Effect of gender and gestational age on short term morbidities and mortality in extremely low birth neonates (original) (raw)
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IOSR Journals , 2019
In a prospective hospital based study ,during the period from1 consecutively delivered live newborns werestudied for the incidence of low birth weight neonates and to evaluate the associated risk factors. Eleven hundrednewbornswere classified as low birth weight babies. The incidence expressed per 1000 live births was 353.7 (35.37%). Of these, 850 (77.27%) weresmall for gestational age neonates and 250 (22.72%) were preterm neonates. Five hundred eighty small for gestational age neonates (68.23%) were weighing between 2001 to 2500 gms. Mothers belonging to the age group of 19-24 years delivered the maximum newborn of low birth weight babies (600/1100) and of (510/600) these 86.33% were small for gestational age neonates. There were 50 neonates with lowbirth weight born to mothers below the age of 18 years. Primiparous mothers were found to contribute higher number of low birthweight neonates (400/1100). Spacing as a factor did not show any major difference. Two hundred eighty low birth weight neonates were born to mothers with significant obstetrical problems such as pregnancy induced hypertension, bad obstetricalhistory and premature rupture of membranes. The incidence of 35.37 % of low birth weight babies is high enough to ring alarmbells.
Study of maternal risk factors for low birth weight neonates: a case-control study
International Journal of Medical Science and Public Health, 2015
development. Low birth weight (LBW) in babies continues to remain a major public health problem worldwide, especially in the developing countries. The prevalence of LBW in India is 28% of all live births. As per the WHO (World Health Organization) estimation approximately 25 million LBW babies are born each year, consisting 15% of all live birth, approximately 93% of them in developing countries. [1] Across the world, neonatal mortality is 20 times more likely for LBW babies compared to heavier babies (≤2.5 kg). [2] LBW is the result of preterm birth, intrauterine growth restriction, or a combination of both pathophysiologic conditions. There are numerous factors contributing to LBW, both maternal and fetal. Weight at birth is directly influenced by Background: Low birth weight (LBW) is an important indicator of reproductive health and general health status of population. Weight at birth is directly influenced by general level of health status of the mother. The maternal risk factors are biologically and socially interrelated; most are, however, modifiable, which vary from one area to another, depending on geographic, socioeconomic, and cultural factors. Objectives: This study was undertaken to evaluate maternal risk factors associated with LBW neonates. Materials and Methods: A case-control study was conducted in a tertiary care government hospital in Solapur, Maharashtra. A total of 220 cases (vaginal delivery or cesarean delivery) and 220 controls who delivered a live-born singleton baby without congenital malformation enrolled within 1 day of delivery. Mothers who had multiple births were excluded. All babies were weighed within 24 h after the birth. The information was gathered from the maternal health records and interviewing the mothers of these infants. Results: The mean age of mothers in case group was 22.6 years and that of controls was 23.92 years. Mean weight gain during pregnancy of mothers in case group was 4.2 kg and that of controls was 5.9 kg. Mean weight of the newborn of cases and controls was 1664.97 and 2548.35 g, respectively. Spacing <2 years between this and last pregnancy, pregnancy-induced hypertension, tobacco exposure, lower socioeconomic status (class IV+V), prepregnancy weight <45 kg, late antenatal care (ANC) registration were identified as significant risk factors for LBW neonates. Significant association was found between maternal education (illiterate/primary), prematurity, cesarean delivery, age of mother <20 or >30 years, height <145 cm, maternal occupation (laborer), nuclear family, primigravida, anemia, inadequate ANC, and LBW. Conclusion: Health education, socioeconomic development, maternal nutrition, and increasing the use of health services during pregnancy are all important factors for reducing LBW.
IOSR Journals , 2019
Background In recent trends, there is increasing number of babies born with very low birth weight. These VLBW babies are at risk of developing hypoglycemia, sepsis, hyperbilirubinemia, respiratory distress when compared to term babies. By studying the risk factors leading to very low birth weight and their morbidities, health professionals will be able to anticipate and manage them accordingly. Methods This is a Prospective cohort study where all VLBW neonates admitted in our NICU were enrolled. Relevant details were collected which includes maternal details, maternal risk factors, order of birth, gestational age , antenatal steroids, mode of delivery and baby's details include their sex, need of resuscitation, Apgar score, gestational age, birth weight and need of mechanical ventilation , surfactant therapy were recorded Results: A total of 382 VLBW neonates were included. Out of 382 neonates, 199(52%) were males and 183(48%) were females, 195(51%) were born out of normal vaginal delivery and 187(49%) by caesarean section. Their Mean birth weight was 1.25 kg in males and 1.27 kg in females. Majority of VLBW neonates were in the gestational age group between 28-32 weeks (n = 224, 59%) and 32-34 weeks (n = 92, 24%).The most common maternal risk factor associated with VLBW being Gestational hypertension-210(55%) followed by Anemia-63(17%),.The major morbidity was sepsis (n=133, 35%) followed by RDS (n= 105, 27%), TTN (n= 85, 22%). The most common mortality was Sepsis (n=49, 52%), RDS (n= 38, 40%). Conclusion Prematurity is the primary cause behind these neonatal deaths. This emphasizes the need to prevent preterm deliveries. Effective preventive strategies to decrease the preterm birth will be the next big step to decrease the perinatal morbidity rate.
