Birth Weight Research Articles

Preconception Physical Activity and Maternal Health Outcomes: An Integrative Review of Studies from 2016-2025.

Preconception physical activity may lower the risk of adverse maternal health outcomes. This integrative review examined the relationship between preconception physical activity and maternal health outcomes. Six electronic databases (i.e., Cochrane Library, PubMed, Science Direct, PsycInfo, SAGE Journals, and Sports Discus) were searched for relevant articles. Articles were eligible for inclusion if they were (1) published between January 1, 2016, and January 9, 2025, in an English-language peer-reviewed journal; (2) included a measure of preconception physical activity; and (3) reported maternal health outcomes during or after birth. Search procedures retrieved a total of 3608 articles. After a thorough screening process, seven articles met the inclusion criteria of this review. Five articles reported data from prospective cohort studies, and two articles employed cross-sectional designs. Outcomes examined included gestational hypertension (n = 3), gestational diabetes/glucose metabolism (n = 4), preeclampsia (n = 2), infant birth weight (n = 2), pregnancy weight gain (n = 1), duration of pregnancy (n = 1), and mode of delivery (n = 1). Higher preconception physical activity engagement was linked to reduced risks of gestational hypertension (n = 1), gestational diabetes/glucose metabolism (n = 2), preeclampsia (n = 2), low birth weight (n = 1), excessive pregnancy weight gain (n = 1), and post-term delivery (n = 1). Three studies found greater risk reduction with increased moderate-to-vigorous physical activity. Engaging in regular moderate-to-vigorous physical activity during preconception is associated with a reduced risk of numerous adverse maternal health outcomes.

International Comparison of Surgical Management Practices for Necrotizing Enterocolitis in Neonates: Insights from Cohorts in the Netherlands and Finland.

Surgical management of necrotizing enterocolitis (NEC) can result in significant morbidity and mortality. Surgical management varies in the absence of international evidence-based guidelines. We aimed to gain insight into practice variation between expert centers in the Netherlands and Finland.Bicentric retrospective cohort study including all infants treated surgically for NEC (Bell's stage ≥IIA) in two centers in the Netherlands and Finland between 2000 and 2021. Main outcomes were preoperative, intraoperative, and 3-month postoperative characteristics.We included 191 patients (122 Dutch and 69 Finnish). Median gestational age and birth weight were lower in Finnish patients (median [min.-max.]: 25 + 4/7 [23 + 0/7-39 + 0/7] vs. 28 + 2/7 [23 + 6/7-41 + 6/7], p < 0.001, and 795 g [545-4,000] vs. 1,103 g [420-3,065], p < 0.001). Indication for surgery was mostly pneumoperitoneum in Finnish patients (56.5% vs. 37.7%; p = 0.02) versus clinical deterioration on conservative treatment in Dutch patients (51.6% vs. 23.2%; p < 0.001). A fixed-bowel loop was also more often an indication in Finland (20.3% vs. 3.3%; p < 0.001. Ostomy creation was more common in Finnish patients (92.8% vs. 53.3%; p < 0.001) and primary anastomosis in Dutch patients (29.5% vs. 4.4%; p < 0.001). Open-close procedures occurred in 13.9% of Dutch cases, versus 1.4% of Finnish cases (p = 0.004). Mortality at 3 months was comparable when excluding open-close procedures (24.8% vs. 19.1%; p = 0.46).We observed varying populations, indications for surgery, and surgical approaches in NEC between the Netherlands and Finland. The occurrence of open-close procedures is 10-fold higher (13.9% vs. 1.4%) in the Netherlands compared to Finland. Long-term outcomes remain to be studied. These results point toward significant practice variation and strengthen the need for European management guidelines.

Evaluation of First-Trimester Low Percentile Nuchal Translucency Association with Adverse Perinatal Outcomes and Fetal Congenital Anomalies.

