Low Birth Weight Newborns Research Articles

Effect of per Capita Income on the Relationship between Periodontal Disease during Pregnancy and the Risk of Preterm Birth and Low Birth Weight Newborn. Systematic Review and Meta-Analysis.

This work analyzed the available evidence in the scientific literature about the risk of preterm birth and/or giving birth to low birth weight newborns in pregnant women with periodontal disease. A systematic search was carried out in three databases for observational cohort studies that related periodontal disease in pregnant women with the risk of preterm delivery and/or low birth weight, and that gave their results in relative risk (RR) values. Eleven articles were found, meeting the inclusion criteria. Statistically significant values were obtained regarding the risk of preterm birth in pregnant women with periodontitis (RR = 1.67 (1.17–2.38), 95% confidence interval (CI)), and low birth weight (RR = 2.53 (1.61–3.98) 95% CI). When a meta-regression was carried out to relate these results to the income level of each country, statistically significant results were also obtained; on the one hand, for preterm birth, a RR = 1.8 (1.43–2.27) 95% CI was obtained and, on the other hand, for low birth weight, RR = 2.9 (1.98–4.26) 95% CI. A statistically significant association of periodontitis, and the two childbirth complications studied was found, when studying the association between these results and the country’s per capita income level. However, more studies and clinical trials are needed in this regard to confirm the conclusions obtained.

Smoking and Smoking Cessation in the Risk for Fetal Growth Restriction and Low Birth Weight and Additive Effect of Maternal Obesity.

Many studies have shown that neonates of smoking mothers have a lower birth weight, but several issues remain poorly studied, e.g., the effects of giving up smoking or the combined effects of smoking and maternal obesity. Therefore, we evaluated a prospective cohort of 912 mothers in a single pregnancy, recruited in Poland, in 2015−2016. In the cohort, we recorded 72 (7.9%) newborns with birth weight <10th percentile, 21 (2.3%) fetal growth restriction (FGR) cases, and 60 (6.6%) low birth weight (LBW, <2500 g) newborns. In the cohort, 168 (18.4%) women smoked before pregnancy; the mean number of cigarettes/day was 10.8 (1–30), and the mean number of years of cigarette smoking was 8.5 (1–25). Among smokers, 57 (6.3%) women smoked in the first trimester. Adjusted odds ratio (AOR) of newborn outcomes (with 95% confidence intervals, CI) was calculated in multi-dimensional logistic regressions. Compared to participants who had never smoked, smoking before pregnancy was associated with a higher odds ratio of birth weight <10th percentile (AOR = 1.93, CI: 1.08–3.44, p = 0.027), but the result for LBW (AOR = 2.76, CI: 1.05–7.26, p = 0.039) and FGR (AOR = 1.13, CI: 0.38–3.36, p = 0.822) had the wider confidence interval or was insignificant. Effects of smoking cessation before pregnancy were statistically insignificant for the studied outcomes. Smoking in the first trimester was associated with a higher risk of birth weight <10th percentile (AOR = 4.68, CI: 2.28–9.62, p < 0.001), LBW (AOR = 6.42, CI: 1.84–22.36, p = 0.004), and FGR (AOR = 3.60, CI: 0.96–13.49, p = 0.057). Smoking cessation in the second/third trimester was associated with a higher odds ratio of birth weight <10th percentile (AOR = 4.54, CI: 1.58–13.02, p = 0.005), FGR (AOR = 3.36, CI: 0.6–18.74, p = 0.167), and LBW (AOR = 2.14, CI: 0.62–7.36), p = 0.229), to a similar degree to smoking in the first trimester. The odds ratios were higher in the subgroup of pre-pregnancy body mass index ≥25 kg/m2 for the risk of birth weight <10th percentile (AOR = 6.39, CI: 2.01–20.34, p = 0.002) and FGR (AOR = 6.25, CI: 0.86–45.59, p = 0.071). The length of cigarette smoking time was also the risk factor for studied outcomes. Conclusions: Smoking in the first trimester increased the studied risks, and the coexistence of excessive maternal weight increased the effects. Smoking cessation during the second/third trimester did not have a protective effect.

