Low Weight Newborns Research Articles

Weight gain in low-birth-weight newborns and associated factors in Central Benin settings

Background: There is an association between low birth weight (LBW) and neonatal morbidity and mortality. The aim of the study was to identify associated factors with low 4-week weight gain among low-birth-weight newborns benefiting from the "optimized mother-newborn care model" within Bohicon health district in Benin. Methods: This was a retrospective, analytical study of 124 low-weight newborns benefiting from the "optimized mother-newborn care model", monitored for four weeks, and their mothers. Data on newborns and mothers as well as on the healthcare system were gathered through documentary review and interviews. Logistic regression was used to investigate associated factors with weight gain. Results: Of the 124 newborns monitored, more than half (54.84%) were female, their average birth weight was 2110.24±217.05 grams, and 103 (83.06%) reached the weight threshold of 2500 grams after four weeks. The mean age of the 101 mothers surveyed was 23.47±5.23 years. High household size (OR=5.65; CI95%: [1.04-30.71]), absence of home visits by community health workers (OR=10.93; CI95%: [1.54-77.14]), breastfeeding by expressing milk directly from the breast into baby’s mouth (OR=13.90; CI95%: [2.57-74.97]) and non-consumption of hindmilk by the newborn (OR=10.93; CI95%: [1.72-47.08]), were associated with weight gain in these low-weight newborns. Conclusions: The "optimized mother-newborn care model" appears to improve weight gain in low-birth-weight newborns. Taking into account the factors associated with low weight gain in low-weight newborns could improve the effectiveness of the implemented model in this health district.

Higher risk of preterm twin delivery among shorter nulliparous women

ObjectiveTo determine if maternal height in nulliparous women influences pregnancy results in twin pregnancies. Material and methodsRetrospective cohort analysis evaluating twin pregnancies followed at Centro Hospitalar Universitário Lisboa Central, between 1995 and 2020. Of the 2900 pregnancies followed in that period, 886 nulliparous women with dichorionic twin pregnancies were selected. Two groups were considered: A - maternal height <163 cm (<Q2) (n = 436) and B - maternal height ≥167 cm (≥Q3) (n = 234), The following results were compared: Age, body mass index (BMI), premature contractions, premature rupture of membranes (PROM), hypertensive disorders, gestational diabetes, gestational age at birth, delivery <28, <32, <34, < 36, ≥37 weeks (wks), average weight of newborns, very low birth weight, low birth weight, cesarean section rate, stillbirths, five minute Apgar score, neonatal death and perinatal death. Result(s)PTB rates decreased along increasing maternal height. The comparison between group A and group B revealed no statistically significant differences in maternal characteristics (age, mode of conception - spontaneous or ART pregnancies, or BMI). Statistically significant differences were found in mean gestational age at birth (35.1 ± 1.8 vs. 36.0 ± 2.6 wks), PTB rates < 32, 34 and 36 wks, OR: 3.2, 2.3 and 2.4 respectively, p < 0.01. Shorter women had a 1.7× and 2.6× increased risk for significantly low (<2500 g) and very low (<1500 g) newborn birth weight (BW), respectively, and a 40 % increased risk of Cesarian delivery. No significant differences were shown with respect to stillbirths, neonatal and perinatal deaths, which had a low incidence in this study. In ART pregnancies we found the same results regarding PTB rates and newborn birthweight in shorter women. In Logistic Regression analysis, maternal height <Q2 is an independent risk factor for PTB under 32, 34 and 36 wks, adjusted OR: 2.0. 2.2 and 2.4, respectively, 95 % CI 1.1–3.7, p = 0.021. ConclusionIncreased pregnancy risk in nulliparous shorter women should be taken into consideration in double embryo transfers.

Thulium Laser for the Treatment of Posterior Urethral Valves in Infants.

