Low Birth Weight Preterm Neonates Research Articles

Ocular blood flow in preterm neonates

Retinopathy of prematurity (ROP) is a disorder affecting low birthweight, preterm neonates. In the preterm eye, the retina is not fully developed and neovascularization may occur at the margin between the developed vascular retina and undeveloped avascular retina. Without timely treatment by laser or intravitreal anti-vascular endothelial growth factor (VEGF) therapy, this can lead to tractional retinal detachment and blindness. Visualization of the retina in regular examinations by indirect ophthalmoscopy is hence the current standard of care, but the exams are stressful and interpretation of images is subjective. The upregulation of VEGF in ROP would suggest an increase in ocular blood flow. In this report, we evaluate the potential of ultrafast plane-wave Doppler ultrasound (PWU) to detect increased flow velocities in the orbital vessels supplying the eye in a gentle exam with objective findings. We imaged both eyes of 50 low-birthweight preterm neonates using 18 MHz PWU. Flow velocity in the central retinal artery (CRA) and vein (CRV), and the short posterior ciliary arteries were determined and values at each ROP Stage compared. We found significantly increased velocities in the CRA and CRV in Stage 3 ROP eyes, where intervention would be considered. We compared multivariate models for identifying Stage 3 eyes comprised solely of clinical factors, solely of Doppler parameters, and clinical plus Doppler parameters. The respective models provided areas under their respective ROC curves of 0.760, 0.812, and 0.904. PWU Doppler represents a gentle, objective means for identifying neonates at risk for ROP that could complement ophthalmoscopy.

Infective Endocarditis due to Unusual Pathogens Complicated with Pulmonary Thromboembolism: A Rare Occurrence in a Premature Infant

Background: Survival of low birth weight preterm neonates has increased with the availability of better neonatal care, however, the use of central lines for longer duration increases the risk of bacterial and fungal sepsis. Neonatal infective endocarditis (IE) is a rare presentation of neonatal sepsis and is often associated with complications and high mortality. Clinical Description: A 36 weeker, premature baby, hospitalized for early onset sepsis, was transferred to our hospital on day 15 of life, with an umbilical catheter in situ, with fever, respiratory distress, and persistent thrombocytopenia. Clinical examination revealed decreased oxygen saturation, crepitations in the right lung field, systolic murmur, and hepatomegaly. Management and Outcome: Baseline investigations revealed positive septic screen with thrombocytopenia with meningitis, neonatal cholestasis, and right sided consolidation on chest X ray. A two dimensional echocardiography (ECHO) revealed vegetation on the tricuspid valve, and blood culture from two sites revealed growth of Candida tropicalis and Serratia marcescens. Colistin, tigecycline, and amphotericin B therapy were initiated as per sensitivity along with low molecular weight heparin for prevention of embolization. The baby developed acute worsening in respiratory distress after 4 weeks of therapy. Repeat ECHO revealed increased size of cardiac vegetation and computed tomography of thorax with pulmonary angiography revealed pulmonary thromboembolism. Unfortunately, the baby succumbed to complications of IE. Conclusion: Invasive instrumentations such as umbilical catheterization and prolonged hospitalizations of premature newborns predispose them to develop IE, especially with unusual organisms. Such infections have a complicated course and may be fatal.

Multimodal Sensory Stimulation among Very Low Birth Weight Preterm Newborns: A Quasi-experimental Study at a Tertiary Care Hospital in Agartala, Tripura, India

