Newborn Status Research Articles

Comparative analysis of plasma folate, homocysteine and erythrocyte folate levels in pregnant women after folic acid administration during different pregnancies

Background: To examine and evaluate the alterations in plasma folate, homocysteine (HCY), and erythrocyte folate (FOA) concentrations among expectant mothers following folic acid supplementation in distinct pregnancies. Methods: A retrospective analysis was conducted on clinical data from 416 pregnant women admitted to our hospital between October 2020 and October 2023. These women were selected as the subjects of observation and divided into two groups based on their folic acid intake duration: an observation group (n=210) who consumed folic acid before and during early pregnancy, and continued taking it throughout mid and late pregnancy (≥ 20 days per month), and a control group (n=206) who took folic acid before and during early pregnancy but did not continue taking it in mid and late pregnancy (≥ 20 days per month). The prenatal levels of folate, HCY, and FOA were compared among the different groups of pregnant women. Pearson correlation analysis was used to explore the relationship between changes in folate, HCY, and FOA levels in pregnant women. Moreover, the fasting blood glucose (FBG) and 2-hour postprandial blood glucose (P2BG) levels were compared between the two groups of pregnant women. The incidence of gestational diabetes (GDM), gestational hypertension (HIP), and gestational anemia were also compared. Additionally, comparisons were made regarding the changes in delivery mode, newborn height, weight, head circumference, and chest circumference between the two groups of pregnant women. Results: The control group exhibited significantly lower levels of plasma folate and FOA compared to the observation group, while the levels of HCY were significantly higher in the control group than in the observation group, with statistically significant differences (P<0.05). Results from Pearson correlation analysis indicated a significant positive correlation between plasma folate and FOA (r=0.116, P<0.05), a significant negative correlation between plasma folate and HCY (r=-0.411, P<0.05), and a significant negative correlation between plasma FOA and HCY (r=-0.286, P<0.05). The levels of FBG and P2BG during pregnancy were found to be significantly lower in the observation group compared to the control group, with statistically significant differences (P<0.05). Furthermore, the incidence of gestational anemia and HIP was significantly lower in the observation group than in the control group, with statistically significant differences (P<0.05). The occurrence of cesarean section was significantly lower in the observation group compared to the control group. The newborns in both groups exhibited normal height, weight, head circumference, and chest circumference. Notably, the newborns in the observation group had significantly higher values for height, weight, head circumference, and chest circumference compared to those in the control group, with statistically significant differences (P<0.05). Conclusion: By consuming folic acid before and during early pregnancy, and consistently throughout mid and late pregnancy, it is possible to increase the levels of folic acid and FOA in pregnant women's bodies. This, in turn, facilitates rapid foetal development, enhances the nutritional status of newborns, and decreases the likelihood of cesarean section. Additionally, early supplementation of folic acid can effectively reduce the occurrence of pregnancy-related complications, thereby improving the prognosis for both mothers and infants.

Safety and Efficacy of opioid-sparing Anesthesia Compared with Traditional opioid-anesthesia

Objectives: The rationale of adoption opioid sparing anesthesia (OSA) is to achieve perioperative analgesia with a minimal amount of opioid combined to non-opioid adjuvants during and after surgery, namely multimodal anesthesia. The OSA approach was originally developed to overcome the known complications of opioid-based anesthesia (OA) and the present scoping review (ScR) aims at providing the clinical evidence of safety and efficacy of OSA with respect to OA. Methods: This ScR is mainly focused on studies presenting evidence on the safety and efficacy of OSA versus OA. PubMed, EMBASE databases were utilized to find relevant studies. Search strategy included the following keywords: “opioid sparing anesthesia complications, opioid sparing anesthesia efficacy, opioid sparing anesthesia safety”. The findings from the 25 included studies were categorized into the following subsections: article characteristics, goals of the studies, OSA protocols, and surgical settings analyzed. Results: In the 25 reviewed studies, evidence related to the impact of OSA versus OA was considered. Intraoperative safety and efficacy endpoints include hemodynamic stability and anesthetic/analgesic requirements. Postoperative endpoints include early cognitive dysfunction, opioid-induced bowel disorder, the physical status of mothers and newborns after labor and emergency cesarean, systemic immune and inflammation modifications, postoperative recovery, in-hospital and long-term opioid requirement, early postoperative pain, chronic postsurgical pain. The studies reported a lower intraoperative mean arterial pressure and heart rate fluctuations when α2 agonists are adopted, while no differences were recorded for other complication rates. Analysis of OSA approaches for the postoperative conditions includes α2 agonists, NMDA receptor blocking agents, gabapentinoids, nefopam hydrocloride and locoregional anesthesia techniques with a positive impact on most of the endpoints considered. Discussion: The clinical implementation of OSA encompasses the perioperative use of non-opioid drugs and locoregional anesthesia techniques. The reviewed studies reported OSA as a feasible approach to reduce opioid-related complications with no impact on patient’s safety.

