Pub Date : 2020-10-01DOI: 10.22038/IJN.2020.44916.1748
M. Talebi, V. Vakili, Z. Shaye, Mahmoud Velayati
Background: Smoking is very important during pregnancy because of severe fetal and maternal complications. No community-based studies have been conducted on pregnant women in Iran. This study aimed to investigate the prevalence of smoking during pregnancy, as well as maternal and neonatal complications in Mashhad, Iran, during 2017.Methods: This cross-sectional study reviewed the information of 1140 and 92,225 smoking and non-smoking pregnant women during pregnancy, respectively, and 3-5 days after delivery using Sina Electronic Health Record System in Mashhad, Iran, during 2017. All data were extracted, encoded, and entered into SPSS software (version 16).Results: Out of the total of 93,365 pregnant women with a mean age of 22.36 years, the prevalence of smoking during pregnancy was significantly higher among those who live in the city (i.e., Mashhad), compared to individuals living in the suburbs or villages. The mean rates of stillbirth, prematurity, very-low-birth-weight, and low-birth-weight were higher in smoking pregnant mothers, compared to non-smoking ones (p <0.0001). The prevalence of smoking among literate and employed pregnant mothers was significantly higher than illiterate and unemployed pregnant women (p <0.0001). The mean birth weight of newborns of smoking mothers (1528gr) was less than the half mean of the birth weight (3180gr) of newborns of non-smoking mothers (p <0.0001).Conclusion: The prevalence of smoking in mothers living in Mashhad, Iran, was 1.2%, which is less than the global average. The results of this study showed that smoking during pregnancy has many maternal and fetal complications.
{"title":"Smoking during Pregnancy and Maternal and Neonatal Complications in Mashhad, Suburbs, and Subsidiary Villages: A Population-based Cross-Sectional Study","authors":"M. Talebi, V. Vakili, Z. Shaye, Mahmoud Velayati","doi":"10.22038/IJN.2020.44916.1748","DOIUrl":"https://doi.org/10.22038/IJN.2020.44916.1748","url":null,"abstract":"Background: Smoking is very important during pregnancy because of severe fetal and maternal complications. No community-based studies have been conducted on pregnant women in Iran. This study aimed to investigate the prevalence of smoking during pregnancy, as well as maternal and neonatal complications in Mashhad, Iran, during 2017.Methods: This cross-sectional study reviewed the information of 1140 and 92,225 smoking and non-smoking pregnant women during pregnancy, respectively, and 3-5 days after delivery using Sina Electronic Health Record System in Mashhad, Iran, during 2017. All data were extracted, encoded, and entered into SPSS software (version 16).Results: Out of the total of 93,365 pregnant women with a mean age of 22.36 years, the prevalence of smoking during pregnancy was significantly higher among those who live in the city (i.e., Mashhad), compared to individuals living in the suburbs or villages. The mean rates of stillbirth, prematurity, very-low-birth-weight, and low-birth-weight were higher in smoking pregnant mothers, compared to non-smoking ones (p <0.0001). The prevalence of smoking among literate and employed pregnant mothers was significantly higher than illiterate and unemployed pregnant women (p <0.0001). The mean birth weight of newborns of smoking mothers (1528gr) was less than the half mean of the birth weight (3180gr) of newborns of non-smoking mothers (p <0.0001).Conclusion: The prevalence of smoking in mothers living in Mashhad, Iran, was 1.2%, which is less than the global average. The results of this study showed that smoking during pregnancy has many maternal and fetal complications.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"9 1","pages":"99-105"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84204957","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 : 2020-10-01DOI: 10.22038/IJN.2020.46421.1783
T. E. Shirvani, F. Nayeri, M. Shariat, N. Niknafs, M. R. Mirjalili, Seyyed Nasrollah Hosseini, Vafa Ghorbansabagh
Background: Respiratory distress syndrome (RDS) is a common lung problem in neonates born before 28 weeks of pregnancy. The current study aimed to assess the clinical outcomes of Nasal Continuous Positive Airway Pressure (NCPAP), as compared to humidified high flow nasal cannula (HHFNC) in the treatment of premature neonates with RDS.Methods: This randomized control trial was conducted on 60 preterm neonates (gestation Results: There were no significant differences in primary and secondary outcomes, including pneumothorax, patent ductus arteriosus (PDA), chronic lung disease, surfactant injection, tracheal intubation, death, necrotizing enterocolitis (NEC), days of delay in establishing full enteral feeds, duration of hospitalization, and the number of the days for oxygen requirement between NCPAP and HHFNC groups.Conclusion: HHFNC and NCPAP techniques have the same efficacy in the treatment of RDS in neonates, and there was no difference between the two techniques in terms of treatment failure and clinical outcomes. Since HHFNC is less invasive with the same efficacy compared to CPAP, we recommend that it can be used as a primary modality in preterm neonates with RDS.