Objective: Thulium laser (ThL) has become popular in urology, because of its powerful action on tissue, achieving optimal ablation and hemostasis. Aim of our article was to evaluate efficacy of ThL in infants affected by posterior urethral valve (PUV) ablation. Patients and Methods: Clinical charts of 25 infants (age ≤12 months) who underwent PUV ablation were retrospectively reviewed. According to our protocol, all patients performed voiding cystourethrography and cystoscopy 6 to 8 months after initial treatment. Several factors, including age and weight at surgery, operative time, postoperative bleeding, catheterization period, postoperative urinary retention, retreatment for valve remnants, and stricture at follow-up, were evaluated. Preoperative, intraoperative, and postoperative data were analyzed. Results: Mean age at primary surgery was 4.5 months (5 days-10.5 months) and mean weight at primary surgery was 5.7 kg (2.5-10.3 kg). Mean operative time was 29.5 minutes (range 15-50 minutes). None of the patients experienced intraoperative and postoperative bleeding. In all cases, postoperative catheterization period was 1 day. Residual valves were found in 6 of 25 (24%) patients. No cases of urethral stricture were registered during follow-up (48.4 months, range: 11-95). Analyzing literature data using other techniques, complication rate of ThL PUV ablation seems lower than standard treatments (electrofulguration, cold knife) and comparable with those reported with other laser techniques. Conclusion: PUV ablation with ThL has proven to be feasible and safe in infants. Further studies are needed to define the real effectiveness of this laser technology in PUV ablation. Miniaturized instruments and ThL technology make early PUV treatment feasible also in low body weight newborns.

Insight Into Neonatal Sepsis: An Overview.

There are approximately 1.3 million cases of neonatal sepsis reported worldwide with deathsoccurring more commonly in preterm and low-weight newborns. Neonatal sepsis is the third major cause of neonatal deaths resulting in 203,000 deaths per year. It is divided into two subtypes based on time of occurrence: early-onset neonatal sepsis (ENS), occurring within the first 72 hours of birth usually due to perinatal risk factors, and late-onset neonatal sepsis (LOS) usually occurring after the first week of life and up to 28th day of life. There are many complications associated with neonatal sepsis including septic shock, multiple organ failure, and death. It is vital for clinicians to know the signs and symptoms of neonatal sepsis in order to diagnose it early. Preventive measures, early diagnosis, appropriate antibiotic administration, timely supportive management, and the establishment of efficient management are vital in the prevention of severe complications or death. In this review, we aim to provide the most up-to-date information regarding risk factors, pathophysiology, signs and symptoms, diagnosis, and treatment of neonatal sepsis. We discuss the maternal and neonatal risk factors involved in the pathogenesis of neonatal sepsis and the signs and symptoms of early and late neonatal sepsis.We focus on the different pathogens involved and the markers used in the diagnosis and treatments available for each.

Conservative management of preterm premature rupture of membranes &lt; 30 weeks of gestational age: Effectiveness of clinical guidelines implementation strategies

To compare obstetrical and neonatal outcomes in patients with p-PROM (preterm premature rupture of membranes) at less than 30 weeks of gestational age before and after the application of protocols developed on the basis of international guidelines and to identify local barriers and strategies for their implementation. Single and twin pregnancies with p-PROM < 30 weeks of gestation without signs of infection were retrospectively collected. The population was divided in two groups. Group A contained patients treated before the introduction of the protocol, hospitalized from the day of the p-PROM to delivery and treated according to clinicians’ practice. Group B included patients managed according to a standardized protocol, treated with home care management under strict surveillance, after 48 h of hospitalization. 19 women with 21 newborns in group A and 22 women with 26 newborns in group B were enrolled. Maternal characteristics and p-PROM gestational age were comparable. In group A we observed minor latency time from diagnosis to delivery (1.6 vs 6.5 weeks, p < 0.001) with lower gestational age at delivery (25.8 ± 2 vs 30.7 ± 4.2 weeks, p = 0.00) and lower newborn weight (859 ± 268 vs 1511 ± 917 g, p = 0.002). Concerning neonatal outcomes, in group A there were lower Apgar score at 1 min (4.0 ± 2.1vs 6.3 ± 2, p = 004), longer hospitalization (42 ± 38 vs 68 ± 38 days, p = 0.05) and, even if non statistically significant, major rate of neonatal mortality (11,5% vs 19%, p = 1.00) and of neonatal complications (need of neonatal intensive care unit, sepsis, bronchopulmonary dysplasia, retinopathy of prematurity, mechanical ventilation). Postnatal follow-up showed comparable outcomes at 24 months of correct age. Educational and interdisciplinary meetings, along with group performance audit and standardization of procedures are successful strategies to implement guidelines application. Applying this strategy, we developed a protocol according to international guidelines for the treatment of early onset p-PROM based on a standardized conservative management at home, achieving better results compared to hospital management in terms of latency, gestational age at delivery, neonatal weight and neonatal hospitalization.