This study aimed to evaluate the association of first-trimester low percentile nuchal translucency (NT) thickness values with adverse perinatal outcomes and fetal congenital anomalies.In this retrospective study, 2,150 pregnant women who screened first trimester NT and delivered at Kayseri City Hospital were divided into three groups based on their fetal NT thickness percentiles as follows: third percentile NT group (n: 101), 3rd to 10th percentile NT group (n: 242), and 10th to 90th percentile NT group (n: 1,807).First-trimester NT thickness was analyzed in 5 mm intervals according to gestational age, and the mean NT value was 0.76 mm in the third percentile, 0.95 mm in the 3rd to 10th percentile, 1.51 mm in the 50th percentile, and 2.36 mm in the 90th percentile. Fetal birth weight was significantly decreased in the third percentile NT group and 3rd to 10th percentile NT group compared with the 10 to 90th percentile NT group. Small for gestational age, intrauterine growth restriction with abnormal Doppler value and second-trimester spontaneous abortion rates were significantly increased in the third percentile NT group and the 3rd to 10th percentile NT group compared with the 10th to 90th percentile NT group. The study did not find an increased risk for fetal congenital anomalies in the third percentile group or the 3rd to 10th percentile group.The results indicated that first-trimester NT thickness values below the 10th percentile were associated with low fetal birth weight and adverse perinatal outcomes. Additionally, low percentile first-trimester NT thickness was not a risk factor for fetal congenital abnormalities. · First trimester NT screening is a well-explained phenomenon.. · There is little information regarding decreased NT below the 10th percentile.. · NT thickness values below the 10th percentile were associated with adverse perinatal outcomes..

Consecutive Lactation, Infant Birth Weight and Sex Do Not Associate with Milk Production and Infant Milk Intake in Breastfeeding Women

Consecutive Lactation, Infant Birth Weight and Sex Do Not Associate with Milk Production and Infant Milk Intake in Breastfeeding Women

Efficacy of late cervical cerclage for preventing preterm birth in pregnancies complicated by cervical incompetence: retrospective cohort study

ObjectivesTo compare different periods of cerclage placement in preventing preterm birth in singleton pregnancies complicated by cervical incompetence.MethodsThis retrospective cohort study was conducted at a tertiary hospital in Shanghai, China. A total of 499 singleton pregnancies undergoing prophylactic cervical cerclage between January 1, 2021, and June 30, 2023, at Shanghai East Hospital were included in the study. Participants were classified into the early cerclage group (cerclage performed at 11+ 0 to 15+ 6 weeks of gestation) and the late cerclage group (cerclage performed at 16+ 0 to 19+ 6 weeks of gestation).ResultsThe median gestational ages at delivery were similar between the early cerclage group and the late cerclage group (median (IQR) 38.1 (36.6–39.1) vs. 38.3 (37.1–39.0) weeks, p = 0.568). There was no difference in preterm birth rates of < 37 (28.0%, 93/332 vs. 21.0%, 35/167, p = 0.089), < 34 (14.8%, 49/332 vs. 11.4%, 18/167, p = 0.218), or < 28 (6.9%, 23/332 vs. 3.0%, 5/167, p = 0.072) weeks of gestation between the early cerclage group and the late cerclage group. The incidence rates of chorioamnionitis, premature rupture of membranes, and cesarean section were comparable between the two groups. As a primary indicator of neonatal outcomes, the survival rates of newborns at three months post-delivery were similar between the early and late cerclage groups (94.6%, 314/332 vs. 98.2%, 164/167, p = 0.061). Birth weights of newborns in the early and late cerclage groups were not significantly different (median (IQR) 3080.0 (2652.5–3450.0) vs. 3210.0 (2600.0–3550.0) g, p = 0.100). The incidence rate of 5-minute Apgar scores < 7 in the late cerclage group was significantly lower than that in the early cerclage group (1.8%, 3/167 vs. 6.3%, 21/332, p = 0.026). The incidence rates of neonatal intensive care unit admission, and respiratory distress syndrome were similar between the two groups.ConclusionsOur retrospective study demonstrated that the efficacy and risk of prophylactic cervical cerclage performed at 16+ 0 to 19+ 6 weeks of gestation were comparable to those of earlier cerclage performed at 11+ 0 to 15+ 6 weeks. Our study provided robust evidence supporting the safety and clinical feasibility of late cerclage in preventing preterm birth, which offers valuable insights into optimizing the cerclage period for high-risk pregnancies.

