Pub Date : 2023-09-27DOI: 10.1177/09732179231190257
Daljit Singh, Subhash Chandra Shaw, Ankur Nigam
Organized perinatal and newborn care in armed forces hospitals includes preconception and antenatal care, care during labor and childbirth, immediate newborn care, care of small and sick newborn including screening for hypoglycemia, care of healthy newborns in the first week including newborn screening for thyroid disorders, Glucose 6 phosphate dehydrogenase deficiency, universal hearing screening, and universal pulse oximetry. Neonatal mortality was 24.3% in less than 26 weeks (n = 37), 32.6% in neonates born between 26 weeks to 27+6 weeks (n = 95), 6.2% in neonates born between 28 weeks and 31+6 weeks (n = 242), 0.8% in 32 weeks to 36+6 weeks (n = 1890), and 0.1% in term neonates (n = 21,292). The comprehensive health care model in armed forces can be a model for other institutes and health systems for more effective neonatal health care.
{"title":"State of Newborn Care in Armed Forces Hospitals","authors":"Daljit Singh, Subhash Chandra Shaw, Ankur Nigam","doi":"10.1177/09732179231190257","DOIUrl":"https://doi.org/10.1177/09732179231190257","url":null,"abstract":"Organized perinatal and newborn care in armed forces hospitals includes preconception and antenatal care, care during labor and childbirth, immediate newborn care, care of small and sick newborn including screening for hypoglycemia, care of healthy newborns in the first week including newborn screening for thyroid disorders, Glucose 6 phosphate dehydrogenase deficiency, universal hearing screening, and universal pulse oximetry. Neonatal mortality was 24.3% in less than 26 weeks (n = 37), 32.6% in neonates born between 26 weeks to 27+6 weeks (n = 95), 6.2% in neonates born between 28 weeks and 31+6 weeks (n = 242), 0.8% in 32 weeks to 36+6 weeks (n = 1890), and 0.1% in term neonates (n = 21,292). The comprehensive health care model in armed forces can be a model for other institutes and health systems for more effective neonatal health care.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"2022 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135536048","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 : 2023-09-06DOI: 10.1177/09732179231193874
Sushree Smita Behura, Vetsa Snigdha Hasa, C. Jena, Santosh Kumar Panda
To compare an infrared thermometer (IRT) at the forehead with a Digital thermometer (DT) at the axillary site in neonates in the delivery room. Temperature was assessed simultaneously in 65 neonates born at ≥34 weeks in the delivery room with IRT at the forehead site and DT at the axillary site at 1 and 5 min of age. Immediately after delayed cord clamping, skin-to-skin contact (SSC) was given for vaginal-born neonates, and a radiant warmer was used for cesarean-born neonates. In a total of 130 paired measurements, the intraclass correlation coefficient (ICC) between the IRT and the DT was good, ICC = 0.859, P < 0.001; the bias (SD) was –0.16(0.42)°C in Bland-Altman analysis. The correlation between IRT and DT during SSC was ICC = 0.881, P < .001, and the bias (SD) was –0.14(0.33)°C; and for neonates cared under radiant warmer, the ICC was 0.846, P < .001 with bias (SD) of –0.17(0.47)°C. Temperature assessed by IRT at the forehead site shows good reliability with DT at the axillary site in neonates for thermal management in the delivery room.