The Kangaroo Method Treatment Effectively Increases Low Newborn Weight (LBW)

Background: LBW is one of the highest causes of neonatal death in developing countries. Indonesia ranks 8th based on the number of neonatal deaths per year according to WHO data. The Infant Mortality Rate (IMR) in Indonesia in 2019 was 72,000 babies and 19% of deaths were caused by premature and LBW babies. Many cases of death in LBW occur because babies who experience LBW are susceptible to exposure to nosocomial infections, tend to have co-morbidities and the body's organs are not ready to face the external environment and case management is not optimal. One cheap and easy solution that can be done when a baby has LBW is to apply the Kangaroo Method of Care (PMK). Methods: The design used in this study is Traditional Literature Review obtained from 3 data based, namely Pubmed, Science Direct, Google Scholar using inclusion and exclusion criteria. Keywords used in the literature search: Kangaroo-Mother care Method and Weight Gain and Infant, Low Birth Weight. Of the 14 journals found, the journal selection was carried out using PICOS, then analyzed one by one with the results of 12 journals from Google Scholar data and 2 journals from PubMed data.Results: The results of the article review found that the Kangaroo Method Treatment can be carried out in LBW from the age of 0 days with a minimum administration time of 1 hour a day, the implementation must be in accordance with the readiness of the mother and baby, and the maximum application can increase the baby's weight. Conclusion: Kangaroo-Mother care has been proven to be effective in increasing body weight in LBW babies so that FMD can be intervened in LBW babies

Maternal sepsis in pregnancy and the puerperal periods: a cross-sectional study.

Maternal sepsis is a life-threatening condition and ranks among the top five causes of maternal death in pregnancy and the postpartum period. Herein, we conducted a retrospective study on sepsis cases to explain the related risk factors by comparing them with bloodstream infection (BSI) and control maternities. In total, 76 sepsis cases were enrolled, and 31 BSI and 57 maternal cases of the same age but with neither sepsis nor BSI were set as controls. Genital tract infection (GTI) and pneumonia were the two most common infection sources in both sepsis (22 cases, 29% and 29 cases, 38%) and BSI cases (18 cases, 58% and 8 cases, 26%). Urinary tract infection (UTI)/pyelonephritis (9 cases, 12%) and digestive infection cases (11 cases, 14%) only existed in the sepsis group. Significantly different infection sources were discovered between the sepsis-death and sepsis-cure groups. A higher proportion of pneumonia and a lower proportion of GTI cases were present in the sepsis-death group (17 cases, 45% pneumonia and 9 cases, 24% GTI) than in the sepsis-cure group (12 cases, 32% pneumonia and 13 cases, 34% GTI). In addition, although gram-negative bacteria were the dominant infectious microorganisms as previously reported, lower proportion of gram-negative bacteria infectious cases in sepsis (30 cases, 50%) and even lower in sepsis-death group (14 cases, 41%) was shown in this study than previous studies. As expected, significantly greater adverse maternal and fetal outcomes, such as higher maternal mortality (26.3% vs. 0% vs. 0%), higher fetal mortality (42.2% vs. 20.8% vs. 0%), earlier gestational age at delivery (26.4 ± 9.5 vs. 32.3 ± 8.1 vs. 37.7 ± 4.0) and lower newborn weight (1,590 ± 1287.8 vs. 2859.2 ± 966.0 vs. 3214.2 ± 506.4), were observed in the sepsis group. This study offered some potential pathogenesis and mortality risk factors for sepsis, which may inspire the treatment of sepsis in the future.

Placental levels of essential and non-essential trace element in relation to neonatal weight in Northwestern Spain: application of generalized additive models.

