-Corbin (1998) method in three phases of open, axial, and selective coding. \u0000Results: During analysis, 1420 initial (open) codes, 19 subcategories, and two specific categories were obtained to explain the ethical challenges of decision-making on the sustaining or terminating the life of extremely premature infants. These categories included 1) Independent decision-making of physicians, followed by two subcategories of \"professional decision-making based on knowledge and clinical experience\" and \"uncertainty about the consequences of consulting with parents\", and 2) Improper conditions and facilities, followed by three subcategories of \"lack of local scientific resources on medical ethics\", \"inefficient neonatal intensive care units\", and \"lack of efficient rules and guidelines\". According to the obtained results, factors leading to ethical challenges included the lack of ethical and legal guidelines tailored to clinical conditions, lack of local scientific documentation in accordance with clinical conditions and health facilities available in the Neonatal Intensive Care Unit (NICU), conflicts between the current law on life preservation and moral guidelines, and lack of facilities, manpower, and equipment in the NICU. \u0000Conclusion: A physician’s decision is based on personal scientific and clinical experiences according to the conditions of the wards.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"15 1","pages":"70-80"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84901276","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 : 2021-04-01DOI: 10.22038/IJN.2021.51074.1903
Sindu Ayalew Yimer, Marta Berta Badi, Birhanu Wubale Yirdaw
Background: Exclusive breastfeeding is defined as feeding only breast milk without any other liquids or solids, except for medicine. For mothers with positive human immunodeficiency virus (HIV), adherence to exclusive breastfeeding added with antiretroviral therapy extremely reduces the risk of transmitting the virus to their exposed neonates. Therefore, the World Health Organization has recommended exclusive breastfeeding for exposed infants within the first 6 months of life. This study was performed to identify factors associated with adherence to exclusive breastfeeding among HIV-positive mothers. Methods: The required data in this facility based cross-sectional study was collected using a structured questionnaire through a face-to-face interview. Descriptive statistics were used to show the frequency distributions of factors associated with the dependent variable. Logistic regression was applied to identify factors associated with the outcome variable. The odds ratio was used for the measure of association, and statistical tests with p-values of less than 0.05 were considered significant. Results: The proportion of adherence to exclusive breastfeeding among HIV-positive mothers was found to be 80.8% (95% CI: 77.2-84.6). It was revealed that having good knowledge (adjusted odds ratio [AOR]=7.363, CI=3.37-12.98), receiving exclusive breastfeeding counseling during the postnatal period (AOR=4.88, CI=2.68-8.916), timely initiation of exclusive breastfeeding (AOR=4.429, CI=2.378-8.25), and making 4 or more antenatal care visits (AOR=2.557, CI=1.413-4.629) were identified to be the significant factors. Conclusion: The proportion of adherence to exclusive breastfeeding among HIV-positive mothers was found to be low. Interventions that seek to increase exclusive breastfeeding should focus on ensuring four antepartum care visits and postpartum counseling.
{"title":"Adherence to Exclusive Breastfeeding and its Associated Factors among HIV-Positive Mothers in Referral Hospitals of Amhara Regional State, Northwest Ethiopia, 2018","authors":"Sindu Ayalew Yimer, Marta Berta Badi, Birhanu Wubale Yirdaw","doi":"10.22038/IJN.2021.51074.1903","DOIUrl":"https://doi.org/10.22038/IJN.2021.51074.1903","url":null,"abstract":"Background: Exclusive breastfeeding is defined as feeding only breast milk without any other liquids or solids, except for medicine. For mothers with positive human immunodeficiency virus (HIV), adherence to exclusive breastfeeding added with antiretroviral therapy extremely reduces the risk of transmitting the virus to their exposed neonates. Therefore, the World Health Organization has recommended exclusive breastfeeding