Retinopathy of prematurity- clinical profile on incidence, risk factors and outcome

Background: Retinopathy of prematurity is one of the important causes of preventable blindness in the world. Thereby timely screening, diagnosis and hence treatment is of utmost importance.Methods: This study was done in the neonatal intensive care unit of tertiary hospital, Surendranagar. Study design being observational, data collected from clinical examination and records of the preterm babies &lt;34 weeks and low birth weight babies &lt;1.5 kg and further screened them for retinopathy of prematurity. The incidence of ROP in the neonatal intensive care unit (NICU), risk factors which predispose to ROP (Retinopathy of prematurity) and outcome of these cases were analysed.Results: As per this study, ROP was found to be more common in &lt;30 weeks gestation and&lt;1 kg neonate, and found to be associated with oxygen exposure, blood product use, antenatal steroids and surfactant.Conclusions: The analysis of the incidence and risk factors, will henceforth help in identifying and acting on time, thereby improving overall outcome of the preterm and low birth weight new-borns.

Are morphokinetic parameters of embryo development associated with adverse perinatal outcomes following fresh blastocyst transfer?

Research questionAre obstetric and perinatal complications associated with morphokinetic parameters of embryo development? DesignThis proof-of-concept pilot study included a retrospective analysis of embryo morphokinetic parameters of 85 live births following day 5 single blastocyst transfer. Kinetic variables included time interval (hours) from time of pronuclei fading (tPNf) to: time of 2 cells (tPNf–t2), 9 cells (tPNf–t9), morula (tPNf–tM), start of blastulation (tPNf–tSB), full blastocyst (tPNf–tB) and expanded blastocyst (tPNf–tEB). Multivariable logistic models were used to calculate the risk of perinatal complications after adjustment for confounders. ResultsThe mean interval of tPNf–tSB was significantly longer for newborns with congenital anomalies compared with healthy newborns (79.49 ± 5.78 versus 71.7 ± 6.3, respectively, P = 0.01) and for embryos of women who had gestational diabetes mellitus compared with normoglycemic women (76.56 ± 7.55 versus 71.5 ± 6.13, respectively, P = 0.015). The mean interval of tPNf–t9 was significantly longer for low-birthweight newborns compared with normal weight (49.25 ± 5.54 versus 45.47 ± 4.77, respectively, P = 0.01). Preterm delivery was associated with several longer intervals of cell divisions compared with delivery at term (tPNf–t5: 28.76 ± 3.13 versus 26.64 ± 2.40, respectively, P = 0.01; tPNf–t6: 30.10 ± 3.05 versus 27.68 ± 2.30, respectively, P < 0.001; tPNf–t7: 32.08 ± 4.11 versus 28.70 ± 2.67, respectively, P < 0.001; tPNf–t8: 34.75 ± 4.95 versus 30.70 ± 4.10, respectively, P < 0.001; tPNf–t9: 50.23 ± 5.87 versus 45.44 ± 4.67, respectively, P < 0.001). For each of the outcomes, the association remained significant after adjusting for confounders. ConclusionThis study indicates that there may be a possible association between adverse perinatal outcomes and morphokinetic parameters. Larger studies are needed to establish this association.

Low Selenium Levels in Amniotic Fluid Correlate with Small-For-Gestational Age Newborns

Background: Identifying women at risk for small-for-gestational-age newborns (SGA) is an important challenge in obstetrics. Several different risk factors have been suggested to contribute to the development of SGA. Previous research is inconclusive on the role selenium (Se) plays in the development of SGA. The aim of the study was therefore to explore the role of Se concentrations in amniotic fluid in order to understand its possible role in the development of SGA. Study Design: This prospective, single center study investigated the relationships between Se concentrations in amniotic fluid and pregnancy outcomes. Amniotic fluid was collected from pregnant women during amniocentesis at 16/17 weeks of pregnancy. Se values were determined using the electrothermal atomic absorption spectrometry and expressed in µg/L. Characteristics of mothers and newborns were obtained from women and delivery records. Results: 327 samples of amniotic fluid were evaluated. Patients with SGA newborns had significantly lower mean values of amniotic fluid concentrations of Se compared to appropriate-for-gestational-age (AGA) newborns (4.8 ± 1.9 µg/L versus 5.6 ± 2.5 µg/L (p = 0.017)). Adjusting for different risk factors, Se remained the only significant factor impacting the outcome of a newborn (b = −0.152, s.e. = 0.077; p < 0.048). Se levels in amniotic fluid did not correlate with pre-eclampsia or preterm delivery. Conclusion: Amniotic fluid Se levels represent a viable root of further investigation and assessment in order to identify women with low birth weight newborns early. Women with decreased Se levels had a statistically significant chance of developing SGA. Further research is needed to elucidate the link between Se, other trace elements, and other risk factors and their impact on the development of SGA newborns.

