Background: Low birth weight (LBW) has been defined as a birth weight of <2.5 kilogram regardless of gestational age. In India, every 3rd born child is of LBW. LBW is associated with increased neonatal mortality and morbidity, compromised growth and cognitive development.Methods: This is a retrospective cohort study using previously collected data from January 2015 to December 2015.Results: Out of 1238 live births, 485 (39.17%) were LBW. 456(94.01%) were LBW weighing >1500 grams (LBW), 22(4.53%) were VLBW, and 07(1.44%) were ELBW. 361(74.43%) were LBW2 (birth weight ≥2000 - <2500 grams), 95(19.58%) were LBW1 (birth weight ≥1500 - <2000 grams). 289(59.58%) of LBW neonates were full term. SNCU admission is significantly higher in LBW neonates (25.8% vs 9.61%). Morbidities were higher in LBW neonates compared to normal birth weight neonates. Difference was more significant in incidence of sepsis (3.72% vs 0.83%), RDS (2.19% vs 0%), TTN (5.48% vs 2.36%), hypoglycemia (1.31% vs 0%), feed intolerance (1.09% vs 0%) and risk of major congenital malformation (1.97% vs 0.27%). Need for respiratory support was 4.82% in LBW vs 2.36% in normal birth weight neonates. Morbidities were significantly higher in VLBW and ELBW neonates. Immediate poor outcome was in 3.92% in LBW neonates, while it was 0.56% in normal weight neonates. Poor immediate outcome was 1.11% in LBW2, 2.10% in LBW1, 10% in VLBW1, 41.66% IN VLBW2, and 100% in ELBW.Conclusions: LBW neonates are at higher risk of morbidities and mortalities. The major determinant for mortality in LBW babies is the birth weight. The best option to prevent LBW is by improving maternal health. Improvement of perinatal and neonatal services in government sector and public private partnership model of free neonatal care can help to achieve the INAP goal of NMR <10 by 2030.
Background: Late premature infants are born near term, but are immature. As a consequence, late preterm infants are at higher risk than term infants to develop morbidities. Although late preterm infants are the largest subgroup of preterm infants, there is a very limited data available on problems regarding late preterm infants in rural India.Methods: This is a retrospective cohort study using previously collected data from neonates born at Dhiraj Hospital and neonates who were born outside but admitted at SNCU of Dhiraj Hospital, Piparia, Vadodara district, Gujarat, India between January 2015 to December 2015.Results: 168 late preterm infants and 1025 term infants were included in this study. The need for SNCU admission is significantly higher in late preterm compared to full term (41.07% vs 2.04%). Morbidities were higher in late preterm neonates compared to full term neonates. Sepsis (4.76% vs 1.07%), TTN (10.11% vs 2.04%), hyperbilirubinemia (19.04% vs 9.36%), RDS (1.78% vs 0.09%), hypoglycemia (1.78% vs 0.29%), PDA (1.78% vs 0.58%), risk of major congenital malformation (2.38% vs 0.58%). Need for respiratory support was 5.95% in late preterm vs 2.04% in full term neonates. Immediate neonatal outcome in terms of death and DAMA (non-salvageable) cases was poor in late preterm neonates compared to full term neonates (1.19% vs 0.78%).Conclusions: Late preterm neonates are at higher risk of morbidities and mortalities. They require special care. Judicious obstetric decisions are required to prevent late preterm births.