{"title":"Continuous Positive Airway Pressure or Humidified High Flow Nasal Cannula for Respiratory Distress Syndrome: A Randomized Control Trial among Premature Neonates","authors":"T. E. Shirvani, F. Nayeri, M. Shariat, N. Niknafs, M. R. Mirjalili, Seyyed Nasrollah Hosseini, Vafa Ghorbansabagh","doi":"10.22038/IJN.2020.46421.1783","DOIUrl":"https://doi.org/10.22038/IJN.2020.46421.1783","url":null,"abstract":"Background: Respiratory distress syndrome (RDS) is a common lung problem in neonates born before 28 weeks of pregnancy. The current study aimed to assess the clinical outcomes of Nasal Continuous Positive Airway Pressure (NCPAP), as compared to humidified high flow nasal cannula (HHFNC) in the treatment of premature neonates with RDS.Methods: This randomized control trial was conducted on 60 preterm neonates (gestation Results: There were no significant differences in primary and secondary outcomes, including pneumothorax, patent ductus arteriosus (PDA), chronic lung disease, surfactant injection, tracheal intubation, death, necrotizing enterocolitis (NEC), days of delay in establishing full enteral feeds, duration of hospitalization, and the number of the days for oxygen requirement between NCPAP and HHFNC groups.Conclusion: HHFNC and NCPAP techniques have the same efficacy in the treatment of RDS in neonates, and there was no difference between the two techniques in terms of treatment failure and clinical outcomes. Since HHFNC is less invasive with the same efficacy compared to CPAP, we recommend that it can be used as a primary modality in preterm neonates with RDS.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"37 1","pages":"50-56"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74753116","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 : 2020-10-01DOI: 10.22038/IJN.2020.42513.1704
H. Dalili, Nahid Farrokhzad, Zeinab Kavyani, L. Sahebi, A. Habibelahi, Mina Ashrafzadeh, Firuzeh Faridpur, M. Shariat
Background: Risk scoring systems evaluate neonatal outcomes using perinatal and neonatal status. The present study aimed to predict the mortality risk of preterm or low birth weight infants using the Clinical Risk Index for Babies (CRIB-II) and Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE-II) scoring systems.Methods: This prospective cohort study investigated the preterm neonates admitted to the Neonatal Intensive Care Unit (NICU) of Vali-e-Asr Hospital, Tehran, Iran, with the birth weight of ˂1500g or a gestational age˂32weeks using the CRIB-II and SNAPPE-II scoring systems within the first 12 h after birth. The area under the curve, sensitivity, specificity, positive and negative predictive values of the scoring systems, as well as the association between neonate factors and neonatal death were calculated in this study.Results: Out of 344 neonates under study, 253casessurvived after24hof birth and 91 newborns died. The total CRIB-II scores in survived and deceased infants were 6.12 and 10.28, respectively. The area under the receiver operating characteristic (ROC) curve with a cut-off point of 8.5 was obtained at 0.838. Moreover, the sensitivity, specificity, positive predictive value, and negative predictive value were estimated at 74.4%, 78.65%, 55.37%, and 89.68%, respectively, for the CRIB-II system. Total scores of SNAPPE-II in survived and deceased infants were 16.9 and 51.6, respectively. The area under the ROC curve with a cut-off point of 27.5 was determined at 0.887. Sensitivity (84.44%) and specificity (79.05%) were calculated for the SNAPPE-II. Furthermore, positive and negative predictive values were 58.91% and 93.46%, respectively.Conclusion: This study demonstrated that the CRIB-II and SNAPPE-II scoring systems can be useful mortality predictors for at-risk neonates.
