Baby's Blood Research Articles

Maternal Anxiety and Sleep Quality Affects of Neonatal Brain-Derived Neurotrophic Factor

Anxiety conditions and sleep disorders in pregnant women will affect theBrain-Derived Neurotrophic Factor (BDNF) level of the baby's umbilical cord blood, which will then affect the growth and development of the baby. This study aims to assess the relationship between maternal anxiety and sleep quality with neonates' BDNF levels. The research design was a cross-sectional study. Pregnant Women who gave birth by cesarean delivery method with a gestational age of ≥ 37 weeks, Totally 78 pregnant women were recruited. Anxiety levels and sleep quality were assessed by questionnaire, and BDNF levels were taken from the umbilical cord blood and then checked using the ELISA method. Data were analyzed by One-Way-Anova and Independent T-test. There was a significant association between anxiety levels and sleep quality with Neonatal BDNF levels (p = 0.000). The results obtained for pregnant women without anxiety, the mean level of BDNF is 2.017 ± 0.138 ng /ml, mild anxiety the mean value of BDNF level is 1.792 ±0.134 ng/ml, moderate anxiety the mean value of BDNF level is 1.708±0.177 ng/ ml, severe anxiety the mean value of BDNF levels was 1.585±0.257 ng/ml . Pregnant women with good sleep quality had the mean BDNF level of 1.969±0.211 ng/ml, while the mean BDNF level of poor sleep quality was 1.673 ±0.188 ng/ml. Conclusion: The higher the anxiety level of pregnant women, the lower the average Neonatal BDNF level is. The worse the sleep quality of pregnant women, the lower the average Neonatal BDNF level is.

Cord Blood Bilirubin as an Early Marker of Hyperbilirubinemia in Term and Late Preterm Newborns at 48 Hours of Life: A Prospective Cohort Study

Introduction: Jaundice is a common clinical condition present during the neonatal period, which can be either physiological or pathological. Early discharge of newborns is a common practice in our country due to medico-social and economic reasons, making post-discharge follow-up of infants challenging compared to developed countries. Aim: To determine the correlation between cord blood bilirubin levels and the occurrence of hyperbilirubinemia at 48 hours of life in newborns with a gestational age of ≥35 weeks. Materials and Methods: This cohort study was conducted in the Department of Pediatrics at Dr SMCSI Medical College, Karakonam, Trivandrum, Kerala, India, over a one-year period from June 2017 to June 2018. The exposure variables included the mother’s blood group, baby's blood group, mode of delivery, gestational age, gender, and weight of the baby. The outcome variables included cord blood and 48-hour serum total and direct bilirubin levels. The data was coded and entered into Microsoft Excel and analysed using Statistical Package for Social Science (SPSS) version 16.0. Descriptive measures were calculated, and the correlation between cord and 48- hour bilirubin levels was assessed using Pearson's correlation coefficient formula. Other statistical tests applied were chisquare test and independent t-test. Results: Total subjects of 500 (243 female and 257 were males) participants were included in the study.Among the 21 babies who underwent phototherapy, 11 were female and 10 were male, and 15 were full term and six were late preterm for their gestational age . Of the 21 babies needing phototherapy, 15 were delivered by normal vaginal delivery, and six were delivered by LSCS. Correlation between cord blood bilirubin and serum bilirubin at 48hr is 0.477 with a p-value <0.001; which indicates mild correlation between the cord blood Total Bilirubin (TB)and serum TB. A cord TB value of 1.45 mg/dL had a sensitivity of 95.2% and specificity of 32.5%. A value of 1.55 mg/dL had a sensitivity of 90.5% and specificity of 40.9%. A cord TB value of 1.65 mg/dL had a sensitivity of 66.7% and specificity of 53.9%. These findings suggest that cord bilirubin levels can be used to predict which babies require further evaluation and treatment. Conclusions: Cord blood serum bilirubin can serve as a useful screening test for predicting neonatal hyperbilirubinemia and ensuring safe post-natal hospital discharge.