Adequate gestational progression depends to a great extent on placental development, which can modify maternal and neonatal outcomes. Any environmental toxicant, including metals, with the capacity to affect the placenta can alter the development of the pregnancy and its outcome. The objective of this study was to correlate the placenta levels of 14 essential and non-essential elements with neonatal weight. We examined relationships between placental concentrations of arsenic, cadmium, cobalt, copper, mercury, lithium, manganese, molybdenum, nickel, lead, rubidium, selenium, strontium, and zinc from 79 low obstetric risk pregnant women in Ourense (Northwestern Spain, 42°20'12.1″N 7°51.844'O) with neonatal weight. We tested associations between placental metal concentrations and neonatal weight by conducting multivariable linear regressions using generalized linear models (GLM) and generalized additive models (GAM). While placental Co (p = 0.03) and Sr (p = 0.048) concentrations were associated with higher neonatal weight, concentrations of Li (p = 0.027), Mo (p = 0.049), and Se (p = 0.02) in the placenta were associated with lower newborn weight. Our findings suggest that the concentration of some metals in the placenta may affect fetal growth.

Stage-by-stage correction of aortic coarctation in low-weight newborns (first experience)

Aortic coarctation in low-weight (less than 2.2 kg) and premature newborns with comorbid conditions is still a current problem of neonatology and cardiac surgery. The closure of the patent ductus arteriosus and the inability to maintain its functioning with prostaglandin medication leads to fatal complications due to a violation of systemic perfusion. Surgical intervention in this group of patients has extremely high risks and unsatisfactory results. In such situations, stage-by-stage correction is a promising direction. Stenting of aortic coarctation allows restoring hemodynamics at the level of the aortic isthmus with minimal risks. In the inter-stage period, it becomes possible to treat comorbid conditions and prepare a patient for radical correction.

Home visit to premature and low birth weight newborns: nurse's experience report.

To report the structures of the experience of nurse's home visits to premature and low birth weight newborns. This is a descriptive study of the experience report type, structured on the experience of the nurse authors in the development of 48 home visits in a city in the state of São Paulo and its microregion between August 2020 and 2021 with eight mothers of premature and low weight newborns. The guiding documents "Home visit for families with preterm and low birth weight newborns" and "Strategy of guiding questions for home visits" were created and used to promote open narratives from parental caregivers about caring for at-risk newborns, creating a relational space aimed at joint construction. The documents used have favored home visits, helping nurses to establish professional bonds and build relational space through dialogue when conducting their activities in the home environment.

ВЛИЯНИЕ НОВОЙ КОРОНАВИРУСНОЙ ИНФЕКЦИИ НА ТЕЧЕНИЕ БЕРЕМЕННОСТИ И РОДОВ, А ТАКЖЕ ИХ ИСХОДЫ ДЛЯ МАТЕРИ И НОВОРОЖДЕННОГО (СИСТЕМАТИЧЕСКИЙ ОБЗОР)