Аналіз стану здоров'я дітей першого року життя

Ukraine entered the 21st century with one of the worst vital signs in Europe and the burden of many socio-economic and demographic problems. Adverse quantitative and especially qualitative indicators of population reproduction have become stable. Therefore, the most important medical and social task and one of the main activities of the Ministry of Health of Ukraine is the formation and maintenance of public health. The defining stage in the formation of human health is the first year of life. Purpose — to study the state and trends of changes in the main indicators of the health of children in the first year of life for the period 2000–2019. Materials and methods. A retrospective analysis of the incidence of children in the first year of life, infant mortality, over the past 20 years in the context of individual pathological conditions is carried out. The information base of the study was the data of state and industry statistics for 2000–2019. Methods of a systematic approach, statistical data processing, epidemiological analysis of graphic images were used. Results. The study revealed that the unfavorable demographic situation in Ukraine is accompanied by an unsatisfactory state of the main predictors of a healthy start in the life of infants, the formation and maintenance of their health. Over the past two decades, there has been a high level with a negative trend of diseases of the reproductive system of women, a high frequency of the combination of pregnancy and extragenital diseases remains. There is a negative trend towards an increase in the generalized objective criterion of the health of the generation, which is born and the socio-economic well-being of the population — the frequency of premature, low birth weight, incl. With very low birth weight. Only thanks to the introduction of modern medical organizational technologies with proven efficiency in the activities of the maternal and child health service was it possible to achieve a decrease in the incidence of newborns from 280.8 per 1000 live births in 2000 up to 172.14 in 2019. At the same time, the increase in the incidence of newborns with diseases that have a direct impact on the development of chronic and disabling diseases at all stages of life is of concern — congenital pneumonia, neonatal sepsis, other disorders of the cerebral status of the newborn, neonatal jaundice. According to the assessment of the dynamics of the general morbidity of children in the first year of life, its level is still high, with a positive trend — 2018.8 per 1000 children who reached 1 year in 2000 and 1393.1 in 2019, the growth rate is -30.9% with a traditionally leading position in the level and structure of the incidence of respiratory diseases — 810.2 per 1000 children who have reached one year of life and 58.15%, certain conditions occurring in perinatal period — 126.7 ‰ and 9.06%, diseases of the skin and subcutaneous tissue — 63.9‰ and 4.59%, diseases of the blood and hematopoietic organs and certain disorders involving the immune mechanism — 63.0‰ and 4.52%. Conclusions. The positive dynamics of morbidity in children of the first year of life is confirmed by a decrease in infant mortality from its maximum level of 11.9 per 1000 live births in 2000 up to 7.0 in 2019, the growth rate is -41.2% due to all its components with a more intensive reduction in postneonatal mortality from 5.28‰ to 2.57‰, the growth rate is -51.3% against the background of an increase in the concentration of mortality in the neonatal period from 55.9% to 64.5%, respectively. No conflict of interest was declared by the authors. Key words: newborns, children of the first year of life, low birthweight newborns, morbidity, infant mortality.

Artificial uterus -research background to improve survival and outcome of extremely low birth weight newborns

In clinical research, of worldwide interest, some medical devices are being studied as a new reproductive technology, which can both guarantee the implantation of the embryo or support the premature newborn outside the maternal uterus (human and animal);

Effectiveness of Planned Teaching Program on Knowledge of Postnatal Mothers Regarding Care of Low Birth Weight Newborns in JK Lon Hospital, Kota (Rajasthan)

Effectiveness of Planned Teaching Program on Knowledge of Postnatal Mothers Regarding Care of Low Birth Weight Newborns in JK Lon Hospital, Kota (Rajasthan)

Long term outcomes of infants born by mothers with thyroid dysfunction during pregnancy.