{"title":"Determination of Predictive Power of CRIB-II and SNAPPE-II in Mortality Risk of Neonates with Low Gestational Age or Birth Weight Admitted to the Neonatal Intensive Care Unit","authors":"H. Dalili, Nahid Farrokhzad, Zeinab Kavyani, L. Sahebi, A. Habibelahi, Mina Ashrafzadeh, Firuzeh Faridpur, M. Shariat","doi":"10.22038/IJN.2020.42513.1704","DOIUrl":"https://doi.org/10.22038/IJN.2020.42513.1704","url":null,"abstract":"Background: Risk scoring systems evaluate neonatal outcomes using perinatal and neonatal status. The present study aimed to predict the mortality risk of preterm or low birth weight infants using the Clinical Risk Index for Babies (CRIB-II) and Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE-II) scoring systems.Methods: This prospective cohort study investigated the preterm neonates admitted to the Neonatal Intensive Care Unit (NICU) of Vali-e-Asr Hospital, Tehran, Iran, with the birth weight of ˂1500g or a gestational age˂32weeks using the CRIB-II and SNAPPE-II scoring systems within the first 12 h after birth. The area under the curve, sensitivity, specificity, positive and negative predictive values of the scoring systems, as well as the association between neonate factors and neonatal death were calculated in this study.Results: Out of 344 neonates under study, 253casessurvived after24hof birth and 91 newborns died. The total CRIB-II scores in survived and deceased infants were 6.12 and 10.28, respectively. The area under the receiver operating characteristic (ROC) curve with a cut-off point of 8.5 was obtained at 0.838. Moreover, the sensitivity, specificity, positive predictive value, and negative predictive value were estimated at 74.4%, 78.65%, 55.37%, and 89.68%, respectively, for the CRIB-II system. Total scores of SNAPPE-II in survived and deceased infants were 16.9 and 51.6, respectively. The area under the ROC curve with a cut-off point of 27.5 was determined at 0.887. Sensitivity (84.44%) and specificity (79.05%) were calculated for the SNAPPE-II. Furthermore, positive and negative predictive values were 58.91% and 93.46%, respectively.Conclusion: This study demonstrated that the CRIB-II and SNAPPE-II scoring systems can be useful mortality predictors for at-risk neonates.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"30 1","pages":"74-80"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80934405","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: The first 28 days of life are the most sensitive time regarding a child’s survival and health. Neonatal death accounts for a major part of under-five deaths, especially in sub-Saharan Africa. In this regard, the present study aimed to identify the causes of neonatal deaths in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia.Methods: The present institution-based descriptive cross-sectional study was conducted on neonates admitted to the neonatal intensive care unit of Ayder Comprehensive Specialized Hospital from June 2018 to May 2019. The required data were extracted from the medical charts of the patients during admission and discharge and their death certificates. The collected data were analyzed in SPSS software (version 23) using descriptive statistics to describe the prevalence and causes of neonatal deaths. The final results were summarized using frequencies and proportions.Results: In total, 1785 neonates were admitted during the study period and 1388 (77.8%), 99 (5.5%), and 298 (167 per 1000 live births) of them were treated and discharged, discharged against medical advice, and died, respectively. The causes of 139 (46.6%), 72 (24.2%), 63 (21.1%), and 22 (7.4%) neonatal deaths in the hospital were prematurity- related complications, neonatal sepsis, perinatal asphyxia, and congenital anomalies, respectively. The highest mortality rate was observed in neonates with respiratory distress syndrome since 89 out of 127 (70.8%) afflicted neonates died. Moreover, the second-highest mortality rate was found in newborns with perinatal asphyxia as 63 out of 174 (36.2%) afflicted newborns died. Furthermore, it was found that almost all deaths (98.3%) occurred during the first seven days after birth.Conclusion: Based on the results, it can be concluded that the neonatal mortality rate was substantially high among the studied neonates. Moreover, the case fatality rate of respiratory distress syndrome was alarmingly high. Therefore, all the people who are in charge must devote a considerable effort to improve the health care delivered to neonates.
