Proportion Of Babies Research Articles

Postnatal Steroids Use for Bronchopulmonary Dysplasia in a Quaternary Care NICU.

Intercenter variation and trends in postnatal steroids (PNS) use among preterm infants for prevention or treatment of bronchopulmonary dysplasia (BPD) is known. Understanding intracenter PNS use patterns facilitate implementation of center-specific change interventions to optimize outcomes.This study aimed to (i) quantify the proportion of infants who received PNS, and describe the timing, type, trends over time, regimen used, and deviations, and (2) describe the clinical characteristics and unadjusted outcomes of infants who received PNS. This was a cohort study in a quaternary neonatal intensive care unit including infants born at less than 33 weeks, and who received PNS for prevention or treatment of BPD between 2011 and 2021. Following data were included: proportion of babies who received PNS; type of PNS; age at initiation and duration; trends over time; deviation from published regimen; morbidity, mortality, and cointerventions. One hundred and eighty four infants (8% of <33 week' infants) received PNS. The median (interquartile range [IQR]) gestational age and birth weight were 25 (24-26) weeks and 720 (625-841) grams, respectively. The median (IQR) day of initiation and duration of PNS use were 29 (19-38) and 10 (10-22) days, respectively. One hundred and fifty-seven (85%) infants received dexamethasone (DX) and 22 (12%) received hydrocortisone as the first PNS course, and 71 (39%) infants received multiple courses. The proportion of infants receiving PNS remained unchanged, but the cumulative median dose received for BPD per patient increased by 56%. Nearly one-third of cumulative PNS dose came from PNS used for non-BPD indications. Forty-six percent infants had a deviation from published regimen (±20% deviation in duration or ±10% deviation in dose). Survival, survival without major morbidity, moderate-to-severe BPD, and technology dependence at discharge were 87, 2, 91, and 67%, respectively. Increased variation in PNS use, deviation from published regimen, and concurrent PNS exposure from non-BPD indication offer insights into implementing interventions to improve processes. · In this quaternary NICU, 8% of infants born before 33 weeks were administered postnatal steroids (PNS).. · The percentage of infants given PNS remained stable; however, the cumulative dose per patient for BPD rose.. · The study identified targeted interventions to minimize clinical practice variations at the center..

Geographic heterogeneity of SARS-CoV-2 circulation in Abidjan, Ivory Coast: a prospective study.

Few studies on SARS-CoV-2 seroprevalence in Ivory Coast have been conducted since the first case was reported on March 11, 2020. The main objective of this study was to observe and better understand the circulation of SARS-CoV-2 in Abidjan. This prospective study collected data concerning age, sex, vaccination status, municipality of origin, monthly income, frequency of malaria, and frequency of diarrheal diseases in persons who gave their informed consent. Venous blood samples were taken to test for anti-SARS-COV-2 antibodies (IgM and IgG) using the VIDAS automated system. A total of 1504 patients were recruited and tested for antibodies directed against SARS-COV-2. Data analysis revealed the presence of anti-SARS-CoV-2 in 53.5% of participants, 17.3% of the participants had a previous symptomatic infection, 31.4% had an asymptomatic infection, and 44.8% were never in contact with the virus. Seroprevalence of SARS-CoV-2 was higher in Marcory (70.9%) and Cocody (61.1%) than in the remaining townships (48.4%). Township rates of serologically confirmed SARS-CoV-2 infection correlated with poverty index (p = 0.025), children < 5 years' proportion in the township (p = 0.026), and levels of malaria (p = 0.034). In the city of Abidjan, COVID-19 is strongly modulated by poverty, the proportion of babies and toddlers in the community, or exposure to malaria.

COMPARISON OF PATHOLOGICAL VERSUS SUSPICIOUS CARDIOTOCOGRAPHY IN PREDICTING FETAL DISTRESS IN TERMS OF APGAR SCORE AND UMBILICAL CORD PH AT ONE MINUTE ON CAESAREAN SECTION