According to Barker’s hypothesis, sub-optimal conditions during gestation might affect the predisposition for diseases in adulthood. Alteration in endocrine functions during pregnancy, such us thyroid function or glucose metabolism, are not exempt. It is well known that subclinical hypothyroidism and thyroperoxidase antibodies-positive euthyroidism during early pregnancy are associated with increased risk of gestational diabetes mellitus and both conditions influence pregnancy outcome and newborn development and metabolism at short and long terms. Fetal production of thyroid hormones starts from the 12th week of gestational age. The transplacental passage of maternal thyroxine (T4) is therefore essential for the fetal neurological development, especially during the first half of pregnancy. If this passage is interrupted, such as in premature birth, neonates are more susceptible to develop impaired thyroid function, because of physiological immaturity of their hypothalamic-pituitary-thyroid axis, acute illnesses and stressful events (sepsis, invasive procedures, drugs). The aim of this review is to investigate the short and long term effects of maternal dysthyroidisms on term and preterm newborns, with particular attention to the metabolic and thyroid consequences. Metabolic syndrome, higher body mass index and greater waist circumference, seem to be more prevalent in children of TPO-Ab-positive mothers. Maternal hypothyroidism may be associated with higher risk of gestational diabetes and adverse birth outcomes, such as preeclampsia, preterm delivery, fetal death and low birth weight offspring. In adulthood, preterm (< 37 weeks of gestational age) or low birth weight (<2.500 g) newborns seem to be more susceptible to develop gestational diabetes, preeclampsia, type 2 diabetes mellitus and behavioral alterations. (www.actabiomedica.it)

Low Birth Weight Newborns and Associated Factors at Selected Referral Hospital in Rwanda

Background&#x0D; Low birth weight (LBW) is a major public health problem worldwide that is linked to childhood morbidity and mortality. Newborns considered ‘Very LBW’ have a high risk of disease and death during infancy. Maternal socioeconomic status, medical factors, and lifestyle are linked to LBW, but these factors remain unknown in Rwanda is unknown.&#x0D; Objective&#x0D; To describe the factors associated with LBW among newborns at a selected referral hospital in Rwanda.&#x0D; Methods&#x0D; A prospective, cross-sectional design study was used to assess 108 mothers who delivered a low birth weight newborn.&#x0D; Results&#x0D; Mothers had a mean age of 30.6 years, 79.6% married, 23.1% primary educated, 50.6% unemployed, and 61.9% lived in a rural area. The majority of LBW (63%) were in the first category of LBW (2500-1500g), and over a quarter (25.9%) with Very LBW (VLBW). Mothers were 89.7% multigravida, and 88.8% had a previous unsuccessful pregnancy, 81.3% premature birth, 97.9% LBW. Over half, 59.8% had hypertension during pregnancy. Lifestyle included 45.5% doing strenuous work, and 50.9% heavy lifting during pregnancy. The level of education (p=0.009), spouse employment (p=0.017), having previous premature baby (p=0.025), previous history of miscarriage (p=0.028), presence of hypertension (p=0.020) and antenatal care visits (p=0.025) the trimester of miscarriage were significantly associated to type of low birth weight.&#x0D; Conclusion&#x0D; Demographic, pregnancy history and lifestyle factors remain a concern to mothers and neonates born with low birth weight. Educational awareness campaigns among mothers with the factors above are crucial to reduce morbidity and mortality related to low birth weight.&#x0D; Rwanda J Med Health Sci 2020;3(2):214-224

Active case detection of malaria in pregnancy using loop-mediated amplification (LAMP): a pilot outcomes study in South West Ethiopia

