Female Neonate Research Articles

Sigmoid colon perforation in a SARS-CoV-2 positive neonate: a uniqueness report and a brief review

BackgroundDespite the relative prevalence of small bowel and proximal colon perforation in the neonatal period, recto-sigmoid perforation is extremely rare. Full-term neonates experience intestinal perforation less frequently than premature infants. Here we report a neonate with sigmoid perforation and simultaneous Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection.Case presentationA 2550 g female neonate born at 38-weeks’ gestation from a coronavirus disease-2019 (COVID-19) infected mother by cesarean section. Despite a good Apgar score in the first and fifth minutes, she was admitted to the neonatal intensive care unit with grunting and mild respiratory distress. She underwent antibiotics and oxygen by head box resulting in an Oxygen Saturation rate of 94%. The patients’ respiratory distress decreased during the second day, resulting once breastfeeding without tolerance. While she passed meconium in the first 2 days, she developed abdominal distention on day 3. The nasopharyngeal SARS-CoV-2 real-time polymerase chain reaction (RT-PCR) was performed with positive results. Surgical consultation was requested and a thoraco-abdominal X-Ray was performed at this stage, which suspected to be a gastrointestinal perforation.Due to clinical deterioration and persistent abdominal distention, a contrast study was performed with water-soluble contrast, which confirmed intestinal perforation. However, the surgical exploration revealed perforation of the sigmoid colon at the posterior segment. The patient underwent antibiotic therapy, abdominal lavage, and colostomy, immediately. She was discharged in good condition approximately 14-days later.ConclusionTo our knowledge, this is the first report of sigmoid colon perforation in a term neonate following COVID-19.

Determinants of fetal macrosomia among live births in southern Ethiopia: a matched case–control study

BackgroundFetal macrosomia defined as birth weight of 4000 g and above regardless of gestational age and associated with adverse maternal and fetal outcomes, especially among women in developing countries like Ethiopia. Despite the observed burden, there is limited evidence on determinants of fetal macrosomia. This study aimed to identify determinants of fetal macrosomia among live births at Wolaita Sodo town Southern Ethiopia.MethodsA facility-based matched case–control study design involved 360 singletons deliveries attended at hospitals in Wolaita Sodo town, southern Ethiopia, with 120 cases and 240 controls included. Cases and control were matched by maternal age. Cases were neonates with a birth weight of ≥ 4000, while controls were neonates with a birthweight between 2500gm and less than 4000gm. Data were collected by interviews, measuring, and reviewing mothers' medical documents. Conditional logistic regression analysis was carried to identify the independent predictor variables. Statistical significance was set using a p-value < 0.05 and 95% CI for AOR.ResultsMale neonates were four times more likely to be macrosomia than female neonates MAOR = 4.0 [95%CI; 2.25–7.11, p < 0.001]. Neonates born at gestational age ≥ 40 weeks were 4.33 times more likely to be macrosomia with MAOR = 4.33 [95%CI; 2.37–7.91, p < 0.001]. Neonates born from physically inactive mothers were 7.76 times more likely to be macrosomia with MAOR = 7.76 [95CI; 3.33–18.08, p < 0.001]. Neonates born from mothers who consumed fruits and dairy products in their diet frequently were 2 and 4.9 times more likely to be macrosomia MAOR = 2.03 [95%CI; 1.11–3.69, p = 0.021] and AOR = 4.91[95%CI; 2.36–10.23, p < 0.001] respectively.ConclusionMothers' physical exercise and consumption of fruit and dairy products were significant predictor variables for fetal macrosomia. Hence, health care providers may use these factors as a screening tool for the prediction, early diagnosis, and timely intervention of fetal macrosomia and its complications.

Correction: Herniated Fallopian Tube in a Female Neonate with Gastroschisis.

Correction: Herniated Fallopian Tube in a Female Neonate with Gastroschisis.