OBJECTIVE: The goal of this study is to see if there is a link between fetal distress as determined by CTG and immediate postpartum umbilical cord blood pH.&#x0D; METHODS: This comparative analytical study was carried out at as Obstetrics and Gynecology Department, Lahore General Hospital, Lahore. We included 454 antenatal patients in our research which were divided in two groups: group-A (Pathological trace) and group-B (Suspicious trace) i.e. 227 in each group. All infants were observed for neonatal outcome as were admitted in neonatal ICU and APGAR score &lt; 7.&#x0D; RESULTS: The mean age of all participating pregnant females was 28.86 ± 6.56 years while the mean age in group-A (Pathological trace) and group-B (Suspicious trace) was 29.34 ± 6.56 years and 28.38± 6.54 years, respectively, with insignificant p-value of 0.119 (i.e &gt; 0.05). In groups A and B, the proportion of babies with an APGAR score of less than 7 was 80.6 % and 5.7 %, respectively, p-value &lt;0.001. The NICU admission rate in group-A (77.1%) was higher than in group-B (9.3%), p-value&lt; 0.001.&#x0D; CONCLUSION: When compared to suspicious CTG, pathologically trace showed a higher rate of APGAR score less than 7, foetal distress, and admission to neonatal ICU. Moreover, pathological CTG trace has higher predictive accuracy for neonatal outcome such as fetal distress, APGAR score &lt; 7 and admission to NICU.

Long-term trends in the incidence and management of shoulder dystocia in a tertiary obstetric unit in Hong Kong.

Because there have been changes in the management of macrosomic pregnancies and shoulder dystocia in the past decade, this study was conducted to compare the incidences of shoulder dystocia and perinatal outcomes between the periods of 2000-2009 and 2010-2019. This retrospective study was conducted in a tertiary obstetric unit. All cases of shoulder dystocia were identified using the hospital's electronic database. The incidences, maternal and fetal characteristics, obstetric management methods, and perinatal outcomes were compared between the two study periods. The overall incidence of shoulder dystocia decreased from 0.23% (134/58 326) in 2000-2009 to 0.16% (108/65 683) in 2010-2019 (P=0.009), mainly because of the overall decline in the proportion of babies with macrosomia (from 3.3% to 2.3%; P<0.001). The improved success rates of the McRoberts' manoeuvre (from 31.3% to 47.2%; P=0.012) and posterior arm extraction (from 52.9% to 92.3%; P=0.042) allowed a greater proportion of affected babies to be delivered within 2 minutes (from 59.0% to 79.6%; P=0.003). These changes led to a significant reduction in the proportion of fetuses with low Apgar scores: <5 at 1 minute of life (from 13.4% to 5.6%; P=0.042) and <7 at 5 minutes of life (from 11.9% to 4.6%; P=0.045). More proactive management of macrosomic pregnancies and enhanced training in the acute management of shoulder dystocia led to significant improvements in shoulder dystocia incidence and perinatal outcomes from 2000-2009 to 2010-2019.

Impact of perceived social support on prenatal outcome among pregnant women

Nigeria’s mortality ranks 14th in the world. Prenatal outcomes such as preterm birth, birth weight and Apgar score are some of the leading causes of prenatal morbidity and mortality worldwide, particularly in sub-Sahara Africa. It is against this backdrop that this study examined the impact of social support on birth outcomes among pregnant women in Eku Baptist Hospital, Delta State. The study was anchored on survey and observational research designs. Primary and secondary data sources were used. The study population was pregnant women in labour. A census of 161 pregnant women who registered at the health facility was taken. Descriptive and inferential statistical tools were used in the study. The study revealed that 23.5% of women with low perceived social support delivered babies with a low birth weight compared to only 5.5% of women who had strong perceived social support. This difference was statistically significant with a p-value of 0.003. Again, 88.2% compared to 72.5% had normal birth weight babies for women with strong social support and weak social support respectively and the differences in birth weight were statistically significant with P= 0.003. Also, 15.7% of women with poor social support had preterm babies compared to 10.9% of women with strong social support. The proportion of babies with neonatal Apgar scores less than 7 born to women who had weak/poor perceived social support (31.4%) was higher than that in women who had strong perceived social support (13.6%) and the relationship was statistically significant with p-value=0.008). The result of the study showed a statistically significant association between perceived social support and neonatal Apgar scores. The regression coefficient R of 0.166 however, shows a low predictive power. Based on the findings of the study, it is suggested that pregnant women should be given emotional, instrumental, informational and appraisal support to achieve better prenatal outcomes.