Background125 million women are pregnant each year in malaria endemic areas and are, therefore, at risk of Malaria in Pregnancy (MiP). MiP is the direct consequence of Plasmodium infection during pregnancy. The sequestration of Plasmodium falciparum parasites in the placenta adversely affects fetal development and impacts newborn birth weight. Importantly, women presenting with MiP commonly develop anaemia. In Ethiopia, the Ministry of Health recommends screening symptomatic women only at antenatal care visits with no formal intermittent preventive therapy. Since MiP can display low-level parasitaemia, current tests which include microscopy and RDT are challenged to detect these cases. Loop mediated isothermal Amplification (LAMP) technology is a highly sensitive technique for DNA detection and is field compatible. This study aims to evaluate the impact of active malaria case detection during pregnancy using LAMP technology in terms of birth outcomes.MethodsA longitudinal study was conducted in two health centres of the Kafa zone, South West Ethiopia. Both symptomatic and asymptomatic pregnant women were enrolled in the first or second trimester and allocated to either Standard of Care (SOC—microscopy and RDT) or LAMP (LAMP, microscopy and RDT). Women completed at least three visits prior to delivery, and the patient was referred for treatment if Plasmodium infection was detected by any of the testing methods. The primary outcome was to measure absolute birth weight, proportion of low birth weight, and maternal/neonatal haemoglobin in each arm. Secondary outcomes were to assess the performance of microscopy and RDT versus LAMP conducted in the field.ResultsOne hundred and ninety-nine women were included and assigned to either LAMP or SOC. Six were lost to follow up. In this cohort, 66.8% of women did not display any clinical symptoms and 70.9% were multi-parous. A reduced proportion of low birth weight newborns was observed in the LAMP group (0%) compared to standard of care (14%) (p <0.001). Improved neonatal haemoglobin was observed in the LAMP (13.1 g/dL) versus the SOC (12.8 g/dL) (p = 0.024) arm. RDT and microscopy had an analytical sensitivity of 66.7% and 55.6% compared to LAMP as a reference standard.ConclusionsThese results support the use of highly sensitive tools for rapid on-site active case detection of MiP which may improve birth outcomes in the absence of IPT. However, further large-scale studies are required to confirm this finding.

Early Protein Intake Influences Neonatal Brain Measurements in Preterms: An Observational Study.

Introduction: To limit extrauterine growth restriction, recent guidelines on nutrition of preterm neonates recommended high protein intake since the first day of life (DOL). The impact of this nutritional strategy on the brain is still controversial. We aimed to evaluate the effects of protein intake on early cerebral growth in very low birth weight newborns.Materials and Methods: We performed serial cranial ultrasound (cUS) scans at 3–7 DOL and at 28 DOL in very low birth weight newborns consecutively observed in the neonatal intensive care unit. We analyzed the relation between protein intake and cerebral measurements at 28 DOL performed by cUS.Results: We enrolled 100 newborns (gestational age 29 ± 2 weeks, birth weight 1,274 ± 363 g). A significant (p < 0.05) positive correlation between enteral protein intake and biparietal diameter (r = 0.490**), occipital–frontal diameter (r = 0.608**), corpus callosum (length r = 0.293*, genu r = 0.301*), caudate head (right r = 0.528**, left r = 0.364**), and cerebellum (transverse diameter r = 0.440**, vermis height r = 0.356**, vermis width r = 0.377**) was observed at 28 DOL. Conversely, we found a significant negative correlation of protein intake given by parenteral nutrition (PN) with biparietal diameter (r = −0.524**), occipital–frontal diameter (r = −0.568**), body of corpus callosum (r = −0.276*), caudate head (right r = −0.613**, left r = −0.444**), and cerebellum (transverse diameter r = −0.403**, vermis height r = −0.274*, vermis width r = −0.462**) at 28 DOL. Multivariate regression analysis showed that measurements of occipital–frontal diameter, caudate head, and cerebellar vermis at 28 DOL depend positively on protein enteral intake (r = 0.402*, r = 0.305*, and r = 0.271*) and negatively by protein parenteral intake (r = −0.278*, r = −0.488*, and r = −0.342*).Conclusion: Brain development in neonatal life depends on early protein intake. High protein intake affects cerebral structures' measurements of preterm newborn when administered by PN. Positive impact on brain development encourages the administration of recommended protein intake mainly by enteral nutrition.

Community-based cluster randomized controlled trial: empowering households to identify and provide appropriate care for low-birthweight newborns in Nepal