Timing of cord clamping: An observational study of cord clamping practice in a maternity hospital in Aotearoa New Zealand

Background: When the umbilical cord is left unclamped after birth, a significant proportion of the blood from the placenta flows into the newborn, increasing the baby's blood volume by approximately 30%. Routine intervention of immediate cord clamping is harmful as it deprives the newborn access to their own blood, resulting in impaired physiological transition at birth and lower iron stores in early infancy. Iron deficiency in early life, even without anaemia, is linked with impaired neurodevelopment. Aim: The aim of this study was to accurately record birth to cord clamping interval at term vaginal births in a tertiary hospital in Aotearoa New Zealand and concurrently to examine some of the circumstances that may influence the timing of when the cord is cut. Method: This observational study was undertaken from August 2017 to April 2018. Participants were pregnant women having a vaginal birth at ≥37 weeks gestation. Data collected included birth to cord clamping interval, mode of birth (spontaneous or instrumental), maternal position for birth and practitioners involved in the birth. Descriptive statistics were used to summarise the data. Results: Participants were 55 women with term vaginal births. The median interval between birth and cord clamping was 3.5 minutes (IQR 2.18 - 5.68 mins). There was a longer median cord clamping time in the group who had a spontaneous birth (median 3.71; IQR 2.67 - 6.23) vs instrumental birth (2.08; IQR 0.55 - 2.30); with maternal side-lying position (6.37; IQR 4.15 - 9.48) vs lithotomy position (2.24; IQR 1.87 - 3.50); with midwife-facilitated birth (4.06; IQR 2.68 - 6.65) vs obstetric-facilitated birth (2.13; IQR 1.48 - 3.28); and when the neonatal team was not called to attend (4.73; IQR3.32 - 8.26) vs when they were called to attend (2.13; IQR 1.28 - 3.27). Discussion: The median cord clamping time of 3.5 minutes aligns with current local, national and international guidelines, although clamping times as short as 0.23 minutes were observed. The study provides a snapshot of practice at one tertiary hospital, examining data on a range of vaginal births, from uncomplicated midwifery-led births to complicated obstetric-led births requiring neonatal team attendance. By identifying some of the circumstances where cords are clamped early, we may be able to modify the associated factors for these births, thereby improving newborn health outcomes in the future.