Normal Value of Perfusion Index in Healthy Neonates Born in Iran.

Perfusion index is a dependable indicator for assessing the perfusion status of newborns. A low perfusion index indicates compromised hemodynamic function. The study aims to investigate perfusion index in asymptomatic newborns aged 35 to 41 weeks who did not require medical support. Healthy neonates born in four major maternity hospitals of Tehran University from 2019 to 2021 were selected. To ensure consistency and reliability in data collection, a detailed manual was developed and distributed, along with comprehensive training sessions for all personnel involved. A total of 994 newborns entered the study. Among them, echocardiography was adversely affected in 218 neonates due to abnormal screening pulse oximetry. Of these 218 neonates, 53 were found to have abnormal echocardiography results. The median perfusion index value in healthy neonates was 1.6%, and the median oxygen saturation was 97%. A percentile perfusion index curve was developed for healthy neonates to establish a normal reference range. Developing a percentile perfusion index curve specific to healthy neonates provides a useful reference range for healthcare providers to assess perfusion status in this population, but further research is needed to confirm its accuracy.

Effect of rooming-in kangaroo mother care on breastfeeding and behavioral status of full-term newborns.

We aimed to assess the effects of rooming-in kangaroo mother care (KMC) on the breastfeeding and behavioral status of full-term newborns. Full-term newborns born from June to December 2021 were divided into Group A (n = 50) and Group B (n = 50) using a random number table. The rooming-in routine nursing intervention and KMC were given to Group A (n = 50) and Group B, respectively. The outcomes were compared. The scores of breastfeeding knowledge, breastfeeding skills, and sense of responsibility for breastfeeding of Group B were higher than those of Group A (p < 0.05). The breastfeeding rate and lactation yield within 3 days of Group B were higher than those of Group A (p < 0.05). Compared with Group A, Group B had higher effective sucking times of newborns and lower behavioral status scores 1, 2, and 3 days after birth, and shorter duration of crying after invasive operation (p < 0.05). The newborns in Group B had better sleep quality, longer sleep time, and lower procedural pain score than those of Group A (p < 0.05). Rooming-in KMC improves the maternal breastfeeding self-efficacy, breastfeeding rate, and lactation yield, ameliorates the behavioral status and sleep quality of newborns, shortens the crying time and relieves the procedural pain.

Maternal education and antenatal attendance in Georgia: A cohort study

Abstract Background Antenatal care (ANC) and maternal education are important determinants for maternal and newborn health outcomes. Understanding the impact of maternal education on ANC is crucial. Purpose To examine the association between maternal education and ANC attendance. Methods A retrospective cohort study utilized nationwide electronic medical birth registry data (2020-2022) in Georgia. the study includes pregnant women and their newborns. A randomized sample was selected, and extracted variables included maternal age, parity, body mass index, education, year of delivery, gestational age, infant sex, Apgar score, birth weight, delivery type, and newborn status. Statistical analysis via IBM SPSS v23 involved chi-square, t-tests, and logistic regression. Results The sample size contains 4976 mothers after excluding cases with missing data (n = 25). The mean maternal age was 30.5 years (SD = 5.4), with a mean BMI of 28.0(SD = 4.8), and the mean gestational week was 38.4(SD = 2.0), with a mean birth weight of 3263.0 (SD = 568.0) grams. Highly educated women had more than 3 times higher odds (OR = 3.636,95%CI:2.575-5.134) of having at least one ANC visit compared to those with Unknown education. primiparous women had significantly higher odds of having at least one ANC visit compared to Multiparous women, OR = 1.519, (95%CI:1.081-2.135). The chi-square test showed significant difference between ANC visits and the number of liveborn/stillborn (χ² = 53.026, p &amp;lt; .001). Moreover, there was a significant association between birth weight categories and ANC visits (χ² = 167.095, p &amp;lt; .001). Conclusions Our study emphasizes the role of education in improving access to ANC among women with low education levels. We can increase ANC visits and improve maternal and newborn health outcomes by focusing educational efforts on pregnant women. Additionally, focusing on high-risk populations, and using tailored interventions can further improve ANC attendance along with maternal and neonatal health. Key messages • Boosting ANC access and improving maternal and neonatal health by tailored community programs. • Conservative communities and underrepresented communities require additional resources to promote tailored healthcare. and extra effort in education about ANC.