Dexmedetomidine in neonates: utilisation trends and safety profile over time in a neonatal intensive care unit

BackgroundDexmedetomidine is an alpha-2 adrenergic agonist with sedative, anxiolytic and analgesic effects. Its use in neonatal intensive care units (NICUs) has been increasing in the last decade. The aim of...

Reconsideration of lowering gestational weight gain guidelines in pregnant women diagnosed with gestational diabetes: evidence from a Belgian study

BackgroundThe suitability of the United States National Academy of Medicine guidelines for gestational weight gain in women with gestational diabetes remains uncertain, raising global concerns. This study aimed to evaluate the association of gestational weight gain with pregnancy and birth outcomes and to determine optimal ranges for gestational weight gain per pre-pregnancy body mass index category in women with gestational diabetes.MethodsAn epidemiological analysis between 2009–2018 analyzed a large Belgian cohort of singleton pregnancies with gestational diabetes and gestational age 38–40 weeks. Multivariate logistic regression assessed associations between gestational weight gain and relevant pregnancy and birth outcomes, with and without adjustment for confounding variables, including maternal age, origin, education, mode of conception, parity, gestational age at delivery, social deprivation, and year of delivery. Potential optimal weight gain ranges were calculated by minimizing the combined risk of small- and large-for-gestational-age infants (SGA, LGA).ResultsA total of 13,060 women with gestational diabetes were included. Compared to recommended weight gain, gestational weight gain above guidelines occurred in 26.9% and was associated with an increased risk of gestational hypertension (aOR 1.41, 95% CI 1.20–1.66, p < 0.001), emergency caesarean section (aOR 1.45, 95% CI 1.25–1.69, p < 0.001), LGA infants (aOR 1.84, 95% CI 1.63–2.08, p < 0.001), and macrosomia (aOR 1.78, 95% CI 1.55–2.04, p < 0.001). Weight gain less than recommended (40.2%) was associated with a decreased risk of gestational hypertension (aOR 0.81, 95% CI 0.69–0.96, p = 0.015), LGA infants (aOR 0.58, 95% CI 0.50–0.66, p < 0.001), and macrosomia (aOR 0.57, 95% CI 0.49–0.65, p < 0.001), but at the expense of an increased risk of SGA infants (aOR 1.68, 95% CI 1.45–1.96, p < 0.001) and low birth weight (aOR 2.28, 95% CI 1.57–3.32, p < 0.001). Based on current analysis, the optimal ranges for gestational weight gain would be 9 to 14 kg for women with a normal weight, 1 to 9 kg for women with overweight, and -7 to 1 kg for women with obesity.ConclusionsThis Belgian study suggests that optimal gestational weight gain for singleton at-term pregnancies complicated by gestational diabetes should be lower than current recommendations, highlighting the need to reevaluate gestational weight gain guidelines in this context.

Analysis of perinatal factors for death or severe intraventricular hemorrhage within the first week of life in preterm infants with gestational age

