Gestational Maturity Research Articles

Early parental vocal contact in neonatal units: rationale and clinical guidelines for implementation.

This paper aims to present clear and evidence-based proposals for the integration of Early Parental Vocal Contact into the clinical practices of neonatal units. In the first part, we present a comprehensive rationale exploring the ontogenesis of voice perception in both term and preterm newborns that establishes a foundational understanding. This knowledge serves as a crucial starting point for developing evidence-based auditory and multisensory interventions aimed at fostering the developmental trajectory of preterm infants. Drawing insights from neuroscience and brain development, our proposals underscore the significance of tailoring auditory environments within neonatal settings. Special attention is given to the unique needs of preterm infants, factoring in their gestational age and maturation levels. In the second part clinical guidelines for implementation are provided and healthcare professionals are supported to assist parents in modulating their vocal interactions, aligning them with the infant's responses. Furthermore, we provide practical suggestions for engaging in discussions with parents about the content, duration, and frequency of vocal interventions. Finally, we delve into the potential roles of caregivers, parents, and health professionals within this enriched parental vocal interactional environment. Our perspective is firmly grounded in an infant and family-centered developmental care philosophy, aiming to enhance the overall well-being and the neurodevelopment of preterm infants in neonatal units.

A study of correlation between foot length and gestational maturity and anthropometric measurements in neonates

Background: This pinnacle’s the importance for alternative measurements which predicts birth weight and gestational age (GA). Foot length is a simple measure and does not require expertise. The aim of this study was to study correlation of foot length and GA among preterm, term and post-term neonates. Methods: This study was a prospective observational study done in 155 babies. Anthropometric measurements were taken within the first 24 hours of life. GA estimation was done using modified Ballard score. Foot length, head circumference and chest circumference were measured and noted. Weight of the baby was recorded using electronic weighing scale. Results: Foot length statistically correlated (p<0.05) with GA assessment using NBS, weight, length, head circumference and chest circumference. The highest correlation of foot length in term SGA and term AGA babies for foot length was with head circumference (r=0.74 and 0.64 respectively). In pre-terms, foot length correlated well with head circumference and birth weight (r=0.92, 0.84 and 0.92 respectively). There were no babies in preterm LGA group and post term SGA and LGA group. Conclusions: Foot length also statistically correlated with other parameters like birth weight, length, head circumference and chest circumference.

Omega-3/omega-6 fatty acids: Effects on growth and neurodevelopment of the fetus and preterm infant. A narrative review

BACKGROUND: Fatty acids of the omega-3/omega-6 groups are used in cases of pregnancy, lactation and preterm birth. In recent decades, pediatrics has been trying to find out whether the use of omega-3/omega-6 has effects on human growth and neurodevelopment. A total of 44 original articles on the topic of omega-3/omega-6 and human growth and nutrition, in gynecology and pediatrics have been selected on PubMed from January 1979 until March 2023. Significant critical issues emerged regarding published studies, despite encouraging evidence on the usefulness of omega-3/omega-6 used in pregnancy, lactation, states of malnutrition, and inflammatory processes, while data on the efficacy of use in fetal, neonatal, and pediatric patients are conflicting. Critical structural and functional issues emerge in the studies that may call into question the validity of the results. The data are encouraging and suggest that certain aspects of the type of administration and dosages of omega-3/omega-6 fatty acid supplementation should be investigated further to help demonstrate the clinical validity of such prescriptions, especially in terms of gestational maturation, growth, and human nutrition in clinical practice in Gynecology and Pediatrics.

Sickle cell anemia in pregnant Saudi women and its impact on birth weight and gestational maturity.

