B. Yaşa, Ilker Gonen, E. Dincer, Aslan Babayiğit, Ozge Saglam, M. Çetinkaya
Background: Deferring the umbilical cord clamping produces more satisfactory neurological and hematological outcomes. Another alternative for the deferred umbilical cord clamping is the umbilical cord milking. Objectives: This study aimed to evaluate different placental transfusion techniques in terms of hematological parameters for term neonates. Methods: This observational study included 120 term infants assigned to groups of deferred cord clamping for 60 seconds (DCC), cut cord milking for four times with a speed of 10 cm/second (CCM), intact cord milking for four times (ICM), and a historical control group of immediate cord clamping (ICC). The primary outcome of this study was hematological parameters at birth and 24th hours. Hyperbilirubinemia, polycythemia, or respiratory distress were secondary outcomes. Results: The median gestational ages and birth weights of neonates were 39 (37 - 40) weeks and 3270 (2365 - 4850) grams, respectively. Umbilical cord hemoglobin (Hb) and hematocrit (Hct) levels were significantly higher in the ICM group (P < 0.01). Hemoglobin and Hct levels at 24th hours of life were similar in DCC, CCM, and ICM groups and significantly higher than those in the ICC group (P < 0.01). No significant difference was found among the groups in terms of hyperbilirubinemia, polycythemia, and respiratory distress. Conclusions: To the best of our knowledge, this study was one of the most comprehensive studies evaluating the effects of different placental transfusion strategies on hematological parameters in term infants and the first study exploring intact cord milking in term infants. Intact cord milking was suggested to be associated with higher hemoglobin levels at birth. All DCC, ICM, and CCM techniques were found to be more effective than ICC in terms of early hematological parameters.
{"title":"Different Placental Transfusion Strategies and Their Effects on Short - Term Hematological Parameters in Term Infants","authors":"B. Yaşa, Ilker Gonen, E. Dincer, Aslan Babayiğit, Ozge Saglam, M. Çetinkaya","doi":"10.5812/ijp-133597","DOIUrl":"https://doi.org/10.5812/ijp-133597","url":null,"abstract":"Background: Deferring the umbilical cord clamping produces more satisfactory neurological and hematological outcomes. Another alternative for the deferred umbilical cord clamping is the umbilical cord milking. Objectives: This study aimed to evaluate different placental transfusion techniques in terms of hematological parameters for term neonates. Methods: This observational study included 120 term infants assigned to groups of deferred cord clamping for 60 seconds (DCC), cut cord milking for four times with a speed of 10 cm/second (CCM), intact cord milking for four times (ICM), and a historical control group of immediate cord clamping (ICC). The primary outcome of this study was hematological parameters at birth and 24th hours. Hyperbilirubinemia, polycythemia, or respiratory distress were secondary outcomes. Results: The median gestational ages and birth weights of neonates were 39 (37 - 40) weeks and 3270 (2365 - 4850) grams, respectively. Umbilical cord hemoglobin (Hb) and hematocrit (Hct) levels were significantly higher in the ICM group (P < 0.01). Hemoglobin and Hct levels at 24th hours of life were similar in DCC, CCM, and ICM groups and significantly higher than those in the ICC group (P < 0.01). No significant difference was found among the groups in terms of hyperbilirubinemia, polycythemia, and respiratory distress. Conclusions: To the best of our knowledge, this study was one of the most comprehensive studies evaluating the effects of different placental transfusion strategies on hematological parameters in term infants and the first study exploring intact cord milking in term infants. Intact cord milking was suggested to be associated with higher hemoglobin levels at birth. All DCC, ICM, and CCM techniques were found to be more effective than ICC in terms of early hematological parameters.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"44 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73758551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Ichthyosis is an epidermal disruption that increases insensible water loss. Hypernatremic dehydration is a consequence of skin disruption. This study reviewed the treatment of hypernatremic dehydration in patients with ichthyosis comparing to patients with intact skin. Case Presentation: We studied five neonates with hypernatremia, including three ichthyosis cases and two normal-skin neonates. This case-series study showed that the sodium correction rate is slower in infants with ichthyosis than in infants with normal skin. The first and second neonates needed less sodium than fluid intake than normal skin infants, although fluid requirement was lower in the third ichthyosis infant than in others due to less skin disruption in this infant. Conclusions: Fluid therapy in hypernatremic dehydration in ichthyosis patients is different from neonates with intact skin because of excessive insensible water loss in these patients. It may be needed to give more fluid and less sodium depending on the degree of skin disruption, which may not be determined by physical examination.