BackgroundMost newborn deaths occur among those of low birthweight (LBWt), due to prematurity &/or impaired fetal growth. Simple practices can substantially mitigate this risk. In low-income country settings where many births occur at home, strategies are needed that empower mothers to determine if their babies are at higher risk and, if so, to take measures to reduce risk. Earlier studies suggest that foot-length may be a good proxy for birthweight. An earlier Nepal study found a 6.9 cm cut-off performed relatively well, differentiating normal from low birthweight.MethodsCommunity-based, cluster-randomized controlled trial. Objective: to determine whether family-administered screening, associated with targeted messages improves care practices known to mitigate LBWt-associated risks. Participants: women participating in a parent trial in rural Nepal, recruited late in pregnancy. Women were given a 6.9 cm card to assess whether the baby’s foot is small; if so, to call a number on the card for advice. Follow-up visits were made over the 2 weeks following the birth, assessing for 2 behavioral outcomes: reported skin-to-skin thermal care, and care-seeking outside the home; assessed restricting to low birthweight (using 2 cutoffs: 2500 g and 2000 g). Randomization: 17 clusters intervention, 17 control.The study also documented performance along the presumed causal chain from intervention through behavioral impact.Results2022 intervention, 2432 control. Intervention arm: 519 had birthweight < 2500 g (vs. 663 among controls), of which 503 were available for analysis (vs. 649 among controls). No significant difference found on care-seeking; for those < 2500 g RR 1.13 (95%CI: 0.97–1.131). A higher proportion of those in the intervention arm reported skin-to-skin thermal care than among controls; for those < 2500 g RR 2.50 (95%CI: 2.01–3.1). However, process measures suggest this apparent effect cannot be attributed to the intervention; the card performed poorly as a proxy for LBWt, misclassifying 84.5% of those < 2000 as normal weight.ConclusionsAlthough the trial found an apparent effect on one of the behavioral outcomes, this cannot be attributed to the intervention; most likely it was a result of pure chance. Other approaches are needed for identifying small, at-risk babies in such settings, and targeting them for appropriate care messaging.Trial registrationClinicalTrials.gov NCT02802332, registered 6/16/2016.

Implementing the Family-Led Care model for preterm and low birth weight newborns in Malawi: Experience of healthcare workers.

BackgroundEvery Preemie–SCALE developed and piloted the Family-Led Care model, an innovative, locally developed model of care for preterm and low birth weight babies receiving kangaroo mother care.AimThe aim of this study was to describe healthcare workers’ experience using Family-Led Care.SettingThis study was conducted in five health facilities and their catchment areas in Balaka district, Malawi.MethodsThe mixed-methods design, with two data collection periods, included record reviews, observations and questionnaires for facility staff and qualitative interviews with health workers of these facilities and their catchment areas. The total convenience sample comprised 123 health professionals, support staff and non-professional community health workers.ResultsFacility-based staff generally had positive perceptions of Family-Led Care (83%). Knowledge and application-of-knowledge scores were 69% and 52%, respectively. A major change between the first and the second data periods was improvement in client record-keeping. Documentation of newborn vital signs increased from 62% to 92%. Themes emerging from the qualitative interview analysis were the following: benefits of Family-Led Care; activities supporting the implementation of Family-Led Care; own care practices; and families’ reaction to and experience of Family-Led Care.ConclusionThis article reports improved quality of care through better documentation and better follow-up of preterm and low birth weight babies receiving kangaroo mother care according to the Family-Led Care model. Overall, health workers were positive about their involvement, and they reported positive reactions from families. Lessons learned have been incorporated into a universal Family-Led Care package that is available for adaptation by other countries.

Prevalence of anaemia and associated factors in pregnant women admitted in a tertiary care health institute of Jaipur, Rajasthan

Introduction: Anaemia is a global health related major public health problem among pregnant women, specially affecting developing countries like India. In pregnant women it is a major contributing factor of maternal mortality and perinatal mortality. Objectives: 1. To find out prevalence of Anaemia in pregnant women of Jaipur. 2. To find out prevalence of Low Birth Weight newborns, Still births and Cesarian Section. 3. To find out various socio-demographic factors and their association with anaemia of pregnancy. Materials and Methods: All pregnant women, who were admitted for delivery in Jaipur National University, Institute for Medical Sciences and Research Centre, Jaipur, Rajasthan during the study period of 1st January 2018 to 31 December 2018. Sampling Method and Sample Size: Study sample was calculated by complete enumeration technique and, 1227 admitted cases of delivery were selected for study. Results: Total 64.72% of pregnant women were suffering from anaemia. Mild anaemia was 29.50%, Moderate anaemia in 34.55%, and Severe anaemia was observed in 0.65% of pregnant women. Total 67.67% Hindu pregnant women were anaemic while only 60.40% Muslim pregnant women were found to be anaemic. Among the anaemic mothers, 21.92% had newborn birth weight less than 2 kg, 24.05% had birth weight 2-2.5 kg and 54.03% had birth weight more than 2.5 kg weight. 50.88% delivered normally and 47.60% underwent LSCS. 1.52% had stillbirth among anaemic pregnant women. Conclusion: Improved dietary practices, consumption of locally available iron rich foods and a balanced diet, and effective national programme will go a long way in preventing iron deficiency in pregnant women. Keywords: Anaemia, LSCS, Still birth, Pregnant women.

