Introduction: Inadequate intake of calorie or inadequate breastfeeding can cause neonatal hyperbilirubinemia. The present study was conducted to examine the correlation between frequency and duration ...of breastfeeding and the severity of neonatal hyperbilirubinemia among newborns admitted to Ghaem Hospital of Mashhad (Iran) due to neonatal hyperbilirubinemia.
Methodology: The present cross-sectional study was conducted on 634 newborns with idiopathic hyperbilirubinemia referred to either Emergency Department or Neonatal Clinic in Ghaem Hospital. The required data were collected through a researcher-made questionnaire covering information related to mothers and babies. The examined neonates were examined based on the frequency and duration of breastfeeding and the severity of hyperbilirubinemia. The collected data were analyzed using statistical tests of Shapiro-Wilk and Chi-squared (SPSS-19.5).
Results: According to the results, at bilirubin levels of 1-12 mg/dl, 12.1-16 mg/dl, 16.1-20 mg/dl and >20 mg/dl, the average frequencies of breastfeeding were respectively 10.66, 9.83, 9.19 and 7.50 times a day. The average serum bilirubin level in newborns with ≤7 times breastfeeding per day (19 mg/dl) was higher than newborns with >7 times breastfeeding per day (16 ml/dl). Additionally, by an increase in the frequency of breastfeeding, the percentage of weight loss decreased in the examined newborns. The results also showed that in newborns with bilirubin levels <20 mg/dl, the severity of hyperbilirubinemia reduced by increased defecation frequency and decreased percentage of weight loss.
Conclusion: The results of this study showed that increased frequency of breastfeeding, accelerated weight gain and increased defecation frequency reduce the severity of neonatal hyperbilirubinemia. Accordingly, breastfeeding education for mothers with an emphasis on increasing the frequency of breastfeeding is a helpful technique to reduce the severity of hyperbilirubinemia in newborns.
Neonatal sepsis is a dangerous and common disease among infants which is associated with high morbidity and mortality. Interleukins may be helpful for diagnosis of neonatal sepsis. Therefore, this ...study is conducted to investigate the role of interleukins in the diagnosis of neonatal sepsis. In this study, databases including PubMed, Cochrane Library, ISI and Google Scholar were searched up to 2016. Keywords were: Sepsis, neonatal, interleukins, prediction and diagnosis. Study inclusion criteria were: Articles about the relationship between the diagnosis of neonatal sepsis and interleukins; studies on babies; English and Persian articles and enough information from test results. Articles that had focused on adult sepsis or had used other markers except ILs or just their abstracts were available were excluded from the study. Of 100 searched studies, eventually, 16 articles were considered including 12 prospective studies, 3 cross-sectional studies and 1 retrospective study. IL6 has been studied more than other interleukins (50% of articles). ILs 6, 8 and 10 are among the initial markers of neonatal sepsis diagnosis. IL6 above 68 pg/ml had 85% sensitivity and 80% specificity, IL8 above 269.51 pg/ml had 80% sensitivity and 50% specificity, IL10 above 27 pg/ml had 60% sensitivity and 87% specificity and combined interleukins above 186.83 pg/ml had 75.63% sensitivity and 71.49% specificity in sepsis diagnosis. Interleukins can be helpful in the diagnosis of neonatal sepsis based on the results of this study. IL6 had the most sensitivity and IL10 had the most specificity for diagnosis of sepsis.
There are insufficient and contradictory reports regarding the effect of delivery method on the rate of umbilical cord Nucleated Red Blood Cell (NRBC). Therefore, the present study aimed to compare ...the percentages of umbilical cord NRBC in vaginal delivery and emergency cesarean section (C-section) in preterm neonates.
The present cross-sectional study was performed on mothers with vaginal delivery and C-section, from 2020 to 2021. The samples (n = 221) were preterm neonates selected using the convenience sampling method. The percentages of NRBC in neonates born by natural childbirth and by emergency C-section were measured and compared in this research. A researcher-made checklist, which included maternal and neonatal characteristics and laboratory evaluation, was used as a data collection tool.