{"title":"Management of Hypernatremia Dehydration in Three Neonates with Ichthyosis","authors":"Razieh Sangsari, M. Saeedi, K. Mirnia","doi":"10.5812/ijp-129542","DOIUrl":"https://doi.org/10.5812/ijp-129542","url":null,"abstract":"Introduction: Ichthyosis is an epidermal disruption that increases insensible water loss. Hypernatremic dehydration is a consequence of skin disruption. This study reviewed the treatment of hypernatremic dehydration in patients with ichthyosis comparing to patients with intact skin. Case Presentation: We studied five neonates with hypernatremia, including three ichthyosis cases and two normal-skin neonates. This case-series study showed that the sodium correction rate is slower in infants with ichthyosis than in infants with normal skin. The first and second neonates needed less sodium than fluid intake than normal skin infants, although fluid requirement was lower in the third ichthyosis infant than in others due to less skin disruption in this infant. Conclusions: Fluid therapy in hypernatremic dehydration in ichthyosis patients is different from neonates with intact skin because of excessive insensible water loss in these patients. It may be needed to give more fluid and less sodium depending on the degree of skin disruption, which may not be determined by physical examination.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"63 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81116976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: School timings could influence teens' sleeping patterns by interrupting their sleep or the timing of light can shift their biological clock. The COVID-19 pandemic has altered teens’ sleeping schedule making it important to analyze the effects of long-term social distancing on adolescents’ sleep and mood. Objectives: This study analyzes the effects of long-term social distancing, due to the COVID-19 pandemic, on their sleeping patterns and mood. Methods: In this cohort study, data from the 2018 – 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS) were used to compare teens’ sleep patterns in 2020 with those in 2018 – 2019. The primary outcomes of this study were the sleep duration and sleep time of adolescents throughout the week, between 2018 and 2019, and in 2020. The secondary outcomes were the teens’ mood, health perception, and sleep satisfaction, including differences in total sleep time and sleep discrepancies between weekends and weekdays. Results: Around 58 – 63 thousand students were surveyed each year, and the participation rate was 94.9 – 95.6%. After exclusion, 132,839 teens participated in the survey. From 2018–2020, the height and body weight of the participants did not change. After adjusting for participants’ sex and school year, it was found that more teens felt happy, fewer teens experienced sadness and desperation, and fewer teens had suicidal thoughts in 2020, compared with the previous two years. They also slept 10 minutes later (9.743 (95% confidence interval 7.954 - 11.530)), with wake-up times of 3 – 5 minutes later on weekdays (4.684 (3.449 - 5.919)). On weekends during social distancing, they slept 16 minutes later (15.721 (14.077 - 17.366)), with wake-up times of 12 minutes later (12.309 (10.393 - 14.225)). Although they slept five minutes less on weekdays (-5.059 (-6.817 to -3.301)) and three minutes less on weekends (-3.413 (-5.419 to -1.407)), their overall sleep satisfaction increased, and differences in sleep duration between weekdays and weekends decreased in 2020. Conclusions: During social distancing, the mood and sleep efficiency of teens improved. In the future, once the COVID-19 pandemic subsides, online classes can be included in the curriculum of school systems to ensure healthy sleep patterns in teenagers.