Background: Congenital heart disease defined as an abnormality in cardio circulatory structure or function that is mostly present at birth; even it is discovered much later. Recognition of congenital heart disease in newborn is important as this group abnormality constitutes a significant proportion of congenital malformation that present in the neonatal life, and their early detection is important for appropriate management and good outcome. Objectives of present study were to evaluate clinical profile and outcome of various CHDs identified during neonatal period and to study effect of paracetamol used for pharmacological closure of PDA in preterm neonates.Methods: The study was conducted prospectively in NICU, Dhiraj hospital, Department of Pediatrics and Neonatology from January 2016 to June 2017 (1.5 years span). Echocardiography screening of all neonates suspected of having CHD was done. Details of all neonates having CHD diagnosed by echocardiography were noted in the prescribed Performa and their incidence, clinical profile and outcome was studied.Results: Total 69 cases of CHD diagnosed by Echocardiography in neonatal period were studied. Incidence of CHD among neonates born at Dhiraj hospital was 8.48 per 1000 live birth. Male: female ratio of all CHD cases was 1.38:1. Risk of neonate with CHD is highest (18.18%) in extremely low birth weight neonates. Incidence of CHD was 4.08% in preterm < 34 weeks, 3.47% in late preterms and 0.51% in full term neonates. 86.95% were diagnosed within first week of life. 26.09% babies had associated anomalies. Presenting problem of neonates was breathing difficulty 42 (60.87%), feeding difficulty 36 (52.17%) and cyanosis 5 (7.25%). 8 (11.59%) neonates were asymptomatic. The most common presenting sign was murmur 46 (75.71%). 56 (81.16%) had Acyanotic CHD and 13 (18.84%) had Cyanotic CHD. Amongst 56 (81.16%) Acyanotic CHD cases, commonest was PDA in 44 (78.5%), followed by VSD in 18 (32.14%), ASD in 5 (12.5%) either in isolation or in combination with other lesions. Amongst Cyanotic Congenital Heart Disease, maximum incidence was of Tricuspid Atresia (TA) in 4 (30.76%) cases; followed by TGA in 3 (23.07%). 20 preterm neonates with PDA received paracetamol for PDA closure. 9 (45.0%) responded to paracetamol while 11 (55%) did not respond. 47(68.12%) were discharged, 10(14.49%) went left against medical advice, 7(10.14%) were referred to higher centre for surgery and 5(7.25%) babies expired.Conclusions: Early recognition of congenital heart disease during neonatal life is important as its appropriate and timely management can result in good outcome.
Background: Respiratory distress syndrome is the most important cause of morbidity and mortality in preterm neonates. Intermittent positive pressure ventilation with surfactant therapy was standard treatment of RDS. IIPV is invasive, costly and requires expertise. It is not a viable option for many of the resource limited SNCU set ups of our country. Trials have showed that CPAP is noninvasive, easy to use, safe and effective. This study was done to find out effectiveness of CPAP in RDS, and also to find CPAP failure factors.Methods: This was a prospective observational study, carried out at SNCU of Dhiraj hospital, Piparia, Vadodara district, Gujarat, India form February 2014 to March 2015. Neonates with diagnosis of respiratory distress syndrome were included in this study.Results: Total 57 (42 inborn and 15 out born) cases of RDS were analyzed in this study. Incidence of RDS was 3.68% of live births. 5(8.8%) settled down with low flow oxygen only. 24 (42.1%) successfully treated with CPAP only. 15 (26.3%) were treated with CPAP and surfactant. 13 (22.8%) were CPAP failure cases which required ventilator support. The variables significantly associated with failure of CPAP were: no exposure to antenatal steroids (p value of 0.025), grade 3-4 RDS on CXR (p value of 0.03), PDA (p value of 0.0264), sepsis/pneumonia (p value of <0.001) and Silverman Anderson score of ≥7 at admission (p value of 0.001). 3 (5.3%) went on DAMA. 5 (8.8%) expired and 49 (85.9%) were discharged. 4 out of 5 (80%) death occurred in very preterm group. 4 (80%) of death occurred in neonates whose mothers did not receive any dose of antenatal steroid. There was no mortality in neonates who were in need of surfactant and received within 6 hours of life. 75% of neonates having sepsis and asphyxia both along with RDS expired.Conclusions: Bubble CPAP is safe and very effective in low resource settings. CPAP failure is significantly associated with no antenatal steroids, grade 3 to 4 x-ray changes of RDS, Silverman Anderson score of ≥7 at beginning of CPAP, presence of significant PDA and association of sepsis/pneumonia.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.