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

2021 ◽  
Author(s):  
Helen Trotman ◽  
Maureen Samms-Vaughan ◽  
Charlene Coore-Desai ◽  
Jody-Ann Reece ◽  
Oluwayomi Olugbuyi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Birth Cohort ◽  
Apgar Score ◽  
Very Low Birth Weight ◽  
Statistical Significance ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Significant Difference ◽  
Minute Apgar Score

Objective The study aimed to determine the outcome of babies born to women ≥40 years in a Jamaican birth cohort. Patients and Methods 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. Results 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). Conclusion Adverse outcomes noted for babies born to women ≥40 years were prematurity and the need for neonatal admission. However, no excess mortality was recorded. Key Points

scholarly journals Risk Factors for Germinal Matrix Haemorrhage-Intraventricular Haemorrhage in Very Low Birth Weight Infants

2021 ◽  
Author(s):  
Abdollah Dehvari ◽  
Mahmoud Imani ◽  
Ebrahim Abdollahi ◽  
Reza Behmadi
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Apgar Score ◽  
Very Low Birth Weight ◽  
Preterm Neonates ◽  
Control Group ◽  
Germinal Matrix ◽  
Significant Difference ◽  
Minute Apgar Score

Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) mainly occurs in preterm neonates and is an important cause of brain injury in them. In this retrospective cross-sectional study from march 2017 to march 2018 in our teaching hospitals, we investigated 250 newborns who were admitted to NICU with a birth weight under 1500 grams with ultrasonographic study for presence and grade of GMH-IVH in their first week of life. Risk factors for GMH-IVH were collected from their records and results been analyzed with SPSS software. From 250 neonates who had inclusion criteria of the study, 22 cases had GMH-IVH in ultrasonographic evaluation. 37.6% of all cases and 31.8% of newborns with GMH-IVH had a 5-minute APGAR score of less than six. 91 cases (39.9%) of the control group and 15 cases (68.1%) of the GMH-IVH group need resuscitation at birth. Of 250 cases 54 (21.6%) died, that 14 cases (63.6%) had GMH-IVH. Our study shows significant differences for birth weight, 5 minute APGAR score, and the need for resuscitation at birth as risk factors for the development of GMH-IVH in very low birth weight neonates, but we do not find a significant difference group in terms of gestational age, gender, route of delivery, fetal presentation, maternal parity, CBC parameters, sepsis, RDS, endotracheal tube suctioning and multiple pregnancies for them. In our study, the protective value for antenatal steroid therapy depends on the completion of the course of treatment for mothers.

Retrolental Fibroplasia and Blood Transfusion in Very Low-Birth-Weight Infants

PEDIATRICS ◽  
1981 ◽  
Vol 68 (6) ◽  
pp. 770-774 ◽  
Author(s):  
Linda M. Sacks ◽  
David B. Schaffer ◽  
Endla K. Anday ◽  
George J. Peckham ◽  
Maria Delivoria-Papadopoulos
Keyword(s):  
Birth Weight ◽  
Blood Transfusion ◽  
Low Birth Weight ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Very Low Birth Weight ◽  
Statistical Significance ◽  
Low Birth Weight Infants ◽  
Retrolental Fibroplasia ◽  
Packed Red Blood Cells

The relative contribution of transfusions of adult blood to the development of retrolental fibroplasia (RLF) in very low-birth-weight infants was examined. Five years of experience with the expanded use of replacement and exchange transfusions in 90 infants with birth weight ≤1,250 gm was reviewed. Twenty percent of the infants developed cicatricial RLF. Exchange transfusion was not related to development of cicatricial RLF. The incidence of RLF in infants receiving ≥130 ml of packed red blood cells per kilogram of birth weight as replacement blood transfusion (RBT) was significantly higher (42.9%) than that in infants receiving 61 to 131 ml of packed red blood cells per kilogram (15.4%) and infants receiving ≤60 ml of packed red blood cells per kilogram (0%), P &lt; .001. The need for RBT, however, was strongly correlated (r = .85, P &lt; .001) with increasing duration of O2 therapy. When O2 therapy was controlled for, the association between RBT and RLF did not achieve statistical significance (P = .07). The association between RBT and RLF remained significant when adjusted for duration of therapy in fractional inspired oxygen (FIO2) &gt;0.4. Further detailed studies of large numbers of susceptible infants are warranted to assess the magnitude of the contribution of transfusions of adult blood to development of RLF.

scholarly journals ON THE SUBJECT OF MEDICAL/SOCIAL ASPECTS OF REHABILITATION FOR VERY-LOW-BIRTH WEIGHT INFANTS IN EARLY CHILDHOOD