ETIOLOGICAL FACTORS OF NEONATAL HYPERBILIRUBINEMIA IN TRIBAL COMMUNITY OF MEGHALAYA, INDIA - A CROSS-SECTIONAL STUDY

Objective: To identify the etiological factors of neonatal hyperbilirubinemia in tribal population of Meghalaya, India. Design: Cross sectional study. Setting: Neonatal intensive care unit under (level II NICU) Department of Paediatrics and Neonatology of Nazareth Hospital, Meghalaya, India. Participants: Neonates of Khasi, Jaintia and Garo tribes with neonatal jaundice admitted in NICU of Nazareth Hospital, Meghalaya, India. Main Outcome Measures: Demographic variables of the study population, Mean TSB values of various etiological factors, Effect of various etiological factors in early onset neonatal jaundice, Nature and duration of interventions needed for the neonates studied. Results: In 58.9% of the 409 neonates studied, no cause could be assigned for the development of jaundice. Of the remaining, 19.8% was attributed to low birth weight whereas 19% had ABO incompatibility and 10.8% were premature. 9.3% had sepsis, 8.5% had G6PD deciency while 3.2% were born to mothers with diabetes mellitus. Rh incompatibility was the causative factor in 1.7%. In 1.7%, pre-lacteal feed was associated with jaundice. In 62.3% of cases delayed cord clamping was found to be associated. Conclusions: Total serum bilirubin tends to be higher in female neonates, of term gestation, with birth weight 2500 g or above and with ABO incompatibility. Delayed initiation of breast feeding, those with positive history of neonatal jaundice in older siblings and those with proven neonatal sepsis were also found to have higher levels of bilirubin. Neonates who were given pre-lacteals and those born to diabetic mothers show lower mean total serum bilirubin levels. Most neonates who developed jaundice within 24 hours of life (early onset jaundice) had ABO incompatibility.

1045-P: Relative Cord Hyperleptinaemia Is Associated with Higher Cord C Peptide and Lower Birthweight in Male but Not Female Neonates Born to Overweight/Obese Women

Aim: Umbilical cord leptin is higher than expected in some babies (relative cord hyperleptinaemia) . We test the hypothesis that a higher cord leptin:fat mass ratio, putatively reflecting “leptin resistance” might be associated with adverse pregnancy outcomes. Methods: Secondary analyses from Vitamin D And Lifestyle Intervention for gestational diabetes prevention (DALI) trial a pan European study among women with a BMI ≥29 kg/m2 between 2012-14. Cord sampling and skin caliper measurements followed standardized methods. Serum cord leptin (µg/l) to fat mass ratio (kg) was classified into low, middle, and high tertiles across (where stated) and within sexes. Large/small for gestational age (SGA) used GROW. Pregnancy outcomes were compared between low and high tertiles adjusted for potential confounders using binomial logistic regression. Results: Among the 349 eligible babies (mean gestational age 39.7 ± 1.4 weeks, female 49%) the median (interquartile range) leptin-fat mass ratio (both sexes combined) was 20.2 (11.4-30.8) , top tertile (TT) was &amp;gt;25.3 and low tertile (LT) was &amp;lt;14.9 . Compared with babies in the LT group, those in the TT group had higher cord erythropoietin (30.2 (16.7-59.2) vs. 20.3 (12.4-35.6) µg/l p = 0.002, respectively, both sexes) with higher cord serum C peptide (0.7 (0.5­-1.0) vs. 0.5 (0.3-0.8) µg/l p = 0.005) , lower birthweight (3435 ± 5vs. 37± 412 gm, p = 0.002) in boys but not in girls. Cord glucose was similar. Among males, those in the TT had higher risk of SGA (25.0% vs. 8.5%; OR 3.61 (95%CI 1.21-10.76)) but lower risk of cesarean section (0.39 (0.17-0.88)) . Among females, mothers in the TT had higher rate of pregnancy induced hypertension (3.93 (1.21-12.71)) . Conclusions: Relative cord hyperleptinaemia is associated with reduced fetal growth (boys only) , and possible relative fetal hypoxia (both sexes) . Further studies are required to evaluate the implications of these findings on future metabolism. Disclosure J.Immanuel: None. D.M.Jensen: None. E.R.Mathiesen: Consultant; Novo Nordisk A/S, Speaker's Bureau; Novo Nordisk A/S. D.J.Hill: None. P.Damm: Advisory Panel; Novo Nordisk A/S. F.J.Snoek: Advisory Panel; Abbott Diabetes, Lilly Diabetes, Roche Diabetes Care, Research Support; Novo Nordisk A/S, Sanofi, Speaker's Bureau; Insulet Corporation. J.Adelantado: None. E.Wender-ozegowska: None. D.Simmons: Other Relationship; Elsevier, Research Support; Abbott, Hitachi, Ltd., Novo Nordisk, Speaker's Bureau; Sanofi. G.Desoye: None. M.Vanpoppel: None. A.Kautzky-willer: None. R.Corcoy: None. A.Bertolotto: Research Support; AstraZeneca, Novo Nordisk, Speaker's Bureau; Abbott Diagnostics, Lilly Diabetes. F.P.Dunne: None. J.Harreiter: None. L.Andersen: None. Funding EU FP7 (242187)