Maternal antenatal profile and immediate neonatal outcome in very low birth weight babies
IP Innovative Publication Pvt.Ltd, 2017
Objective: To find out maternal risk factors associated with VLBW babies and study maternal risk factors associated with morbidity and mortality of VLBW babies. Materials and Method: The study was a prospective cohort analysis of case records of 110 inborn VLBW babies admitted in Neonatal intensive care unit, of a Teaching hospital during the period of 1 year. Pregnant mother after 24 weeks of gestation were followed up till delivery to report outcome and impact of maternal antenatal profile on VLBW. For calculation of neonatal mortality or morbidity, delivered babies were to be followed up to discharge or death. Morbidity and mortality were compared according to birth weight and gestational age of baby. Only those causes of morbidity where statistical significance with relation to such maternal antenatal factors could be drawn, were studied by using Chi-square test. Results: Majority (81.82%) mothers of VLBW babies had adverse risk factors. Anemia, PROM >=12 hours and PIH were the commonest adverse maternal factors associated with very low birth weight babies. Majority (75.45%) VLBW babies developed one or other kinds of morbidity. The commoner morbidity in VLBW were neonatal sepsis (30%), RDS (19.09%) and NNH (18.18%). The mortality in VLBW babies was only 21.81%. RDS (50%) was the commonest cause of death in VLBW, followed by sepsis (16.6%).The mortality was highest in babies weighing less than 750 gram and less than 28 weeks of gestation. Both morbidity and mortality decreased significantly in babies with higher birth weight. APH, multiple pregnancy and LSCS had statistically significant association (p<0.001) with RDS in VLBW babies. Presence of PROM >=12 hours and maternal fever increased the risk of neonatal sepsis. Presence of PIH, abnormal presentation, multiple pregnancies and meconium staining of liquor were significantly associated with asphyxia. Conclusion: In our study, various adverse maternal factors were associated with very low birth weight and their morbidities. The identification of adverse maternal factors and its appropriate management can lead to better outcome of the baby. Introduction The birth weight is an indicator which gives us an idea about the quality of life, the socioeconomic status, health awareness and nutritional status of the community. The birth weight in all population groups is the single most determinant of the chances of the newborn to survive and experience normal growth and development. (1) Very low birth weight has been defined as birth weightless than 1.5kg, birth weight being taken preferably within first hour of life before significant weight loss occurs. In India around 3% babies are VLBW babies. (2) VLBW can be caused by either a short gestational period or retarded intrauterine growth or a combination of both. Prematurity is usually defined as gestational age less than 37 weeks and small for gestational age (SGA) or small for date (SFD) babies are those with birth weight less than 10 th percentile for their gestational age. (2) As babies weighing less than 2kg are more vulnerable to increased morbidity and mortality, they deserve priority in admission to special care nurseries and by this criterion alone, 10% of newborn babies in India qualify for admission to special care nurseries. (3) The common causes of morbidity and mortality in VLBW babies include birth asphyxia, respiratory
Retrospective Evaluation of Frequency, Morbidities and Mortality of Low Birth Weight Infants
Southern Clinics of Istanbul Eurasia, 2019
The aim of this study was to determine the frequency, morbidity, and mortality of low birth weight (LBW) infants born in a single hospital and to compare this group with infants of normal birth weight. Methods: Infants born in our hospital between January 1, 2013 and December 31, 2017 with a birth weight <2500 g were included in the study group. Babies with a birth weight >2500 g were randomly selected as a control group. The demographic and clinical characteristics, neonatal intensive care unit (NICU) hospitalization, etiology, morbidity, presence of asphyxia, and mortality were recorded and statistically analyzed. Results: In a 5-year period, the frequency of LBW infants (<2500 g) was 8.72% (n=2120). Among LBW infants, there were more females than males (p<0.001). The median first and fifth minute Apgar score in the study group was 7 and 8, while it was 8 and 9 in the control group, which yielded a statistically significant difference between the groups (p<0.001). Mothers younger than 20 years and over the age of 35 years were found to have a statistically significantly greater number of babies with LBW (p=0.041 and p=0.028). The mortality rate in LBW infants was determined to be 20 in 1000 live births. The rate of asphyxia observed among LBW infants and newborns with normal birth weight was found to be 0.6% and 0.28%, respectively. It was observed that 66% of newborns with LBW required hospitalization in the NICU, compared with 16% of those with a normal birth weight. The leading etiologies for NICU admission among LBW infants were sepsis (n=738, 34.81%), respiratory distress syndrome (RDS) (n=634, 29.9%), and transient tachypnea of the newborn (TTN) (n=489, 23.99%). When compared with the control group, RDS, TTN, congenital pneumonia, sepsis, hyperbilirubinemia, hypoglycemia, polycythemia, and feeding intolerance were more frequent among the LBW group (p<0.005). The leading morbidities among LBW infants were retinopathy of prematurity (n=177, 8.35%), anemia (n=111, 5.24%), bronchopulmonary dysplasia (n=49, 2.38%), intraventricular hemorrhage (n=32, 1.51%), and necrotizing enterocolitis (n=16, 0.75%). Conclusion: The frequency of low birth weight has varied over time but continues to be a concern. Since Apgar scores were lower and the rates of asphyxia, hospitalization, morbidity and mortality were all increased among LBW infants, antenatal follow-up of these high risk neonates is essential. Optimum resuscitation and medical care by an experienced NICU team after birth is invaluable.
