These findings suggest that supplementation with selenium during pregnancy might be an effective approach for the prevention of postpartum depression.

Context: Premature rupture of membrane is a serious complication in pregnancy and responsible for one third of preterm labors associated with the neonatal and delivery outcomes.Objective: The current study aimed at investigating the risk factors of premature rupture of membrane on delivery and neonatal implications. Data Sources:The articles on the databases, including PubMed, Cochrane Library, ISI and Google Scholar up to 2017 were searched to conduct the current study. The keywords used were "premature rupture of membrane", "neonatal," "risk factors", "maternal", and "delivery". Study Selection:The inclusion criteria were articles on the relationship between maternal risk factors and Premature Rupture of Membrane (PROM), neonatal outcomes of PROM, the delivery outcomes of PROM, the study of mothers and infants, English and Persian language articles, and sufficient information on the PROM. The articles investigating amniotomy or the ones that only their abstracts were available were excluded from the study.Data Extraction: The data extracted from the above mentioned databases were fed with the following titles in the Excel software: Authors' names and surnames, year of study, type of study, place of study, case group, control group, maternal risk factors, delivery outcomes, neonatal outcomes of PROM, and the results of the study. Results:Out of 90 articles, 15 articles were finalized including one prospective study, five crosssectional papers, six retrospective articles, and three historical cohort studies. Maternal risk factors included age; parity; education; occupation; diabetes; blood pressure; cervical length along with abortion history; history of infection, upper urinary tract infection, and sexually transmitted diseases. Moreover, delivery complications were cesarean section, oligohydramnios, chorioamnionitis, and placental abruption. Neonatal complications included prematurity, respiratory distress syndrome, asphyxia, infection, meningitis, sepsis, pneumonia, perinatal mortality, patent arterial duct, necrotizing enterocolitis, IVH, pulmonary hypoplasia, hyperbilirubinemia, and antibiotic intake. Conclusions:Based on the results of the current study, the most important risk factors for PROM were diabetes and maternal hypertension associated with neonatal and maternal complications. Infection was the most important maternal and neonatal complication. Citation: Boskabadi H, Zakerihamidi M. Evaluation of Maternal Risk Factors, Delivery, and Neonatal Outcomes of Premature Rupture of Membrane: A Systematic Review Study. Journal of Pediatrics Review. 2019; 7(2):77-88. http://dx.

Background:Asphyxia is considered an important cause of morbidity and mortality in neonates. This condition can affect many vital organs including the central nervous system and may eventually lead to death or developmental disorders.Objectives:Considering the high prevalence of asphyxia and its adverse consequences, the present study was conducted to evaluate the risk factors for birth asphyxia and assess their correlation with prognosis in asphyxiated infants.Patients and Methods:This two-year follow-up cohort study was conducted on 260 infants (110 asphyxiated infants and 150 healthy neonates) at Mashhad Ghaem Hospital during 2007 - 2014. Data collection tools consisted of a researcher-designed questionnaire including maternal and neonatal information and clinical/laboratory test results. The subjects were followed-up, using Denver II test for 6, 12, 18, and 24 months (after discharge). For data analysis, t-test was performed, using SPSS version 16.5. P value ≤ 0.05 was considered statistically significant.Results:Of 260 neonates, 199 (76.5%) and 61 (23.5%) cases presented with normal neonatal outcomes and with abnormal neonatal outcomes (developmental delay), respectively. Variables such as the severity of asphyxia (P = 0.000), five-minute Apgar score (P = 0.015), need for ventilation (P = 0.000), and severity of acidosis at birth (P = 0.001) were the major prognostic factors in infants with asphyxia. Additionally, prognosis was significantly poorer in boys and infants with dystocia history (P = 0.000).Conclusions:Prevalence of risk factors for developmental delay including the severity of asphyxia need for mechanical ventilation, and severity of acidosis at birth, dystocia, and Apgar score were lower in surviving infants; therefore, controlling these risk factors may reduce asphyxia-associated complications.