Objective: To analyze the incidence and perinatal factors of death or severe intraventricular hemorrhage (sIVH) within the first week of life in preterm infants with gestational age <32 weeks. Methods: Based on the online data platform of Sina-northern Neonatal Network (SNN), a case-control study was conducted using clinical data from 8 903 preterm infants with gestational age <32 weeks admitted to 35 neonatal intensive care units (NICU) between 2019 and 2023. Infants were classified by gestational age at birth into very preterm infants and extremely preterm infants. Infants who died or developed sIVH within the first week of life were defined as the case group, while those who survived and did not develop sIVH were defined as the control group. The general information of the infants, maternal perinatal factors, the 5th minute Apgar score, incidence of hypothermia or early-onset sepsis, and the first arterial blood pH value were compared between the case and control groups of very preterm infants and extremely preterm infants. The χ² test and Wilcoxon rank-sum test were used for intergroup comparisons. A multivariable logistic regression model nas used to analyze the factors for death or sIVH within the first week of life in very preterm and extremely preterm infants. Results: Among the 8 903 preterm infants with gestational age <32 weeks, 4 993 (56.1%) were male, with a gestational age at birth of 30.0 (28.4, 31.0) weeks. A total of 865 cases (9.7%) were death or sIVH within the first week of life. The case group took up 5.8% (426/7 316) and 27.7% (439/1 587) of very preterm infants and extremely preterm infants, respectively. Compared to the control group, the case group of very preterm and extremely preterm infants both had higher incidences of low gestational age, low birth weight, small for gestational age, the 5th minute Apgar score ≤7, early-onset sepsis, hypothermia at admission, and first arterial blood pH <7.20 (all P<0.001). The proportion of mother's full course antenatal corticosteroids use were both lower in both case group (both P<0.001). Multivariate Logistic regression analysis revealed several risk factors for death or sIVH within the first week of life in very preterm and extremely preterm infants, including: low gestational age (OR=0.70 and 0.74, 95%CI 0.60-0.82 and 0.66-0.83, both P<0.001), low birth weight (OR=0.99 and 0.99, 95%CI 0.99-1.00 and 0.99-1.00, both P<0.05), early-onset sepsis (OR=1.82 and 2.20, 95%CI 1.42-2.34 and 1.74-2.79, both P<0.001), the 5th minute Apgar score ≤7 (OR=1.41 and 2.69, 95%CI 1.10-1.81 and 2.17-3.34, both P<0.01), hypothermia at admission (OR=1.55 and 1.38,95%CI 1.17-2.07 and 1.08-1.76,both P<0.05) and the first arterial blood pH <7.20 (OR=2.20 and 2.57, 95%CI 1.70-2.84 and 2.05-3.21, both P<0.001). Multiple births were an independent risk factor only for extremely preterm infants (OR=1.32, 95%CI 1.02-1.71, P<0.05). Prenatal administration of a full course of antenatal corticosteroids was identified as a protective factor in very preterm and extremely preterm infants (OR=0.74 and 0.62, 95%CI 0.58-0.95 and 0.51-0.76, both P<0.05). Conclusions: The incidence of death or sIVH within the first week of life remains high in preterm infants with gestational age <32 weeks. The smaller gestational age and lower birth weight, early-onset sepsis, birth asphyxia, hypothermia at admission, and a first arterial blood pH <7.20 were independent risk factors for death or sIVH within the first week of life in preterm infants with gestational age <32 weeks. A full course of antenatal corticosteroids significantly reduced the risk of these adverse outcomes.

Analysis of colonization rate and molecular characteristics of Staphylococcus aureus on tracheotomy wounds at early postoperational stage in neonates

Objective: To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods: This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children's Hospital, Capital Medical University from January 1st 2020 to December 31st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results: Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2(4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11,P=0.020). Conclusions: The colonization rate and infection rate were high on the tracheotomy incision in neonates. The major type was MRSA, and the most common molecular strain was ST59-SCCmec Ⅳ-t437.

Ultrasound Reference Values of Ventriclo/Hemispheric Ratio and Evans Ratio Based on Most Correlated Covariates for Neonates Born at 25-41 Gestational Weeks: A Prospective Cross-Sectional Study.

This study aimed to establish ultrasound reference values for the ventriculo/hemispheric ratio (V/HR) and Evans ratio in neonates between 25 and 41 weeks of gestation, based on the most correlated covariates (MCCs). Data for V/HR and Evans ratio were collected from 1-to 7-day-old neurologically healthy neonates born or hospitalized at Hunan Provincial Maternal and Child Health Care Hospital and Yueyang Maternal and Child Health Hospital between March 2023 and September 2024. Max-min normalized quantile regressions were utilized to analyze the correlation between exploratory and dependent variables and to identify the MCCs. Reference values were established using the percentile method and MCCs, and the reliability of V/HR and Evans ratio was assessed via the intraclass correlation coefficient (ICC). A total of 1595 newborns were recruited. The V/HR median was positively correlated with the cesarean delivery (normalized regression coefficient (NRC) = 0.010, p < 0.05) but negatively correlated with the left side (NRC = -0.010, p < 0.05). The Evans ratio median was only positively correlated with the cesarean delivery (NRC = 0.010, p < 0.05). The 95th percentile (P95) of V/HR was only associated with the left side (NRC = -0.010, p < 0.05), while the P95 of the Evans ratio was unassociated with any covariates (all p > 0.05). Therefore, the MCC of V/HR at P95 was the left side, while the Evans ratio at P95 had no MCCs. The upper limits (P95) of LV/HR, RV/HR, and the Evans ratio were 0.33, 0.35, and 0.34, respectively. The ICCs of all indices exceeded 0.60, indicating moderate reliability or higher. We present the reference values for LV/HR, RV/HR, and Evans ratio. The medians and P95s of V/HR and Evans ratio are NOT correlated with GA, birth weight, and age. The reliability of the V/HR and Evans ratio is up to par.