International Journal of Research in Medical Sciences, 2017
Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality...
Morbidity in extreme low birth weight newborns hospitalized in a high risk public maternity
Revista Brasileira de Saúde Materno Infantil, 2017
Objectives: to determine the prevalence of the most common morbidities in extremely low birth weight (ELBW) infants hospitalized in a newborn intensive care unit (NICU) and to evaluate the influence of these morbidities through the length of in-hospital stay. Methods: observational, longitudinal, prospective and analytical study in a high risk reference maternity NICU from Sergipe, realized with 158 ELBW infants admitted between March 2014 and April 2015. The analysis of the hospitalization time was realized through the Kaplan-Meier method. Results: the average weight of premature was 785,2g ± 138,2g. The gestational age vary from 22 to 35 weeks and the average was 26,8 weeks. Of those admitted at NICU, sixty three (39,9%) were discharged and 95 (60,1%) died. The time of hospitalization was influenced for morbidities as: patent ductus arteriosus (PDA), intraventricular hemorrhage and sepsis. Acute respiratory distress syndrome was the most common complication (157 - 99,4%). The inci...
International Journal of Public Health and Clinical Sciences, 2020
Background: Cases of Low Birth Weight babies (LBW) are a health problem that is found in many countries, especially in developing and lagging countries. The causes of LBW babies are multifactorial, one of which is maternal and obstetric. The purpose of this study was to determine the relationship between maternal and obstetric factors with the incidence of LBW. Materials and Methods: This study was a case control study design. The study was conducted at the Regional General Hospital dr. Pirngadi Medan with 190 babies born in the year 2018 (130 LBW babies, 59 babies of normal weight). Samples were obtained as many as 68 divided into 34 case groups and 34 control groups. Factors such as lack of iron supplementation (anemia), history of LBW at previous labor, history of hypertension in pregnancy (preeclampsia, eclampsia), placenta previa, placental abruption. Data were analyzed using Chi-square test, and multiple logistic regression test. Result: The study showed that factors related to LBW incidence in newborns were ? maternal anemia (p = 0.032), history of LBW at previous delivery (p = 0.014), and placenta praevia (p = 0.027). Unrelated factors were history of hypertension in pregnancy (p = 1.124), placental abruption (p = 0.241). The most dominant factor associated with the incidence of LBW is the history of LBW at previous deliveries (PR = 4.35), meaning that mothers who have a history of previous deliveries of LBW babies have a 4.3 times higher chance than mothers who do not have a history of LBW at previous deliveries. Conclusion: LBW is associated with anemia, a history of LBW at previous labor, and placenta previa. Health workers must routinely educate mothers at ANC to prevent LBW babies. Conclusion: The conclusion of this study that of the factors associated with the incidence of LBW in newborns is anemia, a history of LBW in previous labor, and placenta previa. While the history of hypertension and placental abruption does not show a real relationship.
Ibrahim Cardiac Medical Journal, 2019
Background & objective: Term low birth weight neonate represents a heavy burden on healthcare services worldwide due to their higher incidence of morbidity and mortality than term normal weight neonates. Certain maternal factors contribute to delivering term low birth weight neonates. This study was designed to identify the proportion of term low birth weight neonates in a tertiary care hospital and their association with maternal risk factors. Methods: This case-control study was carried out in the Department of Obstetrics & Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka over a period of 15 months between April 2017 to June 2018. Term low birth weight (< 2500 gm) neonates delivered in Obstetrics Ward were taken as cases, while the term normal weight neonates taken from the same place were controls. A total of 80 cases and 140 controls who met the eligibility criteria were consecutively included in the study. The maternal factors (that may contribute to t...
International Journal of Contemporary Pediatrics, 2019
Background: Preterm birth is one of the major clinical problems in neonatology as it is commonly associated with perinatal mortality, serious neonatal morbidity and in some cases, it leads to childhood disability. The objective of this study was to find out the outcomes of VLBW and ELBW babies in the form of mortality and morbidity in neonatal period.Methods: A cross sectional study was conducted in SNCU, MKCG Medical College, Berhampur, Odisha between 2011 to 2013. All babies with birth weight less than 1500gm, admitted between days 1 to day 7 of life were enrolled in the study. Babies were broadly divided in to two groups i.e.VLBW group (weight 1000-1499gm) and ELBW group (weight<1000gm). Details of antenatal history, sociodemographic profile and birth history including significant events were noted. Outcome measures included were death, cured and with sequelae.Results: Total number of babies enrolled in this study were two hundred twelve (n=212) and following observations were...