It is well documented that sickle cell anemia (SCA) in pregnancy increases the risk of problems that can influence the growth and maturation of the newborn. To assess the gestational maturity and birth weight of babies born to Saudi mothers with SCA in the Jazan region. A case-control study was conducted in three hospitals in the Jazan region. An interview with a semi-structured questionnaire was used to collect data from the participants' women, and then the birth weight was taken. Of 187 delivered women, 20.3% had SCA (13% had sickle cell disease, and the remaining had sickle cell trait). Among the 38 affected mothers, 15.7% were considered to have an additional risk (7.9% had diabetes mellitus, 5.3% had hypertension, and 2.6% were smokers). The mean birth weight was 2.95 ± 0.40 kg and 2.99 ± 0.55 kg in the case and control groups, respectively. However, the low birth weight babies constitute 31% of the delivered babies in the SCA group with a weight of 2.33 ± 0.16 kg and 15% of the control group with a mean weight of 2.16 ± 0.30 kg. The gestational age was 39.36 ± 1.02 weeks in the SCA group compared to 39.5 ± 1.17 weeks in the control group. Maternal age and hypertension significantly influence the birth weight in the SCA group compared to the influence of diabetes mellitus on the birth weight in the control group. This study indicates that SCA in pregnant mothers influences birth weight, which is more impacted by maternal age and co-morbidities. Therefore, a multidisciplinary approach must monitor these risky pregnancies well to avoid undesirable neonatal outcomes.

Risk factors of immature retina on the first screening for retinopathy of prematurity

Background Immature retina is characterized by peripheral retinal avascularity. Retinal development is influenced by risk factors that affect retinal maturity.
 Objective To identify risk factors for immature retina on the first retinopathy of prematurity (ROP) screening at the Neonatology Care Unit, Al-Islam Hospital, Bandung, in 2013-2021.
 Methods This case-control, retrospective, observational study was performed by evaluating medical records of preterm infants screened for ROP. The subjects were divided into two groups, immature retina and mature retina. We recorded potential risk factors including gestational age (GA), birth weight (BW), birth weight for gestational age, respiratory distress syndrome (RDS), oxygen therapy >7 days, asphyxia, sepsis, multiple transfusion, apnea of prematurity (AOP), patent ductus arteriosus (PDA), and bronchopulmonary dysplasia (BPD) and analyzed them for potential associations with retinal development.
 Results On the first ROP screening of 203 premature infants, 5 (2.5%) had ROP, 90 (44.6%) had immature retinas, and 107 (53.0%) had mature retinas. Bivariate logistic regression analysis showed significant relationships between immature retina (P<0.05), GA (OR=0.575; P=0.000), BW (OR=0.997; P=<0.001), gestational age maturity (OR=2.639; P=0.006), RDS (OR=1.809; P=0.042), oxygen therapy of >7 days (OR=4.494; P=0.002), sepsis (OR=2.028; P=0.034), multiple transfusions (OR=4.656; P=0.000), AOP (OR=2.553; P=0.002), PDA (OR=2.119; P=0.030). Multivariate regression analysis revealed a significant simultaneous relationship between all the risk factors and immature retina, with a Nägelkerke R2 value of 0.421.
 Conclusion GA, BW, gestational age maturity, oxygen therapy of >7 days, sepsis, multiple transfusions, AOP, and PDA are significant risk factors of immature retina, be it independently or simultaneously.

Analysis of Pregnancy Complications and Epigenetic Gestational Age of Newborns

Preeclampsia, gestational hypertension, and gestational diabetes, the most common pregnancy complications, are associated with substantial morbidity and mortality in mothers and children. Little is known about the biological processes that link the occurrence of these pregnancy complications with adverse child outcomes; altered biological aging of the growing fetus up to birth is one molecular pathway of increasing interest. To evaluate whether exposure to each of these 3 pregnancy complications (gestational diabetes, gestational hypertension, and preeclampsia) is associated with accelerated or decelerated gestational biological age in children at birth. Children included in these analyses were born between 1998 and 2018 and spanned multiple geographic areas of the US. Pregnancy complication information was obtained from maternal self-report and/or medical record data. DNA methylation measures were obtained from blood biospecimens collected from offspring at birth. The study used data from the national Environmental Influences on Child Health Outcomes (ECHO) multisite cohort study collected and recorded as of the August 31, 2021, data lock date. Data analysis was performed from September 2021 to December 2022. Three pregnancy conditions were examined: gestational hypertension, preeclampsia, and gestational diabetes. Accelerated or decelerated biological gestational age at birth, estimated using existing epigenetic gestational age clock algorithms. A total of 1801 child participants (880 male [48.9%]; median [range] chronological gestational age at birth, 39 [30-43] weeks) from 12 ECHO cohorts met the analytic inclusion criteria. Reported races included Asian (49 participants [2.7%]), Black (390 participants [21.7%]), White (1026 participants [57.0%]), and other races (92 participants [5.1%]) (ie, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, multiple races, and other race not specified). In total, 524 participants (29.0%) reported Hispanic ethnicity. Maternal ages ranged from 16 to 45 years of age with a median of 29 in the analytic sample. A range of maternal education levels, from less than high school (260 participants [14.4%]) to Bachelor's degree and above (629 participants [34.9%]), were reported. In adjusted regression models, prenatal exposure to maternal gestational diabetes (β, -0.423; 95% CI, -0.709 to -0.138) and preeclampsia (β, -0.513; 95% CI, -0.857 to -0.170), but not gestational hypertension (β, 0.003; 95% CI, -0.338 to 0.344), were associated with decelerated epigenetic aging among exposed neonates vs those who were unexposed. Modification of these associations, by sex, was observed with exposure to preeclampsia (β, -0.700; 95% CI, -1.189 to -0.210) and gestational diabetes (β, -0.636; 95% CI, -1.070 to -0.200), with associations observed among female but not male participants. This US cohort study of neonate biological changes related to exposure to maternal pregnancy conditions found evidence that preeclampsia and gestational diabetes delay biological maturity, especially in female offspring.

