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Article
Study of risk factors for neonatal thrombocytopenia in preterm infants

Author: Basil M. Hanoudi
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2015 Volume: 14 Issue: 1 Pages: 64-69
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Thrombocytopenia is a common hematological problem in neonatal care units. Neonatal thrombocytopenia has been defined as platelet count less than 150x109 /L, regardless of gestational age.Objectives: To determine the frequency and assess the severity of neonatal thrombocytopenia in preterms, and the maternal and neonatal conditions as risk factors. Patients and methods: A cross sectional study was carried out in the neonatal care unit of Child Central Teaching Hospital/ Baghdad, over a period of six months (30th of June to 31st of December 2013). Study group included only preterms who had thrombocytopenia. Data of neonates was collected by direct interviewing of the mothers or other family members, clinical assessment and examination and relevant investigations were done.Results: The frequency of preterm neonatal thrombocytopenia was 95 (13.04%), out of 728 neonates admitted to neonatal care unit. Male to female ratio was 1.37:1, male gender was significantly associated with prematurity and mild to moderate severity thrombocytopenia (P 0.016, P 0.019). Prematurity was significantly associated with late onset neonatal thrombocytopenia (P 0.035). Late-onset thrombocytopenia, and 32- <37 wk gestational age group were significantly associated with mild to moderate severity thrombocytopenia group (P 0.008, and 0.004 respectively). Sepsis was a frequently associated risk factor in thrombocytopenic preterms, and found in 70 (73.68%) cases of preterm thrombocytopenia (with only 8 cases were culture positive and 62 cases were clinical based diagnosis). Also birth asphyxia, respiratory distress syndrome, and Rh incompatibility were significantly associated with thrombocytopenic prematures (P 0.026, 0.001, 0.008 and 0.036 respectively). Birth asphyxia, respiratory distress syndrome, sepsis and Rh incompatibility were significantly associated with moderate to severe thrombocytopenia (P 0.001, 0.001, 0.003 and 0.011 respectively). There was no significant difference between the presence of maternal disease and gestational age to the severity of neonatal thrombocytopenia (P 0.458, 0.698 respectively).Conclusions: Preterm thrombocytopenia is relatively common in neonatal care units. Sepsis, respiratory distress syndrome and birth asphyxia were significant neonatal risk factors of thrombocytopenia at lower gestational age preterms. Most episodes were late onset with mild or moderate severity.


Article
Gender Differences of Placental Dysfunction in Severe Prematurity
علاقة اختلافات الجنس واعتلال المشيمة بالولادات المبكرة

Author: Maha Mohamed Al-Bayati د. مها محمد البياتي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 1 Pages: 52-55
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Several obstetric complications have been reported to be related to fetal gender such as prematurity, preeclampsia and placental abruption. Objective: To investigate whether a sex difference exists in findings at placental histology of extreme prematurity.Design: Cross-sectional.Setting: Gynecology and Obstetrics department, Al-Kadhimyia Teaching Hospital, Baghdad, Iraq Patients and Methods: Fifty deliveries before 32 weeks of gestation of singleton, liveborn, non-anomalous infants were included in the study. Placental histological findings were compared between male (n=25) and female (n=25) neonates.Results: Male fetuses had distributions rate of nulliparity, maternal age , gestational age at delivery as female fetuses , but higher birth weight centiles ([55.09±11.3] vs. [43.09±8.2]). Placental histology showed no association between fetal gender and lesion of acute inflammation (p=0.09) , intraplacental vascular pathology (p=0.2) or uteroplacental vascular pathology (p=0.5).However ,lesion of chronic inflammation had a significantly higher score in male than in female fetuses (p=0.01).when we examined the distribution of chronic placental inflammation ,significantly more severe lesions were noted in male than in female fetuses at the implantation site (i.e the area of interstitial trophoblast invasion of the maternal decidua and maternal endovascular trophoblast remodeling ),than within the placental villi (chronic villitis) or in the amniochorionic membranes (where interstitial trophoblast invasion is minimal). Conclusion: In premature deliveries at <32 weeks ,male fetal gender is associated with placental lesions suggestive of a maternal immune response against the invading interstitial trophoblast .The immunological basis of these findings deserves further studies.Key wards: Gender difference, prematurity, placental histology.