Association Between Different Feeding Methods and Bronchopulmonary Dysplasia in Preterm Infants: A Retrospective Cohort Study.

Background: This study examines the relationship between feeding methods during the first 2 weeks post-birth-mother's own milk (MOM), donor human milk (DHM), and formula-and the incidence of bronchopulmonary dysplasia (BPD) in preterm infants. Materials and Methods: A retrospective cohort study was conducted on preterm infants (<32 weeks gestation or <1,500 g birth weight) admitted to Fujian Maternal and Child Health Hospital from March 2023 to February 2024. Infants were grouped by primary feeding method within the first 2 weeks after birth, defined as MOM, DHM, or formula contributing to ≥50% of total feeding. The primary outcome was BPD incidence; the secondary outcome included necrotizing enterocolitis (NEC) stage II or higher, periventricular leukomalacia (PVL), retinopathy of prematurity (ROP), and sepsis. Results: BPD incidence was lower in the MOM and DHM groups compared with formula (22%, 16% vs. 35%; p = 0.03). Adjusted odds ratios for BPD were 3.35 (95% CI 1.43, 7.85) in the formula group versus MOM and 6.48 (95% CI 1.47, 28.57) versus DHM, with no significant difference between MOM and DHM. NEC incidence was also lower in MOM and DHM groups (7.15%, 9.38% vs. 20.21%; p = 0.016). No significant differences were observed in ROP, PVL, or sepsis rates. Conclusions: MOM and DHM reduce the risk of BPD and NEC in preterm infants, with DHM being as safe as MOM.

The impact of anemia on pregnant women on premature labor and low birth weight

Introduction: Anemia in pregnant women is one of the health problems that often occur and can have a negative impact on pregnancy. Iron and other nutrient deficiencies during pregnancy can increase the risk of complications, including premature labor and low birth weight (BBLR). This study aims to analyze the effect of anemia in pregnant women on premature labor and BBLR incidence. Research Methodology: This study uses an observational design with a retrospective cohort approach. Data is collected from the medical records of pregnant women who have given birth in the hospital for a certain period. The research sample consisted of pregnant women who experienced anemia and those who did not experience anemia. Result: The results showed that pregnant women with anemia had a higher risk of preterm labor compared to pregnant women without anemia (OR = 2.5; p &lt; 0.05). In addition, the prevalence of babies with low birth weight was higher in mothers with anemia (OR = 3.1; p &lt; 0.05). The results of the multivariate analysis showed that anemia in pregnant women was an independent risk factor for the incidence of premature labor and BBLR after being controlled by other factors such as maternal age, nutritional status, and obstetric history. Conclusion: Anemia in pregnant women has a significant effect on the increased risk of premature labor and low birth weight. Therefore, efforts to prevent and treat anemia during pregnancy must be improved through early screening, nutrition education, and iron and folic acid supplementation to reduce adverse impacts on mothers and babies

Hematological indicators and their impact on maternal and neonatal outcomes in pregnancies with thalassemia traits.