Retinopathy of prematurity screening in Johannesburg, South Africa: A comparative study

Background: Timeous screening of retinopathy of prematurity (ROP) is an important predictor of ROP screening outcomes, and hospitals at different levels of care might have different access to ROP screening by ophthalmologists, resulting in different ROP screening outcomes.Objective: To compare ROP screening outcomes between premature babies from a neonatal facility at a central hospital to those from regional hospitals in Johannesburg.Setting: Retinopathy of prematurity screening in babies born at central and non-central hospitals in Johannesburg, South Africa, between 01 January 2015 and 31 June 2020.Methods: A cross-sectional study describing clinical findings in babies referred for ROP screening at a central Johannesburg hospital.Results: A total of 2035 ROP screening records were included in the study. The babies screened from the central hospital and regional hospitals were 1081 (53.1%) and 954 (46.9%), respectively. The proportion of babies with ROP were 125 (11.6%) and 121 (12.7%) in the central hospital and regional hospitals, respectively, and this difference was not statistically significant, p = 0.435. There was a significant association between gestational age (GA) categories and birth weight (BW) with the hospital of birth, with proportionately more babies with GA 28 weeks, 212 (19.6%) versus 158 (16.6%) p 0.001, and BW 1500 g, 894 (82.7%) versus 737 (77.3%) p = 0.001, being referred by the central hospital compared to regional hospitals.Conclusion: The prevalence of ROP in regional hospitals does not seem to differ from that found in central hospitals.

Corticosteroids to safely reduce neonatal respiratory morbidity after late preterm and term planned caesarean section birth? A randomised placebo-controlled feasibility study

ObjectivesTo assess the feasibility of conducting a randomised placebo-controlled trial of corticosteroids prior to planned caesarean section from 35+0 to 39+6 weeks.DesignA triple-blind, placebo-controlled, parallel, trial randomised at the participant...

Association of socioeconomic status with adverse birth outcomes at the Women and Newborn Hospital of the University Teaching Hospitals in Lusaka, Zambia

Background: Low socioeconomic status has generally been associated with adverse birth outcomes worldwide. Adverse birth outcomes significantly contribute to perinatal morbidity and mortality worldwide with some literatures showing conflicting results. At Women and New-born Hospital in Zambia, this relationship had remained unclear among women who experienced poor neonatal outcome; hence the study was done to explore this association between socioeconomic status and adverse birth outcomes.&#x0D; Methods: A retrospective cohort study was conducted. Secondary data from ZAPPS study that had been collected prospectively between August 2015 and September 201 7 was retrieved. Altogether, 1,450 participants' information was retrieved, out of which 1,084 data records were set out for analysis after excluding those not meeting eligibility criteria. Socioeconomic status was an explanatory variable which was estimated using the standardized wealth score derived from principal component analysis of 14 variables. The wealth quintiles were further categorised into poor and not poor. Response variables were low birth weight, preterm birth and small for gestation age. SPSS version 21 was used for data analysis and p value&lt; 0.05 was significant &#x0D; Results: This study found the incidences of SGA, LBW and preterm births to be 164, 124 and 13 5 per 1000 live births respectively. In survival analysis, the proportion of babies who survived LBW among mothers who were poor was lower (82.9%) compared to babies born to rich mothers (87.5%) (p-value = 0.189). Furthermore, the proportion of babies who survived SGA for the poor was lower (79 .1 % ) compared to babies born to none poor mothers (85.8%) (p-value = 0.032) and preterm birth for the poor (78.4%) compared to babies born to mothers who were rich (83 .6%) (p-value = 0.022). In multiple Cox regression analysis socioeconomic status was not a significant risk factor for SGA ( aHR = 1.08; 95% CI; p=0.099), LBW and preterm birth (aHR = 1.17; 95% CI; p= l.41). However, male babies (aHR = 1.80; 95% CI; p=0.012), domestic violence or abuse during pregnancy (aHR = 3.48; 95% CI [1.59 - 7.34]; p = 0.002) and maternal anaemia (aHR = 2.1; 95% CI; p = 0.019) were risk factors for SGA while prior preterm birth ( aHR = 2.02; 95% CI; p = 0.002), HIV infection (aHR = 1.22; 95% CI; p = 0.040) and anaemia (aHR = 1.37; 95% CI; p = 0.009) were predictors of preterm delivery. &#x0D; Conclusion: There was no statistically significant association between low socioeconomic status and adverse birth outcomes although being pregnant with a male baby, HIV infection, anaemia and prior preterm birth were significantly associated with SGAand preterm.