Introduction: There is a continuous search for an effective intervention to help preterm low birth weight neonates overcome their poor growth and developmental outcomes. Most researchers have examined the effect of Oromotor Stimulation (OMS) on feeding performance. Studies exploring Multimodal Sensory Stimulation (MSS) on various outcome parameters are sparse and reveal inconsistent results. Aim: To analyse the effectiveness of MSS in improving weight gain, length of hospitalisation, and feeding performance in preterm Very Low Birth Weight (VLBW) neonates. Materials and Methods: This quasi-experimental study was conducted between June 2021 and December 2022 in the Paediatrics Department of Agartala Government Medical College, Agartala, Tripura, India. A total of 104 hospitalised neonates with gestational age from 28 to less than 37 weeks and birth weight from 1000 to less than 1500 grams (VLBW) were included in the study. All neonates received standard care and Kangaroo Mother Care (KMC). On the advice of some faculties, several of them also received MSS. All neonates were divided into two groups: those who received MSS and those who did not, and they were monitored until discharge. Mean hospitalisation length, weight gain, and transition time were derived and statistically analysed using Chi-square and Mann-Whitney U tests. Results: In the present study, the mean gestational age was 32.04±1.75 and 32.679±1.19 weeks, and the M:F ratio was 1.43:1 and 1.30:1 in the MSS-given and MSS-not given groups, respectively. Mean weight gain was significantly higher in the MSS-given group (97.00±123.09 g versus- 23.42±43.96 g). Mean hospitalisation length was longer in the MSS-given group, but transition time did not differ significantly across the groups. Conclusion: Multimodal sensory stimulation is effective in promoting weight gain in preterm VLBW neonates.

Unraveling Leukocyte Profile Shifts and Platelet Dynamics Following Leukoreduced Packed Red Cell Transfusions in Very Low Birth Weight Preterm Neonates.

Background Packed red blood cell (PRBC) transfusions are routine in neonatal care and the most common blood product administered to sick neonates. However, their impact on leukocyte and platelet profiles in very low birth weight (VLBW) preterm infants remains largely unexplored.This study examines leukocyte profile shifts and platelet dynamics following leukoreduced PRBC transfusions in VLBW preterm infants, offering insights to improve neonatal care and reduce unnecessary interventions. Methods The study utilized a retrospective cohort design within a single center, focusing on VLBW preterm infants who received PRBC transfusions at a level 3 NICU between January 2014 and June 2019. Data collection encompassed white blood cell (WBC) and platelet count measurements taken 24 hours before and up to 72 hours after PRBC transfusion. Neonates lacking complete blood count (CBC) data within the 72-hour post-transfusion window were excluded. A subgroup analysis distinguished the outcome between the initial PRBC transfusion and subsequent ones. The statistical significance of pre- and post-transfusion laboratory data was determined using the Wilcoxon signed ranks test and paired T-test. Results A cohort of 108 VLBW preterm infants who underwent a total of 402 PRBC transfusions was included in the analysis. The subjects exhibited a mean gestational age of 27.2 ± 2.5 weeks and a mean birth weight of 913 ± 264 grams. Analysis of pre- and post-transfusion data revealed no significant differences in total white blood cell count (WBC), absolute neutrophil count (ANC), absolute monocyte count (AMC), absolute eosinophil count, and absolute lymphocyte count. Notably, the platelet count was significantly decreased in the post-transfusion group (p < 0.001). In a subset analysis limited to the first-time transfusions among the 108 infants, a statistically significant increase was observed in total WBC, AMC, and ANC following transfusion. Conclusions The findings of this study highlight that PRBC transfusions can prompt an increase in neutrophils, monocytes, and eosinophils, coupled with a decline in platelet counts, all within a 72-hour window post-transfusion. Notably, these changes were predominantly discernible after the initial transfusion, with subsequent transfusions demonstrating consistency, except for the observed platelet count reduction. Recognizing these patterns could prove instrumental in averting undue investigations for suspected sepsis, particularly following the initial transfusion event. However, further in-depth investigations are necessary to uncover the underlying factors responsible for the shifts in leukocyte and platelet profiles triggered by PRBC transfusions.