Significance. COVID-19 is a potentially fatal infection, however data on its progression in pregnant women is currently limited. The most important issues remain the features of the COVID-19 progression in pregnant women, the impact of COVID-19 on the course of pregnancy, approaches to the treatment of pregnant women and their delivery, as well as the impact of a new coronavirus infection on the fetus, the study of which is an urgent task. Purpose: to summarize data on the impact of a new coronavirus infection on pregnancy and delivery, as well as its outcomes for the mother and newborn according to scientific publications by Russian and foreign authors. Material and methods. Relevant publications on COVID-19 progression in pregnant women, the COVID-19 impact on pregnancy, delivery and its outcomes for the mother and newborn were analyzed. The systematic review was conducted according to PRISMA guidelines using PICO(S) criteria. Results. According to data from early research, pregnant women with COVID-19 had a more severe course of the disease, higher risk of gestational complications, higher demand for intensive care in intensive care unit - 1.5% versus 0.9% in non-pregnant women, as well as artificial lung ventilation (1.7 times), although mortality in the groups of pregnant and non-pregnant did not differ equaling to 0.2%. Among possible risks of complications after COVID-19 infection the domestic and foreign literature names spontaneous miscarriages in the first and second trimesters of pregnancy, premature rupture of membranes, premature birth, birth of newborns of low weight for gestational age and prematurity, development of fetoplacental insufficiency, delayed fetal development due to lower utero-placental blood flow during COVID-19, exacerbation of chronic somatic conditions (diseases of the cardiovascular system, respiratory system, autoimmune processes, endocrine disorders), and postpartum bleeding. The COVID-19 effect on fetus is still the subject of numerous discussions and studies, there is evidence that women with COVID-19 have a higher risk of premature birth with all the consequences for the newborn. Conclusion. Physiological changes associated with pregnancy increase maternal susceptibility to infections in general, so the course of the disease may have its own characteristics during pregnancy. The new coronavirus infection is more severe in pregnant women with chronic diseases, obesity, arterial hypertension, and in older age groups. According to the data obtained, adverse outcomes include early and late spontaneous miscarriages, hemostasiological disorders in pregnant women and parturient women, fetoplacental insufficiency with fetal growth retardation, preterm delivery of newborns who are small for gestational age, and their prematurity with all the consequences.

The Relationship between Low Newborn Baby Weight (Bblr) and the Incident of Neonatal Asphyxia

Low birth weight (LBW) is a significant factor contributing to neonatal asphyxia, a critical condition occurring during the neonatal period. This study aims to investigate the correlation between LBW and the incidence of neonatal asphyxia at Permata Madina General Hospital, located in Panyabungan District, Mandailing Natal Regency in 2023. Employing an analytical survey method with a cross-sectional approach, the study population comprised 48 patients at the hospital. Samples were selected using a total sampling technique. Data analysis involved univariate and bivariate analyses, including frequency distribution and the Chi-Square test. Results revealed that 20 respondents (41.7%) had low birth weight babies, with the majority of cases of neonatal asphyxia occurring in this group (15 respondents, 31.3%). Statistical analysis indicated a significant relationship between LBW and neonatal asphyxia at Permata Madina General Hospital in 2023, with a p-value of 0.002 (p&lt;0.05). The findings suggest that babies with low birth weight are at greater risk of experiencing asphyxia compared to those with normal birth weight. The study emphasizes the importance of enhancing the quality of healthcare services in hospitals to facilitate early detection and treatment of LBW infants, thereby reducing the incidence of neonatal asphyxia among this vulnerable population.

Glycation-Driven Inflammation: COVID-19 Severity in Pregnant Women and Perinatal Outcomes.

The link between being pregnant and overweight or obese and the infectivity and virulence of the SARS CoV-2 virus is likely to be caused by SARS-CoV-2 spike protein glycosylation, which may work as a glycan shield. Methylglyoxal (MGO), an important advanced glycation end-product (AGE), and glycated albumin (GA) are the results of poor subclinical glucose metabolism and are indices of oxidative stress. Forty-one consecutive cases of SARS-CoV-2-positive pregnant patients comprising 25% pre-pregnancy overweight women and 25% obese women were recruited. The aim of our study was to compare the blood levels of MGO and GA in pregnant women with asymptomatic and symptomatic SARS-CoV-2 infection with pregnant women without SARS-CoV-2 infection with low risk and uneventful pregnancies and to evaluate the relative perinatal outcomes. The MGO and GA values of the SARS-CoV-2 cases were statistically significantly higher than those of the negative control subjects. In addition, the SARS-CoV-2-positive pregnant patients who suffered of moderate to severe COVID-19 syndrome had higher values of GA than those infected and presenting with mild symptoms or those with asymptomatic infection. Premature delivery and infants of a small size for their gestational age were overrepresented in this cohort, even in mild-asymptomatic patients for whom delivery was not indicated by the COVID-19 syndrome. Moreover, ethnic minorities were overrepresented among the severe cases. The AGE–RAGE oxidative stress axis on the placenta and multiple organs caused by MGO and GA levels, associated with the biological mechanisms of the glycation of the SARS-CoV-2 spike protein, could help to explain the infectivity and virulence of this virus in pregnant patients affected by being overweight or obese or having gestational diabetes, and the increased risk of premature delivery and/or low newborn weight.