{"title":"Causes of Neonatal Death in Ayder Comprehensive Specialized Hospital, Ethiopia","authors":"Fikaden Berhe Hadgu, Gebregziabher Berihu Gebrekidan","doi":"10.22038/IJN.2020.47286.1809","DOIUrl":"https://doi.org/10.22038/IJN.2020.47286.1809","url":null,"abstract":"Background: The first 28 days of life are the most sensitive time regarding a child’s survival and health. Neonatal death accounts for a major part of under-five deaths, especially in sub-Saharan Africa. In this regard, the present study aimed to identify the causes of neonatal deaths in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia.Methods: The present institution-based descriptive cross-sectional study was conducted on neonates admitted to the neonatal intensive care unit of Ayder Comprehensive Specialized Hospital from June 2018 to May 2019. The required data were extracted from the medical charts of the patients during admission and discharge and their death certificates. The collected data were analyzed in SPSS software (version 23) using descriptive statistics to describe the prevalence and causes of neonatal deaths. The final results were summarized using frequencies and proportions.Results: In total, 1785 neonates were admitted during the study period and 1388 (77.8%), 99 (5.5%), and 298 (167 per 1000 live births) of them were treated and discharged, discharged against medical advice, and died, respectively. The causes of 139 (46.6%), 72 (24.2%), 63 (21.1%), and 22 (7.4%) neonatal deaths in the hospital were prematurity- related complications, neonatal sepsis, perinatal asphyxia, and congenital anomalies, respectively. The highest mortality rate was observed in neonates with respiratory distress syndrome since 89 out of 127 (70.8%) afflicted neonates died. Moreover, the second-highest mortality rate was found in newborns with perinatal asphyxia as 63 out of 174 (36.2%) afflicted newborns died. Furthermore, it was found that almost all deaths (98.3%) occurred during the first seven days after birth.Conclusion: Based on the results, it can be concluded that the neonatal mortality rate was substantially high among the studied neonates. Moreover, the case fatality rate of respiratory distress syndrome was alarmingly high. Therefore, all the people who are in charge must devote a considerable effort to improve the health care delivered to neonates.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"48 1","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85874915","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 : 2020-10-01DOI: 10.22038/IJN.2020.46949.1800
Masoumeh Mirzamoradi, A. Ebrahimi, P. Pooransari, S. S. Gargari, S. Piri
Background: This study aimed to report the incidence of bowel obstruction, chromosomal abnormality, congenital infection, fetal growth restriction (FGR), and otheranomalies in fetuses with hyperechogenic bowel (HEB) diagnosed during the second-trimester fetal ultrasound scan.Methods: In total, 350 fetuses with a diagnosis of HEB in our maternal-fetal medicine referral center were evaluated with a detailed fetal ultrasound examination by an experienced perinatologist. If no associated anomalies were observed, women were counseled about the risk of potential fetal disorders and offered appropriate testing, including detailed fetal sonography, karyotype, maternal cytomegalovirus (CMV), and toxoplasmosis serology,as well as serial fetal biometry and bowel diameter follow up.Results: Altogether there were 18(5.1%) fetuses with associated problems, including major anomalies, chromosomal abnormalities, and CMV infection. Moreover, 32(9.1%) fetuses developed FGR during follow-up.Conclusion: An overall rate of adverse conditions of 14.2% with prenatally detected HEB serves to inform obstetricians and emphasizes the importance of careful screening fetal ultrasound studies and timely referral for an additional assessment about associated findings.It should be noted that isolated HEB has good outcomes.
{"title":"Clinical Significance of Hyperechogenic Bowel in Second-Trimester Ultrasound Scan","authors":"Masoumeh Mirzamoradi, A. Ebrahimi, P. Pooransari, S. S. Gargari, S. Piri","doi":"10.22038/IJN.2020.46949.1800","DOIUrl":"https://doi.org/10.22038/IJN.2020.46949.1800","url":null,"abstract":"Background: This study aimed to report the incidence of bowel obstruction, chromosomal abnormality, congenital infection, fetal growth restriction (FGR), and otheranomalies in fetuses with hyperechogenic bowel (HEB) diagnosed during the second-trimester fetal ultrasound scan.Methods: In total, 350 fetuses with a diagnosis of HEB in our maternal-fetal medicine referral center were evaluated with a detailed fetal ultrasound examination by an experienced perinatologist. If no associated anomalies were observed, women were counseled about the risk of potential fetal disorders and offered appropriate testing, including detailed fetal sonography, karyotype, maternal cytomegalovirus (CMV), and toxoplasmosis serology,as well as serial fetal biometry and bowel diameter follow up.Results: Altogether there were 18(5.1%) fetuses with associated problems, including major anomalies, chromosomal abnormalities, and CMV infection. Moreover, 32(9.1%) fetuses developed FGR during follow-up.Conclusion: An overall rate of adverse conditions of 14.2% with prenatally detected HEB serves to inform obstetricians and emphasizes the importance of careful screening fetal ultrasound studies and timely referral for an additional assessment about associated findings.It should be noted that isolated HEB has good outcomes.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"15 1","pages":"69-73"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75301790","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 : 2020-10-01DOI: 10.22038/IJN.2020.39707.1632