P106. In search of an animal model for IUGR to study differences in morbidity and mortality between male and female neonates

P106. In search of an animal model for IUGR to study differences in morbidity and mortality between male and female neonates

Gastroschisis Due to Maternal Exposure to Carbimazole in A Term Neonate

Pregnant women with hyperthyroidism need careful management, which is due to the increased risk of maternal and fetal complications. However, safe and effective therapies for hyperthyroidism during pregnancy remain limited. Carbimazole is an anti-thyroid agent and has been used to treat hyperthyroidism. Gastroschisis is a congenital severe abdominal birth defect of the fetus but its etiology remains unclear. Here, we present a case of a female term neonate who developed gastroschisis after being exposed to carbimazole in uteroduring the first and half of the second trimester.

Herniated Fallopian Tube in a Female Neonate with Gastroschisis.

Herniated Fallopian Tube in a Female Neonate with Gastroschisis.

Establishing normal ranges for fetal and neonatal small and large intestinal lengths: results from a prospective postmortem study.

To establish reference intervals (RIs) for fetal and neonatal small and large intestinal lengths. Linear measurements on small and large intestines were made upon postmortem examination of 131 preterm and term infants with gestational ages between 13 and 41 weeks. All cases were referred from the Eastern Ontario and Western Québec regions to a tertiary care hospital. Age and sex partitions were considered and RI limits were estimated. Data consisted of 72 male (54.96%) and 59 female (45.04%) fetuses and neonates with mean gestational age of 25.6 weeks. Results showed that small and large intestinal lengths increased linearly with gestational age. RIs for small intestinal length (cm) of fetuses and neonates aged 13-20 weeks were (21.1, 122.4); of those aged 21-28 weeks were (57.7, 203.8); of those aged 29-36 weeks were (83.6, 337.1); and of those aged 37-41 weeks were (132.8, 406.4). RIs for large intestinal length (cm) of fetuses and neonates from the same four age groups were (5.1, 21.4), (12.7, 39.7), (32.4, 62.4), and (29.1, 82.2). Establishing accurate RIs for premature and term infants has clinical relevance for pathologists performing postmortem analysis and for surgeons planning postoperative management of patients. The results of this study reaffirm that fetal small and large intestinal lengths increase linearly with gestational age irrespective of sex. Future studies should aim to further investigate the role of possible confounders on growth of fetal intestinal length, including maternal factors such as age and substance use during pregnancy.

Term Infant with Bilateral Parenchymal Brain Hemorrhages.

Term Infant with Bilateral Parenchymal Brain Hemorrhages.

Factors Affecting the Neonatal Outcome with Anorectal Malformation in Underdeveloped Countries