Association of socioeconomic status with adverse birth outcomes at the Women and Newborn Hospital of the University Teaching Hospitals in Lusaka, Zambia

Background: Low socioeconomic status has generally been associated with adverse birth outcomes worldwide. Adverse birth outcomes significantly contribute to perinatal morbidity and mortality worldwide with some literatures showing conflicting results. At Women and New-born Hospital in Zambia, this relationship had remained unclear among women who experienced poor neonatal outcome; hence the study was done to explore this association between socioeconomic status and adverse birth outcomes.&#x0D; Methods: A retrospective cohort study was conducted. Secondary data from ZAPPS study that had been collected prospectively between August 2015 and September 201 7 was retrieved. Altogether, 1,450 participants' information was retrieved, out of which 1,084 data records were set out for analysis after excluding those not meeting eligibility criteria. Socioeconomic status was an explanatory variable which was estimated using the standardized wealth score derived from principal component analysis of 14 variables. The wealth quintiles were further categorised into poor and not poor. Response variables were low birth weight, preterm birth and small for gestation age. SPSS version 21 was used for data analysis and p value&lt; 0.05 was significant &#x0D; Results: This study found the incidences of SGA, LBW and preterm births to be 164, 124 and 13 5 per 1000 live births respectively. In survival analysis, the proportion of babies who survived LBW among mothers who were poor was lower (82.9%) compared to babies born to rich mothers (87.5%) (p-value = 0.189). Furthermore, the proportion of babies who survived SGA for the poor was lower (79 .1 % ) compared to babies born to none poor mothers (85.8%) (p-value = 0.032) and preterm birth for the poor (78.4%) compared to babies born to mothers who were rich (83 .6%) (p-value = 0.022). In multiple Cox regression analysis socioeconomic status was not a significant risk factor for SGA ( aHR = 1.08; 95% CI; p=0.099), LBW and preterm birth (aHR = 1.17; 95% CI; p= l.41). However, male babies (aHR = 1.80; 95% CI; p=0.012), domestic violence or abuse during pregnancy (aHR = 3.48; 95% CI [1.59 - 7.34]; p = 0.002) and maternal anaemia (aHR = 2.1; 95% CI; p = 0.019) were risk factors for SGA while prior preterm birth ( aHR = 2.02; 95% CI; p = 0.002), HIV infection (aHR = 1.22; 95% CI; p = 0.040) and anaemia (aHR = 1.37; 95% CI; p = 0.009) were predictors of preterm delivery. &#x0D; Conclusion: There was no statistically significant association between low socioeconomic status and adverse birth outcomes although being pregnant with a male baby, HIV infection, anaemia and prior preterm birth were significantly associated with SGAand preterm.

Securing peripheral intravenous catheters in babies without applying adhesive dressings to the skin: a proof-of-concept study

BackgroundMost babies admitted to a Neonatal Intensive Care Unit (NICU) require a peripheral intravenous catheter (PIVC). PIVCs are secured using splints and adhesive dressings applied to the skin. Removing the dressings causes skin injury, pain, and risks infection. We designed the Pēpi Splint, which supports PIVCs without the application of adhesive dressings to the skin. We sought to determine the effectiveness and acceptability of the Pēpi Splint using a proof-of-concept design.MethodsEligible babies were > 1000 g and > 30 weeks’ corrected gestation admitted to Wellington Regional NICU and who required a PIVC. All babies received the same care as those not in the study, with the addition of the Pēpi Splint. Primary outcomes were the proportion of babies in which the Pēpi Splint secured the PIVC for the required time and proportion of babies who experience an adverse event. Secondary outcomes were the acceptability of the Pēpi Splint as reported by the parents.ResultsThirty-eight babies, median (range) birth weight 2625 g (396—4970) and gestation 37wk (22—41). When the Pēpi was applied the postnatal weight was 2969 g (1145 – 4970) and gestation 37wk (29 – 41). The Pēpi Splint held the PIVC secure for 34/38 babies (89%), for a duration of 37 h (6 to 97). There were no adverse events. Of the four babies reported to have unsecure PIVCs, two were due to the securement two were displaced during feeding. Fifty-eight parents responded to a questionnaire (32 mothers, 26 fathers). Of these parents 52 (90%) would participate again and 52 (90%) would recommend participating to others. Overall, clinicians reported the Pēpi Splint was easy to use 33/38 (87%).ConclusionThe Pēpi Splint safely secures PIVCs without adhesive dressings being applied to the skin and is acceptable to both parents and clinicians. Our findings provide support for a larger multicentred randomised controlled trial.Trial registrationRegistered with the Australian and New Zealand Clinical Trials Registry Reference ACTRN12620001335987.