{"title":"The Effects of Long-term Social Distancing on Sleep and Mood in Adolescents During the COVID-19 Pandemic","authors":"S. Rhie","doi":"10.5812/ijp-130598","DOIUrl":"https://doi.org/10.5812/ijp-130598","url":null,"abstract":"Background: School timings could influence teens' sleeping patterns by interrupting their sleep or the timing of light can shift their biological clock. The COVID-19 pandemic has altered teens’ sleeping schedule making it important to analyze the effects of long-term social distancing on adolescents’ sleep and mood. Objectives: This study analyzes the effects of long-term social distancing, due to the COVID-19 pandemic, on their sleeping patterns and mood. Methods: In this cohort study, data from the 2018 – 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS) were used to compare teens’ sleep patterns in 2020 with those in 2018 – 2019. The primary outcomes of this study were the sleep duration and sleep time of adolescents throughout the week, between 2018 and 2019, and in 2020. The secondary outcomes were the teens’ mood, health perception, and sleep satisfaction, including differences in total sleep time and sleep discrepancies between weekends and weekdays. Results: Around 58 – 63 thousand students were surveyed each year, and the participation rate was 94.9 – 95.6%. After exclusion, 132,839 teens participated in the survey. From 2018–2020, the height and body weight of the participants did not change. After adjusting for participants’ sex and school year, it was found that more teens felt happy, fewer teens experienced sadness and desperation, and fewer teens had suicidal thoughts in 2020, compared with the previous two years. They also slept 10 minutes later (9.743 (95% confidence interval 7.954 - 11.530)), with wake-up times of 3 – 5 minutes later on weekdays (4.684 (3.449 - 5.919)). On weekends during social distancing, they slept 16 minutes later (15.721 (14.077 - 17.366)), with wake-up times of 12 minutes later (12.309 (10.393 - 14.225)). Although they slept five minutes less on weekdays (-5.059 (-6.817 to -3.301)) and three minutes less on weekends (-3.413 (-5.419 to -1.407)), their overall sleep satisfaction increased, and differences in sleep duration between weekdays and weekends decreased in 2020. Conclusions: During social distancing, the mood and sleep efficiency of teens improved. In the future, once the COVID-19 pandemic subsides, online classes can be included in the curriculum of school systems to ensure healthy sleep patterns in teenagers.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"13 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74756354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soheil Ahmadzadeh Irandoost, R. S. Badv, M. Oghabian, B. Yarali, Reza Azizi Malamiri, H. Hashemi, S. Raminfard, Tayyebeh Ebrahimi, Mahmoud Mohammadi, M. Ashrafi
Background: Preliminary studies have shown that electrical source imaging (ESI) has numerous advantages for the pre-surgical evaluation of epileptic patients. However, the role of ESI for children with non-lesional drug resistance in focal epilepsy has been poorly characterized. Objectives: This study aimed to investigate this issue according to interictal epileptiform discharges (IEDs) and constraints in developing countries. Methods: The present study used long-term video electroencephalography (EEG) monitoring (LTM) data that were recorded using the standard 19 scalp electrodes (10 - 20 system) and 3 tesla T1 image data. Accordingly, first, IEDs were clustered and then assessed by an epileptologist. Afterward, some operations were conducted that included EEG inverse problem solving with three known methods, namely brain electrical source analysis (BESA) with the individual head model, cortical classical LORETA analysis recursively analysis (CLARA) with the individual head model, and BESA with the age template head model. Seven children were processed in this project. Results: In most cases (n = 5, 71%), the seizure onset zone (SOZ) was the same in the LTM report and the present proposed methodology. Moreover, this study succeeded in localizing the region of the predicted SOZ. Conclusions: According to limitations in a developing country, for the configuration of multi-modal studies (e.g., 3T magnetic resonance imaging, LTM, and ESI) with a specific and valuable protocol, this investigation defined a pilot study with a 7 data sample for the first step. These findings, based on the small sample size, suggest that ESI based on combining ensemble methods improves information for children with focal drug-resistant epilepsy. It is hoped that future studies with large sample sizes show the role of ESI in developing countries more than before.
