Newborns In Control Group Research Articles

Features of cytokine status of the newborns with seizures

The aim of the present study was to assess the level of cytokines in newborn children of various gestational terms with seizures. A prospective, comprehensive study of 307 newborns of various gestational ages with seizures was carried out.
 Evaluation of anamnestic data, antenatal, intrapartum risk factors with using statistical methods showed that mothers of newborns (respectively, full-term and premature) with seizures had a high percentage of extragenital diseases (31.83.7% 2 = 15.4, p = 0.009, vs 62.35.0% 2 = 27.2, p1 0.001), gynecological disorders (49.13.6% 2 = 37.1 p 0.001, and 47.05.1% 2 = 9.69 p1 = 0.046), threatened miscarriage (9.12.5% 2 = 11.290 p 0.001, and 28.54.7% 2 = 14.779 p1 0.001), anemia of pregnancy (40.03.6% 2 = 14.9 , p 0.001 vs 66.44.3% 2 = 18.9, p 0.001). After EEG examination, we found that in most cases, 78 (30.0%) newborns exhibited polymorphic convulsions, i.e. a combination of different types of convulsions. The atypical convulsions were reported in 64 (24.5%) newborns, with a predominance of preterm infants 61 (40.4%). Clonic seizures were more common in full-term infants (n = 34; 30.9%) and preterm (n = 26; 17.2%). Myoclonic convulsions were found mainly in preterm newborns 21% (13.9%). Tonic convulsions were found in only 5 cases (5.3%). According to neurosonographic data, brain swelling was reported in 83 (31.8%), ventriculomegaly in 44 (16.9%), ventriculitis in 43 (16.5%), intraventricular hemorrhage in 66 (15.3%) newborns of the main group. In the control group, periventricular hemorrhage was observed in 37 (14.2%) newborns. Frequency of these disorders in preterm infants was 18.6% higher than in full-term infants (2 = 13.3; p = 0.004). Altered immunological reactivity in newborns with seizures manifested as abnormal cytokine status and significantly elevated pro-inflammatory cytokines (IL-1, 1.9-fold; IL-6, 3-fold; TNF 3.3-fold increase) compared with newborns of control group. Increased concentration of pro-inflammatory cytokines in newborns with HIE is associated with maintenance of seizure activity and aggravates further unfavorable neurological outcome. The cerebral disorders and dysfunction of different organs and systems were found to correlate with immune parameters. Hence, the expression of pro-inflammatory cytokines may be used as a screening marker in diagnostics and prediction of neonatal seizures in presence of perinatal hypoxic-ischemic lesions of the central nervous system.

Obstetric and perinatal pathology in pregnant women who had complications from the group of the Great Obstetrical Syndromes

The objective: to analyze the obstetric and perinatal outcomes of childbirth in pregnant women who had complications from the group of the great obstetrical syndromes.Materials and methods. A retrospective statistical analysis of obstetric and perinatal outcomes of childbirth of 239 pregnant women (the Ist group – main one) who had complications from the group of the great obstetrical syndromes (GOS). They were divided into three subgroups: Ia subgroup included 103 pregnant women with severe preeclampsia (PE), Ib subgroup – 67 pregnant women with placental insufficiency, with clinical manifestation of fetal intrauterine growth retardation (IUGR), Ic subgroup – 69 pregnant women with spontaneous preterm birth in the gestational age 22-36 weeks. The control group (CG) included 56 practically healthy pregnant women with a normal reproductive history and uncomplicated course of this pregnancy.Statistical processing of the study results was performed using standard programs Microsoft Excel 5.0 and Statistica 6.0.Results. The incidence of gestational diabetes mellitus in patients of the I group (28 (11.7 %) women) was higher than in CG (2 (3.6 %) persons). Cervical insufficiency was diagnosed in every fifth patient of Ic subgroup (12 (17.3 %) patients; χ2=15.56, p<0.01; OR=9.25; CI 95%: 2.55–33.54 relative to CG), gestational anemia – in 179 (74.8 %) pregnant women in the I group and 18 (32.1 %) women in CG (p<0.01).A significantly high rate of mild congenital malformations was present in subgroup Ib (7 (10.4 %) of pregnant women; χ2=12.67, p<0.01; OR=7.93; CI 95%: 2.14-29.26). 21 patients in the I group had with antenatal fetal death, 6 (5.8 %) – severe PE, 11 (16.4 %) – IUGR. Five cases of early neonatal mortality was diagnosed in the I group. The rate of perinatal mortality in the I group was high and amounted to 108.7 ‰.The operative delivery in the I group was performed in 127 (53.1 %) patients which is significantly more than in CG (χ2=42.93, p<0.01; OR=4.93; CI 95%: 2.99– 8.13). In 24 (18.9 %) pregnant women in the I group the indication for operative delivery was acute distress, which is significantly more than in CG (2 (3.6 %) women; χ2=7.36, p<0.01; OR=5.17; CI 95%: 1.2–22.28). The mean score on the Apgar scale in newborns in CG was significantly higher compared with the I group (p<0.01).Conclusions. The course of pregnancy and childbirth in women who had complications from the group of the great obstetrical syndromes was accompanied by the development of gestational diabetes, gestational anemia and cervical insufficiency. Complications such as fetal distress, severe preeclampsia, fetal growth retardation with decompensated hemodynamic disorders of the uterine and placental blood circulation, led to a high frequency of cesarean section in these patients.