Background: With optimal perioperative and postoperative care, the survival and outcomes of new-born with anorectal malformations (ARM) have improved significantly in developed countries, but sepsis, low birth weight, late presentation, and intense new-born care is still lacking in developing countries influencing the outcome. This analysis was conducted to assess aspects for poor outcomes (mortality) in new-born with anorectal malformations. Study Design: A prospective analytical study. Place and duration: In the Department of Paediatric Surgery at Divisional Headquarters Teaching Hospital Mirpur for six months duration from January 2021 to June 2021. Methods: 48 total consecutive neonates with anorectal malformations (ARMs) admitted to the Paediatric Surgery department were included. The studied variables comprised age at admission, birth weight, sex, type of malformation, sepsis at admission, type of surgery performed, postoperative issues, and their association with the results. Statistical analysis was executed with SPSS 21.0. Results: 48 neonates with ARM were enrolled in the study. 60.4% (29) of the research population are male neonates and 39.6% (19) are female neonates. 2.3 ± 0.7 days was the mean age at admission (minimum age was 1 day and the maximum 4 days) and 2.8 ± 0.9 kg was the mean body weight at birth (minimum weight was 1.7 kg, and the maximum weight was 4.5 kg). The communal reason of mortality in patients postoperative was sepsis (50%). There was a statistically significant correlation amid sepsis and low birth weight (p = &lt;0.01) on admission (p = 0.002) with mortality. Comparing the result with age at the time of presentation (p = 0.19) and complications postoperatively (p = 0.18), no statistically significant correlation was found. Conclusions: Lack of trained midwives / LHV, Lack of resources, late admission, intensive care sepsis, and ultimately mortality are contributing factors in developing countries. Good prenatal care, awareness of midwives / community nurses to refer these patients on time, and adequate intensive care can improve the outcomes of ARM surgery. Keywords: Sepsis, Imperforate anus, low birth weight, primary PSARP, cloaca and Pelvic divided colostomy

Congenital syphilis in neonates: a case report

Background: Congenital syphilis (CS) in neonates is diagnosed when Treponema pallidum was identified in a laboratory test of neonates infected by mothers with syphilis. Recently, CS is still a significant and growing health problem worldwide despite being preventable. This case report will provide an overview of CS management conducted at our center, Sanjiwani Hospital, Gianyar, Bali-Indonesia. Case presentation: We report a case of CS in a newborn female neonate with the positive result of TPHA and VDRL titer 1/128 from a mother diagnosed with the latent phase of syphilis infection. On physical examination found subcostal retraction of the chest, grunting on auscultation, and jaundice. The treatments given include oxygen via cannula nasal with 2 liters per minute, intravenous access with dextrose 10%, the antibiotic combination of cefotaxime 125 mg every 12 hours and gentamicin 12.5 mg every 24 hours. For the management of CS, the patient was given Benzathine Penicillin G at a dose of 125,000 IU single dose intramuscularly. Phototherapy was assisted the patient for 48 hours to manage the hyperbilirubinemia. The patient was discharged on the eight days of treatment with oral antibiotic cefixime 12.5 mg every twelve hours for three days. Conclusion: The entity of CS is a disease suffered by infants with clinical manifestations or examination supporting the diagnosis of syphilis. The mother should do a screening during her pregnancy to prevent untreated syphilis and its complications for her babies.

Neonatal Tinea: A Rare Entity and a Case Report

Introduction: Dermatophyte infections are a rarity in infants, with infection in neonates being still rarer. Case Report: We present a case of a 15-day-old female neonate with few, well-defined, scaly plaques present on the right cheek. Initial suspicion was of contact dermatitis and seborrheic dermatitis. Presence of tinea corporis and cruris in the father prompted us to do KOH examination which revealed the presence of fungal elements. Affected neonate was given treatment in the form of topical sertaconazole for 2 weeks after which the lesions resolved. After 2 months follow up, no recurrence was seen. Conclusion: Always when in doubt, examination of the paramedical staff, doctors and family members handling the baby can give a clue to the diagnosis.

Atypical fetal junctional ectopic tachycardia: a case report and literature review

BackgroundJunctional ectopic tachycardia (JET) is caused by ectopic rhythms, originating in the atrioventricular node, typically with heart rate between 200 and 250 bpm. Herein, we present a case of fetal JET with normal fetal heart rate and a review of nine cases.Case presentationA 32-year-old, gravida 2, para 1, woman in whom fetal JET could not be diagnosed prenatally because the fetal heart rate was within the normal range. The fetus was diagnosed with premature restriction of the foramen ovale, and a cesarean section was performed, owing to the right heart overload that was characterized by fetal ascites and abnormal fetal Doppler velocity. Postnatally, the female neonate was diagnosed with JET on a 12-lead electrocardiogram, which revealed a neonatal heart rate of 158 bpm with narrow QRS and atrioventricular dissociation. After failure to respond to amiodarone therapy, she was treated with flecainide, which controlled the JET rate from 120 to 150 bpm. Fetal tachycardia with ventriculo-atrial (VA) dissociation or 1:1 VA conduction with a shorter VA interval than that of atrioventricular reentrant tachycardia confirmed the diagnosis of fetal JET.ConclusionsJET should be suspected even in the absence of tachycardia in patients with ductus venosus and pulmonary vein retrograde flow or tricuspid and mitral regurgitation without a cardiac anomaly, as tachycardia might sometimes be intermittent in cases of JET.