2019 ◽  
Vol 20 (1) ◽  
pp. 30-35
Author(s):  
A. V. Migali ◽  
K. A. Kazakova ◽  
Yu. S. Akoyev ◽  
V. M. Studenikin ◽  
M. A. Varichkina ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Very Low Birth Weight ◽  
Intensive Therapy ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Team Care ◽  
Care Approach ◽  
Paroxysmal Disorders

Innovative technologies in the reanimation and intensive therapy permitted to improve the survival of premature infants, including those with extremely low birth weight infants. There are considered various issues of practical medical care for very-low-birth weight infants in the first three years of life. The special attention is given to patients with bronchopulmonary dysplasia (BPD). There is briefly presented the own authors’ experience of the observation for premature infants in conditions of a multidisciplinary team care approach. There were described such important aspects of the mentioned category of patients as neurodietology/nutritional rehabilitation, compliance with aseptic environmental conditions, the correction of visual and hearing impairment, treatment of neurological deficit, especially neuropharmacology, treatment of paroxysmal disorders and epilepsy.

scholarly journals Hospital Regimens Including Probiotics Guide the Individual Development of the Gut Microbiome of Very Low Birth Weight Infants in the First Two Weeks of Life

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1256 ◽  
Author(s):  
Stefan Kurath-Koller ◽  
Charlotte Neumann ◽  
Christine Moissl-Eichinger ◽  
Raimund Kraschl ◽  
Claudia Kanduth ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Bacterial Load ◽  
Oxygen Demand ◽  
Individual Development ◽  
Low Birth Weight Infants ◽  
Multicenter Cohort Study ◽  
Fecal Microbiome ◽  
Significant Difference

Background: It is unknown to what extent the microbiome of preterm infants is influenced by hospital regimens including the use of different probiotics when it comes to the prevention of necrotizing enterocolitis (NEC). Methods: Prospective controlled multicenter cohort study including very low birth weight infants from three neonatal intensive care units (NICUs) between October 2015 and March 2017. During this time span, stool was sampled every other day during the first two weeks and samples were subjected to amplicon-based microbiome analyses. Out of these, seventeen negative controls were processed (German Registry of Clinical Trials (No.: DRKS00009290)). Results: The groups (3 × 18 infants) showed no statistically significant difference regarding gestational age, birth weight, APGAR scores and oxygen demand. 2029 different taxa were detected, including Enterococcus and Staphylococcus, as well as the probiotic genera Lactobacillus and Bifidobacterium predominating. The bacterial load was found to increase earlier on when probiotics were used. Without probiotics administration, Lactobacillus and Bifidobacterium contributed only marginally to the fecal microbiome. Some infants did not respond to probiotic administration. The samples from all centers participating reached a very similar diversity after two weeks while the microbiome samples from all three centers clustered significantly yet varied from each other. Conclusion: Probiotics proved to be safe and initiated an earlier increase of bacterial load (with marked individual divergences), which might play a crucial role in the prevention of neonatal morbidities. Meconium was found not to be free of bacterial DNA, and oral antibiotics did not influence the fecal microbiome development negatively, and hospital regimes led to a center-specific, distinct cluster formation.

Peritoneal dialysis in extremely and very low-birth-weight infants

2020 ◽  
Vol 40 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Kathrin Burgmaier ◽  
Agnes Hackl ◽  
Rasmus Ehren ◽  
Angela Kribs ◽  
Mathias Burgmaier ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Kidney Injury ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Daily Cycles ◽  
Good Clinical Condition ◽  
Increasing Demand

The outcome of extremely low-birth-weight (ELBW) and very low-birth-weight (VLBW) infants has substantially improved in recent years. As acute kidney injury is frequent in these infants due to various risk factors, there is an increasing demand for renal replacement therapy in these patients. Data on that topic, however, are scarce. We review the available literature on that topic and report our experience on temporary dialysis in three extremely immature infants (two ELBW and one VLBW) with acute kidney failure. Peritoneal dialysis (PD) was performed for 19, 23, and 44 days until recovery of native renal function. At recent follow-up of 18 and 24 months, two patients are in good clinical condition with chronic kidney disease stages 1 and 4, respectively. One patient deceased at the age of 12 months due to secondary liver failure. The dialysis regimen applied in our study differed significantly from older infants with extremely short dwell times and accordingly high numbers of daily cycles. The use of rigid acute PD catheters was associated with less catheter-related complications (leakage, dislocation, and obstruction) as compared to ascites drainage catheters. In summary, PD was technically feasible and effective also in extremely immature infants, but frequent adjustments of dialysis regimens and high numbers of daily cycles posed immense efforts on both, parents and medical staff.

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