Patent Ductus Arteriosus Device Closure with AMPLATZER Duct Occluder-II in a Low Birth Weight Preterm Neonate- First Experience in Pakistan

We report a successful closure of large patent ductus arteriosus (PDA) in a low-birth weight preterm neonate using an ADO IIdevice for the first time in AFIC/NIHD Rawalpindi. A hemodynamically significant PDA in a preterm neonate carries anincreased risk of morbidity, including chronic lung disease, necrotizing enterocolitis and renal impairment. After the failure ofmedical therapy, successful, timely and safe transcatheter closure of PDA using appropriate equipment is a milestone inmanaging PDA in preterm neonates.

Association of maternal age 35 years and over and prenatal care utilization, preterm birth, and low birth weight, Mexico 2008-2019.

To evaluate prenatal care utilization, low birth weight, and preterm birth among women aged 35 years and older in Mexico from 2008 to 2019. We conducted a historical cohort study of all singleton live births in Mexico from 2008 to 2019. Outcomes were inadequate prenatal care, preterm birth, and low birth weight. We compared outcomes among women aged 35-39, 40-44, and 45-49 years with births to women aged 20-34 years. We used logistic regression to account for individual, health system, and contextual confounders. We included a total of 19 526 922 births; 2325 725 (11.9%) were to women aged 35 years and older. Women aged 45-49 years had the lowest levels of education, were more likely to be uninsured, and came from highly marginalized municipalities while those aged 35-39years had the highest levels of education and insurance and came from the least marginalized municipalities. The odds of inadequate prenatal care (adjusted odds ratio [aOR] 1.12; 95% confidence interval [CI] 1.09-1.15), preterm birth (aOR 2.05; 95% CI 1.97-2.13), and low birth weight (aOR 2.03; 95% CI 1.95-2.12) were highest for women aged 45-49 years, compared with women aged 20-34 years. The odds of adverse perinatal outcomes increased progressively with age, but the odds of inadequate prenatal care (aOR 0.77; 95% CI 0.76-0.77) were lowest for women aged 35-39 years, when compared with women aged 20-34 years. Women who deliver at 35 years and over are a heterogeneous group in Mexico. Being 35 years old and older is associated with increases in preterm birth and low birth weight neonates. Women who give birth between 45 and 49 years may be especially vulnerable.

What is the association between common medications (indomethacin, ibuprofen and acetaminophen) and spontaneous intestinal perforations in premature infants? A systematic review protocol

Background: Spontaneous intestinal perforation (SIP) affects very low birth weight preterm neonates and accounts for 44% of gastrointestinal perforations. Commonly used medications such as indomethacin, ibuprofen and acetaminophen for PDA closure, increases the risk of intestinal perforation. Unfortunately, the majority of the data combine SIP with those affected by necrotizing enterocolitis (NEC) despite them being separate entities. This systematic review aims to explore the association between the use of common medications and SIP in the premature infant cohort independently from NEC. Methods: Our study will focus on preterm infants with exposure to either indomethacin, ibuprofen or acetaminophen where SIP is a reported outcome. A health science librarian will search Medline and Medline in Process via OVID, Embase Classic + Embase via OVID, the LILACS database, the ScIELO database and the Cochrane Library including EBM Reviews - Cochrane Central Register of Controlled Trials. Search dates for each database will be from their respective dates of inception to March 2022. All articles will undergo screening by two independent reviewers, and if selected, data extraction with risk of bias assessment by two independent reviewers. A third reviewer will settle any disagreements that may occur. Incidence of SIP will be measured as a proportion. Individual proportions will be pooled using a random effects logistic regression model. The comparative incidence of SIP by treatment group will be measured using the odds ratio. Odds ratios will be pooled using the DerSimonian and Laird random effects model for meta-analysis. PROSPERO Registration: CRD42017058603

Evaluation of the impact of kangaroo mother care on neonatal mortality and hospitalization: A meta-analysis.