for exposed infants within the first 6 months of life. This study was performed to identify factors associated with adherence to exclusive breastfeeding among HIV-positive mothers. Methods: The required data in this facility based cross-sectional study was collected using a structured questionnaire through a face-to-face interview. Descriptive statistics were used to show the frequency distributions of factors associated with the dependent variable. Logistic regression was applied to identify factors associated with the outcome variable. The odds ratio was used for the measure of association, and statistical tests with p-values of less than 0.05 were considered significant. Results: The proportion of adherence to exclusive breastfeeding among HIV-positive mothers was found to be 80.8% (95% CI: 77.2-84.6). It was revealed that having good knowledge (adjusted odds ratio [AOR]=7.363, CI=3.37-12.98), receiving exclusive breastfeeding counseling during the postnatal period (AOR=4.88, CI=2.68-8.916), timely initiation of exclusive breastfeeding (AOR=4.429, CI=2.378-8.25), and making 4 or more antenatal care visits (AOR=2.557, CI=1.413-4.629) were identified to be the significant factors. Conclusion: The proportion of adherence to exclusive breastfeeding among HIV-positive mothers was found to be low. Interventions that seek to increase exclusive breastfeeding should focus on ensuring four antepartum care visits and postpartum counseling.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"19 1","pages":"56-62"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82554761","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 : 2021-04-01DOI: 10.22038/IJN.2021.47035.1803
R. Farhadi, Mansoureh Gholamrezaei, Hamid Mohammadjafari, A. Alipour
Background: Acute kidney injury (AKI) is a clinical syndrome in which the sudden loss of kidney function leads to kidney failure to maintain fluid hemostasis and electrolytes. Considering the increased hospitalization of patients in the neonatal intensive care unit (NICU), the prevalence of AKI due to common diseases, surgical procedures, various drugs, as well as the importance of long-term complications, this study aimed to determine the prevalence and related risk factors for the development of AKI in neonates admitted to NICU. Methods: This descriptive cross-sectional study was conducted on 173 newborns admitted to Boo-Ali-Sina Hospital in Sari, Iran, during 2016-2018. Patients’ demographic characteristics, clinical findings, laboratory results, clinical outcomes, and risk-related disease factors were recorded. Data were analyzed using SPSS software (version 16). Results: The prevalence rate of AKI in infants admitted to Neonatal intensive care unit was 26.6%, consisting of 87% (n=40) prerenal, 8.7% (n=4) renal, and 2.2% (n=1) postrenal AKI cases. Furthermore, 6.4%, 9.2%, and 11% of the patients had grade 1, grade 2, and grade 3 AKI, based on RIFLE criteria. It should be mentioned that RDS, TTN, and seizure were the most common causes of hospitalization in the NICU. The most common laboratory disorders were acidosis, hyponatremia, anemia, and leukocytosis. Furthermore, anemia (89.1% vs. 19.7 %), hypernatremia (8.7% vs. 2.4%), and hyperkalemia (26% vs. 8% ) were significantly greater in AKI than in the non-AKI group. Conclusion: AKI was common in NICU, and accounted for about one-fourth of the admitted patients. The most common type of AKI was prerenal. The patients were equally distributed in all three stages. Eventually, anemia, hypernatremia, and hyperkalemia can be considered risk factors for AKI.
背景:急性肾损伤(AKI)是一种临床综合征，其中肾脏功能的突然丧失导致肾功能衰竭以维持液体止血和电解质。考虑到新生儿重症监护病房(NICU)患者住院率的增加，常见疾病、外科手术、各种药物导致AKI的发生率，以及长期并发症的重要性，本研究旨在确定NICU新生儿AKI的患病率及相关危险因素。方法:对2016-2018年在伊朗萨里Boo-Ali-Sina医院住院的173名新生儿进行描述性横断面研究。记录患者的人口学特征、临床表现、实验室结果、临床结局和与风险相关的疾病因素。数据分析采用SPSS (version 16)软件。结果:新生儿重症监护病房住院婴儿AKI患病率为26.6%，其中87% (n=40)为肾前AKI, 8.7% (n=4)为肾后AKI, 2.2% (n=1)为肾后AKI。此外，根据RIFLE标准，分别有6.4%、9.2%和11%的患者为1级、2级和3级AKI。值得一提的是，RDS、TTN和癫痫发作是NICU最常见的住院原因。最常见的实验室疾病是酸中毒、低钠血症、贫血和白细胞增多症。此外，AKI组的贫血(89.1% vs. 19.7%)、高钠血症(8.7% vs. 2.4%)和高钾血症(26% vs. 8%)显著高于非AKI组。结论:AKI在NICU中较为常见，约占入院患者的四分之一。最常见的AKI类型是预防性的。患者在所有三个阶段均匀分布。最终，贫血、高钠血症和高钾血症被认为是AKI的危险因素。