Asphyxia as a Risk Factor for Neonatal Hypoglycemia

Introduction: Hypoglycemia leads to brain developmental disturbances and abnormality on its function. Perinatal stress including asphyxia is a significant cause of neonatal hypoglycemia, thus, it is important to prevent it by controlling its relevant confounding variables. The aims of this study were to identify the risk factors of neonatal hypoglycemia and its related variables, focusing on the role of asphyxia in neonatal hypoglycemia.Material and Methods: We conducted a nested case control study using a cohort data from South East Asia Regional Neonatal-Perinatal Database year 2013 of the Maternal and Perinatal Unit, Dr. Sardjito General Hospital Yogyakarta. We randomly selected neonatal hypoglycemia as a case and neonatal without hypoglycemia as a control group. We identify the risk factors from the cohort data. Logistic regression analyses were performed to investigate the association between hypoglycemia and risk factors.Results: A total of 1563 newborns were recruited in this study. Five hundred and twenty newborns were excluded due to incomplete data and major congenital anomalies. By simple randomization sampling, we selected 52 newborns in cases group and 104 newborns in control group. In multivariate models, being asphyxia, low birth weight (LBW), large for gestational age (LGA), and early onset of neonatal sepsis showed significant effects on risk of hypoglycemia, OR= 2.8 (95% CI: 1.01 – 7.80), OR 7.1 (95% CI 1.54-32.37), OR 37.2 (95% CI 6.28-219.85), and OR 40.6 (95% CI 10.84-152.01), respectively.Conclusion: Asphyxia, LBW, LGA and early onset neonatal sepsis were significant risk factor for neonatal hypoglycemia.

Effect and safety of medical elastic net bandage on fixing limb venous indwelling needle for newborns

Objective To discuss about the effect and safety of medical elastic net bandage on fixing limb venous indwelling needle for newborns. Methods A total of 120 newborns hospitalized in the pediatric department of this center from September 2012 to December 2015 were selected as study objects.Random number table was used to divide into intervention group and control group (60 cases each).3 M surgical dressing with gauze fixation method was used for the venous indwelling needle of newborns in control group and 3 M transparent surgical dressing with elastic net bandage fixation method was used for the venous indwelling needle of newborns in intervention group.The fixation effect, retention time and adverse reactions of the two groups were compared. Results 54 cases had successful fixation in intervention group, 2 cases had secondary fixation, 3 cases had indwelling needle falling-off and 1 case had transfusion leakage.40 cases of control group had successful fixation, 8 cases had secondary fixation, 7 cases had indwelling needle falling-off and 5 cases had transfusion leakage.Compared with the control group, the fixation success rate of intervention increased obviously, the occurrence rate of secondary fixation, indwelling needle falling-off and transfusion leakage reduced obviously, and the difference had statistical significance(P<0.05). Compared with the control group, the indwelling time of limb venous indwelling needle to the child patients of intervention group was obviously extended.For the part of indwelling needle of child patients in intervention group, 1 case(1.67%) had skin allergy, 1 case(1.67%) had leakage swelling, and the total occurrence rate was 3.34%.For the part of indwelling needle of child patients in control group, 3 cases(5.00%) had skin allergy, 1 case(1.67%) had infection, 2 cases(3.33%) had leakage swelling, and the total occurrence rate was 10.00%.Compared with control group, the total incidence of adverse reactions of children in the intervention group decreased significantly, and the difference was statistically significant(P<0.05). Conclusion Medical elastic mesh bandage used in fixed newborn body can significantly extend the indwelling venous indwelling needle indwelling time, and reduce the incidence of adverse reactions.It is safe and effective, and it is worthy of clinical popularization and application. Key words: Medical elastic net bandage; Newborn; Limb vein indwelling needle; Application effect

Comparison of two different fixation methods for nasal continuous positive airway pressure in newborns