PERFIL EPIDEMIOLÓGICO DA MORTALIDADE NEONATAL NO ESTADO DO PIAUÍ, BRASIL

Introdução: A redução da mortalidade infantil é ainda um desafio para os serviços de saúde. Apesar do declínio observado no Brasil, a mortalidade infantil permanece como uma grande preocupação em Saúde Pública. No Piauí com a implantação da Rede Cegonha e do Componente Neonatal nos últimos anos pode-se perceber um declínio no índice de mortalidade materna, infantil e neonatal, mas ainda continua-se perdendo mães e bebês por causas evitais. Apesar dos avanços que o estado teve após a implantação da rede cegonha esse desenvolvimento não se deu por igual em todas as regiões de saúde, ficando a maior parte da assistência centralizada ainda na capital. Objetivo: Este trabalho teve o objetivo de avaliar o perfil epidemiológico da mortalidade neonatal o estado do Piauí. Metodologia: Foi realizado um estudo retrospectivo, descritivo, abordagem quantitativa, e os dados foram coletados no sistema do DATASUS e tabulados utilizando o TABWIN E TABNET. Resultados: Observou-se uma redução do número absoluto total de óbitos entre os anos 2007 a 2015, havendo um aumento de aproximadamente 4,5% entre os anos de 2015 e 2016. A mortalidade neonatal precoce compreendeu mais de 3/4 dos óbitos neonatais. Mais de 53% dos óbitos são de RN de baixo peso. Cerca de 48,7% dos óbitos referem-se aos prematuros. Conclusões: Os achados revelaram as principais características dos óbitos neonatais no Piauí na série temporal (2007-2016).

A Proxy for Detecting IUGR Based on Gestational Age Estimation in a Guatemalan Rural Population.

In-utero progress of fetal development is normally assessed through manual measurements taken from ultrasound images, requiring relatively expensive equipment and well-trained personnel. Such monitoring is therefore unavailable in low- and middle-income countries (LMICs), where most of the perinatal mortality and morbidity exists. The work presented here attempts to identify a proxy for IUGR, which is a significant contributor to perinatal death in LMICs, by determining gestational age (GA) from data derived from simple-to-use, low-cost one-dimensional Doppler ultrasound (1D-DUS) and blood pressure devices. A total of 114 paired 1D-DUS recordings and maternal blood pressure recordings were selected, based on previously described signal quality measures. The average length of 1D-DUS recording was 10.43 ± 1.41 min. The min/median/max systolic and diastolic maternal blood pressures were 79/102/121 and 50.5/63.5/78.5 mmHg, respectively. GA was estimated using features derived from the 1D-DUS and maternal blood pressure using a support vector regression (SVR) approach and GA based on the last menstrual period as a reference target. A total of 50 trials of 5-fold cross-validation were performed for feature selection. The final SVR model was retrained on the training data and then tested on a held-out set comprising 28 normal weight and 25 low birth weight (LBW) newborns. The mean absolute GA error with respect to the last menstrual period was found to be 0.72 and 1.01 months for the normal and LBW newborns, respectively. The mean error in the GA estimate was shown to be negatively correlated with the birth weight. Thus, if the estimated GA is lower than the (remembered) GA calculated from last menstruation, then this could be interpreted as a potential sign of IUGR associated with LBW, and referral and intervention may be necessary. The assessment system may, therefore, have an immediate impact if coupled with suitable intervention, such as nutritional supplementation. However, a prospective clinical trial is required to show the efficacy of such a metric in the detection of IUGR and the impact of the intervention.