{"title":"Non-invasive Electrical Source Imaging for Localizing Epileptiform Discharges in Children with Focal Epilepsy Based on Developing Country’s Limitations","authors":"Soheil Ahmadzadeh Irandoost, R. S. Badv, M. Oghabian, B. Yarali, Reza Azizi Malamiri, H. Hashemi, S. Raminfard, Tayyebeh Ebrahimi, Mahmoud Mohammadi, M. Ashrafi","doi":"10.5812/ijp-121981","DOIUrl":"https://doi.org/10.5812/ijp-121981","url":null,"abstract":"Background: Preliminary studies have shown that electrical source imaging (ESI) has numerous advantages for the pre-surgical evaluation of epileptic patients. However, the role of ESI for children with non-lesional drug resistance in focal epilepsy has been poorly characterized. Objectives: This study aimed to investigate this issue according to interictal epileptiform discharges (IEDs) and constraints in developing countries. Methods: The present study used long-term video electroencephalography (EEG) monitoring (LTM) data that were recorded using the standard 19 scalp electrodes (10 - 20 system) and 3 tesla T1 image data. Accordingly, first, IEDs were clustered and then assessed by an epileptologist. Afterward, some operations were conducted that included EEG inverse problem solving with three known methods, namely brain electrical source analysis (BESA) with the individual head model, cortical classical LORETA analysis recursively analysis (CLARA) with the individual head model, and BESA with the age template head model. Seven children were processed in this project. Results: In most cases (n = 5, 71%), the seizure onset zone (SOZ) was the same in the LTM report and the present proposed methodology. Moreover, this study succeeded in localizing the region of the predicted SOZ. Conclusions: According to limitations in a developing country, for the configuration of multi-modal studies (e.g., 3T magnetic resonance imaging, LTM, and ESI) with a specific and valuable protocol, this investigation defined a pilot study with a 7 data sample for the first step. These findings, based on the small sample size, suggest that ESI based on combining ensemble methods improves information for children with focal drug-resistant epilepsy. It is hoped that future studies with large sample sizes show the role of ESI in developing countries more than before.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"11 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80242369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Narges Khazaei, M. Shariat, M. Effatpanah, Mohammad Ali Pourmirzaiee, M. Olfat, S. H. Mirlohi
: The patient was an 11-year-old boy who was referred to our emergency department with a chief complaint of dry cough and shortness of breath. He was diagnosed with asthma when he was three years old and was treated with inhalers as needed. On physical examination, he had respiratory distress and biphasic wheezing. The patient was initially managed as an asthma attack; however, he did not respond to the treatment completely. After a pulmonology consult, he underwent a spirometry test, which was compatible with an obstructive pattern. He was a candidate for fiberoptic bronchoscopy, which revealed findings in favor of vocal cord dysfunction (VCD) and adult-onset laryngomalacia. As part of the management of VCD, we referred him to a psychiatric clinic, evaluating for psychological problems as aggravating factors. We found that he suffered from psychological disorders, including somatic symptoms disorders and mild to moderate depression. The patient was treated for his psychiatric problems. He responded to the treatment well, and the cough and dyspnea attacks resolved gradually after a few months.
{"title":"An 11-Year-Old Boy with Dry Cough and Respiratory Distress (from Children’s Medical Center Grand Rand)","authors":"Narges Khazaei, M. Shariat, M. Effatpanah, Mohammad Ali Pourmirzaiee, M. Olfat, S. H. Mirlohi","doi":"10.5812/ijp-127928","DOIUrl":"https://doi.org/10.5812/ijp-127928","url":null,"abstract":": The patient was an 11-year-old boy who was referred to our emergency department with a chief complaint of dry cough and shortness of breath. He was diagnosed with asthma when he was three years old and was treated with inhalers as needed. On physical examination, he had respiratory distress and biphasic wheezing. The patient was initially managed as an asthma attack; however, he did not respond to the treatment completely. After a pulmonology consult, he underwent a spirometry test, which was compatible with an obstructive pattern. He was a candidate for fiberoptic bronchoscopy, which revealed findings in favor of vocal cord dysfunction (VCD) and adult-onset laryngomalacia. As part of the management of VCD, we referred him to a psychiatric clinic, evaluating for psychological problems as aggravating factors. We found that he suffered from psychological disorders, including somatic symptoms disorders and mild to moderate depression. The patient was treated for his psychiatric problems. He responded to the treatment well, and the cough and dyspnea attacks resolved gradually after a few months.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"2003 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82930427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Razieh Sangsari, Hosein Dalili, M. Kadivar, M. Saeedi, K. Mirnia, Azam Fathi, Javad Hakimelahi
Background: Patent ductus arteriosus (PDA) is a disease presenting on the first days of birth, associated with unpleasant complications such as exaggerated respiratory distress and increased mortality, requiring prompt treatment. Objectives: This study evaluated the relationship between perfusion index and the recovery of patients diagnosed with PDA. Methods: In this cross-sectional study, 22 neonates with PDA (as the case group) and 22 healthy neonates (as the control group) were selected. The difference in perfusion index (PI) before and after arterial duct closing was determined, and also the relationship between pre-ductal and post-ductal PI in the case and control groups was evaluated. Data were analyzed by SPSS version 21. Results: The results showed a significant difference in the mean scores of pre-ductal and post-ductal PI before and after arterial duct closure (P = 0.004). Also, pre-ductal and post-ductal PI scores were significantly lower in the case group than in the control group (P < 0.001) Conclusions: According to our findings, PI in infants with PDA is low at presentation and increases after treatment. Therefore, PI can be used as an indicator to evaluate response to treatment during follow-up, particularly when repeated echocardiography is not accessible.