Prenatal ultrasonographic characteristics and prognosis of isolated redundant foramen ovale flap

ObjectiveTo analyze the prenatal ultrasonographic characteristics and prognosis of the isolated redundant foramen ovale flap (RFOF). MethodsFrom January 2014 to December 2021, we collected data on fetal echocardiography analyses and perinatal outcomes for fetuses with isolated RFOF in Peking University People's Hospital. ResultsWe found that 0.31% (87/28308) of participants have RFOF. The four-chamber results of the foramen ovale flap (FOF) showed that it was stiff and extended >50% or reached the lateral wall of the left atrium (LA) in diastole. As seen from the foramen ovale(FO) channel and four-chamber views, the hypermobile and redundant flap were observed shrinking and stretching with the fetal cardiac cycle, which is similar to jellyfish. The lateral displacement of flow from LA to the left ventricle (LV) around the FOF on color doppler demonstrated thin linear blood flow from the right to left and a reversal of flow across FO. A uniphasic, but not biphasic, pattern of FOF displacement was observed on M-mode. Stages I (23/87) and II (51/87) had a higher ratio of ventricular disproportion than Stage 0 (11/87) and III (2/87). We observed the RA/LA (right/left atrium) ​> ​1.2 in 53 cases (60.9%), RV/LV (right/left ventricle) ​> ​1.2 in 53 cases (60.9%), PA/AO (pulmonary/aortic artery) ​> ​1.2 in 53 cases (60.9%), and moderate or severe tricuspid regurgitation in 10 cases and moderate pericardial effusion in 2 cases (2.2%). Seventy-four RFOF cases had follow-up data. Neonatal death occurred in 2 cases; 72 fetuses survived with normal or minor heart defects. ConclusionRFOF should be considered if the left side of the heart of a fetus is smaller and related to hypermobile FOF. For isolated RFOF cases, a monthly follow-up is recommended to monitor arrhythmia or fetal hydrop status. Prompt treatment is recommended for those with adequate gestational age and lung maturity.

Biventricular biaxial mechanical testing and constitutive modelling of fetal porcine myocardium passive stiffness

The evaluation of fetal heart mechanical function is becoming increasingly important for determining the prognosis and making subsequent decisions on the treatment and management of congenital heart diseases. Finite Element (FE) modelling can potentially provide detailed information on fetal hearts, and help perform virtual interventions to assist in predicting outcomes and supporting clinical decisions. Previous FE studies have enabled an improved understanding of healthy and diseased fetal heart biomechanics. However, to date, the mechanical properties of the fetal myocardium have not been well characterized which limits the reliability of such modelling. Here, we characterize the passive mechanical properties of late fetal and neonatal porcine hearts via biaxial mechanical testing as a surrogate for human fetal heart mechanical properties. We used samples from both the right and left ventricles over the late gestational period from 85 days of gestation to birth. Constitutive modelling was subsequently performed with a transversely isotropic Fung-type model and a Humphrey-type model, using fiber orientations identified with histology. We found no significant difference in mechanical stiffness across all age groups and between the right and left ventricular samples. This was likely due to the similarity in LV and RV pressures in the fetal heart, and similar gestational maturity across these late gestational ages. We thus recommend using the constitutive model for the average stress-stress behaviour of the tissues in future modelling work. Furthermore, we characterized the variability of the stiffness to inform such work.