A CASE OF INCOMPATIBILITY DUE TO MATERNAL ANTI-C

Hemolytic disease of the fetus and newborn (HDN) is a condition in which the lifespan of an infant's red blood cells (RBCs) is shortened by the action of specific IgG antibody (ies) derived from the mother directed against Rhesus or other blood group antigens on fetal RBCs that are inherited from the father but are not expressed by the mother. The widespread use of Rh immune globulin has dramatically decreased the occurrence of anti D-HDN among D negative pregnant women, but has not eliminated the problem. No measures are available to prevent sensitization to other blood groups, most notably other Rhesus (C,c,E,e), Kell and Duffy antigens. In this article, a case of anti-c incompatibility is presented and the issue of risks involving Rh negative blood transfusion in aloimmunized patients with anti-c is discussed. Twin live babies named newborn1, sex female, and newborn2 were born from the 8th pregnancy of a 38 year-old brazilian mother from Pinhão-Paraná-Brazil through a normal vaginal route. Medical report of newborn1 during twenty days described levels of indirect bilirubin oscillating between 7 to 11 mg/dl and hemoglobin dropping from 13,9 to 10,1 g/dl without jaundice, phototherapy or transfusion registered. Thirty days postnatal, newborn1 had hemoglobin 7,7 g/dl and indirect bilirubin 11,3mg/dl and a blood transfusion was required. Antibody screen of the mother was positive and crossmatching with O negative blood was not compatible. Other tests, performed at Hemocentro Regional de Guarapuava-Paraná, identified mother's blood as A positive, phenotype C(+)c(-)E(-)e(+)K1(-), antibody screen detected anti-c antibodies with 1:256 titre. Baby's blood sample was identified as O positive, phenotype C(+)c(+)E(-)e(+)K1(-) with the direct anti-globulin test (DAT) positive (2+). After centrifugation with saline solution baby's sample after showed yellowed supernatant. A blood transfusion with 30 ml of O positive, c antigen negative blood, match compatible with the mother's serum, was transfused without reactions. At the hospital the mother revealed that these were her 8th and 9th children. Also, she said to be illiterate and that ignored her pregnancy until the 8th month and for it she simply did not have antenatal care. Unfortunately details about her other pregnancies could not be got. Anti-c is an important Rh antibody that may cause severe HDN, and in some cases may be as severe as anti-D HDN. In a series of 1022 cases of non Rh D aloimmunization Kenneth found that only anti-c was associated with severe HDN that ended in hydropic stillbirth or necessitated intrauterine blood transfusion[1]. This was not the case presented in the article. Nevertheless, an important aspect embedded issue along with anti-c that goes unnoticed by many refers to the matter of Rh negative blood available for transfusion, including aloimmunized anti-c patients. The stereotype held by Rh negative blood as universal blood not applies to anti-c. If ones take into account the high incidence of c antigen both in Rh positive and Rh negative blood among the population, we can suppose that people having anti c antibodies, like the mother in the article, are sitted on an authentic powder keg where a transfusional mistake, either for misinformation or any reason can bring unexpected results.

Late-Onset Sepsis in a Premature Infant Mediated by Breast Milk: Mother-to-Infant Transmission of Group B Streptococcus Detected by Whole-Genome Sequencing.

BackgroundLate-onset group B Streptococcus (LOGBS) sepsis is a cause of infection and death in infants. Infected breast milk has been considered a source of neonatal GBS infection and invasive infection. However, mother-to-infant transmission of GBS detected by the high-resolution diagnostic method is rarely reported.MethodsThis study describes a low-weight premature infant who developed late-onset GBS septicemia 21 days after birth. GBS strains isolated from the mother’s cervical secretion, the mother’s milk, and the baby’s blood were cultured to identify the source of GBS infection. We further confirmed the GBS isolates through matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS). Finally, we performed whole-genome sequencing (WGS) and phylogenetic analyses on the GBS strains recovered.ResultsGBS isolates were cultured from the bloodstream of the premature infant and the mother’s milk, respectively. Subsequently, WGS and phylogenetic analyses on three GBS isolates demonstrated that the GBS strain from the infant’s bloodstream was 100% homologous to that from the mother’s breast milk, which had some different gene fragments from the GBS strain from the mother’s cervical secretion. It provided evidence that this infant’s late-onset GBS septicemia originated from his mother’s breast milk instead of the vertical mother-to-infant transmission.ConclusionThrough WGS and phylogenetic analysis of the GBS strains, we proved in this study that the late-onset GBS sepsis in a premature infant was derived from his mother’s breast milk. It indicated that WGS diagnosis is an effective tool for infection tracing. Furthermore, this report provides direction for preventing late-onset GBS infection.

Risk of alcohol consumption during pregnancy on fetus

Miscarriage, premature birth, stillbirth, low birth weight, and a range of lifelong disorders can caused by excessive alcohol consumption during pregnancy is called fetal alcohol spectrum disorders. Alcohol is the most hazardous teratogens which are substances that can detriment an advancing fetus. Every time a pregnant woman has a drink; her unborn child has only, too. Alcohol, like carbon monoxide from cigarettes, passes easily through the placenta from the mother's bloodstream into her baby's blood and puts her fetus at risk of having a fetal alcohol spectrum disorder. Drinking alcohol while pregnant can result in cognitive, social, and motor inadequacies and distinctive lifelong challenges. Usage of alcoholic beverages by pregnant women perhaps results in abortion, fetal mortality and prematurity. The intentions of this review is to teach the women about risk of alcohol consumption during pregnancy on their child and also on themselves and warn them to cease alcohol during pregnancy totally to safe their child from various defects and themselves from unexpected health challenges.