The kangaroo mother care (KMC) technique for preterm and low-birthweight (LBW) neonates, which consists of skin-to-skin contact, is thought to have a beneficial impact on clinical outcomes. Hence, the current meta-analysis aims to evaluate the influence of KMC on neonatal mortality and length of hospitalization compared with conventional care. A systematic literature search of studies published between 1988 and 2021 found 24 trials involving 19,980 participants, of which 10,354 received KMC and 9626 were controls under conventional care. To measure the impact of applying KMC in preterm LBW neonates on mortality and the length of hospital stay, statistical analysis using dichotomous and continuous analysis methods was performed employing fixed and random models to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs). Compared to the control group, the application of KMC in preterm LBW neonates resulted in significantly lower mortality (OR: 0.65, 95% CI: 0.44-0.97, p = 0.03) in a short term (within 2 months, I2 = 71%) and long term (3-12 months) (OR: 0.72, 95% CI: 0.59-0.87, p = 0.0007, I2 = 0%), and had no significant impact on the length of hospital stay (OR: -1.43, 95% CI: -2.88-0.02, p = 0.05, I2 = 86%). In comparison with the control group, the implementation of KMC in preterm LBW neonates resulted in significantly lower mortality but had no significant impact on the length of hospitalization. More studies are needed to confirm the current findings.

Prevalence and Risk Factors of Apnea in Preterm Neonates Admitted to the French Medical Institute for Mothers and Children Hospital in Kabul City: An Analytic Cross-Sectional Study

Introduction: Prematurity is one of the leading causes of neonatal death in Afghanistan and complicates many serious problems including apnea. Although recurrent and prolong apnea of prematurity (AOP) may be directly or indirectly associated with significant adverse outcomes, there isn’t enough scientific information regarding the prevalence and risk factors of this problem in Afghanistan, therefore, this study is performed to obtain such information. Objective: To determine the prevalence rate and risk factors for apnea of prematurity in neonates admitted to the Neonatal Intensive Care Unit of the French Medical Institute for Mothers and Children Hospital, Kabul City. Patients and Methods: This analytic cross-sectional study was conducted at the Neonatal Intensive Care Unit of the French Medical Institute for Mothers and Children Hospital in Kabul City, Afghanistan. The study participants were preterm neonates. Statistical analysis was performed by SPSS 24. Results: 75 preterm newborns were enrolled in this study and the apnea of prematurity were developed in 48% of them. Extremely low birth weight preterm neonates had a 71.4% prevalence rate of such apnea, while in very low birth weight and low birth weight the rates were 47.4% and 36.4% respectively. Based on gestational age, the prevalence rates of apnea in the early and moderate preterm neonates were 55.6% and 52.8% respectively, whilst also in late preterm neonates it was 42.8%. The apnea of prematurity appeared more prevalent in boys (54.3%) than girls (45.7%). The preterm neonates in the apnea group versus the non-apnea group had the mean birth weight of (1233.33 ± 235.25g vs 1333.46 ± 274.44g, 90%CI= -198 _ -1.4), mean maternal age of (24.78 ± 3.68y vs 26.62 ± 4.58y, 90%CI= -3.44_-0.23) and RR of anemia (2.2, P=0.05). Conclusion: The overall prevalence rate of AOP in preterm neonates was 48% and the highest rates were seen within extremely low birth weight and early preterm neonates. The lower neonatal birth weight, neonatal anemia and younger maternal age were found to be the risk factors for apnea of prematurity.

Autonomic Nervous System in Preterm Very Low Birth Weight Neonates with Intraventricular Hemorrhage.