The aim of this study is to compare the obstetric, neonatal, and hematological indicators of pregnant women with thalassemia traits with those of pregnant women without such traits. This retrospective cohort study was conducted from January 2017 to October 2023 at the Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dali University. The study included 185 cases of thalassemia traits and 185 control cases. Data were analysis using the SPSS program (Version 27.0). Significant differences were observed in gravidity and parity histories (p<0.05). Significant differences were also observed in the rates of gestational diabetes mellitus (GDM), hypertensive disorder of pregnancy (HDP), cesarean delivery, adherent placenta, and anemia in the second and third trimesters following the number of RR (95 % CI): 2.182 (1.101-4.324), 9.000 (1.152-70.325), 2.091 (1.555-2.811), 3.401 (1.280-9.009), 4.222 (2.102-8.481), and 2.053 (1.476-2.855), respectively (p<0.05). However, no significant differences were noted in the rates of preterm birth, low birth weight, macrosomia, intrauterine growth restriction, fetal distress, fetal malformation, and stillbirth (p>0.05). Furthermore, significant differences were noted in the levels of hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW) during the first, second, and third trimesters (p<0.05). As pregnancy progresses, the levels of Hb tend to decrease, while the MCH and RDW levels increase. On the other hand, the level of MCV remain the same overtime. Thalassemia traits are significantly associated with anemia during pregnancy, particularly in the second and third trimesters. Furthermore, thalassemia traits are related to an increased incidence of GDM, HDP, and cesarean delivery.

Case Report: Delayed recurrence of staphylococcal scalded skin syndrome in an extremely low birth weight infant

Case Report: Delayed recurrence of staphylococcal scalded skin syndrome in an extremely low birth weight infant

The associations of preterm birth and low birth weight with childhood growth curves between birth and 12 years: a SITAR-based longitudinal analysis

The associations of preterm birth and low birth weight with childhood growth curves between birth and 12 years: a SITAR-based longitudinal analysis

Extremely Low Birth Weight in Preterm Newborn: A Case Report

Aim: The aim of the case report is to describe the management of Extreme Low Birth Weight Infant with presentations of prematurity, RDS and anemia.Methodology: A 20-year-old primipara was admitted in our hospital at 24 gestational weeks. The mother had premature rupture of membrane with oligohydramnios which was confirmed through ultrasound. The labor was augmented and mother delivered via spontaneous vaginal delivery at 26 gestational weeks, a live female infant at 690g birth weight with APGAR of seven at 1 minute, seven at 5 minutes and eight at 10 minutes. The infant first examination showed chest indrawing, deep breathing (R=61cycles/min, Pulse=113b/mins) and prostration (++), blood sugar (8.6mmols) and temperature of 34.3oc. The child also developed jaundice and anemia. Child was managed on maintenance fluids, nasogastric tube feeds, oxygen therapy and antibiotics 1st line, expressed breast milk, kangaroo Mother care (KMC), IPC and vital monitoring. The child was discharged at 54th day of life stable with no noted developmental delays. Findings: Specific problems that should be considered among the ELBW infants include thermoregulation, respiratory distress syndrome, cardiovascular problems, CNS, electrolyte imbalance, impaired glucose homeostasis, infection bronchopulmonary issues, ROP and anemia in prematurity. Our case had predominant presence of ineffective thermoregulation, RDS, electrolyte imbalance, anemia and risk for infections. Therefore, the survival and development of extremely low birth weight infants depends on holistic multidisciplinary approach during intrapartum, hospital stay and 1 year after discharge. Unique Contribution to Theory, Policy and Practice: The case emphasizes on the need for early initiation of keen monitoring and implementation of holistic management on premature and ELBW babies to prevent complications and improve on survival rate and outcomes. The case report highlights key problems that are manifested among ELBW infants and proper initiation of management immediately after birth can improve outcome and survival of the infant.