Frequency Risk Factors and Pattern of Congenital Anomalies in Neonates in Nawabshah Pakistan

Objectives: The objectives of this study were to determine the frequency, risk factors and pattern of congenital anomalies in neonates admitted at a tertiary care hospital.&#x0D; Methodology: It was a descriptive cross-sectional study. Research was conducted at NICU Pediatric ward, PMCH Nawabshah. Duration of study was 6 months after the approval of synopsis from January 2020 to July 2020. This study involved 300 neonates in NICU which were screened for congenital anomalies. Age, gender and birth weight of the neonate was recorded. Mothers were also enquired about consanguinity and use of folic acid and smoking and diabetic status during pregnancy. Frequency and type of birth defect were noted and were compared across various subgroups based on various neonatal and maternal factors.&#x0D; Results: The mean age of the neonates was 10.5±7.4 days while the mean birth weight was 2.89±0.74 Kg. There were 174 (58.0%) male and 126 (42.0%) female neonates with a male to female ratio of 1.4:1. 77 (25.7%) neonates were low birth weight. Birth defect was noted in 35 (11.7%) neonates. 3 neonates had multiple anomalies. The frequency of birth defects was significantly higher in women with no use of folic acid during pregnancy (14.8% vs. 5.2%; p-value=0.015) and cousin marriage (16.6% vs. 2.8%; p-value&lt;0.001).&#x0D; Conclusion: In the present study, 11.7% of neonates had birth defects comprising of congenital hydrocele, spina bifida, cleft lip/palate and club foot that were associated with lack of folic acid use during pregnancy and cousin marriages. Public awareness against cousin marriages and antenatal counseling of mothers for routine folic acid use during pregnancy should be assured for this.

Association between Wood and Other Biomass Fuels and Risk of Low Birthweight in Uganda: A Cross-Sectional Analysis of 2016 Uganda Demographic and Health Survey Data.

In utero exposure to household air pollution (HAP) from polluting cooking fuels has been linked to adverse pregnancy outcomes including low birthweight (LBW). No previous study in Uganda has attempted to investigate the association between the different types of biomass cooking fuels and LBW. This study was conducted to investigate the association between wood and other biomass cooking fuel use with increased risk of LBW, using the 2016 Uganda Demographic and Health Survey for 15,270 live births within five years prior to interview. LBW, defined as birthweight of <2500 g, was estimated from maternal recall and health cards. Association between household exposure to the different solid biomass cooking fuels and LBW was determined using multivariable logistic regression. Biomass cooking fuels were used in 99.6% of the households, with few (0.3%) using cleaner fuels and 0.1% with no cooking, while the prevalence of LBW was 9.6% of all live-births. Although the crude analysis suggested an association between wood fuel use and LBW compared to other biomass and kerosene fuel use (AOR: 0.82; 95% CI: 0.67–1.00), after adjusting for socio-demographic and obstetric factors, no association was observed (AOR: 0.94; 95% CI: 0.72–1.22). LBW was significantly more likely among female neonates (AOR: 1.32 (95% CI: 1.13–1.55) and neonates born to mothers living in larger households (AOR: 1.03; 95% CI: 1.00–1.07). LBW was significantly less likely among neonates delivered at term (AOR: 0.39; 95% CI: 0.31–0.49), born to women with secondary or tertiary level of education (AOR: 0.80; 95% CI: 0.64–1.00), living in households with a higher wealth index (AOR: 0.69; 95% CI: 0.50–0.96), Eastern (AOR: 0.76; 95% CI:0.59–0.98) and Northern (AOR: 0.75; 95% CI: 0.57–0.99) regions. The study findings suggest inconclusive evidence regarding the association between the use of wood compared to other biomass and kerosene cooking fuels and risk of LBW. Given the close observed association between socioeconomic status and LBW, the Ugandan government should prioritize public health actions which support female education and broader sustainable development to improve household living standards in this setting.