背景:动脉导管未闭(PDA)是一种出现在出生第一天的疾病，伴有令人不快的并发症，如呼吸窘迫加重和死亡率增加，需要及时治疗。目的:探讨灌注指数与PDA患者恢复的关系。方法:采用横断面研究方法，选取患有PDA的新生儿22例作为病例组，健康新生儿22例作为对照组。测定动脉导管闭合前后灌注指数(PI)的差异，并评价病例组与对照组导管前、导管后PI的关系。数据采用SPSS version 21进行分析。结果:动脉导管闭合前后导管前、导管后PI平均评分差异有统计学意义(P = 0.004)。此外，病例组的导管前和导管后PI评分明显低于对照组(P < 0.001)。结论:根据我们的研究结果，PDA患儿的PI在发病时较低，治疗后升高。因此，PI可以作为随访期间评估治疗反应的指标，特别是在无法获得重复超声心动图的情况下。
{"title":"Evaluation of the Relationship Between Perfusion Index and the Improvement of Patent Ductus Arteriosus","authors":"Razieh Sangsari, Hosein Dalili, M. Kadivar, M. Saeedi, K. Mirnia, Azam Fathi, Javad Hakimelahi","doi":"10.5812/ijp-134709","DOIUrl":"https://doi.org/10.5812/ijp-134709","url":null,"abstract":"Background: Patent ductus arteriosus (PDA) is a disease presenting on the first days of birth, associated with unpleasant complications such as exaggerated respiratory distress and increased mortality, requiring prompt treatment. Objectives: This study evaluated the relationship between perfusion index and the recovery of patients diagnosed with PDA. Methods: In this cross-sectional study, 22 neonates with PDA (as the case group) and 22 healthy neonates (as the control group) were selected. The difference in perfusion index (PI) before and after arterial duct closing was determined, and also the relationship between pre-ductal and post-ductal PI in the case and control groups was evaluated. Data were analyzed by SPSS version 21. Results: The results showed a significant difference in the mean scores of pre-ductal and post-ductal PI before and after arterial duct closure (P = 0.004). Also, pre-ductal and post-ductal PI scores were significantly lower in the case group than in the control group (P < 0.001) Conclusions: According to our findings, PI in infants with PDA is low at presentation and increases after treatment. Therefore, PI can be used as an indicator to evaluate response to treatment during follow-up, particularly when repeated echocardiography is not accessible.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"47 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84349032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ellieh Khoei, Seyed Abolfazl Afjehi, S. Tajalli, Roqayeh Aliyari, M. Fallahi
Background: Neonates of infertile couples are golden babies, and taking care of them is of paramount importance. However, it is not yet clear if the prognosis is different between these neonates and those from fertile couples. Objectives: The present study aimed to assess neonates conceived by assisted reproductive technology (ART). Methods: In this cohort study, 165 newborns conceived by ART and 165 naturally conceived newborns were included. The prospective study was conducted from April 2020 to October 2021. A neonatologist examined all newborns after birth, and outcomes were followed up over one year and compared with neonates of fertile couples using appropriate statistical tests. Results: The preterm neonates (60% vs. 38%) were higher in ART cases (P < 0.001) than in the other cases. Also, the mean gravid and parity were lower, but the nulliparity was higher in the ART group (P < 0.001) than in the other cases. Moreover, multiple pregnancies (45% vs. 10%; P < 0. 001) and the C/S rate (91% vs. 67%) were higher in ART cases (P < 0.001) than in the other cases. Similarly, the preeclampsia rate (16 % vs. 6%; P = 0.004) and the number of females were higher in the ART group (P = 0.035) than in the other groups. However, birth weight (P = 0.002) and the Apgar were significantly lower (P = 0.002; P = 0.012) in the ART group than in the other groups. IUGR was significantly higher (17% vs. 7%) (P = 0.006), while NEC and RDS were more common in the ART group (P < 0.001) than in the other groups. In addition, more extended hospital stay (P < 0.001) and more common re-admission and weight < the 5th percentile after one year were observed in the ART group (P = 0.021) than in the other groups. Conclusions: According to the findings, pregnancy after ART has more side effects before and after birth and in infancy, not only because of multistation but also due to manipulations in ART.