A Study on Variation of Placental Index in Different Gestational Age Groups of Healthy Pregnant Mother of Bangladesh

Background: The placenta is an organ that is absolutely essential to the survival of the fetus. All the enabolites needed for fetal metabolism come from the mother’s blood and fetal catabolites are passed back into the mother’s circulation through the placenta. So, as a mirror, it reflects the intra-uterine status of the fetus.Objectives: This study was done to provide information about the placental index in different gestational ages of healthy pregnancies.Materials and Methods: This cross-sectional descriptive study was performed on 80 human placentas in the Department of Anatomy, Mymensingh Medical College, Mymensingh, from January to December 2018 of healthy Bangladeshi pregnant mother in relation to different gestational age. By purposive sampling technique the collected samples were divided into three gestational age groups. They were Group A (28 to 36 weeks), Group B (37 to 40 weeks) and Group C (above 40 weeks) and examined morphologically by fine dissection method. The placental index (placental coefficient) was calculated by dividing placental weight by the birth weight of the baby.Result: The mean (± SD) placental index was 0.17±0.09 in group A, 0.14±0.01 in group B and 0.15±0.03 in group C. It was also observed that the mean placental index decreased with gestational age up to a certain level then increased. The mean difference of the placental index between groups A and C was statistically moderately significant (p &lt; 0.01) but the difference between groups A and B, B and C was statistically non-significant (p &gt; 0.05). Conclusion: The present study showed an increase in birth weight will be followed by increased placental weight which is useful both clinicians and researchers for further studies to evaluate the correlation of placental index with pregnancy and neonatal outcome. KYAMC Journal. 2024; 15(02): 83-87

Maternal vitamin D status and its implications on the newborn – A narrative review

The pandemic of vitamin D deficiency affects all ages, including pregnant women and newborns. The functional significance of maternal and neonatal vitamin D deficiency is incompletely understood. Neonatal vitamin D insufficiency has been linked with preterm birth, seizures, neonatal respiratory distress syndrome, sepsis, acute gastroenterocolitis, and a higher risk of hospital admissions. The potential underlying mechanisms include the effect of vitamin D receptor polymorphism, defective immune effector cells, placental inflammation and gut dysbiosis. About 50% of all neonatal hypocalcemic seizures are attributable to vitamin D deficiency. Serum total calcium levels below 8.0 mg/dL should lead to a high index of suspicion for vitamin D deficiency-related seizure. With appropriate supplementation, hypocalcemic seizures recover without any long-term neurodevelopmental sequelae. Several studies also indicate the benefit of vitamin D supplementation during pregnancy on neonatal anthropometric measures, that is, birth weight (BW), birth length, femur length, head circumference, and ponderal index. The BW has an inverted U shape relationship with vitamin D levels, with benefit observed up to 20 ng/mL. Thus, current evidence underscores the possible detrimental effects of maternal vitamin D deficiency on adverse neonatal outcomes. Hence, maternal vitamin D supplementation may be beneficial for optimal health of the newborns.

Impact of different treatment attitudes on survival and risk factors for poor clinical outcomes in extremely preterm infants: a retrospective real-world study

To explore the impact of different treatment attitudes on the survival status of extremely preterm infants (EPIs) and evaluate the mortality and occurrence of severe complications in actively treated infants, as well as their risk factors. A retrospective analysis was conducted on perinatal data of EPIs born between January 1, 2016, and December 31, 2023, who were admitted to the neonatal intensive care unit of Nanjing Women and Children's Healthcare Hospital within 24 hours after birth. The analysis focused on the attributable risk of mortality associated with different treatment attitudes in EPIs of varying gestational ages and birth weights. A multivariate logistic regression model was used to analyze the risk factors for mortality and severe complications in the actively treated group. A total of 485 EPIs were included. As gestational age or birth weight increased, the attributable risk of mortality with care withdrawal increased. Active treatment significantly improved the survival status of EPIs born at a gestational age of ≥24 weeks. Multivariate logistic regression analysis indicated that lower gestational age and the need for mechanical ventilation within 72 hours after birth were independent risk factors for mortality or severe complications in EPIs (P<0.05). Active treatment can significantly extend the survival time of EPIs born at a gestational age of ≥24 weeks. Lower gestational age and the need for mechanical ventilation within 72 hours after birth are closely associated with poor survival outcomes in EPIs.

Normal ranges of the fetal weight determined by ultrasound in the population of the Hospital das Clínicas of the Faculdade de Medicina da Universidade de São Paulo.

Normal ranges of the fetal weight determined by ultrasound in the population of the Hospital das Clínicas of the Faculdade de Medicina da Universidade de São Paulo.