Intestinal Resection is More Likely to be Effective in Necrotizing Enterocolitis Extending to Colon than in Disease Limited to the Small Intestine.

Background:The prognosis in surgical necrotizing enterocolitis (NEC) has focused on the total length of the resected bowel; the relative impact of small intestinal vs colonic resection is not well studied.Objective:We hypothesized that intestinal resections may reduce mortality and length of hospital stay (LOS) more likely in infants who have NEC extending into the colon than in those with disease limited to the small intestine. We also investigated the relationship between gestational maturation and NEC-related mortality.Methods:A retrospective study of 153 patients compared demographic, clinical, and histopathological information in infants who had NEC limited to the small intestine vs disease with colonic involvement.Results:Our 153 infants had a mean (±standard deviation) gestational age of 27.4 ± 3.4 weeks and a birth weight of 987 ± 505 g. NEC was limited to the small intestine in 103 (67.3%) infants and extended into the colon in 50 (32.7%). Infants with small intestinal NEC needed shorter bowel resections of 28 ± 31.9 cm than 42.2 ± 40.7 cm in those with colonic involvement (p = 0.02). The LOS was longer in NEC limited to the small intestine than in disease with colonic lesions (96 ± 88.1 vs 69.7 ± 19.1 days; p <0.05). In small intestinal NEC, mortality decreased to <50% beyond a gestational age (GA) >37 weeks. In contrast, infants with NEC that involved the colon had mortality <50% mortality beyond 27.3 weeks’ GA (p = 0.008).Conclusions:Bowel resections may be more likely associated with shorter LOS in surgical NEC that involves both the small bowel and colon, even when longer segments of the gastrointestinal tract are removed, than in disease limited to the small intestine.

Comparison of Efficacy Between Paladai and Syringe Feeding in Stable Preterm Neonates-A Randomized Control Trial.

Background: Feeding abilities of preterm neonates differ based on their gestational and postnatal maturity. Maturity of sucking pattern and improved coordination between sucking and swallowing and breathing, which is seen in babies with a gestation of 32 weeks onward, makes trial of oral feeds more successful in these babies. The oral feeds can be given either with a cup and spoon or a paladai. However, we observed that the milk spilt during feeding was an issue due to a wider spout of the paladai. Feeding through syringe is practiced in many neonatal units. However, there is a lack of scientific literature regarding the syringe feeding of neonates. We hypothesized that giving oral feeds using a syringe could reduce the spillage of milk. This study was done to compare the volume of feeds wasted (spillover) during oral feeding between paladai and syringe feeding. Methods: The order of feeding of 75 nurse baby pairs was randomized to either the syringe or the paladai groups. The volume of milk spilt was assessed by weighing a gauze pad placed under the neck of the baby before and after feeds. Time taken to complete the feeds, the rate of feeding, and events like vomiting and choking after feeding were noted. Feeding satisfaction among the nurses was recorded on a 5-point Likert scale. Results: The average mean time for completion of feeds by paladai was 9 minutes against 8.9 minutes in syringe feeding. The median rate of feeding was 3.57 minutes in the paladai group and 3.5 minutes in the syringe group. The median spillover volume was 3.33 mL in the paladai feeds and 3.23 mL in the intervention group. Seventy percent of the nurses reported better satisfaction with syringe feeds compared to paladai feeds. Conclusion: This study demonstrates that the milk spillover (wastage) during syringe feeding is not different from paladai feeds. However, the majority of nurses felt the syringe feeding was more satisfactory than paladai feeding. CTRI Reg. No: CTRI/2021/05/033479 dated 07.05.2021.