Maintaining Normothermia in Preterm Babies during Stabilisation with an Intact Umbilical Cord.

Background: We had experienced an increase in admission hypothermia rates during implementation of deferred cord clamping (DCC) in our unit. Our objective was to reduce the number of babies with a gestation below 32 weeks who are hypothermic on admission, whilst practising DCC and providing delivery room cuddles (DRC). Method: A 12 month quality improvement project set, in a large Neonatal Intensive Care Unit, from January 2020 to December 2020. Monthly rates of admission hypothermia (<36.5 °C) for all eligible babies, were tracked prospectively. Each hypothermic baby was reviewed as part of a series of Plan, Do, Study Act (PDSA) cycles, to understand potential reasons and to develop solutions. Implementation of these solutions included the dissemination of the learning through a variety of methods. The main outcome measure was the proportion of babies who were hypothermic (<36.5 °C) on admission compared to the previous 12 months. Results: 130 babies with a gestation below 32 weeks were admitted during the study period. 90 babies (69.2%) had DCC and 79 babies (60%) received DRC. Compared to the preceding 12 months, the rate of hypothermia decreased from 25/109 (22.3%) to 13/130 (10%) (p = 0.017). Only 1 baby (0.8%) was admitted with a temperature below 36 °C and 12 babies (9.2%) were admitted with a temperature between 36 °C and 36.4 °C. Continued monitoring during the 3 months after the end of the project showed that the improvements were sustained with 0 cases of hypothermia in 33 consecutive admissions. Conclusions: It is possible to achieve low rates of admission hypothermia in preterm babies whilst providing DCC and DRC. Using a quality improvement approach with PDSA cycles is an effective method of changing clinical practice to improve outcomes.

Temporal trends in routine predischarge pulse oximetry screening: 6 years’ experience in a UK regional neonatal unit

ObjectivesTo evaluate the continued impact of pulse oximetry screening (POS) in a regional neonatal unit (NNU) and identify trends in screening outcomes in comparison with our previous experience.DesignRetrospective review of...

Maternal and Perinatal Outcome in Adolescent Pregnancies as Compared to Adult Pregnancies

Introduction: Adolescence is the period between the ages of 10-19 years that encompasses time from onset of puberty to full legal ages (WHO 2002).&#x0D; Objective: The objective of the study was to explore effect of maternal ages on fetomaternal and perinatal outcome.&#x0D; Methods: This is a hospital based retrospective case-control study conducted over 1 year (March 2017 to February 2018) in the department of Obstetrics and Gynaecology in Tribhuvan University Teaching Hospital to study the antenatal complications and perinatal outcome in adolescent pregnant women as compared to pregnant women of age 20-30 years.&#x0D; Results: During this study period, there were 4980 deliveries out of which adolescent pregnancy were 140(2.8%). Anemia was significantly more in teenage group (16.42% vs 8.57%, p=0.047). Incidence of hypertensive disorders was 5.71% and 1.42% (p=0.05) in teenage and adult group. Proportion of babies with intrauterine growth restriction was 5.71% in teenage and 1.42% (p=0.05) in adult group. Low birth weight babies were significantly higher in teenage group than adult group 16.42% vs 8.57% (p=0.047). NNU admission and apgar score were significantly higher in teenage group 5.71% vs 1.42%.&#x0D; Conclusion: Teenage pregnancies are associated with adverse obstetric and perinatal outcome.

Diagnosis and management of fetal growth restriction: the ISUOG guideline and comparison with the SMFM guideline.

Diagnosis and management of fetal growth restriction: the ISUOG guideline and comparison with the SMFM guideline.

Neonatal Outcome of Babies Born to Women 40 Years and Older in a Jamaican Birth Cohort.