{"title":"Comparison of Infrared Thermometer with Digital Thermometer in Neonates During Delivery Room Care","authors":"Sushree Smita Behura, Vetsa Snigdha Hasa, C. Jena, Santosh Kumar Panda","doi":"10.1177/09732179231193874","DOIUrl":"https://doi.org/10.1177/09732179231193874","url":null,"abstract":"To compare an infrared thermometer (IRT) at the forehead with a Digital thermometer (DT) at the axillary site in neonates in the delivery room. Temperature was assessed simultaneously in 65 neonates born at ≥34 weeks in the delivery room with IRT at the forehead site and DT at the axillary site at 1 and 5 min of age. Immediately after delayed cord clamping, skin-to-skin contact (SSC) was given for vaginal-born neonates, and a radiant warmer was used for cesarean-born neonates. In a total of 130 paired measurements, the intraclass correlation coefficient (ICC) between the IRT and the DT was good, ICC = 0.859, P < 0.001; the bias (SD) was –0.16(0.42)°C in Bland-Altman analysis. The correlation between IRT and DT during SSC was ICC = 0.881, P < .001, and the bias (SD) was –0.14(0.33)°C; and for neonates cared under radiant warmer, the ICC was 0.846, P < .001 with bias (SD) of –0.17(0.47)°C. Temperature assessed by IRT at the forehead site shows good reliability with DT at the axillary site in neonates for thermal management in the delivery room.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45269573","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 : 2023-09-06DOI: 10.1177/09732179231180979
G. Bhoojata, S. Laxman, PV Rama Rao
Congenital hepatic arteriovenous malformations (AVM) are extremely rare, with an incidence of less than 1 in 1 hundred thousand, and the literature is limited to only a few case reports. They are characterised by an abnormal arterial connection to a fistulous venous connection within the liver. This results in high flow, low resistance circulation that causes high output cardiac failure. We report a late-preterm male newborn who presented with respiratory distress and signs of cardiac failure on day 1 of life. The newborn is diagnosed with hepatic AVM as the cause of severe pulmonary arterial hypertension (PAH) and cardiac failure. This case report, along with the literature review, emphasises the need for a high index of suspicion to look for hepatic AVM in a newborn presenting with unexplained PAH and cardiac failure and also discusses different management strategies for hepatic AVM.
{"title":"Congenital Hepatic Arteriovenous Malformation: Often Missed Cause for Neonatal Pulmonary Arterial Hypertension","authors":"G. Bhoojata, S. Laxman, PV Rama Rao","doi":"10.1177/09732179231180979","DOIUrl":"https://doi.org/10.1177/09732179231180979","url":null,"abstract":"Congenital hepatic arteriovenous malformations (AVM) are extremely rare, with an incidence of less than 1 in 1 hundred thousand, and the literature is limited to only a few case reports. They are characterised by an abnormal arterial connection to a fistulous venous connection within the liver. This results in high flow, low resistance circulation that causes high output cardiac failure. We report a late-preterm male newborn who presented with respiratory distress and signs of cardiac failure on day 1 of life. The newborn is diagnosed with hepatic AVM as the cause of severe pulmonary arterial hypertension (PAH) and cardiac failure. This case report, along with the literature review, emphasises the need for a high index of suspicion to look for hepatic AVM in a newborn presenting with unexplained PAH and cardiac failure and also discusses different management strategies for hepatic AVM.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43038521","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 : 2023-09-04DOI: 10.1177/09732179231193897
Anusha Kosigi, Gokul Krishnan R.
Neonatal jaundice affects 85% term and most of the preterm infants. Unconjugated bilirubin is bound by albumin, which promotes its transit and lessens bilirubin toxicity, thereby serves as early determinant for the risk of pathological hyperbilirubinemia among neonates. Present study was undertaken to know the utility of cord blood bilirubin (CBB), cord blood albumin (CBA), and their ratio at time of birth for the development of significant neonatal hyperbilirubinemia. To evaluate CBB/CBA ratio at the time of delivery as potential predictive factor for the development of significant neonatal hyperbilirubinemia and compare this with CBB and CBA alone. Prospective observational analytical study. Total 178 inborn term neonates delivered during 3-month time period (22nd October, 2022−22nd January, 2023). Cord blood sample was collected at birth for CBA, CBB, and blood grouping/phenotyping. Transcutaneous bilirubin (TCB) measurements were done 12 hourly in all babies for the first 7 days of life/till discharge, and also in the case of development of significant clinical jaundice. For TCB values above cut-off, serum total bilirubin was done and need for phototherapy (PT) decided based on cut offs suggested in AAP 2004 nomograms. Cut-off values of CBB and CBA as obtained by the receiver operating characteristic (ROC) curves were 1.98 mg/dL and 3.14 g/dL, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CBB were 83.33%, 63.15%, 41.66%, and 92.30%, while for CBA, 41.66%, 71.05%, 31.25%, and 79.41%. CBB/CBA cutoff ratio was 0.630 with 91.66% sensitivity, 86.84% specificity, 68.75% PPV, and 97.05% NPV. Compared to CBB and CBA alone, CBB/CBA ratio has greater sensitivity, specificity, PPV, and NPV and it may serve as a better indicator for prediction of pathological hyperbilirubinemia in neonates.