Rh incompatibilty: A case study

Rh incompatibility occurs during pregnancy. Rh antibodies cross the placenta and attack the baby's red blood cells leading to Hemolytic anemia. With Rh incompatibility, the woman's immune system reacts and creates Rh antibodies. Rh incompatibility happens only when the father of the baby is Rh-positive. Difference in blood type between a pregnant woman and her child causes Rh incompatibility. Nurse plays a vital role to offer psychological support to the mother and also to the members of the family.

Ultrasound and molecular genetic diagnostic methods for Rh-isoimmunized pregnancy

Hemolytic disease of the newborn (HDN) in Russia is diagnosed in approximately 0.6% of them [6]. There are 19 main erythrocyte group systems that combine more than 100 antigens, as well as numerous private and common erythrocyte antigens with other tissues [9]. Typically, the baby's red blood cells have some of the paternal antigens that the mother does not have. At the same time, HDN usually develops due to incompatibility between the fetus and mother for Rh or ABO antigens, rarely for other antigenic systems (due to their lower immunogenicity).

Hemolitička bolest novorođenčeta

Introduction/Aim: Haemolytic disease of the newborn is haemolytic anaemia that occurs as a consequence of mismatched blood of the parents, that is, the mismatch of blood elements between the mother and fetus in the ABO or Rh system. The aim of this study is to report a case of haemolytic disease of the newborn which occurred as a result of ABO incompatibility. Case report: Indirect hyperbilirubinemia was registered in a female newborn in the 18th hour of life. The blood group of the newborn was A Rh (D) positive, the direct Coombs test was positive and anti-A antibodies were detected in baby's blood. This case was successfully managed with phototherapy and simple red blood cells transfusion without the need for exchange transfusion. Conclusion: ABO incompatibility can be a major problem in the prenatal, perinatal or neonatal periods. Special attention should be paid to pregnant women whose children from previous pregnancies had hyperbilirubinemia or whose pregnancies were ended in miscarriage.

Analisis Ijārah, Wadī’ah dan Maslahah terhadap Transaksi Penyimpanan Darah Tali Pusat Bayi di Rumah Sakit Mitra Keluarga Darmo Satelit Surabaya

This research is field research that discusses the transaction of storing a baby's umbilical cord blood that occurs at the Darmo Satelit-Surabaya "Mitra Keluarga" Hospital in the theoretical perspective of maslahah (benefits), Ijārah (lease) and Wadī'ah (savings). This study proposes two problem formulations, namely: first, a description of the baby's umbilical cord blood storage transactions that occurred at the Darmo Satelit-Surabaya "Mitra Keluarga" Hospital. Two, analysis of maslahah, Ijārah, and Wadī'ah on transactions for storing baby's umbilical cord blood at the Darmo Satelit-Surabaya "Mitra Keluarga" Hospital. The results of the study concluded that the hospital stores umbilical cord blood that has been cut and stored through stem cell transplantation and cell therapy. From the perspective of Ijārah, Wadī'ah, and maslahah, the practice is permissible because there is no element of garār and gives maslahah for human life.