Investigating the Status of Mothers and Newborns' Access to Safe and Quality Care from the Perspective of Midwifery Personnel Working in Government Hospitals: A Cross-Sectional Study

Aim The present study was conducted to determine the status of mothers’ and newborns' access to safe and quality care from the perspective of midwifery personnel. Background Safe and quality care is recognized as a principle in providing healthcare to mothers and newborns. Methods This was a cross-sectional study conducted through random sampling on 270 midwifery personnel working in government hospitals of Mashhad University of Medical Sciences in 2023. The data were collected using a questionnaire created by a researcher and analyzed using descriptive and inferential statistical tests in SPSS-22 statistical software at a significance level of less than 0.05. Results The average age of the participants was 34.41 ± 7.93 years. The results showed the status of mothers' and newborns' access to safe and quality care to be in the average range of 38.30 ± 6.67. The midwifery personnel have demonstrated adherence to scientific and specialized protocols regarding the way for childbirth and how to care for mothers and newborns to be the most frequent (51.5%), while the provision of emotional and psychological support to women who have given birth with newborn problems to be the least frequent (8.5%). Conclusion Midwifery personnel believe that the safe and quality care provided to mothers and newborns is adequate. Midwifery personnel are committed to following evidence-based practices, but need additional training and resources to support women in need emotionally and psychologically. This is particularly concerning given the potential impact of maternal mental health on both the mother and the newborn.

Study of the somatic, neurological and osteopathic status of full-term newborns born by cesarean section in a planned and emergency manner