{"title":"Incidence and Risk Factors of Acute Kidney Injury in Neonatal Intensive Care Unit","authors":"R. Farhadi, Mansoureh Gholamrezaei, Hamid Mohammadjafari, A. Alipour","doi":"10.22038/IJN.2021.47035.1803","DOIUrl":"https://doi.org/10.22038/IJN.2021.47035.1803","url":null,"abstract":"Background: Acute kidney injury (AKI) is a clinical syndrome in which the sudden loss of kidney function leads to kidney failure to maintain fluid hemostasis and electrolytes. Considering the increased hospitalization of patients in the neonatal intensive care unit (NICU), the prevalence of AKI due to common diseases, surgical procedures, various drugs, as well as the importance of long-term complications, this study aimed to determine the prevalence and related risk factors for the development of AKI in neonates admitted to NICU. Methods: This descriptive cross-sectional study was conducted on 173 newborns admitted to Boo-Ali-Sina Hospital in Sari, Iran, during 2016-2018. Patients’ demographic characteristics, clinical findings, laboratory results, clinical outcomes, and risk-related disease factors were recorded. Data were analyzed using SPSS software (version 16). Results: The prevalence rate of AKI in infants admitted to Neonatal intensive care unit was 26.6%, consisting of 87% (n=40) prerenal, 8.7% (n=4) renal, and 2.2% (n=1) postrenal AKI cases. Furthermore, 6.4%, 9.2%, and 11% of the patients had grade 1, grade 2, and grade 3 AKI, based on RIFLE criteria. It should be mentioned that RDS, TTN, and seizure were the most common causes of hospitalization in the NICU. The most common laboratory disorders were acidosis, hyponatremia, anemia, and leukocytosis. Furthermore, anemia (89.1% vs. 19.7 %), hypernatremia (8.7% vs. 2.4%), and hyperkalemia (26% vs. 8% ) were significantly greater in AKI than in the non-AKI group. Conclusion: AKI was common in NICU, and accounted for about one-fourth of the admitted patients. The most common type of AKI was prerenal. The patients were equally distributed in all three stages. Eventually, anemia, hypernatremia, and hyperkalemia can be considered risk factors for AKI.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"51 1","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74723395","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 : 2021-02-14DOI: 10.22038/IJN.2021.49621.1866
J. Mirlashari, L. Holsti, Jamaladin Begjani, Ramak Roohipoor, A. Kasaeian, Aida Safaiee Fakhr
Background: Examination for retinopathy of prematurity (ROP) is one of the procedures that can be stresssful for infants admitted to the neonatal intensive care unit. Purpose: This study compared breast milk and sucrose for pain relief and coping with stress of ROP examination by using the ALPS-Neo scale.Methods: The study included 63 preterm infants (breast milk group (21), sucrose group (21) and distilled water group (21)). Infants were given 0.5 ml/kg of breast milk, sucrose or distilled water two minutes before the examination. The ROP eye examinations were video recorded from 5 minutes before to 15 minutes after the examination, and infants’ pain and stress levels were assessed using the ALPS-Neo by two blinded evaluators 5 minutes before, during, and 5, 10, and 15 minutes after examination.Results: No statistically significant differences were found during the examinations in the mean scores of ALPS-Neo among the three groups (P> 0.05). However, statistically significant differences were found between the three groups after examinations (P
{"title":"A comparison of breast milk and sucrose in neonatal pain relief and coping with stress of ROP examination: using the ALPS-Neo scale","authors":"J. Mirlashari, L. Holsti, Jamaladin Begjani, Ramak Roohipoor, A. Kasaeian, Aida Safaiee Fakhr","doi":"10.22038/IJN.2021.49621.1866","DOIUrl":"https://doi.org/10.22038/IJN.2021.49621.1866","url":null,"abstract":"Background: Examination for retinopathy of prematurity (ROP) is one of the procedures that can be stresssful for infants admitted to the neonatal intensive care unit. Purpose: This study compared breast milk and sucrose for pain relief and coping with stress of ROP examination by using the ALPS-Neo scale.Methods: The study included 63 preterm infants (breast milk group (21), sucrose group (21) and distilled water group (21)). Infants were given 0.5 ml/kg of breast milk, sucrose or distilled water two minutes before the examination. The ROP eye examinations were video recorded from 5 minutes before to 15 minutes after the examination, and infants’ pain and stress levels were assessed using the ALPS-Neo by two blinded evaluators 5 minutes before, during, and 5, 10, and 15 minutes after examination.Results: No statistically significant differences were found during the examinations in the mean scores of ALPS-Neo among the three groups (P> 0.05). However, statistically significant differences were found between the three groups after examinations (P","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76633060","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 : 2021-02-14DOI: 10.22038/IJN.2021.50368.1884