Umbilical Cord Blood banking and its Therapeutic uses: A Review

The Cord blood is the blood from the baby that is left in the umbilical cord and placenta postpartum. Cord blood contains all the normal elements of blood-red blood cells, white blood cells, platelets and plasma. But it is also rich in haematopoietic stem cells, similar to those found in the bone marrow. Haematopoietic stem cell cells that can be used to treat some types of diseases. The first successful transplantation using haematopoietic stem cells from cord blood was performed in 1988 by a team lead by Dr E. Gluckman to treat a five-year-old boy suffering from Fanconi’s anaemia. It has been estimated that more than 35,500 transplants have been performed in children and adults for the correction of inborn errors of metabolism, hematopoietic malignancies, and genetic disorders of the blood and immune system. The umbilical cord is a narrow tube-like structure that connects the growing baby to the placenta. The cord is sometimes called the baby's “supply line” because it carries the baby's blood back and forth, between the baby and the placenta. It delivers nutrients and oxygen to the baby and excretes the baby's waste products. Three cord blood banking options are available public, private and direct donation banks. The protocols and standards for screening collections and storage of cord blood have now been established worldwide for both public and private cord blood banks. The use of cord blood provides viable options for paediatric patients with malignant conditions, hemoglobinopathies, metabolic disorders, immune deficiencies and regenerative applications.

Comparison of the effects of epidural and spinal anesthesia on analgesia and blood gases in neonates born by natural vaginal delivery: A clinical trial study

Introduction: One of the concerns of painless deliveries is the safety of neonates. This clinical trial study aimed to compare the effects of epidural and spinal anesthesia on the mortality rate of neonates.
 Methods: This clinical trial was conducted in Hamadan Hospital in Iran. Ninety women, ages 18 to 45, were randomly assigned to receive epidural or subdural anesthesia. Using a checklist, the following were collected: demographic information, midwifery, hemodynamic status, mothers' pain intensity, and analyses of the baby's umbilical cord blood. The data were analyzed by SPSS version 16 for statistical analysis. Twenty-two of the patients with spinal anesthesia and epidural anesthesia were excluded from the study.
 Results: There was no significant difference between the two groups in terms of age, gestational age, parity, and severity of pain before or after anesthesia. The hemodynamic status of the mothers before and during the first postoperative period was in the normal range, except that in the spinal group, a decrease in systolic blood pressure was observed in normal range compared with the epidural anesthesia group. In blood gas analysis, the mean pH, partial pressure of carbon dioxide (PCO2), and bicarbonate (HCO3) did not show significant differences between the two groups (p > 0.05). The only complications were acidosis and epidural anesthesia.
 Conclusion: Based on the findings of the present study, both spinal and epidural opioids have no adverse effects on the health of neonates. However, both spinal and epidural opioid are preferred due to fewer changes in the hemodynamic changes in mothers and in umbilical cord blood gas.

Novel Design and Evaluation of an Automatic and Portable Phototherapy Device Using for Newborn Jaundice Treatment

Jaundice in infants is one of the most common diseases at birth. In preterm infants, the risk is more than 80%, and in term infants, the rate is reduced to about 60%. One of the most effective and low-risk ways to treat neonatal jaundice is the use of light therapy or phototherapy. Fluorescent lamps, tungsten halogen lamps, LEDs, optical fibers and etc are used in these devices. Bilirubin reacts to green light and blue light. The green light's wavelength is in the range of 570-495 nm. The blue light has a wavelength of 495-450 nm and an absorption range of 450 nm. Studies have found that the best light for phototherapy devices is a light that has the wavelength of 400 to 520 nm, and because the blue light absorption rate is about 450 nm, so it is used in phototherapy. In addition to its proper absorption rate, it also has antimicrobial activity against bacteria. It is difficult to determine the exact duration of the phototherapy, because each infant has his/her specific conditions and the exact duration cannot be determined generally. Phototherapy should be continued until the bilirubin level in the baby's blood is sufficiently reduced, monitored by the supervision, and does not pose a threat to the baby. Phototherapy devices have different types, each with advantages over their predecessors. In existing models, because of their unique features like high sensitivity to bilirubin reduction, higher power, and efficiency, lighter, lower heat generation, lower cost and longer life devices, LED light sources are widely used in phototherapy devices. According to all the studies, we are looking for a device with proper coverage, portability, and moving the baby with the device without separating the baby from the baby as well as providing a quiet space for the mother and baby away from the hospital environment.