{"title":"Prediction of Neonatal Hyperbilirubinemia from Cord Blood Bilirubin and Cord Blood Albumin Ratio in Healthy Term Indian Neonates","authors":"Anusha Kosigi, Gokul Krishnan R.","doi":"10.1177/09732179231193897","DOIUrl":"https://doi.org/10.1177/09732179231193897","url":null,"abstract":"Neonatal jaundice affects 85% term and most of the preterm infants. Unconjugated bilirubin is bound by albumin, which promotes its transit and lessens bilirubin toxicity, thereby serves as early determinant for the risk of pathological hyperbilirubinemia among neonates. Present study was undertaken to know the utility of cord blood bilirubin (CBB), cord blood albumin (CBA), and their ratio at time of birth for the development of significant neonatal hyperbilirubinemia. To evaluate CBB/CBA ratio at the time of delivery as potential predictive factor for the development of significant neonatal hyperbilirubinemia and compare this with CBB and CBA alone. Prospective observational analytical study. Total 178 inborn term neonates delivered during 3-month time period (22nd October, 2022−22nd January, 2023). Cord blood sample was collected at birth for CBA, CBB, and blood grouping/phenotyping. Transcutaneous bilirubin (TCB) measurements were done 12 hourly in all babies for the first 7 days of life/till discharge, and also in the case of development of significant clinical jaundice. For TCB values above cut-off, serum total bilirubin was done and need for phototherapy (PT) decided based on cut offs suggested in AAP 2004 nomograms. Cut-off values of CBB and CBA as obtained by the receiver operating characteristic (ROC) curves were 1.98 mg/dL and 3.14 g/dL, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CBB were 83.33%, 63.15%, 41.66%, and 92.30%, while for CBA, 41.66%, 71.05%, 31.25%, and 79.41%. CBB/CBA cutoff ratio was 0.630 with 91.66% sensitivity, 86.84% specificity, 68.75% PPV, and 97.05% NPV. Compared to CBB and CBA alone, CBB/CBA ratio has greater sensitivity, specificity, PPV, and NPV and it may serve as a better indicator for prediction of pathological hyperbilirubinemia in neonates.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41400377","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 : 2023-09-01DOI: 10.1177/09732179231173775
S. Bansal, Monica Kaushal, S. Nimbalkar, Swarnarekha Bhat
The periviable period is defined as delivery between 20 0/7 weeks and 25 6/7 weeks of gestation. It has long been considered a “gray area,” as there are still no clear guidelines on initial resuscitation and subsequent treatment of the newborn. This lack of guidance compounds the uncertainty in decision-making in low- and middle-income countries with limited resources. The decision to treat or not has far-reaching economic, social, cultural, and sometimes even religious implications for the parents and family. This review explores the perspectives of parents, caregivers, and policymakers in detail to utilize the existing evidence better. We present arguments for and against resuscitation in the periviable period, discussing concerns surrounding neurodevelopmental outcomes, cost, parental concerns, nonuniformity of evidence, and ethical considerations. A large survival gap exists between developed and developing countries, and the infrastructure and clinical care network in low- and middle-income country are not strong enough to provide adequate support for these infants and their families. Antenatal factors, socioeconomic and cultural issues, center capacity, and resuscitation capacity of birthing centers should be considered when making decisions. The neonatologists are expected to be impartial, provide information, and not advise based on their beliefs and outlook; while preserving the autonomy of parents. The only way forward is for parents and caregivers to work together to develop a logical and ethical approach that can be accepted as national and institutional policies.