背景:不孕夫妇的新生儿是黄金婴儿，照顾好他们是至关重要的。然而，目前尚不清楚这些新生儿与那些有生育能力的夫妇的预后是否不同。目的:本研究旨在评估通过辅助生殖技术(ART)受孕的新生儿。方法:本队列研究纳入165例ART妊娠新生儿和165例自然妊娠新生儿。该前瞻性研究于2020年4月至2021年10月进行。一名新生儿科医生在所有新生儿出生后对其进行了检查，并对结果进行了一年多的随访，并使用适当的统计检验将其与有生育能力夫妇的新生儿进行了比较。结果:ART组早产率(60% vs 38%)高于其他组(P < 0.001)。ART组平均妊娠和胎次较低，但无胎次高于其他组(P < 0.001)。此外，多胎妊娠(45% vs. 10%;P < 0。ART组的C/S率(91%对67%)高于其他组(P < 0.001)。同样，子痫前期患病率(16% vs. 6%;P = 0.004)， ART组女性人数高于其他组(P = 0.035)。然而，出生体重(P = 0.002)和Apgar显著降低(P = 0.002;P = 0.012)。IUGR显著高于对照组(17% vs. 7%) (P = 0.006)，而NEC和RDS在ART组较其他组更常见(P < 0.001)。此外，ART组的住院时间延长(P < 0.001)、再入院发生率和1年后体重<第5百分位的发生率均高于其他组(P = 0.021)。结论:ART后妊娠在出生前、出生后和婴儿期的不良反应较多，这不仅与ART的多站性有关，也与ART的操作有关。
{"title":"Infantile Prognosis of Neonates Conceived by Assisted Reproductive Technology: A Prospective Study","authors":"Ellieh Khoei, Seyed Abolfazl Afjehi, S. Tajalli, Roqayeh Aliyari, M. Fallahi","doi":"10.5812/ijp-132408","DOIUrl":"https://doi.org/10.5812/ijp-132408","url":null,"abstract":"Background: Neonates of infertile couples are golden babies, and taking care of them is of paramount importance. However, it is not yet clear if the prognosis is different between these neonates and those from fertile couples. Objectives: The present study aimed to assess neonates conceived by assisted reproductive technology (ART). Methods: In this cohort study, 165 newborns conceived by ART and 165 naturally conceived newborns were included. The prospective study was conducted from April 2020 to October 2021. A neonatologist examined all newborns after birth, and outcomes were followed up over one year and compared with neonates of fertile couples using appropriate statistical tests. Results: The preterm neonates (60% vs. 38%) were higher in ART cases (P < 0.001) than in the other cases. Also, the mean gravid and parity were lower, but the nulliparity was higher in the ART group (P < 0.001) than in the other cases. Moreover, multiple pregnancies (45% vs. 10%; P < 0. 001) and the C/S rate (91% vs. 67%) were higher in ART cases (P < 0.001) than in the other cases. Similarly, the preeclampsia rate (16 % vs. 6%; P = 0.004) and the number of females were higher in the ART group (P = 0.035) than in the other groups. However, birth weight (P = 0.002) and the Apgar were significantly lower (P = 0.002; P = 0.012) in the ART group than in the other groups. IUGR was significantly higher (17% vs. 7%) (P = 0.006), while NEC and RDS were more common in the ART group (P < 0.001) than in the other groups. In addition, more extended hospital stay (P < 0.001) and more common re-admission and weight < the 5th percentile after one year were observed in the ART group (P = 0.021) than in the other groups. Conclusions: According to the findings, pregnancy after ART has more side effects before and after birth and in infancy, not only because of multistation but also due to manipulations in ART.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84662733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Olfat, S. H. Mirlohi, Meisam Sharifzadeh, M. Mohammadpour
{"title":"Is a New Post-infectious Inflammatory Phenomenon Emerging? Increasing Evidence of a New Multiple Organ Involvement Syndrome in Children","authors":"M. Olfat, S. H. Mirlohi, Meisam Sharifzadeh, M. Mohammadpour","doi":"10.5812/ijp-135265","DOIUrl":"https://doi.org/10.5812/ijp-135265","url":null,"abstract":"<jats:p />","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"18 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81725127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Zeng, A. Huang, Yun-xia Sun, J. Zhong, M. Zheng, Youqun Zou, Xin Sun, Yumei Liu