Gestation-Based Viability–Difficult Decisions with Far-Reaching Consequences

Most clinicians rely on outcome data based on completed weeks of gestational of fetal maturity for antenatal and postnatal counseling, especially for preterm infants born at the margins of viability. Contemporary estimation of gestational maturity, based on ultrasounds, relies on the use of first-trimester scans, which offer an accuracy of ±3–7 days, and depend on the timing of the scans and the measurements used in the calculations. Most published literature on the outcomes of babies born prematurely have reported on short- and long-term outcomes based on completed gestational weeks of fetal maturity at birth. These outcome data change significantly from one week to the next, especially around the margin of gestational viability. With a change in approach solely from decisions based on survival, to disability-free survival and long-term functional outcomes, the complexity of the parental and care provider’s decision-making in the perinatal and postnatal period for babies born at less than 25 weeks gestation remains challenging. While sustaining life following birth at the margins of viability remains our priority—identifying and mitigating risks associated with extremely preterm birth begins in the perinatal period. The challenge of supporting the normal maturation of these babies postnatally has far-reaching consequences and depends on our ability to sustain life while optimizing growth, nutrition, and the repair of organs compromised by the consequences of preterm birth. This article aims to explore the ethical and medical complexities of contemporary decision-making in the perinatal and postnatal periods. We identify gaps in our current knowledge of this topic and suggest areas for future research, while offering a perspective for future collaborative decision-making and care for babies born at the margins of viability.

Study of cord blood lipid profile at birth and its relation to gestational maturity and birth weight

Background: Dyslipidemia is attributed for coronary artery diseases. Early detection of dyslipidemia in neonatal cord blood could help to identify possible future risk factors of coronary artery diseases in new born.&#x0D; Aims and Objectives: This study was undertaken to compare lipid profile of small for gestational age (SGA) or preterm and appropriate for gestational age (AGA) or near-term neonates.&#x0D; Material and Methods: A total of 60 neonates were included; of which 33 were AGA and 27 SGA neonates. 2 ml of blood was obtained from the umbilical vein immediately after cord clamping at delivery from each subject and kept in a plain vial, after the serum separation analyzed for biochemical parameters.&#x0D; Results: In SGA neonates, mean TC (total cholesterol), TG (triglycerides) LDL (low density lipoprotein cholesterol), HDL (high density lipoprotein cholesterol) and triglycerides were 66.60±17.76 mg/dl,57.32±23.7 mg/dl, 54.06±20.11 mg/dl, 19.06±17.03mg/dl respectively. SGA neonates had more TC, TG and LDL than AGA neonates (P&lt;0.05). There was significant difference in mean lipid profile between preterm andnear-term neonates. Thus, lipid profiles in SGA neonates in thisstudy are higher than that of AGAneonates.&#x0D; Conclusion: It can be concluded that preterm babies are exposed to more hypercholesterolemia and potentially more atherogenic environment than their term counterparts.

A critical appraisal of Lakshanadhyaya of Kashyapa Samhita with special reference to pediatric examination

Kashyapa Samhita is the only Ayurveda classical text, which deals exclusively with pediatric anatomy, physiology, pathology, and its management. Out of which, chapter number 28 - Lakshanadhyaya has a detailed description of anatomical and physiological features of the child and correlated it with clinical, professional, social, and spiritual fortunes. But, Lakshanadhyaya is incomplete at the end. Objective: To reveal the clinical importance of features mentioned in Lakshanadhyaya and to provide probable justification for particular future predictions given in Lakshanadhyaya. Data Source: Lakshanadhyaya of Kashyapa Samhita published by Chaukhambha Sanskrit Sansthan, Varanasi. Materials and Methods: Relevant materials were searched from sources such as published books, journals, and the Internet. A critical review was done over the same. Result: Acharya Kashyapa has predicted the quality and quantity of life by assessment of anatomical and physiological features of the child from birth till adolescence. All clinical points such as signs of gestational maturity (by examining the skin, hair, movement, and genitals), anthropometry (size of body parts), secondary sex characters (such as pubic hair, breast, and genitals), and systemic examinations (such as per vaginal, per rectal, musculoskeletal, and per abdomen examinations) are covered in Lakshanadhyaya. Conclusion: This article highlights that time to time examination of a child helps to predict their future life. The abdomen, vagina, nail, scrotum, penis, hair, joints, back, gait, etc., are important areas of examination for early detection of impending clinical manifestation.