Introduction. Currently, the frequency of cesarean section (CS) in the world is at least 25 %, in Russia — at least 30 %. It is known that newborns after CS are a special risk group for the development of somatic dysfunctions (SD), which should be considered comprehensively, taking into account their somatic and neurological status.The aim is to study the effect of emergency CS on the somatic, neurological and osteopathic status of newborns and on the course of the early neonatal period.Materials and methods. 60 patients of the Department of Neonatal Physiology, aged 3–5 days of life, without structural pathology or malformations, born by cesarean section, were examined. Children are divided into 2 groups of 30 people. Group 1 — children born by emergency caesarean section (ECS). Group 2 — children born by planned (elective) caesarean section (PCS). A complex of examination methods was used in both groups. The anamnestic method included an assessment of the main risk factors during pregnancy and features of the early neonatal period. The clinical method included assessment of the somatic status of newborns; neurological assessment. Assessment of osteopathic status according to clinical guidelines. Assessment of functional disorders — using neuro-sonography, ultrasound of the hip joints, ultrasound of the abdominal organs. Statistical data processing was carried out using Microsoft Excel and the Medstatistic statistical software package. To study the relationships between the characteristics, a comparison of the populations was carried out based on qualitative characteristics. Fisher′s exact test was used for statistical processing of data. The analysis used a significance level of p&lt;0,05, which reflects the strength of the dependence of the characteristics being compared. Pearson′s coefficient was used as a criterion for the strength of connection.Results. When analyzing risk factors in both groups, a predominance of women over 30 years of age with a complicated pregnancy was noted among mothers. Extragenital pathology (most often pathology of the endocrine system) was detected in 70 % of mothers. In the ECS group, early and more intense jaundice was observed significantly more often (p&lt;0,05) (12 out of 30 children versus 4 out of 30 children in the PCS group); muscular dystonia with a tendency to increase muscle tone in the upper extremities and decrease in the lower extremities (in 22 out of 30 children in this group versus 12 out of 30 children in the PCS group); SD of the head region (13 cases in this group versus 4 cases in the second group). In the PCS group, autonomic disorders were observed significantly more often (p&lt;0,05) (12 out of 30 children versus 2 out of 30 children in the ECS group); SD of the pelvic region (visceral component, 9 cases versus 2 in the ECS group). In children of the ECS group, a statistically significant (p&lt;0,05) relationship was revealed between breech presentation and SD of the pelvic region (somatic component) — contingency coefficient 0,44; structural features of the chest (asymmetry, protruding xiphoid process) and SD of the thoracic region (visceral component) — 0,43; characteristics of the neurological status (hyperexcitability syndrome) and SD of the head region — 0,45. In children of the PCS group, a statistically significant (p&lt;0,05) relationship was revealed between morpho-functional immaturity and SD of the thoracic region (visceral component) — contingency coefficient 0.39; features of the skeletal system of the skull (Gothic palate, combination of Gothic palate and suture entry) and SD of the dura mater — 0,5; structural features of the chest (asymmetry, protruding xiphoid process) and SD of the thoracic region (somatic component) — 0,6; characteristics of the hip joints (asymmetry of the gluteal folds, difficulty in abduction, hypermobility) and SD of the pelvic region (somatic component) — 0,45; postural disorders (flexion, extension, latero-flexion to the right, latero-flexion to the left) and SD of the pelvic region (somatic component) — 0,49; increased muscle tone of the arms and SD of the thoracic region (visceral component) — 0,41.Conclusion. A comparative assessment of the osteopathic status of children born by cesarean section in a planned manner and for emergency indications was carried out, and an analysis of the possible connection of the identified somatic dysfunctions with risk factors for pregnancy and features of the early neonatal period was carried out. Based on the identified relationships between the somatic, neurological and osteopathic statuses of newborns in the first day of life, in the future it is possible to develop optimal timing for consultation with an osteopath for the purpose of earlier diagnosis and correction of somatic dysfunctions.

Results of mother-to-child transmission in hepatitis B-positive mothers who underwent amniocentesis

PurposeThis study aims to analyze whether undergoing amniocentesis during pregnancy in women diagnosed with hepatitis B virus (HBV) infection leads to HBV transmission to newborns.MethodsRetrospective data collection was conducted from June 2019 to November 2022 on expectant mothers positive for hepatitis B surface antigen (HBsAg) who underwent amniocentesis at The Third Affiliated Hospital of Sun Yat-sen University, along with data on their newborns. The study summarized the HBV infection status of newborns born to mothers with different expressions of hepatitis B e antigen (HBeAg), antiviral treatment versus no treatment, and different HBV DNA viral loads before delivery.ResultsIn this study, 346 expectant mothers tested positive for HBsAg, along with 351 newborns (including 5 sets of twins, with 8 infants (2.28%) testing HBsAg-positive at birth. All newborns received dual immunotherapy and were followed up. At 7–12 months, retesting for HBsAg positivity and HBV DNA positivity among infants revealed that out of the infants born with HBsAg positivity, 7 cases had seroconverted to negative, while the remaining infant, who was positive for both HBsAg and HBeAg at birth, tested positive for both HBsAg and HBV DNA at 7–12 months. Thus, one case of vertical transmission of hepatitis B from mother to child occurred in this study. The proportion of infants born with HBsAg + among newborns born to HBeAg-positive mothers (4 cases, 6.06%) was significantly higher than that among newborns born to HBeAg-negative mothers (4 cases, 1.41%) (P < 0.05). The proportion of infants born with HBsAg + showed no significant difference between newborns born to mothers receiving antiviral therapy (2 cases, 2.90%) and those born to mothers not receiving antiviral therapy (6 cases, 2.13%) (P > 0.05). Among expectant mothers with viral load ≥ 6 log 10 IU/mL before delivery, 3 newborns (30.00%) were manifesting HBsAg positivity at birth, significantly higher than the group with viral load < 6 log 10 IU/mL before delivery (5 cases, 1.47%) (P < 0.05).ConclusionAmong HBsAg-positive expectant mothers, only a small number of infants are infected with the hepatitis B virus at birth, the proportion of which is relatively low. Infants born to mothers who are HBeAg-positive or have a viral load ≥ 6 log10 IU/mL have a higher risk of being born positive.