Objectives: This study is designed to explore factors associated with death in newborns with persistent pulmonary hypertension (PPHN). Methods: The clinical data of PPHN cases in the past ten years from a neonatal center in China were retrospectively collected and analyzed, and the death-related factors attributable to PPHN were analyzed by binary stepwise logistic regression analysis. Results: A total of 161 neonates with PPHN were included in this study, with a mortality rate of 18.0% (29/161). Multivariate binary logistic regression analysis indicated that cesarean delivery was negatively associated with death in infants with PPHN (adjusted odds ratio [OR] = 0.289, 95% confidence interval [CI] 0.104 – 0.803), while premature rupture of membranes (PROM) (adjusted OR = 4.032, 95% CI 1.32 - 12.32), congenital lung developmental abnormalities/congenital diaphragmatic hernia (CDH) (adjusted OR = 12.65, 95% CI 1.088 – 147.068), respiratory distress syndrome (RDS) (adjusted OR = 4.802, 95% CI 1.512 – 15.251), inhaled nitric oxide (iNO) (adjusted OR = 12.377, 95% CI 3.22 – 47.576) and norepinephrine (adjusted OR = 2.891, 95% CI 1.03 – 8.118) were the independent factors associated with a higher risk of death from PPHN. Conclusions: Caesarean delivery with medical indication is an independent protective factor against death in neonates with PPHN. PROM, congenital lung developmental abnormalities/CDH, RDS, iNO, and norepinephrine were independent death-related factors in neonates with PPHN.
目的:本研究旨在探讨新生儿持续性肺动脉高压(PPHN)死亡的相关因素。方法:回顾性收集国内某新生儿中心近10年PPHN病例的临床资料进行分析，采用二元逐步logistic回归分析PPHN的死亡相关因素。结果:本研究共纳入新生儿PPHN 161例，死亡率为18.0%(29/161)。多因素二元logistic回归分析显示，剖宫产与PPHN患儿死亡呈负相关(校正优势比[OR] = 0.289, 95%可信区间[CI] 0.104 ~ 0.803)，而胎膜早破(校正优势比[OR] = 4.032, 95% CI 1.32 ~ 12.32)、先天性肺发育异常/先天性膈疝(校正优势比= 12.65,95% CI 1.088 ~ 147.068)、呼吸窘迫综合征(校正优势比[OR] = 4.802、95% CI 1.512 - 15.251)、吸入一氧化氮(校正OR = 12.377, 95% CI 3.22 - 47.576)和去甲肾上腺素(校正OR = 2.891, 95% CI 1.03 - 8.118)是与PPHN死亡风险较高相关的独立因素。结论:有医学指征的剖宫产是预防新生儿PPHN死亡的独立保护因素。胎膜早破、先天性肺发育异常/CDH、RDS、iNO和去甲肾上腺素是PPHN新生儿的独立死亡相关因素。
{"title":"Factors Associated with Newborn Fatality Due to Persistent Pulmonary Hypertension","authors":"K. Zeng, A. Huang, Yun-xia Sun, J. Zhong, M. Zheng, Youqun Zou, Xin Sun, Yumei Liu","doi":"10.5812/ijp-132747","DOIUrl":"https://doi.org/10.5812/ijp-132747","url":null,"abstract":"Objectives: This study is designed to explore factors associated with death in newborns with persistent pulmonary hypertension (PPHN). Methods: The clinical data of PPHN cases in the past ten years from a neonatal center in China were retrospectively collected and analyzed, and the death-related factors attributable to PPHN were analyzed by binary stepwise logistic regression analysis. Results: A total of 161 neonates with PPHN were included in this study, with a mortality rate of 18.0% (29/161). Multivariate binary logistic regression analysis indicated that cesarean delivery was negatively associated with death in infants with PPHN (adjusted odds ratio [OR] = 0.289, 95% confidence interval [CI] 0.104 – 0.803), while premature rupture of membranes (PROM) (adjusted OR = 4.032, 95% CI 1.32 - 12.32), congenital lung developmental abnormalities/congenital diaphragmatic hernia (CDH) (adjusted OR = 12.65, 95% CI 1.088 – 147.068), respiratory distress syndrome (RDS) (adjusted OR = 4.802, 95% CI 1.512 – 15.251), inhaled nitric oxide (iNO) (adjusted OR = 12.377, 95% CI 3.22 – 47.576) and norepinephrine (adjusted OR = 2.891, 95% CI 1.03 – 8.118) were the independent factors associated with a higher risk of death from PPHN. Conclusions: Caesarean delivery with medical indication is an independent protective factor against death in neonates with PPHN. PROM, congenital lung developmental abnormalities/CDH, RDS, iNO, and norepinephrine were independent death-related factors in neonates with PPHN.