Assessment of the relationship between the severity of the labor process and complications of pregnancy in female workers, the health of the fetus and newborn

In modern economic conditions, most women continue to work during pregnancy. According to the year of 2021 statistics, there is about half a million female workers are engaged in heavy physical work in Russia, which makes it relevant to study the impact of working conditions on the course of pregnancy, the health of newborns. The study aims to analyze and assess the occupational risk of health disorders of pregnant women workers, the health of their children born under the influence of a harmful production factor - the severity of labor. The researchers applied the method of analytical review and analysis of the data obtained to assess the risk of the impact of the severity of work on the health status, pregnancy of female workers and the condition of the fetus and newborn. Heavy physical labor, including lifting and moving heavy weights and intense physical exertion is especially unfavorable for pregnant workers. With a single lifting of loads weighing 11 kg or more, the risk of spontaneous miscarriage significantly increases by 31% (OR=1.31; 95% CI 1.08-1.58); preeclampsia - by 35% (OR=1.35; 95% CI 1.07-1.71). When lifting and moving loads with a total weight of 100 kg or more per shift, the risk of preeclampsia increases by 65% (OR=1.65; 95% CI 1.31-2.09), premature birth by 31% (OR=1.31; 95% CI 1.11-1.56); the risk of low birth weight infants increases by 108% (OR=2.08, 95% CI, 1.06-4.11). With intense physical activity during the shift, the risk of developing fetal sizes small for gestational age (SGA) increases by 34% (OR=1.34; 95% CI 1.03-1.73). When working "standing up" for four or more hours, the risk of premature birth increases by 11% (OR=1.11; 95% CI 1.02-1.22); SGA births - by 17% (OR=1.17; 95% CI 1.01-1.35). When working with a body tilt for an hour or more, the risk of developing preeclampsia in a pregnant worker increases by 51% (OR=1.51; 95% CI 1.09-2.08). Prolonged walking during a work shift increases the risk of developing SGA by 21% (OR=1.21; 95% CI 1.06-1.39). Working conditions characterized as heavy physical exertion statistically significantly increase the risks of spontaneous miscarriage, preeclampsia, premature birth, the development of a fetus small for gestational age, low newborn weight, etc. It is necessary to develop regulatory and methodological documents for the prevention of pregnancy complications in female workers engaged in physical labor.

REGIONAL FEATURES OF NEWBORN HEALTH (according to state and industry statistics, perinatal audit "MATRIX - BABIES")