Heart rate variability (HRV) indicates cardiac autonomic nerve activity and is influenced by brain damage during the neonatal period. We aimed to determine whether a correlation exists between the HRV of extremely preterm neonates and neurodevelopmental test scores. Electrocardiogram data of neonates were assessed and HRV patterns in extremely preterm neonates with severe intraventricular hemorrhage (IVH; n = 6) and those with no/mild IVH (n = 28) were compared. We analyzed the relationship between HRV and neurodevelopmental outcomes at 18 months (n = 21) and 3 years (n = 23) in extremely preterm neonates. HRV was significantly associated with IVH severity in extremely preterm neonates (p < 0.05). Neonates with severe IVH exhibited increased HR and decreased mean R-to-R interval (NN) compared with neonates with no/mild IVH. HRV parameters significantly decreased in the severe IVH group, but not in the no/mild IVH group, suggesting that both sympathetic and parasympathetic activities decreased in neonates with severe IVH. Additionally, decreased HR and increased NN were significantly related to impaired neurodevelopmental outcomes in the no/mild IVH group at corrected ages of 18 months and 3 years, respectively (all p < 0.05). HRV was significantly associated with IVH severity and neurodevelopmental outcome in extremely preterm neonates. HRV can distinguish extremely preterm neonates who subsequently had severe IVH from those who had no/low-grade IVH. HRV may identify extremely preterm neonates needing adjuvant neuroprotective interventions. These findings warrant further investigation in a larger population of extremely preterm neonates. · HRV was associated with IVH severity.. · HRV can predict subsequent severe IVH in extremely preterm neonates.. · HRV are predictive of neurodevelopmental outcomes in extremely premature neonates with low-grade IVH..

Successful ‘Kangaroo Mother Care’: A Necessity for Preterm Low Birth Weight Babies in Rural Hospital Settings in Bangladesh

Kangaroo Mother Care (KMC) is a cost-effective solution in taking care of pre-term low birth weight neonates not only in developing countries with scarce resources, but also in developed countries with easy accessibility to technological advances like incubators. It provides an easy solution where the mother herself acts as an incubator and keeps the baby close to her in skinto- skin contact, and provides the baby the warmth, food, shelter and love that the baby needs to ensure its survival.In this paper we described the successful management of a preterm baby born at 29th gestational weeks weighing only 980 gm in a rural setting without any incubator and other technological equipment. The baby was in a critical condition since birth and despite adequate medical therapy she remained hypothermic. The KMC was initiated to keep her warm and marked improvements were noticed in the baby. The baby was discharged at day-14 with a body weight of 1100gm. Baby was in regular follow up and subsequently at 2-months 24days,she reached a desired body weight of 2100gm with improvement in feeding, movement and vital signs.It is concluded that, in a limited resource setting, KMC can act as a very effective measure in preventing neonatal morbidity by adequate heat regulation, exclusive breastfeeding and promoting early discharge from hospital. Bangladesh Journal of Medical Science Vol. 21 No. 04 October’22 Page : 875-882

Women With Kidney Disease Can Be Given a Personal Risk Assessment for Pregnancy

(BMJ. 2021;375:n2526) Advanced chronic kidney disease (CKD) is associated with a higher risk of preterm birth and low birthweight neonates. Studies exploring maternal and neonatal complications associated with CKD have been scarce. A large recent study examined predictive factors for the risk of complications and progression of kidney disease during pregnancy among patients with CKD.

Morbidity and mortality patterns of preterm low birthweight neonates admitted to referral hospitals in the Amhara region of Ethiopia: retrospective follow-up study

ObjectiveThis study aimed to assess the morbidity and mortality patterns of preterm neonates with low birth weight admitted in the Amhara region referral hospitals in Ethiopia.DesignHospital-based retrospective follow-up study.SettingAmhara region...

Pediatric Research Challenge, Alignment with the National Research Agenda

Pediatric Research Challenge, Alignment with the National Research Agenda

Growth and Neurodevelopment Outcome Among Preterm and Very Low Birth Weight Neonates Given Early Aggressive Amino Acid Therapy Admitted in the NICU of a Tertiary Hospital