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"105 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78384328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu Qin, Yan-yun Chen, L. Liao, Yang-yang Wu, Min Chen, Fa-quan Lin
Objectives: It is uncommon for autoimmune hepatitis (AIH) to occur in combination with hereditary spherocytosis (HS). The present study examined the genetic and clinical features of a seven-year-old girl with yellow sclerae and abnormalities in liver function test results. Methods: Blood samples were taken from this girl, her parents, and a parental grandmother to be analyzed using laboratory tests and Sanger and next-generation sequencing (NGS). Results: Spectrin alpha, erythrocytic 1 (SPTA1) gene compound heterozygous mutations, were detected from this proband. Moreover, the proband inherited mutations c.6544G>C (p.D2182H) and Thec.134G>A (p.R45K) from her father and mother respectively. Moreover, both her father and grandmother shared an identical mutation. The mutations were not depicted in the Human Gene Mutation Database. Conclusions: HS shares some clinical features close to AIH hence, in the co-existence of AIH, its diagnosis can be challenging. The concurrent disorder may exist if a single autoimmune hepatopathy cannot explain laboratory findings. Pedigree investigations and genetic analyses might be required for the final diagnosis.
{"title":"Hereditary Spherocytosis Caused by a Novel Compound Heterozygous Mutation of SPTA1 and Autoimmune Hepatitis in a Pediatric Patient","authors":"Yu Qin, Yan-yun Chen, L. Liao, Yang-yang Wu, Min Chen, Fa-quan Lin","doi":"10.5812/ijp-123389","DOIUrl":"https://doi.org/10.5812/ijp-123389","url":null,"abstract":"Objectives: It is uncommon for autoimmune hepatitis (AIH) to occur in combination with hereditary spherocytosis (HS). The present study examined the genetic and clinical features of a seven-year-old girl with yellow sclerae and abnormalities in liver function test results. Methods: Blood samples were taken from this girl, her parents, and a parental grandmother to be analyzed using laboratory tests and Sanger and next-generation sequencing (NGS). Results: Spectrin alpha, erythrocytic 1 (SPTA1) gene compound heterozygous mutations, were detected from this proband. Moreover, the proband inherited mutations c.6544G>C (p.D2182H) and Thec.134G>A (p.R45K) from her father and mother respectively. Moreover, both her father and grandmother shared an identical mutation. The mutations were not depicted in the Human Gene Mutation Database. Conclusions: HS shares some clinical features close to AIH hence, in the co-existence of AIH, its diagnosis can be challenging. The concurrent disorder may exist if a single autoimmune hepatopathy cannot explain laboratory findings. Pedigree investigations and genetic analyses might be required for the final diagnosis.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"22 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78277145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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