{"title":"Resuscitation in the “Periviable” Period—Commentary of Opposing Views","authors":"S. Bansal, Monica Kaushal, S. Nimbalkar, Swarnarekha Bhat","doi":"10.1177/09732179231173775","DOIUrl":"https://doi.org/10.1177/09732179231173775","url":null,"abstract":"The periviable period is defined as delivery between 20 0/7 weeks and 25 6/7 weeks of gestation. It has long been considered a “gray area,” as there are still no clear guidelines on initial resuscitation and subsequent treatment of the newborn. This lack of guidance compounds the uncertainty in decision-making in low- and middle-income countries with limited resources. The decision to treat or not has far-reaching economic, social, cultural, and sometimes even religious implications for the parents and family. This review explores the perspectives of parents, caregivers, and policymakers in detail to utilize the existing evidence better. We present arguments for and against resuscitation in the periviable period, discussing concerns surrounding neurodevelopmental outcomes, cost, parental concerns, nonuniformity of evidence, and ethical considerations. A large survival gap exists between developed and developing countries, and the infrastructure and clinical care network in low- and middle-income country are not strong enough to provide adequate support for these infants and their families. Antenatal factors, socioeconomic and cultural issues, center capacity, and resuscitation capacity of birthing centers should be considered when making decisions. The neonatologists are expected to be impartial, provide information, and not advise based on their beliefs and outlook; while preserving the autonomy of parents. The only way forward is for parents and caregivers to work together to develop a logical and ethical approach that can be accepted as national and institutional policies.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"37 1","pages":"264 - 269"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43210523","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 : 2023-09-01DOI: 10.1177/09732179231193872
Avantika Dhanawat, Prashant Bachina, Santosh Kumar Panda
Biliary atresia (BA), a surgical cause of neonatal cholestasis, needs timely intervention. A term male neonate presented with yellowish discoloration and pale stool on the third week of life, suspected as BA based on the liver function test and hepatobiliary iminodiacetic acid (HIDA) scan. His intraoperative cholangiogram was normal and finally diagnosed as a case of Dubin-Johnson syndrome (DJS) by whole exome sequencing. The baby became anicteric with the cholestasis regimen. DJS is one of the differential diagnoses of BA; genetic evaluation may be considered prior to an invasive cholangiogram in such cases.
{"title":"Dubin Johnson Syndrome Masquerading as Biliary Atresia in a Neonate","authors":"Avantika Dhanawat, Prashant Bachina, Santosh Kumar Panda","doi":"10.1177/09732179231193872","DOIUrl":"https://doi.org/10.1177/09732179231193872","url":null,"abstract":"Biliary atresia (BA), a surgical cause of neonatal cholestasis, needs timely intervention. A term male neonate presented with yellowish discoloration and pale stool on the third week of life, suspected as BA based on the liver function test and hepatobiliary iminodiacetic acid (HIDA) scan. His intraoperative cholangiogram was normal and finally diagnosed as a case of Dubin-Johnson syndrome (DJS) by whole exome sequencing. The baby became anicteric with the cholestasis regimen. DJS is one of the differential diagnoses of BA; genetic evaluation may be considered prior to an invasive cholangiogram in such cases.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42104081","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 : 2023-08-30DOI: 10.1177/09732179231185037
B. Prasad, Priyanka Gupta, L. Parashar, D. Garg, Deepak Tanwar, Surendra Kumar Kushwaha
Developmental dysplasia of hip (DDH) is a developmental disorder leading to life-long disability in child unless diagnosed early and treated well in time. This condition is also included under the screening and early intervention services provided by “Rashtriya Bal Swasthya Karyakram” of National Health Mission in India. The present study was done to assess knowledge, perceptions, and self-confidence of pediatricians/neonatologists, obstetricians, primary care physicians (PCPs), and the orthopedic surgeons regarding the newborn screening for DDH. This cross-sectional study used a prestructured validated online questionnaire in English language. Total 158 physicians, practicing in various private and government, teaching, and nonteaching institutions from Delhi-NCR region (54 pediatrician/neonatologists, 60 PCPs, 30 orthopedic surgeons, and 14 obstetricians), responded to the survey. Questions related to biodemographic details, specialty, professional