Mllt11 Regulates Migration and Neurite Outgrowth of Cortical Projection Neurons during Development.

The formation of connections within the mammalian neocortex is highly regulated by both extracellular guidance mechanisms and intrinsic gene expression programs. There are two types of cortical projection neurons (CPNs): those that project locally and interhemispherically and those that project to subcerebral structures such as the thalamus, hindbrain, and spinal cord. The regulation of cortical projection morphologies is not yet fully understood at the molecular level. Here, we report a role for Mllt11 (Myeloid/lymphoid or mixed-lineage leukemia; translocated to chromosome 11/All1 Fused Gene From Chromosome 1q) in the migration and neurite outgrowth of callosal projection neurons during mouse brain formation. We show that Mllt11 expression is exclusive to developing neurons and is enriched in the developing cortical plate (CP) during the formation of the superficial cortical layers. In cultured primary cortical neurons, Mllt11 is detected in varicosities and growth cones as well as the soma. Using conditional loss-of-function and gain-of-function analysis we show that Mllt11 is required for neuritogenesis and proper migration of upper layer CPNs. Loss of Mllt11 in the superficial cortex of male and female neonates leads to a severe reduction in fibers crossing the corpus callosum (CC), a progressive loss in the maintenance of upper layer projection neuron gene expression, and reduced complexity of dendritic arborization. Proteomic analysis revealed that Mllt11 associates with stabilized microtubules, and Mllt11 loss affected microtubule staining in callosal axons. Taken together, our findings support a role for Mllt11 in promoting the formation of mature upper-layer neuron morphologies and connectivity in the cerebral cortex.SIGNIFICANCE STATEMENT The regulation of cortical projection neuron (CPN) morphologies is an area of active investigation since the time of Cajal. Yet the molecular mechanisms of how the complex dendritic and axonal morphologies of projection neurons are formed remains incompletely understood. Although conditional mutagenesis analysis in the mouse, coupled with overexpression assays in the developing fetal brain, we show that a novel protein called Mllt11 is sufficient and necessary to regulate the dendritic and axonal characteristics of callosal projection neurons in the developing mammalian neocortex. Furthermore, we show that Mllt11 interacts with microtubules, likely accounting for its role in neuritogenesis.

Meeting abstracts from the 15th international conference on neonatal and childhood pulmonary vascular disease

Meeting abstracts from the 15th international conference on neonatal and childhood pulmonary vascular disease

An Uncommon Cause for Respiratory Failure in a Preterm Neonate.

An Uncommon Cause for Respiratory Failure in a Preterm Neonate.

The neonatal onset diabetes mellitus of Chinese neonate with congenital generalized lipodystrophy 2: a case report

BackgroundCongenital generalized lipodystrophy (CGL) is a clinically heterogeneous disorder characterized by near total absence of adipose tissue along with metabolic complications. Diabetes mellitus developed from CGL usually present between ages 15 and 20 years, and there are few reports in neonate.Case presentationIn this report, we described a rare clinical presentation of CGL in a 12-day-old Chinese female neonates with hyperglycemia, hyperlipidemia, and subsequently appeared diabetes, hepatomegaly and fatty liver. The two clinical-exome sequencing identified heterozygous null mutations (c.793C > T and c.565G > T) in BSCL2 gene which was inherited from father and mother respectively. To date, it was the firstly reported CGL patient with neonatal onset diabetes. The neonate was treated with antibiotic, insulin and deeply hydrolyzed formula milk to significantly decrease FBG and serum trigylcerides levels. ConclusionsOur case report analyzes the causes of early onset diabetes may relate with the locus of BSCL2 gene mutations and infection induction. It also suggests the importance of early identification, genetic analysis, and symptomatic treatment in the CGL, which are essential for improving the prognosis of children.