The statistical population of thisresearch included 93 (42.10%) and 128 (57.90%) neonates born by vaginal delivery and by C-section, respectively.The mean (SD) score of gestational ages at birth was 30.75 (2.81) weeks. The mean (SD) score of umbilical cord NRBC level were estimated at 8.01 (5.93) and 25.64 (22.61) for the neonates born by natural childbirth and by emergency C-section, respectively (t=-8.43, df = 150,
<0.001). Statistically significant differences were observed in the gestational age (t=-3.36, df = 218,
= 0.001), fifth-minute Apgar score (t=-2.32, df = 200, p = 0.021), umbilical cord NRBC (t=-8.43, df = 160, p<0.001), and short-term prognosis (
= 0.032) between the two groups. It was also revealed that the number of NRBCs in the dead neonates was about 1.5 times higher than that in the discharged neonates.
Based on the results of the present study, emergency C-section increased the mean of umbilical cord NRBC by three times, compared to that of normal delivery. Since an increase in the NRBC raises the risk of infant death, it is advisable to take steps to maintain the health of children by identifying high-risk neonates through umbilical cord NRBC measurement immediately after delivery and special care.
Context: Premature rupture of membrane is a serious complication in pregnancy and responsible for one third of preterm labors associated with the neonatal and delivery outcomes. Objective: The ...current study aimed at investigating the risk factors of premature rupture of membrane on delivery and neonatal implications. Data Sources: The articles on the databases, including PubMed, Cochrane Library, ISI and Google Scholar up to 2017 were searched to conduct the current study. The keywords used were “premature rupture of membrane”, “neonatal,” “risk factors”, “maternal”, and “delivery”. Study Selection: The inclusion criteria were articles on the relationship between maternal risk factors and Premature Rupture of Membrane (PROM), neonatal outcomes of PROM, the delivery outcomes of PROM, the study of mothers and infants, English and Persian language articles, and sufficient information on the PROM. The articles investigating amniotomy or the ones that only their abstracts were available were excluded from the study. Data Extraction: The data extracted from the above mentioned databases were fed with the following titles in the Excel software: Authors’ names and surnames, year of study, type of study, place of study, case group, control group, maternal risk factors, delivery outcomes, neonatal outcomes of PROM, and the results of the study. Results: Out of 90 articles, 15 articles were finalized including one prospective study, five cross-sectional papers, six retrospective articles, and three historical cohort studies. Maternal risk factors included age; parity; education; occupation; diabetes; blood pressure; cervical length along with abortion history; history of infection, upper urinary tract infection, and sexually transmitted diseases. Moreover, delivery complications were cesarean section, oligohydramnios, chorioamnionitis, and placental abruption. Neonatal complications included prematurity, respiratory distress syndrome, asphyxia, infection, meningitis, sepsis, pneumonia, perinatal mortality, patent arterial duct, necrotizing enterocolitis, IVH, pulmonary hypoplasia, hyperbilirubinemia, and antibiotic intake. Conclusions: Based on the results of the current study, the most important risk factors for PROM were diabetes and maternal hypertension associated with neonatal and maternal complications. Infection was the most important maternal and neonatal complication.