A. Mohammadzadeh, A. Shahfarhat, R. Saeidi, A. Vaezi
Background: Red reflex is a simple test that can detect potentially life-threatening ocular abnormalities. In 2012, a red reflex screening campaign started in Umbria, central Italy. In the present study, we report the results of eye examination in the routine first visit of newborns in a private hospital within 2014-2016.Methods: The red reflex test was carried out as a part of the first health visit of newborns in a private hospital for 2 years. The eyes of all newborns were examined on the first day of life by a handheld ophthalmoscope. The suspected cases with cataract were referred to the Ophthalmologic Department of Mashhad University of Medical Sciences, Mashhad, Iran, for the confirmation of the diagnosis.Results: During the 2 years of the study, a total of 10,484 neonates were delivered in this hospital 10 of whom were referred for ophthalmology consultation due to suspected abnormal red reflex. In 2 cases (0.019%), the diagnosis of congenital cataract was confirmed by an ophthalmologist.Conclusion: The results of the current study are consistent with the findings of previous studies, although the reports on red reflex screening are sporadic in the literature. Due to low cost and easy performance and in spite of high false-positive red reflex test, it appears to be useful for the early diagnosis of congenital low-vision disease for the prevention of vision impairment. In addition, the present study confirmed that the red reflex test should become a part of the first newborn examination immediately after birth.
{"title":"Red Reflex Examination in Neonates for 2 Years Screening","authors":"A. Mohammadzadeh, A. Shahfarhat, R. Saeidi, A. Vaezi","doi":"10.22038/IJN.2020.39707.1632","DOIUrl":"https://doi.org/10.22038/IJN.2020.39707.1632","url":null,"abstract":"Background: Red reflex is a simple test that can detect potentially life-threatening ocular abnormalities. In 2012, a red reflex screening campaign started in Umbria, central Italy. In the present study, we report the results of eye examination in the routine first visit of newborns in a private hospital within 2014-2016.Methods: The red reflex test was carried out as a part of the first health visit of newborns in a private hospital for 2 years. The eyes of all newborns were examined on the first day of life by a handheld ophthalmoscope. The suspected cases with cataract were referred to the Ophthalmologic Department of Mashhad University of Medical Sciences, Mashhad, Iran, for the confirmation of the diagnosis.Results: During the 2 years of the study, a total of 10,484 neonates were delivered in this hospital 10 of whom were referred for ophthalmology consultation due to suspected abnormal red reflex. In 2 cases (0.019%), the diagnosis of congenital cataract was confirmed by an ophthalmologist.Conclusion: The results of the current study are consistent with the findings of previous studies, although the reports on red reflex screening are sporadic in the literature. Due to low cost and easy performance and in spite of high false-positive red reflex test, it appears to be useful for the early diagnosis of congenital low-vision disease for the prevention of vision impairment. In addition, the present study confirmed that the red reflex test should become a part of the first newborn examination immediately after birth.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"195 1","pages":"46-49"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77648711","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 : 2020-10-01DOI: 10.22038/IJN.2020.45342.1756
Maryam Javaheri Abkenar, L. K. Mojen, F. Shakeri, M. Varzeshnejad
Background: Skin is the most important defense mechanism of the neonate's body. The admission to the Neonatal Intensive Care Unit (NICU) is a risk factor for neonatal skin injuries. Therefore, to prevent these complications, it is essential to identify the risk factors. The present study aimed to investigate the incidence of skin injuries and its related factors in neonates admitted to the NICU.Methods: This cohort study was conducted in two NICUs in one perinatal hospital in Tehran, Iran, from January 2018 to June 2018. The sampling was performed using the census method. The data were collected through a demographic characteristics form, a risk factor assessment checklist, and the European Pressure Ulcer Advisory Panel (EPUAP) tool. The data were analyzed in SPSS software (version 19) through Fisher's exact test and chi-square test.Results: Out of 368 neonates, 126 cases had skin injuries, and the others were healthy. The mean values of weight and age of the neonates with skin injuries were 796.68±1606.82 g and 5.18±30.82 days, which was significantly lower than those of the infants without skin injury (p <0.05). The results of the risk factors analysis also showed that the second-grade injuries were the most frequent. Moreover, the drug leakage (14.2%, n=33) and nasal continuous positive airway pressure (12.06%, n=28) had the highest prevalence. The results of the effect of risk factors on the wound grade also showed that drug leakage, diaper rash, and surgical injuries had a significant effect on the wound grade.Conclusion: The results showed that in addition to neonatal conditions, equipment, and neonatal care play a significant role in the incidence of skin injuries. Skin is the most important defense barrier of the neonate's body and it is vitally important to take care of it. Therefore, it is necessary to identify and prevent such injuries.