The effect of the steroid profile on the severity and the outcome of treatment of newborns with congenital malformations

Introduction. Adrenal insufficiency is often found in critical conditions of the neonatal period and has nonspecific symptoms, which greatly complicates its diagnosis. The objective was to study the hormonal status of newborns with congenital malformations (CM according to the outcome of treatment in the intensive care unit.Materials and methods. Study design – observational, dynamic retrospective comparative study. 60 newborns were examined: 26 healthy and 34 with CM. Depending on the severity of the condition, children with CM were divided into two groups. Group I included patients in an extremely severe condition, and in group II – in a stable condition. We studied the concentration of 17-hydroxypregnenolone, aldosterone, dehydroepiandrosterone, cortisol, cortisone, corticosterone, progesterone, testosterone, estradiol and 17-hydroxyprogesterone upon admission to the ICU, immediately after surgery and on the first day after it.Results. In all children with CM, the concentration of 17-hydroxypregnenolone, 17-hydroxyprogesterone, progesterone and dehydroepiandrosterone before surgery was significantly lower compared to healthy newborns, while in group I, it was minimal. After surgery, the concentration of cortisol precursors remained low, but its level increased significantly, especially in children of group I. A risk factor for lethal outcome in newborns with CM needing treatment in the ICU is the 17-OH-pregnenolone/dehydroepiandrosterone ratio, both at the time of admission to the ICU (AUC = 0.821; sensitivity = 68.97; specificity = 100; p = 0.0002; cut-off &lt; 1,52); and on the first day after surgery (AUC = 0.807; sensitivity = 79.3; specificity = 80; р = 0.025; cut-off = 0).Conclusion. The increase in the concentration of cortisol against the background of low level of hormone precursors and the reduction of the 17-OH-pregnenolone/dehydroepiandrosterone ratio in the first day after surgery is a marker of an adverse course of the postoperative period and outcome.

The maternal and newborn health eCohort to track longitudinal care quality: study protocol and survey development.

The MNH eCohort was developed to fill gaps in maternal and newborn health (MNH) care quality measurement. In this paper, we describe the survey development process, recruitment strategy, data collection procedures, survey content and plans for analysis of the data generated by the study. We also compare the survey content to that of existing multi-country tools on MNH care quality. The eCohort is a longitudinal mixed-mode (in-person and phone) survey that will recruit women in health facilities at their first antenatal care (ANC) visit. Women will be followed via phone survey until 10-12 weeks postpartum. User-reported information will be complemented with data from physical health assessments at baseline and endline, extraction from MNH cards, and a brief facility survey. The final MNH eCohort instrument is centered around six key domains of high-quality health systems including competent care (content of ANC, delivery, and postnatal care for the mother and newborn), competent systems (prevention and detection, timely care, continuity, integration), user experience, health outcomes, confidence in the health system, and economic outcomes. The eCohort combines the maternal and newborn experience and, due to its longitudinal nature, will allow for quality assessment according to specific risks that evolve throughout the pregnancy and postpartum period. Detailed information on medical and obstetric history and current health status of respondents and newborns will allow us to determine whether women and newborns at risk are receiving needed care. The MNH eCohort will answer novel questions to guide health system improvements and to fill data gaps in implementing countries.