Introduction. Despite the substantial progress in intensive cares, sepsis is still an important cause of neonatal mortality. Given the role of vitamin D in infection control, this study was conducted ...to compare vitamin D level in infected and uninfected preterm infants. Materials and methods. This cross-sectional study was carried out on 87 preterm infants (45 infected infants and 42 uninfected infants) hospitalized in Mashhad Ghaem Hospital, Iran, during 20152017. The subjects were selected by using convenience sampling. The infected infants (n = 45) included babies with clinical and laboratory findings compatible with infection and/or positive blood or cerebrospinal fluid cultures. The serum levels vitamin D were measured in all infants. A researcher-made questionnaire containing demographic, clinical and laboratory features of infants was used. In addition, independent t-test and chi-square test were applied. SPSS was used to perform the statistical data analysis. Results. 83% of infants had vitamin D deficiency 34.5%, 26.4%, and 21.8% of whom exhibited severe (less than 10 ng/ml), moderate (10.120 ng/ml), mild deficiency (20.130 ng/ml), respectively. The mean vitamin D level of infants was 23.319.40 ng/ml in the control group and 11.028.64 ng/ml in the case group (p = 0.000). In the case group, the mean vitamin D was 8.145.53 ng/ml in early sepsis and 12.629.75 ng/ml in late-onset sepsis (p = 0.121). 95% of infected infants and 71% of uninfected infants had vitamin D less than 30 ng/ml (p = 0.003). Conclusion. Vitamin D deficiency is very common in preterm infants. Serum vitamin D levels in infants with sepsis were lower than those in uninfected infants. Therefore, the correction of vitamin D deficiency may contribute to better control of neonatal infection.
Introduction: Neonatal hypernatremic dehydration (NHD) is a major preventable problem associated with acute and chronic complications in neonates. Thus, the present study investigated the prevalence, ...risk factors, clinical signs, complications, and prognosis of NHD. Materials and methods: In this study, we searched databases (PubMed, EMBASE and Google Scholar) for articles published until 2022. Keywords were: “hypernatremic dehydration”, “neonatal”, “risk factors”, “prognosis”, “complications”, “prevalence”, and “clinical signs”. Persian- or English-language articles with sufficient data on NHD were included in the study. Finally, 24 relevant articles were examined. Results: Significant weight loss, delayed first breastfeeding, breastfeeding frequency, early discharge, use of sugar water and manna, low frequency of urination and defecation, summer season, use of heaters, and late referral age are NHD risk factors. Jaundice, hyperthermia, lethargy, poor feeding, restlessness, decreased skin turgor, and seizure are the clinical signs of NHD. Laboratory findings include increased urea, creatinine, sugar, and sodium levels. Renal problems (azotemia, high creatinine, renal insufficiency, and stones), neurological complications (cerebral edema, seizure, loss of consciousness, cerebral hemorrhage, developmental delay, and hearing impairment), coagulopathy, and thrombocytopenia are the complications of NHD. Conclusion: NHD and its complications could be prevented by prompt and appropriate prevention of risk factors, early detection based on clinical signs, and appropriate treatment.
This dataset offers an insight into the neurodevelopmental trajectories of preterm infants, encapsulating a wide array of neonatal and maternal factors. The data variables include demographic details ...alongside a detailed account of maternal health during pregnancy, encompassing aspects and other complications. Furthermore, the dataset documents neonatal health conditions. It also records critical indicators of neonatal health. The dataset is enriched with data on medical interventions and hospitalization details. It also contains information on the mother's drug usage during pregnancy and sonography results. A significant portion of the dataset is dedicated to the developmental assessment of the infants, utilizing the Bayley Scales to evaluate various domains such as cognitive, language, perceptual, fine motor, and coarse motor skills. The data are categorized to denote normal and abnormal outcomes in these domains, providing a detailed view of the developmental progress of the infants.
The reuse potential of this dataset is substantial, serving as a rich resource for researchers and clinicians aiming to delve deeper into the multifaceted influences on preterm infant development. It can significantly contribute to the formulation of early intervention strategies, fostering a better understanding and enhancement of developmental outcomes in preterm infants.
Retinopathy of prematurity (RoP) is a vasoproliferative disorder caused by the abnormal development of retinal vessels in premature neonates. It is one of the major causes of childhood blindness, ...which is increasing with the increasing survival rate of low birth weight and premature neonates. This study has aimed to evaluate the role of oxidative stress and peroxidant antioxidant balance (PAB) in the pathogenesis and prediction of RoP.
A total of 154 neonates weighing <1500 g admitted at the NICU of Ghaem Hospital, Mashhad, Iran, were enrolled in this cross-sectional study between 2018 and 2020. Blood samples were collected on the first day of birth to assess the peroxidant and antioxidant balance. The demographic, prenatal, and clinical course and postnatal problems were also recorded. The neonates were examined for RoP and divided into control (healthy) and affected (ROP) groups.