Background and aimPrematurity and related problems, especially respiratory distress, are one of the main challenges for neonatal medicine. The aim of this study was to compare vitamin D levels in preterm infants with, and those without respiratory distress.MethodsThis case-control study was conducted in Ghaem and Emam Reza Hospitals in Mashhad (Iran) from 2015 to 2016. In this study, we examined 160 preterm infants weighing less than 2000 grams and born at less than 34 weeks’ gestation. Serum vitamin D levels were measured in preterm infants without- and those with respiratory distress, and their mothers. Neonatal characteristics, including age, sex, birth weight, gestational age, Apgar score and needs for oxygen, resuscitation, ventilation and surfactant were documented. The data were analyzed using SPSS version 16.0.ResultsMeans serum level of maternal vitamin D in control and case groups were 16.66±14.29 ng/dl and 21.23±15.19 ng/dl, respectively (p=0.029). In addition, mean serum level of neonatal vitamin D in control and case groups were 11.69±8.66 ng/dl 17.9±12.55 ng/dl, respectively (p=0.001). Vitamin D levels in premature neonates without respiratory distress and their mothers were significantly different from other preterm neonates with respiratory distress (p=0.029). There was a direct correlation with neonatal and maternal vitamin D levels (r=0.713, p=0.001). The duration of hospitalization (p=0.001), gestational age (p=0.073), birth weight (p=0.001), one- and (p=0.001) five-minute (p=0.001) Apgar scores and head circumference (p=0.002) had significant relation with vitamin D levels in neonates. Death (12.5%) and pneumothorax (7.5%) were the main complications among cases with respiratory distress.ConclusionAccording to the results of present research, neonatal vitamin D levels have a significant association with respiratory distress syndrome and maternal vitamin D levels.

Background: Perinatal asphyxia is a major cause of neurologic morbidity and mortality in infants. Objective: Determine the serum level of interleukin-6 (IL-6) in neonates with perinatal asphyxia and its relation to the severity of hypoxic-ischemic encephalopathy and short term neurological outcome. Methods: Serum IL-6 levels were measured at birth, and at 24 and 48 hour post-partum in 37 consecutive uninfected neonates with peri-natal asphyxia and 45 randomly selected healthy newborns. Results: Serum IL-6 concentrations in the infants who developed hypoxic-ischemic encephalopathy was 43 folds higher compared to values in the normal infants (p < 0.001) and 1.9 folds higher as compared to infants with asphyxia who did not subsequently develop hypoxic-ischemic encephalopathy (p <0.001). Serum IL-6 concentrations were also related to the degree of hypoxic-ischemic encephalopathy and neurologicaldevelopmental outcomes at the time of discharge. Conclusion: Serum levels of IL-6 increased in neonates with asphyxia, and this was most pronounced in neonates with adverse outcomes.

Our findings indicate that selenium supplementation in pregnant women may be associated with a lower frequency of preeclampsia.

Objective: Nucleated-red-blood-cells (NRBC) count in umbilical cord of newborns is been suggested as a sign of birth asphyxia. The present study was conducted to explore the value of NRBC count in prognosis of asphyxiated neonates. Methods: Sixty-three neonates with asphyxia were followed up for two years. Maternal and neonatal information was recorded follow by clinical and laboratory evaluation. NRBC-level was determined per 100 white-blood-cells (WBC). After discharge, follow-up of asphyxiated infants was performed using Denver II test at 6, 12, 18 and 24 months. Neonates were divided into two groups, with favorable and unfavorable outcome based on developmental delay or death. Results: We observed that NRBC count with more than 11 per 100 WBC, had sensitivity of 85% and specificity of 90% in predicting complications of asphyxia, while in absolute NRBC count with more than 1554, the sensitivity and specificity were 85% and of 87%, respectively. Combination of NRBC + HIE (hypoxic ischemic encephalopathy) grade had a high-predictive power for determining the prognosis of asphyxia in neonates. Conclusion: We demonstrate that NRBC/100 WBC and absolute NRCB count can be used as prognostic marker for neonatal asphyxia, which in combination with the severity of asphyxia could indicate high infant mortality, and complications of asphyxia. Further studies in a larger and multi center setting trail are warranted to investigate the value of NRBC and HIE in asphyxiate term infants.

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