Investigation of newborn blood metabolomics in varying intrauterine growth conditions

ObjectivesThis study aimed to investigate changes in the blood metabolic profiles of newborns with varying intrauterine growth conditions. Specifically, we analyzed the levels of amino acids, carnitine, and succinylacetone among full-term newborns, including small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). We aim to identify differential metabolites and metabolic pathways that may offer insights into clinical interventions. MethodsA total of 5106 full-term newborns were included in the study. Blood samples were obtained from all newborns between 3 and 5 days after birth and analyzed using tandem mass spectrometry to detect blood metabolites. Subsequently, we screened for different metabolites and metabolic pathways among the groups using the MetaboAnalystR package (Version 1.0.1) in R software (R-3.6.0). ResultsThe levels of blood amino acids and carnitine metabolism differed significantly among newborns with varying intrauterine growth conditions. Full-term SGA newborns exhibited a decrease in multiple amino acids and an increase in multiple carnitines, while full-term LGA newborns showed an increase in multiple amino acids and acylcarnitines. ConclusionContinuous monitoring of the short-term and long-term growth and metabolic status of full-term SGA and LGA newborns is warranted with individualized dietary and nutritional adjustments to promote healthy growth in a timely manner. The findings of this research contribute to the broader understanding of SGA/LGA and shall inform future research on metabolomics, interventions, and long-term outcomes.

Development of a Low-Cost and Portable Device for Monitoring Heart Rate, Blood Oxygen Saturation, and Body Temperature in Infants Incubator

The risk of newborn infant mortality is commonly associated with hypothermia. Hypothermia is a health disorder and a leading cause of death in newborns, caused by an imbalance in the baby's body temperature. Hypothermia occurs due to a decrease in body temperature resulting from various conditions, especially high oxygen requirements and a decrease in room temperature. The purpose of this study is to monitor the health status of newborns. Monitoring the body temperature and oxygen saturation levels in newborns can help detect abnormalities in infants at an early stage. Oxygen saturation is considered a vital sign that is important in supplying oxygen to the body. This research is expected to assist patients using a baby cuve in providing care for newborns with hypothermia symptoms. The Baby Cuve utilizes the DS18B20 sensor for temperature measurement and the MAX3102 sensor for heart rate and oxygen saturation. The data is then processed using the ESP32 microcontroller, and the results are displayed on an LCD screen. The comparative tools used in this study are the standard thermometer and pulse oximeter. The results of this research indicate that the smallest measurement error value is found in the Spmeasurement of respondent 10, which is 0.1%. The largest measurement error value is found in the Spmeasurement of respondent 2, which is 5.6% based on the obtained data. However, the measurement results are still within the tolerance limit of ±10%.

Hemostatic Status of Neonates with Perinatal Hypoxia, Studied via NATEM in Cord Blood Samples.

Perinatal hypoxia may result in coagulation dysfunction. Diminished blood flow or oxygen to the fetus/neonate during the perinatal period can cause bone marrow and liver function impairment, leading to thrombocytopenia, impaired synthesis of clotting and fibrinolytic factors, and increased destruction of platelets in the small blood vessels. The goal of the present study was to evaluate the hemostatic status of newborns with perinatal hypoxia via the non-activated thromboelastometry (NATEM) assay in cord blood samples. 134 hypoxic neonates born in our maternity unit over a 1.5-year period were enrolled in this observational cohort study, and 189 healthy neonates served as the control group. Participation in the study was voluntary and parents signed informed consent prior to recruitment. Demographic and clinical data were recorded on admission, and the NATEM method was performed on cord blood samples. The following NATEM values were evaluated: clotting time (CT), alpha angle (α-angle), clot formation time (CFT), clot amplitude at 5 and 10 min. (A5, A10), maximum clot firmness (MCF), clot lysis index at 60 min. after CT (LI60), and maximum clot elasticity (MCE). Statistical analysis was conducted utilizing the SAS for Windows 9.4 software platform. Neonates with perinatal hypoxia exhibited decreased fibrinolytic potential in comparison to healthy neonates, as indicated by increased LI60, and this difference was statistically significant (LΙ60: 94 (92-96) Vs 93 (91-95), p value = 0.0001). There were no statistically significant differences noted among the remaining NATEM variables. Our findings indicate decreased fibrinolytic potential in hypoxic neonates in comparison to healthy neonates, suggesting that NATEM could serve as an effective tool for promptly identifying hemostasis dysfunction in this group of neonates.