{"title":"Skin Injuries and its Related Factors in the Neonatal Intensive Care Unit","authors":"Maryam Javaheri Abkenar, L. K. Mojen, F. Shakeri, M. Varzeshnejad","doi":"10.22038/IJN.2020.45342.1756","DOIUrl":"https://doi.org/10.22038/IJN.2020.45342.1756","url":null,"abstract":"Background: Skin is the most important defense mechanism of the neonate's body. The admission to the Neonatal Intensive Care Unit (NICU) is a risk factor for neonatal skin injuries. Therefore, to prevent these complications, it is essential to identify the risk factors. The present study aimed to investigate the incidence of skin injuries and its related factors in neonates admitted to the NICU.Methods: This cohort study was conducted in two NICUs in one perinatal hospital in Tehran, Iran, from January 2018 to June 2018. The sampling was performed using the census method. The data were collected through a demographic characteristics form, a risk factor assessment checklist, and the European Pressure Ulcer Advisory Panel (EPUAP) tool. The data were analyzed in SPSS software (version 19) through Fisher's exact test and chi-square test.Results: Out of 368 neonates, 126 cases had skin injuries, and the others were healthy. The mean values of weight and age of the neonates with skin injuries were 796.68±1606.82 g and 5.18±30.82 days, which was significantly lower than those of the infants without skin injury (p <0.05). The results of the risk factors analysis also showed that the second-grade injuries were the most frequent. Moreover, the drug leakage (14.2%, n=33) and nasal continuous positive airway pressure (12.06%, n=28) had the highest prevalence. The results of the effect of risk factors on the wound grade also showed that drug leakage, diaper rash, and surgical injuries had a significant effect on the wound grade.Conclusion: The results showed that in addition to neonatal conditions, equipment, and neonatal care play a significant role in the incidence of skin injuries. Skin is the most important defense barrier of the neonate's body and it is vitally important to take care of it. Therefore, it is necessary to identify and prevent such injuries.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"27 1","pages":"93-98"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74602817","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 : 2020-10-01DOI: 10.22038/IJN.2020.49341.1860
R. Ghrahani, M. Ghozali, A. Sugianli, T. Yuniati, R. Judistiani, B. Setiabudiawan
Background: Hematological parameters can reflect potential morbidity in premature neonates. Complete blood count (CBC) is a common laboratory examination in neonatal wards, including hematological parameters. Changes may occur during the neonatal period due to gestational age (GA)-related physiological mechanisms. The purpose of this study was to examine CBC in premature neonates at birth and in the first week of life.Methods: This prospective study was performed in the neonatal ward of a general hospital in Bandung, Indonesia. A total of 53 premature neonates, including 31 males and 22 females, classified as G1 (with 28-31 weeks of gestation) and G2 (with 32-34 weeks of gestation), were examined for CBC. The sequential blood samples of both cord blood at birth and peripheral venous blood in the first week of life (i.e., days 2-7) were drawn. The obtained data were analyzed based on the GA at birth and in the first week of life. The CBC at birth and in the first week of life were also compared.Results: At birth, younger premature neonates (i.e., G1 group) showed lower platelet counts, compared to the older ones (i.e., G2 group). In the first week of life, the G1 group showed significantly lower platelet counts and eosinophil counts, compared to the G2 group. Both groups demonstrated a significant decrease in hemoglobin, leukocytes, basophils, and neutrophils, but increased platelet counts in the first week of life.Conclusion: Younger premature neonates indicated lower hematological parameters at birth and in the first week of life. All the premature neonates showed a significant reduction in most hematological parameters in the first week of life.