Comparison of Various Data Mining Algorithms in the Prediction of Risk for Gestational Diabetes

Data Mining is a field of computer science which is used to discover new patterns for large data sets. Classification is an important task in data mining. In different areas of medicine, data mining has contributed to improve the results with other methodologies. Gestational diabetes is a condition characterized by high blood sugar (glucose) levels that is first recognized during pregnancy period of a woman. Diabetes is a disease in which levels of blood glucose, also called blood sugar, are above normal. People with diabetes have problems converting food to energy. Normally, after a meal, the body breaks food down into glucose, which the blood carries to cells throughout the body. Cells use insulin, a hormone made in the pancreas, to help them convert blood glucose into energy.During the second and third trimester, a mother's diabetes can lead to over-nutrition and excess growth of the baby. Having a large baby increases risks during labour and delivery. For example, large babies often require caesarean deliveries and if he or she is delivered vaginally, they are at increased risk for trauma to their shoulder. In addition, when foetal over-nutrition occurs and hyper insulinemia results, the baby's blood sugar can drop very low after birth, since it won't be receiving the high blood sugar from the mother. However, with proper treatment, a gestational diabetic mother can deliver a healthy baby despite having diabetes. In this paper, many classification algorithms like J48, simple CART and Naïve bayes algorithm are used to diagnose the diabetes in pregnant women and they are compared for their accuracy levels.

The Red Blood Cell Membrane of Preterm Infants in the Early Neonatal Period

Objective: to study the nanostructure of red blood cell membranes and erythrocyte index in preterm neonatal infants. Subjects and methods . The trial enrolled 47 neonatal infants, including 33 preterm infants who were included in a study group and 14 fullterm infants who formed a comparative group. The gestational age of the preterm infants was 33.3±1.9 weeks and the birth weight was 2065.4±304.8 g. Red blood cell counts, hemoglobin, and erythrocyte indices were estimat ed and the red blood cells were examined using an atomicforce microscope. Results . At birth, the preterm infants showed macrocytosis, intrauterine poikylocytosis, and the impaired nanostructure of red blood cell membranes. Intrauterine hypoxia affects the red blood cell membrane nanostructures: a phospholipid bilayer and a spectrin matrix, without damaging the membrane protein component. The detected changes are reversible and directed to maintaining the functional ability of red blood cells in a critical situation. At birth, gestational age, a baby's weight, hemoglobin, and blood cholesterol and standard bicarbonate levels influence the parameters of a red blood cell component. The early neonatal period was characterized by an active process on the red blood cell membranes and a change of morphological forms, suggesting the continuing postnatal rearrangement of erythropoiesis and a preterm infant's adaptation to new environmental conditions.

Systemic inflammation in the extremely low gestational age newborn following maternal genitourinary infections.

Gestational genitourinary infections are associated with lifelong disabilities, but it is unknown if neonatal inflammation is involved. Mothers of 914 infants born before 28th gestation week reported cervical/vaginal infection (CVI), and/or urine/bladder/kidney infection (UTI), or neither. Inflammation proteins measured in baby's blood on postnatal days 1, 7, and 14 were considered elevated if in the top quartile for gestational age. Logistic regression models adjusting for potential confounders assessed odds ratios. Compared to mothers with neither UTI/CVI, those with CVI were more likely to have infants with elevated CRP, SAA, MPO, IL-1β, IL-6, IL-6R, TNF-α, RANTES, ICAM-3, E-selectin, and VEGF-R2 on day 1; those with UTI were more likely to have infants with elevated MPO, IL-6R, TNF-R1, TNF-R2, and RANTES on day 7. Placental anaerobes and genital mycoplasma were more common in pregnancies with CVI. Gestational UTI/CVI should be targeted for preventing systemic inflammation in the very preterm newborn.

Prenatal diagnosis of sickle cell disease by the technique of PCR.