Long-term outcomes of preterm and very low birth weight (VLBW) infants have been the focus of published research due to improved neonatal care. One of the long-term morbidities associated with being born too early or VLBW is postnatal growth failure and neurodevelopment delay. Because of this, different strategies were implemented to address this, one of which is initiating early aggressive amino acid therapy at 3 g/kg/day within 24 hours of life with its goal to improve previously mentioned outcomes. This study aims to determine the growth and neurodevelopment outcome among neonates born preterm and VLBW who were given 3 g/kg/day of amino acid. It is important that such delays are detected early on so that appropriate interventions can be initiated to maximize the infant's capabilities. A total of 34 neonates were included in the study where baseline anthropometrics were taken and followed up at the 6th, 9th, and 12th month of corrected age. Results showed 35.2% of the participants were discharged with their anthropometrics below the target range. By the 6th month of corrected age, only 2.94% were below normal and by the 9th month of corrected age, all participants have normal for age anthropometrics. As for the neurodevelopment aspect, 4 of 34 participants (13.8%) were found to be classified as emerging risk and were referred to a neurodevelopment specialist. By the 9th month of corrected age, only 2 were classified as emerging risk and by the 12th month of corrected age, only 1 remained to be at risk for neurodevelopment delay. In conclusion, early aggressive amino acid therapy proves to have a positive effect in the growth and neurodevelopment outcome among preterm and VLBW infants. However, we would like to recommend continued monitoring of neurodevelopment in neonates from this population until 2 years of age, since some delays can be evident later on in life.

Rapid versus Slow Feeding Advancement in Preterm Low Birth Weight Neonates: A Systematic Review and Meta-analysis

Objectives. To compare the clinical outcomes of rapid versus slow enteral feeding advancement in preterm low birth weight neonates.&#x0D; Methods. Searches for randomized controlled trials evaluating the effect of rapid versus slow rate of enteral feeding advancement on the clinical outcomes of preterm, low birth weight neonates were performed in different databases. Two authors screened the articles for inclusion and statistical analysis was done using Review Manager Version 5.3 (RevMan) software.&#x0D; Results. Six trials with a total of 680 subjects comparing enteral feeding advancement protocols were identified. The number of days to reach full feeds in rapid enteral feeding was shorter by 2.79 days (95% CI 1.39, 4.19) and time to regain weight by 3.72 days (95% CI 2.86, 4.59) compared to slow enteral feeding. There was no significant difference in the incidence of feeding intolerance (OR 0.69, 95% CI 0.42, 1.11) and NEC (OR 0.88, 95% CI 0.45, 1.72) between the two groups.&#x0D; Conclusions. Rapid enteral feeding protocols reduce the time to establish full enteral feeds and to regain birth weight in preterm low birth weight neonates. Rapid enteral feeding may facilitate early discharge and help reduce hospital costs for the care of these neonates.

Comparison of mean time of achieving full enteral feed with oral erythromycin as compared to placebo for the treatment of gastrointestinal dysmotility in low birth weight preterm neonates.