{"title":"Hematological Parameters after One Week of Life among Premature Neonates","authors":"R. Ghrahani, M. Ghozali, A. Sugianli, T. Yuniati, R. Judistiani, B. Setiabudiawan","doi":"10.22038/IJN.2020.49341.1860","DOIUrl":"https://doi.org/10.22038/IJN.2020.49341.1860","url":null,"abstract":"Background: Hematological parameters can reflect potential morbidity in premature neonates. Complete blood count (CBC) is a common laboratory examination in neonatal wards, including hematological parameters. Changes may occur during the neonatal period due to gestational age (GA)-related physiological mechanisms. The purpose of this study was to examine CBC in premature neonates at birth and in the first week of life.Methods: This prospective study was performed in the neonatal ward of a general hospital in Bandung, Indonesia. A total of 53 premature neonates, including 31 males and 22 females, classified as G1 (with 28-31 weeks of gestation) and G2 (with 32-34 weeks of gestation), were examined for CBC. The sequential blood samples of both cord blood at birth and peripheral venous blood in the first week of life (i.e., days 2-7) were drawn. The obtained data were analyzed based on the GA at birth and in the first week of life. The CBC at birth and in the first week of life were also compared.Results: At birth, younger premature neonates (i.e., G1 group) showed lower platelet counts, compared to the older ones (i.e., G2 group). In the first week of life, the G1 group showed significantly lower platelet counts and eosinophil counts, compared to the G2 group. Both groups demonstrated a significant decrease in hemoglobin, leukocytes, basophils, and neutrophils, but increased platelet counts in the first week of life.Conclusion: Younger premature neonates indicated lower hematological parameters at birth and in the first week of life. All the premature neonates showed a significant reduction in most hematological parameters in the first week of life.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"51 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83201657","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 : 2020-10-01DOI: 10.22038/IJN.2020.46286.1782
A. Boskabady, Z. Dehnavi, G. Khademi, M. Nematy, H. Esmaily, F. Roudi
Background: The optimum nutritional support of critically ill neonates is considered an essential aspect of their medical management since they are susceptible to rapid nutritional depletion, loss of fat-free mass, organ failure, delayed wound healing, and diminished immune function in the post-gastrointestinal surgery state. Providing appropriate nutritional support for these high-risk patients is a very complex and critical process accompanied by many potential errors. To the best of our knowledge, this study has been the first attempt investigating the energy and protein adequacy and probable barriers to the achievement of nutritional goals in such patients.Methods: The present study was carried out at Akbar Children’s Hospital in Mashhad, Khorasan Razavi province, Iran, during 8 months in 2019. All the gastrointestinal surgical patients admitted to the neonatal intensive care unit (NICU) for at least 72 h were eligible for enrollment in the study. The information on age, gender, primary surgical diagnosis, route of nutritional support, adequacy of received energy and protein, probable barriers to the achievement of nutritional goals, and clinical outcomes were collected in this study.Results: Totally, 59 eligible neonates were included in the study 59.3% (n=35) of whom were male. Among different methods of nutritional support, enteral nutrition (47.5%) was the most frequently used feeding route. Energy and protein adequacy was observed in 35.5% and 79.7% of the patients, respectively. The fluid restriction was the major barrier to the provision of optimum nutritional support, affecting 38.9% of the patients. Finally, nutritional adequacy was observed to be significantly associated with decreased infection rate and length of hospital stay.Conclusion: While 64.5% of the studied neonates did not receive adequate energy, almost 80% of them had adequate protein intake during their post-gastrointestinal surgery state. The awareness of the fluid restriction and non-availability of calorie-dense solutions as the most frequent barriers to the achievement of nutritional goals may lead to making reasonable and realistic decisions on the customized protocols of the NICU patients as well as medical management and insurance coverage of required nutritional products.