The study aimed to determine the outcome of babies born to women ≥40 years in a Jamaican birth cohort. Maternal demographic data and neonatal data for women ≥40 years who delivered live singleton babies and their younger counterparts aged 20 30 years were extracted from the JA KIDS birth cohort dataset. Outcome measures were preterm birth, low birth weight, very low birth weight, extremely low birth weight, macrosomia, a low 5-minute Apgar score <7, admission to the neonatal unit, and neonatal death. Descriptive analyses were performed; statistical significance was taken at the level p <0.05. A total of 5,424 women and their babies were entered into the study, 5,099 (94%) women were aged 20 to 30 years (mean age ± standard deviation [SD]: 24.5 ± 3.2 years) and 325 (6%) were aged ≥40 years (mean age ± SD: 41.5 ± 1.6 years). A greater percentage of preterm babies (18%) were born to women ≥40 years than to their younger counterparts (14%; p = 0.04). There was no difference in the proportion of low birth weight infants, very low birth weight infants, or extremely low birth weight infants born between the two groups (p > 0.05). There was also no significant difference in the proportion of babies who were macrosomic and in those who had a low 5-minute Apgar score <7. There were 866 (16%) neonatal admissions, 67/325 (21%) of these babies were born to women aged ≥40 years and 799/5,099 (16%) were born to their younger counterparts (p = 0.01). The commonest reason for admission was prematurity. While 60 babies died, there was no significant difference between both groups with 56 (1%) born to women 20 to 30 years and 4 (1%) born to women ≥40 years (p = 0.48). Adverse outcomes noted for babies born to women ≥40 years were prematurity and the need for neonatal admission. However, no excess mortality was recorded. · Women 40 years and older are more likely to have a chronic illness such as hypertension and diabetes and to have an operative delivery.. · Babies born to women 40 years and older are more likely to be late premature infants and require neonatal admission.. · However, there is no increased risk of neonatal mortality..

Infant care among mothers in Central and Eastern Provinces of Saudi Arabia, 2017

Background: Parents’ knowledge and attitudes toward infant care are fundamental in terms of child development. Thereby, this study aimed to assess knowledge of infant care among mothers in the central and eastern regions in Saudi Arabia. Methodology: An observational descriptive cross-sectional study was conducted among 367 mothers via questionnaire by convenient sampling method in the central and eastern region in Saudi Arabia. Results: Most participants (92%) had never missed vaccine doses; however, 92% of the participants believed that missing vaccine dose almost had no negative impact on infants. Almost half of the participants used both modes of feeding. Most participants (73%) introduced solid food to their babies during 4-8 months. The proportion of babies who were taken to the emergency for swallowing a foreign body was higher in families with a working mother, while the occurrence of a baby falling or being burnt was higher with a non-working mother. Conclusion: Although the majority of the participants had a good practice regarding infant care, there are still some gaps in maternal knowledge as well as non-compliance of vaccination. Also, it was revealed that nannies could not replace mothers. There was no statistical relationship between missed doses and mothers’ level of education.

Experiência da maternidade e Indicadores Clínicos de Risco para o Desenvolvimento Infantil (IRDIs)

O objetivo do presente artigo foi verificar as repercussões da experiência materna na interação mãe-filho, examinando suas implicações para o desenvolvimento da criança por meio dos IRDIs em uma amostra de mães de bebês nascidos em cidade de porte médio e arredores da região central do Rio Grande do Sul (RS). A amostra do estudo foi composta por díades mães - bebê (n=165) em Hospital Escola. Para a coleta de dados foi utilizado um roteiro de entrevista para investigar informações socioeconômicas, demográficas, obstétricas, psicossociais e a experiência materna. Também foi utilizado os Indicadores Clínicos de Risco para o Desenvolvimento Infantil (IRDIs). Quando se avaliou a associação entre a ausência/presença de risco para os bebês (IRDIs) e a ausência/presença de alteração emocional materna, encontrou-se resultado significativo. Há maior proporção de bebês com risco quando a mãe apresenta alteração emocional no período pós-parto.