The development of modern society is largely due to the state of health of new generations, which determinethe quantitative and qualitative characteristics not only of today's but also of the future population, its cultural, moral andintellectual and defense potential.A retrospective analysis and assessment of the dynamics of newborn health in Ukraine in the XXI century according tostate and industry statistics, perinatal audit according to the WHO methodology "MATRIX - BABIES". Methods of systemapproach, statistical, graphic image are applied.The specifics of the socio-economic and demographic processes in Ukraine in the first decades of the XXI century, inparticular the decrease in the number of newborns born at the institutions of the Ministry of Health of Ukraine from 387.9thousand in 2000 up to 260.5 thousand in 2021 was accompanied by a negative trend of the generalized objective criterion oftheir health, namely an increase in the frequency of low birth weight children from 5.39 to 5.99% and premature newborns4.64 to 5.68%, OR with 95% CI 1.12 (1, 09-1.15), p &lt;0.0001 and 1.24 (1.21-1.27), p &lt; 0.0001 at stable dissociation of thenumber of underweight and premature infants. The range of frequency fluctuations of low weight newborns in the regionalcontext in 2021 reached 1.7 times. The lowest levels (&lt;5%) were registered in Volyn (4.72%), Rivne (4.89%) and Sumy(4.93%), the highest (more than 7%) - in Kiev 8.1%), Transcarpathian (7.49%) and Kirovohrad (7.19%) regions.The frequency of sick newborns showed a positive trend, characterized by instability over the years. Over the pastdecades, this figure has decreased from 280.8 ‰ in 2000 to 196.9% in 2021, OR with 95% CI 0.67 (0, 65-0.67), p &lt;0.0001,but now at the beginning of life almost every fifth child has a deviation in health. Differentiation of the frequency of sicknewborns in the regions showed an extremely high frequency of this indicator in 2021 (more than 250 ‰) in Kyiv. Poltavaand Kyiv at relatively low (&lt;150 ‰) in Ternopil, Mykolaiv, Transcarpathian and Kirovohrad regions.Traditionally, the leading position in the frequency of newborns in the XXI century is occupied by neonatal jaundice dueto excessive hemolysis, other causes – 31,1 - 58,99 ‰, disorders of the respiratory system that occur in the perinatal period- 21,91 - 46,79 ‰, other disorders of the cerebral status of the newborn - 18.58 - 43.66 ‰, congenital anomalies, deformitiesand chromosomal disorders - 29.75 - 30.73 ‰ and birth injuries - 19.7 - 34.46 ‰, growth retardation and malnutrition of thefetus – 18.01 - 73.76 ‰. Consecutive decrease in the frequency of sick newborns is mainly due to a decrease in fetal hypoxiaand asphyxia - a loss rate of 85.1%. cases of growth retardation and malnutrition - 75.6%, birth injuries - 43.2% of congenitalanomalies, deformities and chromosomal disorders - 3.1%, hemolytic disease caused by isoimmunization - 2.92%. At the sametime, the negative dynamics of severe perinatal conditions that cause disability of children, including neonatal sepsis - a 15.7- fold increase, congenital pneumonia - a growth rate of 116.3% of perinatal-specific infections (70.3%) over the period from2010 - оther disorders violations of the cerebral status of the newborn (134.98%.), since 2015 - neonatal jaundice (89.6%).Conclusions. Systematic analysis of some indicators of newborn health showed a negative trend in the generalizedobjective criterion of their health, namely the frequency of low birth weight as a measure of reproductive health of motherswith a positive trend in the frequency of sick newborns as a measure of treatment and diagnosis.

Sexual and Reproductive Health Assessment in a Group of Female Renal Transplant Recipients

Fertility and sexual health are impaired in individuals with chronic kidney disease and can be restored after a successful renal transplant. This is a single-center prospective study about the sexual and reproductive health (including contraceptive methods and gynecologic cancer screening) in renal transplant recipients. Female renal transplant recipients, aged 18 to 49 years at transplant, were interviewed about their gynecologic history, sexual health, and use of contraceptive methods. Ninety-one patients fulfilled the inclusion criteria. The majority of women maintained menstrual cycles during dialysis therapy, being almost 60% of the women in an irregular rhythm. Pregnancies were reported for 51 women, 20% after transplant, and associated with low-weight newborns. The incidence of spontaneous abortion was 12.5%. Thirty-one patients were denied contraceptive methods due to the vasectomy of the partner (n=16) or the belief that they would not become pregnant (n=15). The most common contraceptive method was a condom, and the use of an intrauterine device was rare. Gynecologic assessment and cancer screening were out-of-date in almost one-third of patients. In this study, the majority of women were from low-income areas and had low levels of education. Despite access to public universal health care, adherence to yearly screening tests and use of contraceptive methods were lower than expected.

Histology of Placenta in Normotensive and Hypertensive Cases in Khyber Pakhtunkhwa: A Comparative Study

One of the most common pregnancy complications is Hypertension. It has a major effect on maternal and neonatal morbidities and fatalities. The placenta is an important organ for the maintenance of pregnancy and the nourishment of the fetus. Objective: To compare the morbid variations in the placenta of hypertensive and normotensive mothers. Methods: From the obstetrics and gynecology department, a hundred placentae of hypertension and normotensive females were collected. The placentae were preserved in formalin and sectioned. Blocks prepared were stained with hematoxylin and eosin. Results: The placentae from 50 normotensive mothers with 26±3.1 years (mean age) and 50 hypertensive mothers with 26± 2 years (mean age). In normotensive patients 12% Infarction was seen and 70% of severe hypertensive patients while syncytial knots were found in 70% of cases of severe hypertension, while calcification was observed in 90%. In severe hypertension, stroma fibrosis and hypervascularity increase in proportion to the degree of hypertension, with 50% and 30% cases seen in severe hypertension, respectively. Conclusions: In pregnancy hypertension causes, Stromal fibrosis syncytial knots, calcified, hypervascularity, all of which impair the uteroplacental flow of blood and lower newborn weight.