Nasim Pouralizadeh, G. Maamouri, Abbas Boskabadi, H. Boskabadi, H. Rafatpanah, Ali Moadi, Hassan Mehrad‐Majd
Background: Several studies have reported that two promotor c.-3279T>G, and c.-3156G>A variants in UDP- glucuronosyltransferase (UGT1A1) gene may contribute to neonatal hyperbilirubinemia. However, these variants have not been investigated in Iranian neonates. This cross-sectional study aimed to determine if the UGT1A1 promoter variants are significant risk factors associated with neonatal hyperbilirubinemia. Methods: A total of 178 unrelated neonates comprised 95 infants with neonatal jaundice and 83 healthy controls were enrolled. Using fresh blood DNA, each individual was genotyped by PCR-RFLP and COP-PCR at nucleotides -3279, and -3156, respectively. Logistic regression analyses were performed to assess the association of UGT1A1 promoter variants with the presence of significant hyperbilirubinemia. Anthropometric indices, and clinical variables were also compared between the different genotype groups. Results: Allele and genotype analysis of the c.-3279T>G, and c.-3156G>A variants showed no significant association with the risk of neonatal hyperbilirubinemia neither in the crude nor after adjustment for gestational age, gender, and birth weight in different genetic models (P>0.05). However, in haplotype-association analysis, only one haplotype (A-T) was found to be associated with the risk of neonatal hyperbilirubinemia (OR=0.19, 95% CI; [0.18–0.20], P=0.001). Conclusion: This study failed to demonstrate c.-3279T>G, and c.-3156G>A variants alone may contribute to the risk of neonatal hyperbilirubinemia in Iranian neonates. However, A-T haplotype may play a significant role in increasing the risk of hyperbilirubinemia.
{"title":"Genetic association of UGT1A1 promoter c.-3279T>G, and c.-3156G>A variants with neonatal hyperbilirubinemia in an Iranian Population","authors":"Nasim Pouralizadeh, G. Maamouri, Abbas Boskabadi, H. Boskabadi, H. Rafatpanah, Ali Moadi, Hassan Mehrad‐Majd","doi":"10.22038/IJN.2021.50368.1884","DOIUrl":"https://doi.org/10.22038/IJN.2021.50368.1884","url":null,"abstract":"Background: Several studies have reported that two promotor c.-3279T>G, and c.-3156G>A variants in UDP- glucuronosyltransferase (UGT1A1) gene may contribute to neonatal hyperbilirubinemia. However, these variants have not been investigated in Iranian neonates. This cross-sectional study aimed to determine if the UGT1A1 promoter variants are significant risk factors associated with neonatal hyperbilirubinemia. Methods: A total of 178 unrelated neonates comprised 95 infants with neonatal jaundice and 83 healthy controls were enrolled. Using fresh blood DNA, each individual was genotyped by PCR-RFLP and COP-PCR at nucleotides -3279, and -3156, respectively. Logistic regression analyses were performed to assess the association of UGT1A1 promoter variants with the presence of significant hyperbilirubinemia. Anthropometric indices, and clinical variables were also compared between the different genotype groups. Results: Allele and genotype analysis of the c.-3279T>G, and c.-3156G>A variants showed no significant association with the risk of neonatal hyperbilirubinemia neither in the crude nor after adjustment for gestational age, gender, and birth weight in different genetic models (P>0.05). However, in haplotype-association analysis, only one haplotype (A-T) was found to be associated with the risk of neonatal hyperbilirubinemia (OR=0.19, 95% CI; [0.18–0.20], P=0.001). Conclusion: This study failed to demonstrate c.-3279T>G, and c.-3156G>A variants alone may contribute to the risk of neonatal hyperbilirubinemia in Iranian neonates. However, A-T haplotype may play a significant role in increasing the risk of hyperbilirubinemia.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84333205","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 : 2021-02-07DOI: 10.22038/IJN.2021.46197.1778
