Introduction: Low Birth Weight (LBW) in the newborn is a major health problem in our country and across the world. Identifying the pathological changes in placenta can help in understanding the pathogenesis of LBW babies. Aim: To compare histological changes in placenta of LBW baby and normal birth weight baby and to find out the maternal risk factors associated with LBW baby. Materials and Methods: A case-control study was done on a total of 140 samples which were collected in the study period of August 2017-August 2019 in SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, with 70 placentas from LBW delivery and 70 placentas from normal birth weight delivery. Placentas from preterm delivery were excluded from this study. Histological changes in placenta were assessed in both the groups. Statistical analysis was done with Statistical Package for the Social Sciences (SPSS) version 17. Independent sample Student’s t-test and Chi-square test were used for comparison between two groups. Results: Histological changes like chorioamnionitis, syncitial knots, calcification, Perivillous Fibrin Deposition (PVFD), stromal fibrosis and basement membrane thickening were observed more frequently in placentas from LBW delivery. The commonest histological finding in present study was villous stromal fibrosis in 58 cases (82.9%) followed by excessive syncytial knots in 57 cases (81.4%). In this study, anaemia was the commonest maternal risk factor associated with LBW baby. Conclusion: The structure of placenta has strong relationship with the pregnancy outcome. There are few significant histological changes in placenta of LBW neonates. These changes have an impact in the development of the baby. Study about these changes provides a scope for prevention of certain morbidities in subsequent pregnancies.
Introduction: Appearance, Pulse, Grimace, Activity, Respiration (APGAR) score is used worldwide to assess newborn health immediately after birth. The combination of pH analysis, haematological parameters of cord blood samples and APGAR score compared with the maternal and peri-natal risk factors will help us identify the cause of low APGAR. Aim: To compare the pH of cord blood, haematological parameters, Neutrophil-Lymphocyte Ratio (NLR) and APGAR score with high-risk maternal and peri-natal factors. Materials and Methods: This is a prospective observational study, conducted over a period of six months, at Chettinad Hospital and Research Institute, Chennai. The cord blood samples of 40 newborns (20 normal and 20 high-risk pregnancy) were collected for assessing pH and haematological parameters (complete haemogram, nucleated Red Blood Cells (RBCs), reticulocyte count). APGAR scores were obtained from clinical records. The data obtained in the study was analysed using the International Business Management (IBM) Statistical Package for Social Sciences (SPSS) statistics version 23.0. Results: The authors compared 20 cases of newborns with maternal risk-factors with 20 newborns with no risk factors, and found that low APGAR and acidic pH of cord blood, high NLR was associated with risk factors present in the ante-natal and peri-natal period. Conclusion: The present study observed that a low APGAR, low acidic pH of cord blood, high NLR was seen in mothers with adverse risk factors during pregnancy, compared to the mothers with no associated co-morbidities. Hence, the presence of riskfactors during pregnancy should warrant a close follow-up of the new-born in the immediate postpartum period.
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