Objective To explore the clinical application of two different fixation methods for nasal continuous positive airway pressure (NCPAP) in newborns. Methods One hundred and forty newborns who had NCPAP treatment were selected and divided into experimental group and control group with 70 cases in each group by random digits table method.The newborns in experimental group received self-made caps to fix the prong systems,while the newborns in control group received U shape towel. The incidence of nose, head of facial skin injury, frequency of detachment for nasal prongs and duration mechanical ventilation were compared between two groups. Results The frequency of detachment for nasal prongs per 24 h was (0.65±0.18) times in experimental group and (1.64±0.22) times in control group, and there was significant difference (t=28.68,P 0.05). Conclusions Use of the self-made caps for NCPAP in newborns is associated with significant reduction in the incidence of nose, head of facial skin injury,and the frequency of detachment for nasal prongs.The fixation should be prompted in clinic. Key words: Infant, newborn; Nasal obstruction; Continuous positive airway pressure; Fixation; Skin breakdown

Chlorhexidine – a novel intervention to decrease the nursery stay and antibiotic exposure duration – randomized trial

Objective: To study the effect of chlorhexidine (CHD) application on umbilical cord and evaluate its impact on duration of NICU stay and antibiotic exposure days.Method: We enrolled 140 newborns in our study (70 in intervention group and 70 in control group), and their data were collected. Newborns in control group were given routine umbilical cord care, and intervention group received CHD spray on umbilical cord three times a day and for the next three days of cord fall. In this study, swabs were sent from umbilical cord at the age of three and seven days of life for culture. Data regarding culture-proven sepsis, duration of NICU stay and antibiotic days were recorded in the proforma for data collection.Results: This is a secondary analysis of the data of the randomized control trial. A significant reduction in duration of nursery stay was seen in CHD group in comparison with control group (12.4 ± 5.38 d versus 14.7 ± 6.62 d, p = 0.04, significant). Significant reduction was also seen in days of antibiotic exposure in the intervention group (9.74 ± 6.88 d versus 12.1 ± 7.78 d, p = 0.04, significant).Conclusion: Application of CHD to umbilical cord shortens duration of nursery stay and antibiotic days during nursery admission. This simple intervention may be used as mode in places where nursery facilities are limited, as aid in early discharge and shortening the exposure to antibiotic, which may help in reducing the prevalence of multidrug-resistance microbes. This cheap intervention may also be effective in reducing the economical burden on the health infrastructure of the country and parents.

Not all probiotics are the same: Gut microbiota modulation with a multistrain probiotics

The highest incidence of invasive candidiasis infection (ICI) occurs in low birth weight infant with an estimated incidence of 4% and of 15% in extremely low birth weight infant. Low birth weight is an important risk factor. The other main risk factors associated with invasive candidiasis are the use of multiple antibiotics and central venous catheters, immunosuppression, parenteral nutrition, fungal colonization, and necrotizing enterocolitis. In this population, ICI cause high mortality, lead to significant neurodevelopmental impairment, and result in increate length of hospitalization and cost.[1] Originality of the study is the use of probiotics combination Alkem Batch PWS3002C comprising Bifidobacterium infantis, Lactobacillus acidophilus, Bifidobacterium longum, and Bifidum lactis. These preparations are considered more effective than single probiotic strain, characterized instead by a single bacterial strain. In fact, a recent study showed that the use of a multistrain probiotics have an action of greater efficacy.[2] Important focal point is gastrointestinal symptoms. Another interesting result of this study is that the control group presented a higher percentage of gastrointestinal symptoms than did the probiotic group, which showed an increased food tolerance, shortening the period of parenteral nutrition probably due to its changes in intestinal flora, improvement in mucosal barrier and anti-infiammatory properties. Reduction of stool fungal colonization is an important principal outcome parameter in the probiotics group by reduced invasive fungal sepsis is an important outcome parameter in the probiotics group because reduced invasive fungal sepsis 55.4% in probiotics group versus 75% in the control group.[3] Also the number of days to full enteral feeds and duration of hospitalization was less in probiotic group. Candida albicans is the most commonly isolated species, although C. parapsilosis. These species are commonly isolated in invasive candidiasis, while C. glabrata and C. krusei are isolated only in 3% of ICI. The published data show that fluconazolo use since birth is highly effective in preventing both colonization and infection in preterm neonates. This can lead to a high prevalence of azole-resistant Candida species.[4] In this study 35 (7%) newborns of control group presented C. glabrata infection, while the probiotics group presented only C. albicans. Loss of gut commensals, such as Bifidobacteria and Lactobacilli, due to the difficulties in oral feeding, translates into an increased susceptibility to pathogenic gut colonization. Probiotics are increasingly being used for their beneficial properties, considered to be particularly useful in reducing some symptoms related to gastrointestinal disorders.[5] In particular, preparations of a multistrain, consisting of different bacterial strains but belonging to the same species or anyway similar species are considered more effective than single probiotic strain. Evidence regarding the potential beneficial effects of probiotics supplementation in preterm infants is encouraging. Further studies to assess clinically relevant outcomes are needed.