Background: A baby’s weight at birth is a strong indicator of newborn health and nutrition. Low birth weight (LBW) babies are more susceptible to morbidities and mortality in early neonatal period than normal birth weight (NBW) babies. Among neonatal deaths, 80% occurs in LBW / preterm babies and 75% of total neonatal deaths occur in early neonatal period. The present study was undertaken to know the incidence and early neonatal outcome of LBW babies in rural area.Methods: Prospective observational study was conducted in babies born with <2.5 kg (LBW) birth weight.Results: The incidence of LBW babies was 25.07% with almost an equal contribution from preterm (50.46%) and Term Intra Uterine Growth Restricted (IUGR) (49.53%) babies. The most common morbidity found in LBW babies was Jaundice (40.09%) followed by respiratory distress (18.16%), sepsis (8.72%) and apnea (4.48%). Preterm-LBW babies had more morbidities in terms of apnea (100%), birth asphyxia (88.88%), respiratory distress (87.01%%), sepsis (80.55%) and jaundice (67.64%). Early neonatal mortality was 21.22 per 1000 live births. Mortality was 100% for babies <1 kg in birth weight, 16% in 1-1.499 kg group and 0.75% in 1.5-2.499 kg group in early neonatal period. According to gestational age, mortality in preterm-LBW babies was 88.88% and 11.11% in Term IUGR-LBW babies. The most common cause of death in LBW babies was birth asphyxia (44.44%) followed by hyaline membrane disease (HMD) (33.33%).Conclusions: The present study revealed that preterm babies contributed 50% to incidence of LBW babies. Morbidity and mortality in LBW babies were inversely related to birth weight and gestational age.

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A 3-month-old female baby brought for cleft lip repair was referred to the Department of Pediatrics. On physical examination, her weight was 4.2 kg, head circumference 39 cm, and length 53 cm; she revealed pallor, cleft lip, hepatomegaly (span 8 cm), and grade II splenomegaly (palpable 6 cm below left costal margin from midclavicular line). With the detailed history, we found that this girl was born by a full-term normal delivery to a consanguineously married couple. Her birth weight was 2.7 kg, and she was the third in birth order. The first sibling, a male child, showed failure to thrive, pallor, macrocephaly, global developmental delay, hepatosplenomegaly, recurrent history of lower respiratory tract infections, and expired at 3 years of age with sepsis. The second sibling, a female child, is thriving well. Laboratory investigations showed anemia (Hb, 8.1 gm/dL), thrombocytopenia (80,000) with normal WBC count (8,500/mm 3). Peripheral blood smear showed microcytic, hypochromic red blood corpuscles with immature white blood cells (WBCs; myleocytes, metamyleocytes, and bandforms) and normoblasts (3-4/100 WBC). Bone marrow aspiration revealed erythroid hyperplasia. Hemoglobin electrophoresis was normal. Inborn error of metabolism workup was normal. Malignant infantile osteopetrosis (MIOP), a rare congenital disorder of bone resorption, is caused by the failure of osteoclasts to reabsorb immature bones. We report a 3-month-old female child with cleft lip who was referred to the pediatric department for consultation. She was born to consanguineous parents, and the elder sibling expired at the age of 3 years owing to recurrent respiratory tract infections and hydrocephalus. On examination, we found pallor and hepatosplenomegaly. On follow-up, we came to know that she exhibited delayed developmental history and bilateral optic atrophy. Skeletal radiographs showed dense bones with "bone-in-bone" appearance. The overall clinical features and radiological findings of these patients were sufficient to arrive at the diagnosis of MIOP.

Introduction: Pregnancy Induced Hypertension (PIH) can lead to intrauterine growth restriction resulting in Low Birth Weight (LBW) neonates. LBW remains a significant cause of under-five mortality in India and Asia. Aim: To calculate the prevalence of PIH and to study the correlation between Birth Weight (BW) of neonates and severity of maternal hypertension; and compare the incidence of neonatal morbidities across varying severity of maternal hypertension. Materials and Methods: A longitudinal study was conducted among 153 pregnant mothers, diagnosed with PIH. They were classified into mild {Systolic Blood Pressure (SBP) ≥140- 149 mmHg or Diastolic Blood Pressure (DBP) ≥90-99 mmHg}, moderate (SBP ≥150-159 mmHg or DBP ≥100-109 mmHg) and severe (SBP ≥160 mmHg or DBP ≥110 mmHg) hypertension. A total of 142 neonates, born to PIH mothers, were included. The neonates were followed-up for seven days to check for early neonatal outcomes and deaths. Correlation between maternal blood pressure (systolic and diastolic) and BW of the neonates was assessed using Pearson’s correlation coefficient (r). Binary Logistic Regression (BLR) was performed to analyse the impact of confounders on BW. Results: The prevalence of PIH was 7.76% (153/1972). The mean BW of neonates born to mothers with moderate (2.435 kg) and severe hypertension (2.342 kg) was significantly lower than that of neonates born to mothers with mild hypertension (2.828 kg) (p<0.00001). 1SD increase in SBP resulted in 0.245 kg decrease in BW, while an 1SD increase in DBP resulted in 0.312 kg decrease in BW. After accounting for confounders using BLR, maternal DBP still had a significant negative correlation with BW (r=-0.663; p<0.001). The incidence of prematurity (p<0.0001), small for Gestational Age (GA) (p=0.0283), Respiratory Distress (RD) (p=0.002), Neonatal Hyperbilirubinemia (NNH) (p=0.033) and Neonatal Intensive Care Unit (NICU) admissions (p=0.003) were significantly higher among neonates born to mothers with moderate and severe hypertension than those born to mothers with mild hypertension. Three neonatal deaths (all due to perinatal asphyxia) were observed in this study and there was no statistical significance with respect to deaths across neonates of the three groups (p=0.219). Conclusion: Maternal DBP had a significant negative correlation with BW. The mean BW of neonates born to mothers with severe hypertension was significantly lower compared to those born to mild hypertension.