Cross-Recurrence Quantification Of Cardiovascular Signals In Newborns Is A Sensitive Marker Of Health Status

Background — Analysis of the state of complex biological systems requires the use of sensitive methods for diagnosing interactions using experimental time series. Objective — To evaluate the possibility of using the technique of cross-recurrence quantification (CRQ) in studying the health status of newborns using low-frequency components of RR-interval signals and photoplethysmograms, reflecting the dynamics of the circuits in autonomic regulation of blood circulation. Methods — The study included two groups of neonates: 10 full-term newborns and 10 preterm neonates. We carried out simultaneous recording of electrocardiographic and photoplethysmographic signals. CRQ analysis was employed as the primary tool. Results — We established that some indices of CRQ analysis, characterizing the degree of interaction of the studied circuits, act as sensitive markers. They make it possible to distinguish the dynamics of the studied contours between healthy newborns and preterm neonates. Conclusion — The results of our study confirmed that CRQ is a promising tool in creating methods for diagnosing health conditions, including in newborns.

Model development for anemia prediction in pregnancy

BackgroundThe number of pregnant women who suffer from anemia is still high. Anemia has an impact on the health status of mothers, fetuses, and newborns. This paper aims to develop an anemia risk prediction model for pregnant women in Indonesia. MethodsThe data was obtained from the Indonesian basic health research database years 2013 and 2018. A bivariate method the user to select which variables are significantly affecting anemia in pregnant women. The result was then analyzed using the multivariate for model development and the data was then plotted into a receiver operator characteristic (ROC) to illustrate the relationship between clinical sensitivity and specificity. ResultsThe variables that significantly to the anemia risk status of pregnant women are iron supplement during pregnancy (p = 0.003) and MUAC (p = 0.001) from 2013 data. After analyzing using multivariate, only MUAC and iron supplement during pregnancy could be included in the prediction model since the p-value is less than 0.05. The ROC value is 60.7 % with a sensitivity of 87.8 % and a specificity of 75.7 % for the 2013 data and we got the same ROC score is 60.7 % for the 2018 data with a sensitivity of 94.3 % and a specificity of 90 %. ConclusionResults suggest that the anemia risk prediction model developed based on data from pregnant women in 2013 and 2018 consisted of 2 variables, namely iron consumption and mid-upper arm circumference.

The correlation between vitamin D3 and arginine metabolism levels in newborns with amino acid metabolism disorders.

This study aimed to explore the correlation between vitamin D3 and arginine (Arg) metabolism indicators in newborns with amino acid metabolism disorders. Based on clinical data, 30 newborns with amino acid metabolism diseases admitted to Shijiazhuang Fourth Hospital from June 2021 to June 2022 were selected as the disease group, and 30 healthy newborns from the same period were selected as the healthy group. After enrollment, blood samples were collected to measure the levels of Arg, Glycine (Gly), and vitamin D3 levels. The levels of Arg metabolism indicators and vitamin D3 levels in the 2 groups and the correlation between vitamin D3 levels and Arg metabolism indicators in the affected group were analyzed. The Arg level in the diseased group was higher than that in the healthy group, whereas the Gly and vitamin D3 levels were lower than those in the healthy group (P < .05). There was a significant negative correlation between vitamin D3 and Arg levels in the affected group, and a significant positive correlation with Gly levels (P < .05). Newborns with amino acid metabolism disorders have abnormally high Arg levels, significantly reduced Gly levels, and significantly decreased vitamin D3 levels. The degree of decline was closely related to the levels of indicators of Arg metabolism. Vitamin D3 supplementation can improve the Arg metabolism status of newborns with amino acid metabolism disorders.