Study on Inborn and Outborn Neonatal Admissions in Relation to Gestational Maturity in Neonatal Intensive Care Unit at a Tertiary Care University Hospital in Upper Egypt

AbstractNeonatal morbidity and mortality rates indicate a country's socioeconomic status and the quality, and effectiveness of its health care system. This research aimed to identify the clinical pattern and causes of neonatal admission for inborn and outborn babies in a tertiary care university hospital and their outcomes. Over a year, this prospective hospital-based research was conducted in the neonatal intensive care unit (NICU) of Assiut Children's Hospital in Upper Egypt (January 1st to December 31st, 2020). Gender, birth weight, gestational age, postnatal age, delivery mode, delivery place, admission cause, hospital stay period, and neonatal outcomes were collected. A total of 1,638 newborns were admitted; 930 (56.8%) were preterm and 708 (43.2%) full-term. Inborn admissions were 1,056 (64.5%) and outborn 582 (35.5%). The majority of inborn admissions were preterm 726 (68.8%), and outborn were full-term 378 (64.9%). The commonest admission causes among inborn and outborn preterm infants were respiratory distress syndrome (84.3%) and congenital intestinal obstruction (22.5%), respectively, while multiple congenital anomalies were the commonest cause for admission among both inborn and outborn full-term babies. The mortality rate was 708 (43.2%), higher among inborn (50%) versus outborn (30.9%). The leading cause of death was respiratory distress syndrome among premature inborn with case fatality rate of (56.9%) and multiple congenital anomalies among premature outborn (60%), as well as inborn (67.4%), and outborn (42.6%) full-term neonates. In conclusion, the neonatal mortality rate was high among studied cases. Morbidity and mortality of respiratory distress syndrome and congenital anomalies were alarmingly high. Therefore, all health care providers must devote a considerable effort to improve health care delivered to these neonates.

Preterm Infants Harbour a Rapidly Changing Mycobiota That Includes Candida Pathobionts.

Fungi and the mycobiome are a fundamental part of the human microbiome that contributes to human health and development. Despite this, relatively little is known about the mycobiome of the preterm infant gut. Here, we have characterised faecal fungal communities present in 11 premature infants born with differing degrees of prematurity and mapped how the mycobiome develops during early infancy. Using an ITS1 sequencing-based approach, the preterm infant gut mycobiome was found to be often dominated by a single species, typically a yeast. Candida was the most abundant genus, with the pathobionts C. albicans and C. parapsilosis highly prevalent and persistent in these infants. Gestational maturity at birth affected the distribution and abundance of these Candida, with hospital-associated C. parapsilosis more prevalent and abundant in infants born at less than 31 weeks. Fungal diversity was lowest at 6 months, but increased with age and change of diet, with food-associated Saccharomyces cerevisiae most abundant in infants post weaning. This study provides a first insight into the fungal communities present within the preterm infant gut, identifying distinctive features including the prominence of pathobiont species, and the influence age and environmental factors play in shaping the development of the mycobiome.

A study of postnatal foot length to determine gestational maturity in neonates

Background: Gestational age is a major determinant of newborn prognosis. Early identification of gestational age is a major priority to reduce global mortality from preterm birth. Therefore this study was conducted with an aim to find out an alternate simple, low cost and reliable method to identify accurate gestational ages.Methods: The cross sectional study was carried out at Rukmani Chainani Maternity and Neonatal Unit, SSGH and Medical College, Baroda from December 2019 to May 2020. Total 500 live newborns of different gestational ages within 72 hrs of birth which were appropriate for gestational age were enrolled in this study. Foot length, head circumference, crown heel length and weight were measured. Gestational age was estimated by antenatal USG, Ballard scoring and LMP. Correlation of foot length to gestational age and other anthropometric variables was done.Results: There was statistically significant positive correlation found between foot length and gestational age (correlation coefficient of 0.944 and p value of &lt;0.0001). There was also positive correlation found between foot length and weight, head circumference and length with correlation coefficient of 0.942, 0.888 and 0.906, respectively. Using ROC curve, foot length cut-off value of 7.2 cm can be used for identifying preterm babies with sensitivity of 94.4% and specificity of 95.6%. Regression equation for gestational age calculation was GA=6.669+4.0601[FL].Conclusions: This study had demonstrated that Foot length is a simple and reliable anthropometric measurement to assess gestational age and to screen prematurity.