Association between Total and Individual PCB Congener Levels in Maternal Serum and Birth Weight of Newborns: Results from the Chiba Study of Mother and Child Health Using Weighted Quantile Sum Regression.

Maternal exposure to polychlorinated biphenyls (PCBs) during pregnancy is associated with a low birth weight; however, the congener-specific effects of PCB congeners are not well defined. In this study, we used maternal serum samples from the Chiba Study of Mother and Child Health (C-MACH) cohort, collected at 32 weeks of gestational age, to analyze the effects of PCB congener exposure on birth weight by examining the relationship between newborn birth weight and individual PCB congener levels in maternal serum (n = 291). The median total PCB level in the serum of mothers of male and female newborns at approximately 32 weeks of gestation was 39 and 37 ng g−1 lipid wt, respectively. The effect of the total PCB levels and the effects of PCB congener mixtures were analyzed using a linear regression model and a generalized weighted quantile sum regression model (gWQS). The birth weight of newborns was significantly associated with maternal exposure to PCB mixtures in the gWQS model. The results suggest that exposure to PCB mixtures results in low newborn birth weight. However, specific impacts of individual PCB congeners could not be related to newborn birth weight.

Higher Concordance in Clinical Assessment versus Ultrasound to Estimate Fetal Weight when it compares with Birth Weight in Full-Term Newborns

Introduction: the aim of this trial was to estimate fetal weight by clinical and ultrasound methods and to compare with the weight at birth in full-term newborns. Methods: This is an epidemiological, observational, cross-sectional study of a cohort of healthy full-term newborns. The sample size was 102 neonates born at the Pablo Arturo Suarez Hospital, in Quito, Ecuador, from November 2019 to January 2020. Results: In full-term neonates, the estimate on ultrasound was 80.00%, while in the clinical assessment was 72.29%. The profile of newborn analyzed is man, mestizo, Ecuadorian, born in the highlands region, with a mean gestational age of 38.67 weeks and a mean birth weight of 3,023 grams, in whom it estimated the fetal weight through ultrasound and clinical assessment. The estimation of the absolute error in both methods analyzed was 2.43% to ultrasound and -4.65% to clinical assessment, and both showed moderate concordance, 78.2% to ultrasound, and 85.6% to clinical assessment. Multivariate analysis showed the neonates with modified weight by ultrasound are 13.44 times more likely to show altered weight at birth, while neonates with modified weight by the clinical assessment are 11.95 times more likely to show altered weight at birth. Conclusions: Accuracy in the clinical assessment was always higher than in the ultrasound method, especially in low weight newborns.

COVID-19 positivity associated with traumatic stress response to childbirth and no visitors and infant separation in the hospital

As the novel coronavirus (COVID-19) has spread globally, a significant portion of pregnant and delivering women were infected with COVID-19. While emerging studies examined birth outcomes in COVID-19 positive women, knowledge of the psychological experience of childbirth and maternal wellness remains lacking. This matched-control survey-based study included a sample of women recruited during the first wave of the pandemic in the US who gave birth in the previous six months. Women reporting confirmed/suspected COVID-19 (n = 68) during pregnancy or childbirth were matched on background factors with women reporting COVID-19 negativity (n = 2,276). We found nearly 50% of COVID positive women endorsed acute traumatic stress symptoms at a clinical level in response to childbirth. This group was more than twice as likely to endorse acute stress and to have no visitors during maternity hospitalization than COVID negative women; they were also less likely to room-in with newborns. The COVID positive group reported higher levels of pain in delivery, lower newborn weights, and more infant admission to neonatal intensive care units. Our findings suggest COVID-19 affected populations are at increased risk for traumatic childbirth and associated risk for psychiatric morbidity. Attention to delivering women’s wellbeing is warranted during the pandemic.