Does the Umbilical Cord Nucleated Red Blood Cellcan Help Predict Intraventricular Hemorrhage

Background: Intraventricular hemorrhage (IVH) is one of the most serious complications of premature deliveries, especially in very low birth weight (VLBW) newborns. The current study compared the number of nucleated red blood cells (NRBCs) in newborns with and without IVH.Methods: This cross-sectional study was carried out on 109 VLBW neonates who were referred to the Neonatal Intensive Care Unit (NICU) Department of Ghaem Hospital in Mashhad, Iran. They were investigated to evaluate the predictive value of cord NRBC in the diagnosis of IVH. To this end, 77 neonates who had normal brain ultrasonographywere assigned to the control group and 32 newborns with IVH were allocated to the case group. The percentage of NRBC per 100 white blood cells was determined by a blood sample. These neonates underwent brain ultrasonography3-5 days after the birth; thereafter, mean NRBC/100 WBC and the absolute number of NRBC swere compared in both groups.Results: In the current study, the mean scores of NRBC/100 WBC and the absolute number of NRBCs in neonates with IVH were obtained as 15.19 and 2272.38/μl. In the group without IVH, these values were reported as 40.95% and 5459.17/μl, respectively (P>0.05). Based on receiver operating characteristic (ROC) curve, the NRBC value does not have a diagnostic value in predicting the incidence of IVH.Conclusion: As illustrated by the obtained results, the number of absolute NRBCs and the percentage of NRBC/100 WBC cannot help to predict the probability of neonatal IVH. Nonetheless, further studies are recommended in this regard.

SIGNIFICANT ASSOCIATION BETWEEN ANTI-THYROID PEROXIDASE (ANTI-TPO) ANTIBODIES AND LOW BIRTH WEIGHT IN EUTHYROID PREGNANT WOMEN

Background: Maternal and perinatal morbidities are well-documented complications of pregnancy in women with thyroid dysfunction, both clinical and subclinical. About 2–5% of pregnant women suffer from thyroid disorders and timely intervention can be done if detected early. The presence of anti-TPO Ab is associated with increased rate of pregnancy complications such as miscarriage, preterm delivery, placental abruption, pregnancy-induced hypertension, intrauterine death and low birth weight.&#x0D; Objectives: Study the effect of anti-TPO Ab positivity on pregnancy outcome especially birth weight and estimate the prevalence of anti-TPO Ab in euthyroid pregnant women.&#x0D; Methods: This observational study enrolled 500 euthyroid pregnant women, age 20-35 years, up to 20 weeks gestation. Venous blood samples collected and analyzed for the anti-TPO Ab levels. On the basis of Ab positivity they were divided into anti-TPO Ab positive and Ab negative group. These two groups were followed up till delivery and compared fetal outcomes for birth weight.&#x0D; Result: Prevalence of anti-TPO Ab positivity was 5.2% in euthyroid obstetric women. Most of anti-TPO Ab positive women were overweight. Incidence of low birth weight babies was 4 fold higher in anti-TPO Ab positive women.&#x0D; Conclusion: Anti-TPO Ab positivity significantly associated with prepregnancy BMI and low birth weight of newborns.&#x0D; Keywords: Thyroid peroxidase antibodies, Anti-TPO Ab, Euthyroid, Low birth weight.

Percepção materna diante da utilização do método canguru: uma revisão integrativa

O presente estudo teve como objetivo identificar na literatura o entendimento, compreensão e percepção de mães de neonatos sobre a utilização do método canguru. Trata-se de uma pesquisa do tipo revisão integrativa. A busca dos estudos ocorreu entre os meses de março a abril de 2019 via BVS, SciELO e LILACS, conduzida pela questão de pesquisa: “Como se dá a percepção materna diante da utilização do método mãe canguru em neonatos?”. Foram identificados 14 artigos, em que 14,3% das publicações prevaleceram entre os anos de 2016, 2015, 2013 e 2003 (57,2%) e 7,1% entre os anos de 2018, 2014, 2010, 2009, 2008 e 2007 (42,6%). Após análise, os resultados e informações foram divididos em três categorias: Sensações e expectativas com o RNAs; Influência do ambiente; e Melhora no binômio mãe e filho. Constatou-se, que o Método Mãe Canguru traz benefícios à saúde do recém-nascido de baixo peso, reduz custo e tempo de internação hospitalar, humaniza a assistência e melhora o vínculo mãe-filho.