Sickle cell disease (SCD) is prevalent in Central India and causes major morbidity and mortality. There is a lack of prenatal diagnostic facility near population affected with SCD. This is the pilot study in our region with the aim to establish prenatal diagnostic facility for the couples carrying sickle cell gene in Central India, in order to help them take an informed decision regarding fetus affected with SCD and also to calculate sensitivity of polymerase chain reaction (PCR) technique in our set up with follow up high performance liquid chromatography (HPLC) of baby's blood sample. Fetal sampling was done by chorionic villous biopsy. Extracted DNA was subjected to amplification refractory mutation system (ARMS-PCR) to detect sickle cell mutation (GAG→GTG) in the sixth codon of β globin gene. Follow-up HPLC was done to detect baby's Hb pattern. Prenatal diagnosis of sickle cell anemia was offered in total 37 cases out of which one (2.7%) fetal sample was inadequate. Total 26 (70.27%) fetuses had AS Hb genotype, 3 (8.11%) had AA Hb genotype and 3 (8.11%) had SS Hb genotype while remaining 4 (10.81%) were given AA/AS Hb genotype. All couples with SS fetuses opted for MTP. Follow up HPLC was performed in 24 cases, out of which 18 (75%) were correlated and 6 (25%) were mismatched. In present study sensitivity of ARMS-PCR was 75%. ARMS-PCR is a simple technique to be established initially for providing rapid prenatal diagnosis to the couples with known sickle cell mutation. The sensitivity of ARMS-PCR can be increased by using suitable techniques to detect maternal cell DNA contamination.

BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn.

BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn.

Study of ionic calcium in maternal and cord blood and baby′s blood at 48-h age

Background: Newborns undergo a physiological nadir in serum calcium levels by 24-48 h of age. We have compared the ionic calcium levels in serum of normal as well as high-risk pregnant mothers before delivery, in cord blood of newborns and in neonates at 48 h of age. Materials and Methods: This is a prospective study of 500 pregnant women. One hundred and twenty-two pregnant women did not receive any calcium supplementation antenatally while 378 pregnant women received calcium supplementation antenatally. Results: A statistically significant correlation was found between ionic calcium levels in mothers and in cord blood in the study population and preterm and term babies (coefficient of correlation, r = 0.83, 0.86 and 0.83, respectively). Ionic calcium in baby's blood at 48-h age better correlated with cord blood (r = 0.67) than with maternal blood (r = 0.51). With calcium supplementation antenatally, the mean values for serum calcium of maternal blood, cord blood and baby's blood at 48 h of age were higher than those without antenatal calcium supplementation. Conclusions: Antenatal calcium supplementation may prevent hypocalcemia in the newborn thus preventing neonatal morbidity.

Birth of a healthy infant after preimplantation genetic diagnosis by sequential blastomere and trophectoderm biopsy for β-thalassemia and HLA genotyping

BackgroundPreimplantation genetic diagnosis (PGD) is a widely used technique for couples at genetic risk and involves the diagnosis and transfer of unaffected embryos generated through in vitro fertilization (IVF) techniques. Study designFor those couples who are at risk of transmitting a genetic disease to their offspring, preimplantation embryos can be selected according to their genetic status as well as human leukocyte antigen (HLA) compatibility with the affected child. Stem cells from the resulting baby's umbilical cord blood can be used for transplantation to the affected sibling without graft rejection. ResultsHere we report successful hematopoietic stem cell transplantation (HSCT) after the birth of a healthy infant, who was born after successful PGD testing with both cleavage stage and blastocyst stage biopsy for the purpose of diagnosis of β-thalassemia and HLA compatibility. ConclusionThe specific feature of this work is not only to have the first successful HSCT achieved in Bulgaria after using preimplantation HLA typing technique, it also demonstrates how to accomplish this success via cross-border collaboration of different units, which makes the application of these sophisticated methods possible in hospitals not having the necessary equipments and expertise.