experience, knowledge about the risk factors of DDH, appropriate timing(s) for screening DDH and the modalities used, and natural course of untreated severe and mild DDH were asked. Participants were required to self-assign a grade (score 0-10) for both knowledge and clinical examination skills with reference to screening of DDH. Data was analyzed using SPSS (version 23.0) software. P value <0.05 was considered significant. Only 18% pediatricians, 27% PCPs, 20% orthopedic surgeons, and none of the obstetrician could identify all risk factors for DDH ( P = 0.159). Only 24% physicians knew that the natural evolution of untreated severe DDH is bad with need for multiple surgeries throughout life and only 17% knew that the most common natural evolution of untreated mild hip dysplasia at birth is good with minimal functional sequelae without the need for surgery. Only 56% pediatricians mentioned correctly that the first screening for DDH needs to be done at birth before discharge from the hospital. Orthopedic surgeons, obstetricians, and PCPs were comparable to pediatricians in this knowledge ( P ≥ 0.05). Only 52% pediatricians were aware of both Barlow and Ortolani clinical maneuvers and 18% did not know about any of these tests. Among orthopedic surgeons, 60% knew about both these tests and among obstetricians, only 14% knew about both these tests. Self-assigned score for both knowledge and clinical examination skills were unsatisfactory in all groups, the range of median score being 5 to 7 and 2 to 6, respectively. Clinical examination skills scores were significantly lower among obstetricians than the other groups ( P = 0.001; Kruskal-Wallis test). Clinical examination skills scores were significantly lower than the knowledge scores among PCPs, orthopedic surgeons, and obstetricians ( P = 0.001, 0.026, and 0.005, respectively; Wilcoxon Signed-Rank test). Knowledge was unsatisfactory among all physicians, regardless of their specialty. Self-assigned scores for clinical examination skills, which is a su
{"title":"Newborn Screening for Developmental Dysplasia of Hip—A Survey for Knowledge and Skills Among Physicians in Delhi-NCR Region, India","authors":"B. Prasad, Priyanka Gupta, L. Parashar, D. Garg, Deepak Tanwar, Surendra Kumar Kushwaha","doi":"10.1177/09732179231185037","DOIUrl":"https://doi.org/10.1177/09732179231185037","url":null,"abstract":"Developmental dysplasia of hip (DDH) is a developmental disorder leading to life-long disability in child unless diagnosed early and treated well in time. This condition is also included under the screening and early intervention services provided by “Rashtriya Bal Swasthya Karyakram” of National Health Mission in India. The present study was done to assess knowledge, perceptions, and self-confidence of pediatricians/neonatologists, obstetricians, primary care physicians (PCPs), and the orthopedic surgeons regarding the newborn screening for DDH. This cross-sectional study used a prestructured validated online questionnaire in English language. Total 158 physicians, practicing in various private and government, teaching, and nonteaching institutions from Delhi-NCR region (54 pediatrician/neonatologists, 60 PCPs, 30 orthopedic surgeons, and 14 obstetricians), responded to the survey. Questions related to biodemographic details, specialty, professional experience, knowledge about the risk factors of DDH, appropriate timing(s) for screening DDH and the modalities used, and natural course of untreated severe and mild DDH were asked. Participants were required to self-assign a grade (score 0-10) for both knowledge and clinical examination skills with reference to screening of DDH. Data was analyzed using SPSS (version 23.0) software. P value <0.05 was considered significant. Only 18% pediatricians, 27% PCPs, 20% orthopedic surgeons, and none of the obstetrician could identify all risk factors for DDH ( P = 0.159). Only 24% physicians knew that the natural evolution of untreated severe DDH is bad with need for multiple surgeries throughout life and only 17% knew that the most common natural evolution of untreated mild hip dysplasia at birth is good with minimal functional sequelae without the need for surgery. Only 56% pediatricians mentioned correctly that the first screening for DDH needs to be done at birth before discharge from the hospital. Orthopedic surgeons, obstetricians, and PCPs were comparable to pediatricians in this knowledge ( P ≥ 0.05). Only 52% pediatricians were aware of both Barlow and Ortolani clinical maneuvers and 18% did not know about any of these tests. Among orthopedic surgeons, 60% knew about both these tests and among obstetricians, only 14% knew about both these tests. Self-assigned score for both knowledge and clinical examination skills were unsatisfactory in all groups, the range of median score being 5 to 7 and 2 to 6, respectively. Clinical examination skills scores were significantly lower among obstetricians than the other groups ( P = 0.001; Kruskal-Wallis test). Clinical examination skills scores were significantly lower than the knowledge scores among PCPs, orthopedic surgeons, and obstetricians ( P = 0.001, 0.026, and 0.005, respectively; Wilcoxon Signed-Rank test). Knowledge was unsatisfactory among all physicians, regardless of their specialty. Self-assigned scores for clinical examination skills, which is a su","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43390529","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 : 2023-08-30DOI: 10.1177/09732179231190262