Effects of Caffeine on Breastfeeding Mothers and Infants: A Scoping Review

Objectives:Breastfeeding mothers often consume caffeine in varied quantities. The common dietary sources of caffeine include tea, coffee, chocolate, energy drinks, and sodas. Over time, caffeine has become a widely accepted substance to use throughout pregnancy and lactation. As the range of volumes of caffeine is variable in various beverages, it is essential to explore the positive and negative effects of caffeine on breastfeeding mothers and their babies.Methods:A scoping review of evidence-based literature was undertaken to examine the effects of caffeine on breastfeeding mothers and their babies. We searched major databases using the key terms “caffeine,” “breast milk,” “newborns,” “infants,” “mothers,” and “breastfeeding.” Altogether, 21 articles were shortlisted for this review based on their relevance to the topic.Results:Caffeine travels in small amounts from the mother to the infant, and the infant is typically unaffected in amounts less than 300 mg/d. Caffeine is reported to reduce postnatal depression and fatigue among breastfeeding and has been found useful in treating acute morbidities in neonates like apnea of prematurity, patent ductus arteriosus, and bronchopulmonary dysplasia. A high intake of caffeine (450 mg or more of caffeine per day) in a short time is reported to have detrimental biochemical and neurodevelopmental effects in breastfed infants, anemia, and low iron level in breast milk. Controversy exists surrounding the effects of caffeine on breastfeeding duration of mothers. Recommendations include education and counselling for breastfeeding mothers on the dangers of caffeine consumption, avoidance of frequent and high intake of caffeine during lactation, and monitoring caffeine levels in various beverages/products.Conclusion:The use of caffeine has shown both positive and negative effects on breastfeeding mothers and infants. As a high intake of caffeine (450 mg or more of caffeine per day) is reported to have negative effects, breastfeeding mothers and infants must be protected from the detrimental effects of caffeine through increased education, counselling, and psychosocial support. Clinical practice guidelines are needed on the safe consumption of caffeine by breastfeeding mothers. Future research must examine the effects of varied levels of caffeine found in different products on breast milk composition, duration, health status, and breastfeeding outcomes of term and preterm newborns.

Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns

BackgroundCytomegalovirus (CMV) is one of the most important pathogens associated with congenital infection worldwide. Most congenital CMV-infected infants are asymptomatic at birth; however, some can develop delayed sequelae, especially hearing loss.MethodsThis study aimed to investigate the prevalence of congenital CMV infection in a neonatal intensive care unit in a low-income region of Brazil. The objectives extended to identifying associated factors, assessing the clinical status of infected newborns, and undertaking a two-year follow-up to discern potential long-term consequences in the affected infants. This cross-sectional prospective study enrolled newborns up to three weeks of life requiring intensive medical care. We employed a convenience sampling method to include 498 newborns and 477 mothers in the study. Categorical variables underwent analysis employing Fisher’s exact test, whereas the examination of continuous variables involved the Mann‒Whitney test.ResultsCMV DNA was detected in saliva/urine samples from 6 newborns (1.21%), confirming congenital infection. We noted a significantly greater incidence (OR: 11.48; 95% CI: 2.519–52.33; p = 0.0094) of congenital infection among twins (7.14%) than among nontwins (0.66%). The twin patients exhibited discordant infection statuses, suggesting that only one of the babies tested positive for CMV. Most of the infected children were born to mothers who initiated sexual activity at a younger age (p = 0.0269). Only three out of the six newborns diagnosed with CMV infection underwent comprehensive clinical assessments and received continuous follow-up until they reached two years of age. Only one of the children had weight and height measurements below the norm for their age, coupled with developmental delays.ConclusionsThe prevalence of congenital CMV infection among newborns admitted to the NICU was low and similar to that in the general population. However, we found a significantly greater incidence of congenital CMV infection in twins than in singletons. Interestingly, the twin-infected patients exhibited discordant infection statuses, suggesting that CMV was present in only one of the babies. We also found that most of the infected children were born to mothers who initiated sexual activity at a younger age. Diagnostic accessibility and comprehensive surveillance programs are imperative for effectively managing and preventing congenital CMV infections.

Vitamin D Status of Preterm Newborns at Approximately 4 Weeks of Age in Shenzhen, China: A Retrospective Observational Cohort Study Conducted Across Two Centers

Vitamin D Status of Preterm Newborns at Approximately 4 Weeks of Age in Shenzhen, China: A Retrospective Observational Cohort Study Conducted Across Two Centers

Differences in newborn status between those born from mothers with active covid-19 infection and those born from mothers who underwent covid-19 infection in first trimester of pregnancy - Pilot study

Differences in newborn status between those born from mothers with active covid-19 infection and those born from mothers who underwent covid-19 infection in first trimester of pregnancy - Pilot study