Special Issue No. – 10, June, 2020 Journal &gt; Special Issue &gt; Special Issue No. – 10, June, 2020 &gt; Page 5 “Quantative Methods in Modern Science” organized by Academic Paper Ltd, Russia MORPHOLOGICAL AND ANATOMICAL FEATURES OF THE GENUS GAGEA SALISB., GROWING IN THE EAST KAZAKHSTAN REGION Authors: Zhamal T. Igissinova,Almash A. Kitapbayeva,Anargul S. Sharipkhanova,Alexander L. Vorobyev,Svetlana F. Kolosova,Zhanat

Special Issue No. – 10, June, 2020 Journal &gt; Special Issue &gt; Special Issue No. – 10, June, 2020 &gt; Page 5 “Quantative Methods in Modern Science” organized by Academic Paper Ltd, Russia MORPHOLOGICAL AND ANATOMICAL FEATURES OF THE GENUS GAGEA SALISB., GROWING IN THE EAST KAZAKHSTAN REGION Authors: Zhamal T. Igissinova,Almash A. Kitapbayeva,Anargul S. Sharipkhanova,Alexander L. Vorobyev,Svetlana F. Kolosova,Zhanat

Postnatal foot length of newborn: its correlation with gestational maturity

Background: Neonatal death is one of the major contributors (50%) of Under-five child mortality and 70% of the infant mortality. The main causes of neonatal deaths are prematurity and low birth weight (LBW). This study was undertaken to assess newborn foot length and determine its usefulness in identifying LBW/Preterm Babies.Methods: This is a cross sectional hospital based study of 173 newborn babies, done in KIMS Hospital, Bengaluru. All live newborn infants were included in the study. Newborn babies with lower limb congenital anomalies were excluded from the study.Results: Out of 173 newborn, 99 babies were male (57%) and 74 were female (43%). 122 (70.5%) were term and 51(29.5%) were preterm. 48 (38%) were SGA, 120 (69%) were AGA and 5 (3%) were LGA. Their gestational age ranged from 28 to 40 weeks. In this study positive Correlation between foot length and gestational age was found with the “r” value of 0.823. The study also showed a positive correlation between foot length and weight with the “r” value of 0.831.Conclusions: This study has a good correlation of Foot length with gestational maturity and birth weight. Foot length of 7.45cm can be used as a cut- off point for differentiating between term and preterm babies. Derived equation from this study can be used by ASHAs and Anganwadi workers for the estimation of gestational age in resource poor situations and refer the preterm newborns to higher centres for further management as early as possible to prevent long and short term complications of prematurity.

Post-mortem estimation of gestational age and maturation of new-borns by CT examination of clavicle length, femoral length and femoral bone nuclei

Various parameters can be used for the estimation of gestational age and maturity with arising challenges in the assessment of decomposed bodies. In order to assess gestational age and thus maturity, the study measured the femoral length, the diameter of the distal femoral epiphysis and the presence of the proximal tibial epiphysis compared to a known clavicle length. The resulting gestational ages were compared and statistically evaluated. As a result, discrepancies between the estimated gestational ages became apparent in some cases when comparing the individual structures to be measured. However, there was a clear tendency towards a lower gestational age calculated based on clavicle length and a higher gestational age calculated based on femoral length and distal femoral epiphysis. With regard to the assessment of maturity, it has been concluded that, if the proximal tibial epiphysis is present, maturity can also be assumed based on the diameter of the distal femoral epiphysis and the length of the femur.

Split-week gestational age model provides valuable information on outcomes in extremely preterm infants.

To compare composite outcomes of neonatal mortality or morbidity using a split-week gestational age (GA) model to completed weeks GA maturity at 23-26weeks gestation. This was a retrospective cohort study of infants bornat 23-26weeks GA. Outcomes using a split-week GA model defined as early (X, 0-3) and late (X, 4-6) with X being 23-26weeks GA were compared to outcomes using completed weeks GA, with a similar comparison between the late split of the preceding week (X, 4-6) and early split of the subsequent week (X+1, 0-3). A total of 1345 infants were included in the study. Statistically significant differences were noted in outcomes between the early and late split of the gestational week at 24 (early vs late, 85.6% vs 73.0%), 25 (69.6% vs 56.6%) and 26weeks (55.9% vs 37.4%), but not at 23weeks GA (95.2% vs 94.5%). No statistically significant differences were noted between the late vs early part of the subsequent week (23, 4-6)vs (24, 0-3), and (24, 4-6)vs (25, 0-3) GA. Neonatal outcome estimates using a split week model differs from that based on the use of completed weeks of gestational maturity.