{"title":"Nutritional Support of Critically ill Neonates in Post-Gastrointestinal Surgery State: Adequacy and Barriers","authors":"A. Boskabady, Z. Dehnavi, G. Khademi, M. Nematy, H. Esmaily, F. Roudi","doi":"10.22038/IJN.2020.46286.1782","DOIUrl":"https://doi.org/10.22038/IJN.2020.46286.1782","url":null,"abstract":"Background: The optimum nutritional support of critically ill neonates is considered an essential aspect of their medical management since they are susceptible to rapid nutritional depletion, loss of fat-free mass, organ failure, delayed wound healing, and diminished immune function in the post-gastrointestinal surgery state. Providing appropriate nutritional support for these high-risk patients is a very complex and critical process accompanied by many potential errors. To the best of our knowledge, this study has been the first attempt investigating the energy and protein adequacy and probable barriers to the achievement of nutritional goals in such patients.Methods: The present study was carried out at Akbar Children’s Hospital in Mashhad, Khorasan Razavi province, Iran, during 8 months in 2019. All the gastrointestinal surgical patients admitted to the neonatal intensive care unit (NICU) for at least 72 h were eligible for enrollment in the study. The information on age, gender, primary surgical diagnosis, route of nutritional support, adequacy of received energy and protein, probable barriers to the achievement of nutritional goals, and clinical outcomes were collected in this study.Results: Totally, 59 eligible neonates were included in the study 59.3% (n=35) of whom were male. Among different methods of nutritional support, enteral nutrition (47.5%) was the most frequently used feeding route. Energy and protein adequacy was observed in 35.5% and 79.7% of the patients, respectively. The fluid restriction was the major barrier to the provision of optimum nutritional support, affecting 38.9% of the patients. Finally, nutritional adequacy was observed to be significantly associated with decreased infection rate and length of hospital stay.Conclusion: While 64.5% of the studied neonates did not receive adequate energy, almost 80% of them had adequate protein intake during their post-gastrointestinal surgery state. The awareness of the fluid restriction and non-availability of calorie-dense solutions as the most frequent barriers to the achievement of nutritional goals may lead to making reasonable and realistic decisions on the customized protocols of the NICU patients as well as medical management and insurance coverage of required nutritional products.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"11 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88712036","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 : 2020-10-01DOI: 10.22038/IJN.2020.47649.1815
Ki Eyong, Joan Ikobah, O. Ikpeme, Uzomba Chigozie
Background: Nigeria continues to have one of the highest rates of neonatal deaths in Africa. Hospital-based studies had implicated prematurity, neonatal sepsis, poor antenatal care, and perinatal asphyxia as major causes of neonatal mortality. This study aimed to highlight the predictors of neonatal deaths and offer solutions to reduce them.Methods: This 5-year retrospective review investigated the neonatal mortality rate at the University of Calabar Teaching Hospital from 2013 to 2018. The demographic characteristics, clinical parameters, duration of hospital stay, and challenges encountered in managing the patients were documented in this study. The obtained data were analysed in SPSS software (version 26).Results: Neonatal mortality rate of 60 per 1000 live births was recorded in this study. The major causes of death were prematurity (n=86, 39.8%), perinatal asphyxia (n=45, 20.8%), neonatal sepsis (n=37, 17.1%), and congenital malformation (n=34, 15.7%). Low socioeconomic class and out-born were additional risk factors in this regard.Conclusion: The neonatal mortality rate is higher than the average national rate and the figure obtained in the same center more than a decade ago. Infrastructural decay during the study period may partly explain the high neonatal mortality rate. Enhancement of the infrastructure and use of kangaroo mother care are recommended to reduce neonatal death, especially among premature babies.
{"title":"Predictors of Neonatal Mortality in a Tertiary Institution of a Developing Country","authors":"Ki Eyong, Joan Ikobah, O. Ikpeme, Uzomba Chigozie","doi":"10.22038/IJN.2020.47649.1815","DOIUrl":"https://doi.org/10.22038/IJN.2020.47649.1815","url":null,"abstract":"Background: Nigeria continues to have one of the highest rates of neonatal deaths in Africa. Hospital-based studies had implicated prematurity, neonatal sepsis, poor antenatal care, and perinatal asphyxia as major causes of neonatal mortality. This study aimed to highlight the predictors of neonatal deaths and offer solutions to reduce them.Methods: This 5-year retrospective review investigated the neonatal mortality rate at the University of Calabar Teaching Hospital from 2013 to 2018. The demographic characteristics, clinical parameters, duration of hospital stay, and challenges encountered in managing the patients were documented in this study. The obtained data were analysed in SPSS software (version 26).Results: Neonatal mortality rate of 60 per 1000 live births was recorded in this study. The major causes of death were prematurity (n=86, 39.8%), perinatal asphyxia (n=45, 20.8%), neonatal sepsis (n=37, 17.1%), and congenital malformation (n=34, 15.7%). Low socioeconomic class and out-born were additional risk factors in this regard.Conclusion: The neonatal mortality rate is higher than the average national rate and the figure obtained in the same center more than a decade ago. Infrastructural decay during the study period may partly explain the high neonatal mortality rate. Enhancement of the infrastructure and use of kangaroo mother care are recommended to reduce neonatal death, especially among premature babies.","PeriodicalId":14584,"journal":{"name":"Iranian Journal of Neonatology IJN","volume":"44 1","pages":"9-13"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79031618","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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