Lili Rohmawati, D. Sari, Ika Citra Dewi Tanjung
ABSTRACTBackground and Objective: Zinc is an important micronutrient that is required for optimal foetal growth and development. Zinc deficiency during pregnancy may interfere with intrauterine foetal ossification. Foetal ossification can be measured with specific bone growth markers, such as procollagen type 1-N terminal propeptide (P1NP). The objective of this study was to investigate mean maternal serum zinc levels and assess the correlations between maternal serum zinc levels and cord blood P1NP levels and anthropometric measurements of newborns. Materials and Methods: This was a cross-sectional study conducted at Universitas Sumatera Utara Hospital and other hospitals in Medan from April to October 2019. Eligible subjects were pregnant mothers and their newborns who met the inclusion criteria, and participants were enrolled with a consecutive sampling technique. Maternal serum zinc levels and cord blood P1NP levels were measured prior to delivery, and anthropometric measurements were conducted. Results: A total of 42 subjects were recruited and had a mean maternal serum zinc level of 52.0±9.0 µg/dL. The proportion of pregnant mothers with low serum zinc levels was high (54.8%). There was a significant correlation between maternal serum zinc levels and newborn birth weight (r=0.648), length (r=0.656) and head circumference (r=0.578) (P= 0.001). There was a significant, positive linear correlation between maternal serum zinc levels and cord blood P1NP levels (r=0.469; P=0.002). Conclusion: The mean maternal serum zinc levels during pregnancy were below normal. There were positive significant correlations between maternal serum zinc levels and cord blood P1NP levels and anthropometric measurements of newborns.Keywords: zinc, procollagen type 1-N terminal propeptide, birth weight
{"title":"Correlation between Maternal Serum Zinc Levels, Cord Blood Procollagen type 1-N Terminal Propeptide (P1NP) Levels and Anthropometric Measurements of Newborns","authors":"Lili Rohmawati, D. Sari, Ika Citra Dewi Tanjung","doi":"10.22038/IJN.2021.46197.1778","DOIUrl":"https://doi.org/10.22038/IJN.2021.46197.1778","url":null,"abstract":"ABSTRACTBackground and Objective: Zinc is an important micronutrient that is required for optimal foetal growth and development. Zinc deficiency during pregnancy may interfere with intrauterine foetal ossification. Foetal ossification can be measured with specific bone growth markers, such as procollagen type 1-N terminal propeptide (P1NP). The objective of this study was to investigate mean maternal serum zinc levels and assess the correlations between maternal serum zinc levels and cord blood P1NP levels and anthropometric measurements of newborns. Materials and Methods: This was a cross-sectional study conducted at Universitas Sumatera Utara Hospital and other hospitals in Medan from April to October 2019. Eligible subjects were pregnant mothers and their newborns who met the inclusion criteria, and participants were enrolled with a consecutive sampling technique. Maternal serum zinc levels and cord blood P1NP levels were measured prior to delivery, and anthropometric measurements were conducted. Results: A total of 42 subjects were recruited and had a mean maternal serum zinc level of 52.0±9.0 µg/dL. The proportion of pregnant mothers with low serum zinc levels was high (54.8%). There was a significant correlation between maternal serum zinc levels and newborn birth weight (r=0.648), length (r=0.656) and head circumference (r=0.578) (P= 0.001). There was a significant, positive linear correlation between maternal serum zinc levels and cord blood P1NP levels (r=0.469; P=0.002). Conclusion: The mean maternal serum zinc levels during pregnancy were below normal. There were positive significant correlations between maternal serum zinc levels and cord blood P1NP levels and anthropometric measurements of newborns.Keywords: zinc, procollagen type 1-N terminal propeptide, birth weight","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80487764","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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