KC Sreejith Kumar, Shafiq Ahamed M, Karthik Balasundaran
Neonatal sepsis continues to be an important cause of mortality and morbidity in low- and middle-income countries. The identification and early treatment of infants at risk of early-onset neonatal sepsis (EONS) with empiric antibiotics is a preventive strategy. To study the use of empiric antibiotics in infants at risk for EONS and assess their outcome in terms of the development of sepsis, mortality, and duration of hospital stay. This retrospective cohort study was done at the Special Newborn Care Unit, GMC Thrissur. The data of babies at risk of EONS over a period of 3 years (2020–2022) was collected. One thousand two hundred and thirty-two babies with at least one risk factor for sepsis, as defined by the National Neonatology Forum (NNF) 2021 guidelines, were enrolled in the study. The antibiotic prescription pattern and the outcomes were measured. Empirical antibiotic treatment was received by 61.2% (754/1232) of infants, and of those, 39.5% (298/754) developed EONS. Infants treated with Piperacillin/Tazobactam and Amikacin had a higher incidence of sepsis and mortality than those started on Ampicillin and Gentamicin ( p < .001). In infants less than 32 weeks, the incidence of sepsis increased significantly with increase in number of risk factors ( p < .001). Infants with lower birth weight and gestational age were more susceptible to developing sepsis ( p < .001). EONS was significantly associated with neonatal resuscitation, umbilical vein catheterization, and invasive ventilation ( p < .001). Infants who received empirical antibiotics had a longer hospital stay, with a mean duration of 4.38 days more compared to the no antibiotics group. In infants at risk of EONS, the empirical use of antibiotics alone did not show a favorable effect on the incidence of EONS or sepsis-related mortality.
{"title":"Empiric Antibiotic Use and the Outcome in Infants at Risk of Early Onset Neonatal Sepsis in a Teaching Hospital in South India: A Retrospective Cohort Study","authors":"KC Sreejith Kumar, Shafiq Ahamed M, Karthik Balasundaran","doi":"10.1177/09732179231190262","DOIUrl":"https://doi.org/10.1177/09732179231190262","url":null,"abstract":"Neonatal sepsis continues to be an important cause of mortality and morbidity in low- and middle-income countries. The identification and early treatment of infants at risk of early-onset neonatal sepsis (EONS) with empiric antibiotics is a preventive strategy. To study the use of empiric antibiotics in infants at risk for EONS and assess their outcome in terms of the development of sepsis, mortality, and duration of hospital stay. This retrospective cohort study was done at the Special Newborn Care Unit, GMC Thrissur. The data of babies at risk of EONS over a period of 3 years (2020–2022) was collected. One thousand two hundred and thirty-two babies with at least one risk factor for sepsis, as defined by the National Neonatology Forum (NNF) 2021 guidelines, were enrolled in the study. The antibiotic prescription pattern and the outcomes were measured. Empirical antibiotic treatment was received by 61.2% (754/1232) of infants, and of those, 39.5% (298/754) developed EONS. Infants treated with Piperacillin/Tazobactam and Amikacin had a higher incidence of sepsis and mortality than those started on Ampicillin and Gentamicin ( p < .001). In infants less than 32 weeks, the incidence of sepsis increased significantly with increase in number of risk factors ( p < .001). Infants with lower birth weight and gestational age were more susceptible to developing sepsis ( p < .001). EONS was significantly associated with neonatal resuscitation, umbilical vein catheterization, and invasive ventilation ( p < .001). Infants who received empirical antibiotics had a longer hospital stay, with a mean duration of 4.38 days more compared to the no antibiotics group. In infants at risk of EONS, the empirical use of antibiotics alone did not show a favorable effect on the incidence of EONS or sepsis-related mortality.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42721342","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：