There were significant differences between the two groups in gestational age, duration of oxygen therapy, and first and fifth minute Apgar score (P < 0.005). The mean PAB in infants without and with ROP was 19.79 HK (Hamidi-Koliakos) and 38.45 HK, respectively (P < 0.0001). Also, the mean PAB in neonates with ROP grade 1 and 2 was 36.69 HK and 45.53 HK, respectively (P = 0.002).
According to our findings, the PAB level can be helpful in predicting ROP incidence. With increasing PAB, the possibility of ROP severity will increase.
One of the most common problems in preterm neonates is retinopathy of prematurity (ROP). It has been shown antioxidants may be effective in preventing the development and progression of ROP. ...Considering the antioxidant properties of bilirubin, we decided to investigate the bilirubin level in neonates with ROP and compare it with healthy neonates.
This case-control study was performed on VLBW neonates admitted to the NICU of Ghaem Hospital in Mashhad between 2014 and 2020 for a Jaundice evaluation. Complete neonate's characteristics, maternal history and laboratory results were collected in a questionnaire. Then the neonates were examined for ROP by a fellowship of the retina of an ophthalmologist at 32 weeks or four weeks after birth. The highest bilirubin levels during their hospitalization were also recorded.
Of 427 neonates examined, 121 (37.7%) had a normal eye examination, and 266 (62.3%) had ROP. The mean weight, gestational age and bilirubin were 1455.8 ± 431.4 grams, 31.6 ± 2.3 weeks and 8.8 ± 2.4 mg/dl, respectively. There was a significant difference between controls and neonates with ROP with regard to birth weight, duration of intermittent positive pressure ventilation (IPPV), duration of oxygen therapy, first and fifth minute Apgar scores, the maximum level of bilirubin and gestational age (P < 0.05). It was observed that the maximum level of bilirubin was lower in neonates with higher stages of ROP.
According to the results of this study, higher levels of bilirubin in neonates may be a protective factor against ROP. Moreover, increased levels of bilirubin are associated with reduced severity of ROP. Therefore, prophylaxis phototherapy in premature infants may need to be reconsidered.
Neonatal meningitis is one of the most important and serious neonatal infections with a high mortality and morbidity rate. The present study aimed to investigate the causes, clinical signs, ...laboratory parameters and mortality rates in newborns with bacterial meningitis.
This cross-sectional study was performed on 468 neonates aged 2-28 days admitted to NICU in Ghaem Hospital Mashhad, Iran by available sampling method during 2009-2018. Meningitis was confirmed according to positive results of CSF culture and clinical feature. By using researcher-made questionnaire, neonate's individual data including cardiopulmonary resuscitation, the Apgar score of the first and fifth minutes, gestational age, birth weight, clinical symptoms and laboratory data such as ESR, WBC and positive culture of CSF were studied.
Among 468 newborn suspected to infection, lumbar Puncture (LP) was performed for 233 cases (50%). Of 233 neonates, 148 neonates (63.5%) had negative results for CSF culture and 85 cases (36.5%) had positive CSF culture. 94% of cases with meningitis were born premature. Blood culture had positive results in 80% of infants with late-onset meningitis and negative in 20%. The most common clinical findings were respiratory symptoms (94%).
and
were the most common microorganisms of meningitis. Gestational disorders were observed in 55.3% of newborns with meningitis. C-Reactive Protein (CRP) of neonates with meningitis was twice higher than normal cases, and leukocytes and proteins in the CSF in neonates with meningitis were higher than healthy ones. Finally, 36% of neonates with meningitis died in our study. For analyzing the relationships between variables, independent t-test was used after controlling the normality, and Chi-square was used for analyzing the relationship of variables with nominal scale.
The most common pathogens of meningitis were
and
. Respiratory symptoms were the most common clinical signs, and laboratory symptoms included increased CRP, increased leukocytes and proteins in CSF.
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