INTRODUCTION: Erythromycin, a commonly used macrolide antibiotic, has been found to possess potent prokinetic properties and therefore enhances gastrointestinal motor activity. Its motilin agonist action has been clinically exploited for the treatment of patients with chronic functional pseudo-obstruction, gastro-oesophageal reflux, postoperative intestinal dysmotility, gastroparesis secondary to diabetes, and scleroderma, and after surgical vagotomy.&#x0D; OBJECTIVE: The objective of my study is to compare mean time of achieving full enteral feed with oral erythromycin as compared to placebo for treatment of gastrointestinal dysmotility in low birth weight preterm neonates.&#x0D; &#x0D; MATERIALS AND METHODS:&#x0D; Study design: Randomized controlled trial.&#x0D; Setting: Department of paediatrics, Lahore general hospital, Lahore.&#x0D; Duration of study: This study was conducted for 6 months [December 19, 2017 till June 19, 2018]&#x0D; &#x0D; DATA COLLECTION PROCEDURE: After approval from hospital ethical committee 100 preterm neonates who presented in the paediatrics neonatal unit and emergency department of LGH fulfilling the inclusion criteria were selected. After an informed consent from the parents, the preterm neonates were randomly allocated to two groups using lottery method into Group A and group-B. Preterm neonates assigned to group A received erythromycin (12.5mg/kg/dose every 6 hour through oral route or nasogastric tube). Those allocated to group B received placebo solution (equivalent volume of normal saline orally 6 hourly). Preterm was given oral feed according to protocol (via nasogastric tube, orogastric tube or oral route). Both groups received erythromycin and placebo for 14 days. If patient developed necrotizing enterocolitis or deteriorated after start of study, erythromycin and placebo solution was discontinued. The duration of achieving full enteral feeding, type of milk used was noted in questionnaire along with demographic details of neonate.&#x0D; &#x0D; RESULTS: The mean age of all cases was 6.74 ± 2.29 days while mean age in Erythromycin group was 6.66 ± 2.48 days and in placebo group was 6.82 ± 2.10 days. In erythromycin group there were 35(70%) male and 15(30%) female cases while in placebo group there 21(42%) male and 29(58%) female cases. In erythromycin group 19(38%) cases were on mother feeding and 31(62%) cases were formula feeding and in placebo group 23(46%) cases were on mother feeding while 27(54%) cases were on formula feeding. The mean time to achieve enteral feeding in erythromycin group was 23.04 ± 4.42 days and in placebo was 26.46 ± 4.95 days. The mean time to achieve enteral feeding was statistically less in erythromycin group was statistically less as compared to placebo group, p-value &lt; 0.001.&#x0D; CONCLUSION: The study concludes that the mean time of achieving full enteral feed with oral erythromycin was significantly less as compared to placebo for treatment of gastrointestinal dysmotility in low birth weight preterm neonates. So, therapeutic effects of erythromycin can be utilized to achieve early feeding. This can also help to minimize the related morbidity and hospital stay.&#x0D; Keywords: &#x0D; Gastrointestinal dysmotility, preterm birth, prematurity, low birth weight, enteral feeding, oral erythromycin

Outcomes and Disease Spectrum of LBW Neonates in a Secondary Health Facility.

Globally, 30 million low birth weight (LBW) babies are born every year and 95% of them are from developing countries. LBW neonates are at a high risk of mortality, morbidity, and long-term disability. The objective of this study is to investigate outcomes and disease spectrum among low birth weight neonates. This is a prospective, observational study conducted on 540 neonates admitted in the Mother and Child Hospital, Akure, Ondo State, Nigeria, from 2017 to 2018. Questionnaire, interview, clinical, and diagnostic procedures were used as research tools. There were 137 low birth weight (LBW) neonates, with the mean mothers' age of 31.92 ± 6.60. Of the 540 neonates, 69 (50.4%) and 68 (49.6%) were term and preterm, respectively. There were 64 female neonates (46.7%) and 73 male neonates (53.3%). The mean weight of the neonates was 1.82 ± 0.44 kg, and mean number of days on admission was 6.42 ± 6.75 days. Neonatal sepsis (NNS) was the highest morbidity 51 (37.2%) among the LBW neonates, followed by prematurity 47 (34.4%) and neonatal jaundice (NNJ) 18 (13.1%). Sex (χ2 = 3.584, p=0.310), mode of delivery (χ2 = 4.669, p=0.198), and gestational age (χ2 = 3.904, p=0.272) were not a significant determinant of outcome among LBW neonates. Men were 2.36 times more likely to be preterm (OR = 2.36, 95% CL = 1.01–5.54, p=0.048) among LBW neonates. Outcomes of LBW neonates who were delivered by SVD were not significant compared to preterm delivered by CS (OR = 0.46, 95% CL = 0.13–1.65, p=0.096). Sixty percent (60%) of the mothers had Prolonged Rupture of Membranes (PROM). Morbidities such as hypothermia (72.2%), apnoea (63.6%), haemorrhagic disease of the newborn (HDN) (66.7%), and respiratory distress syndrome (RDS) (66.7%) were more observed with preterm LBW neonates. Importance of qualitative antenatal care (ANC) should be emphasized; anticipation and prevention of LBW births can help mitigate some of the problems they are prone to.