Severity of thrombocytopenia and its outcome in preterm and term neonates admitted in neonatal intensive care unit in a rural tertiary care hospital

Background: Detection of thrombocytopenia is a useful initial assessment for sick neonates, and it is considered as one of the complications of the disease process.Methods: The present study was a prospective hospital based observational study done in 60 neonates in the department of Paediatrics, KIMS, Narketpally during the period of October 2016 to September 2018.Results: The proportion of babies with thrombocytopenia admitted to the NICU was 10.9%. out of the sixty newborns with thrombocytopenia, 31(51.7%) were term babies and 29(48.3%) babies were preterm. Out of 29 preterm babies 3 (5%) were extremely preterm, 5 (8.3%) were very preterm and 21(35%) babies were moderate to late preterm. 32 babies (53.3%) had mild thrombocytopenia, 14 babies (23.3%) babies had moderate thrombo cytopenia and 14 babies (23.3%) had severe thrombocytopenia. The most common etiologic association with thrombocytopenia was septicemia (60%) followed by birth asphyxia (23.3%), maternal Pregnancy induced Hypertension (18.3%), both Disseminated intravascular coagulation and Meconium aspiration syndrome were 6.6% and Necrotizing enterocolitis was 3%. Among the 60 babies admitted with thrombocytopenia, the most frequently seen symptom was not feeding well (35%) and lethargy (33.3%) in all three groups that is babies with mild, moderate, and severe thrombocytopenia. Mortality rate among severely thrombocytopenic neonates was significantly higher (57.14%).Conclusions: Low platelet count was an independent risk factor for poor outcome in our study. Hence it could be used as a prognostic indicator in thrombo- cytopenic neonates.

Linking surveillance and clinical data for evaluating trends in bloodstream infection rates in neonatal units in England.

ObjectiveTo evaluate variation in trends in bloodstream infection (BSI) rates in neonatal units (NNUs) in England according to the data sources and linkage methods used.MethodsWe used deterministic and probabilistic methods to link clinical records from 112 NNUs in the National Neonatal Research Database (NNRD) to national laboratory infection surveillance data from Public Health England. We calculated the proportion of babies in NNRD (aged <1 year and admitted between 2010–2017) with a BSI caused by clearly pathogenic organisms between two days after admission and two days after discharge. We used Poisson regression to determine trends in the proportion of babies with BSI based on i) deterministic and probabilistic linkage of NNRD and surveillance data (primary measure), ii) deterministic linkage of NNRD-surveillance data, iii) NNRD records alone, and iv) linked NNRD-surveillance data augmented with clinical records of laboratory-confirmed BSI in NNRD.ResultsUsing deterministic and probabilistic linkage, 5,629 of 349,740 babies admitted to a NNU in NNRD linked with 6,660 BSI episodes accounting for 38% of 17,388 BSI records aged <1 year in surveillance data. The proportion of babies with BSI due to clearly pathogenic organisms during their NNU admission was 1.0% using deterministic plus probabilistic linkage (primary measure), compared to 1.0% using deterministic linkage alone, 0.6% using NNRD records alone, and 1.2% using linkage augmented with clinical records of BSI in NNRD. Equivalent proportions for babies born before 32 weeks of gestation were 5.0%, 4.8%, 2.9% and 5.9%. The proportion of babies who linked to a BSI decreased by 7.5% each year (95% confidence interval [CI]: -14.3%, -0.1%) using deterministic and probabilistic linkage but was stable using clinical records of BSI or deterministic linkage alone.ConclusionLinkage that combines BSI records from national laboratory surveillance and clinical NNU data sources, and use of probabilistic methods, substantially improved ascertainment of BSI and estimates of BSI trends over time, compared with single data sources.

Penerapan ASI eksklusif 6 bulan versus pemberian makanan pendamping ASI dini di Indonesia

The benefits of breastfeeding are well established, so that in 2001 WHO has revised global recommendation on exclusive breastfeeding that mothers should exclusively breastfeed their children until 6 months old (the old recommendation was previously 4 months). After that, to fulfill the babies need on nutrition, babies are given complementary feeding while breastfeed should be continued until 2 years. Six months exclusive breastfeeding will reduce infant morbidity and mortality in developing countries. In Indonesia, although exclusive breastfeeding for 6 month has been implemented by Ministry of Health, it is only 1% of the mothers exclusively breastfeed their babies for 6 months. In Vietnam, children who were exclusively breastfed for less than 3 months got diarrhoea earlier and the prevalence of diarrhoea was greater than babies who were breastfed for more than 3 months. Complementary feeding should be given when babies are 6 months old. In Indonesia, however complementary feeding have already been given when the babies are just 7 days old or less. The babies got formula, honey, water, sweet water, fruits, etc. Proportion of babies aged less than 1 month receiving commercial complementary feeding was 4 – 5 %, increasing with the increase of age. Early complementary feeding will affect the baby's health.