Clinical outcome and associated factors of respiratory distress syndrome among preterm neonates admitted to the neonatal intensive care unit of Adama Hospital and Medical College.

Aim of the study was to assess the clinical outcome and associated factors of respiratory distress syndrome among preterm neonates admitted to the neonatal intensive care unit of Adama Hospital and Medical College. Hospital-based cross-sectional study was conducted using 242 randomly selected medical records of preterm neonates admitted to Adama comprehensive specialized hospital. Clinical outcome was categorized as poor if the neonate died or left against advice and good if discharged after improvement. Data were coded, entered into Epidata v.7.4.2 and exported to SPSS v.27 for analysis. After initial bi-variable logistic regression analysis, predictor variables with p-value of <0.2 were included in multivariable analysis. Significant association of factors with clinical outcome was claimed at p-value <0.05 and calculated 95% adjusted odds ratio. Majority of admissions were male (63.2%), mean birth weight of 1440.3 g (+321.2 SD) and sepsis (82%), hypothermia (73%), and apnea (21.5%) were leading comorbidities. One hundred fifty-two (62.8%) of preterm neonates had poor outcomes. Neonates born singleton were 47% less likely to develop poor clinical outcomes (adjusted odds ratio 0.53 (0.48-0.94). The odds of poor clinical outcomes were higher during the first 3 days of admission (adjusted odds ratio 3.83 (3.28-14.77). Extremely preterm neonates (adjusted odds ratio 4.16 (4.01-12.97), extremely low birth weight preterm neonates had higher odds of poor clinical outcome. The study found higher poor clinical outcome among preterm neonates admitted with respiratory distress syndrome. Poor outcome was higher in lower gestational age, lower birth weight, twins and majority of it happened during 3 days of their life. Effective preventive care and initiation of low-cost, life-saving interventions including heated humidified high-flow nasal cannula and surfactant administration could significantly improve the clinical outcome of the neonates.

Neurodevelopmental Outcome of Preterm Low Birth Weight Infants at 9 Months of Age

Introduction: The survival of preterm babies has increased worldwide, but the risk of neurodevelopmental disabilities remains high, which is of concern to both the public and professionals. The early identification of children at risk and the outcome of neurodevelopmental disabilities may increase access to intervention, potentially influencing. Objective/Aim: To determine the neurodevelopmental outcomes in preterm infants at 9 months of age. Methodology: Preterm babies &lt;37weeks, weight &lt; 2500 of gestational age (GA) who were admitted in NICU, BSMMU were prospectively included in the study. The prenatal, perinatal and postnatal features of the babies were recorded. Bayley Scales of Infants and Toddler Development, Third Edition (Bayley-III), was applied at 9 month of age. This prospective observational study was conducted in the Department of Neonatology, BSMMU, after approval by Institutional Review Board, over twelve month period. All Preterm low birth weight neonates satisfying the inclusion criteria were enrolled in the study. All patients are managed as per standard clinical guidelines of NICU, BSMMU. We included total 39 infants. The hospital outcomes were recorded as necrotizing enterocolitis (NEC), Bronchopulmonary dysplasia (BPD) and Retinopathy of prematurity (ROP). Data were analyzed using the statistical package for social sciences (SPSS) version 25. P value &lt; 0.05 is considered as statistically significant. Results: All data of 39 babies were obtained during the study, mean birth weight was 1542.82 ± 444.93g, and mean gestational age was 33.00 ± 2.01 weeks. According to Bayley III scores, 23.1% cognitive delay, 7.7% language delay, and 43.6% motor delay were detected. A Positive correlation was found between BW and cognition composite scores (p= 0.001). A negative correlation was found between hospital stay and cognition composite scores (p = 0.002). Conclusion: The neurodevelopmental domain cognition, motor and language scores at 9 months of age are found lower. A Positive correlation was found between birth weight and cognition composite scores. A Positive correlation was found between gestational age and language composite scores.