هدف الدراسة: أعدت هذه الدراسة لبيان تأثير اختلاف الجنس في الفحص النسيجي للمشيمة وتأثيره في الولادة المبكرة.تصميم الدراسة: دراسة مقطعية.مكان الدراسة: أجريت هذه الدراسة في قسم النسائيات والتوليد في مستشفى الكاظمية التعليمي.طريقة العمل: شملت الدراسة خمسون خديجا تمت ولادته قبل الأسبوع ٣٢ , تم فحص الخدج والفحص النسيجي للمشيمة لخمسة وعشرون من الذكور وخمسة وعشرون من الإناث.النتائج: الذكور الخدج كان لديهم معدل التوزيع للبكريات وعمر الأم وأسابيع الحمل عند الولادة ووزن المشيمة ومعدل وزن الطفل للمشيمة كما هو لدى الإناث الخدج . لكن الذكور الخدج كانوا أكثر وزنا.الفحص النسيجي للمشيمة اظهر عدم ارتباط بين جنس الطفل و الالتهابات الحادة للمشيمة, لكن الالتهابات المزمنة كان لها نسب عالية و علاقة مع جنس الطفل (الذكر أكثر من الأنثى) .عند دراسة الالتهابات المزمنة في المشيمة , أكثر الالتهابات كانت في موقع انغراس البويضة في بطانة الرحم أكثر مما في زغابات المشيمة أو الغشاء ما بين الجنين والمشيمة .الاستنتاج: في الولادات المبكرة قبل ٢-٣ أسبوعا ,الذكور لديهم حالات التهابات في المشيمة أكثر من الإناث مما يدل على أن جهاز المناعة الامومي يتحسس أكثر تجاه مشيمة الأطفال الذكور . العلاقة المناعية لهذه الصلة تحتاج دراسة أوفر .


Article
Sociodemographic and Medical Factors of Preterm Delivery According to the Clinical Subtypes of Prematurity

Author: Sijal Fadhil Farhood Al‑Joborae, Farah Wajid Alwan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 4 Pages: 341-348
Publisher: Babylon University جامعة بابل

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Abstract

Background: Preterm delivery is defined as childbirth occurring at <37 completed weeks. Preterm birth remains one of the most importantproblems in pregnancy, as it is still a major health problem worldwide, which results in 75% of neonatal mortality. Often, the cause of pretermdelivery is unknown; however, several etiological risk factors have been identified. Objective: The objective of this study was to examinesociodemographic and medical risk factors of preterm delivery in relation to clinical subtypes as follows: extremely preterm (<28 weeks), verypreterm (28 up to 32 weeks), and moderate‑to‑late preterm (32 up to 37 weeks). Materials and Methods: It is a descriptive hospital‑basedcross‑sectional study which was carried out on a convenient sample of 200 preterm babies who were cared for in the neonatal care units inBabylon Maternity and Pediatrics Hospital, Hilla General Teaching Hospital whose mothers accepted to participate in this study. This studywas conducted over 5 months from March 1, 2018 to August 1, 2018. Results: Thirty‑nine percent of respondent mothers had a history ofabortion and (18.0%) had a history of recurrent preterm birth. Spontaneous preterm delivery (premature rupture of membrane) was the mode ofdelivery in (53.5%) of mothers and (49.5%) of respondents were multigravida. As high as (43.5%) of respondent mothers had current medicalillnesses, hypertension representing (33.33%) of these illnesses. Forty percent of mothers had irregular ANC and (15.5%) did not have anyantenatal care at all. Conclusion: Several significant risk associations between preterm birth according to clinical subtypes of prematurity andthe following risk factors were identified as follows: maternal age, gravidity, birth order, BMI, educational level, mode of delivery, history ofabortion, contraceptive use before pregnancy, and genetic defects.


Article
HISTOCHEMICAL ANALYSIS OF PLACENTAL PHOSPHATASES IN CASES OF PRETERM PREECLAMPSIA
تحليل نسيجي كيميائي لانزيمى الفوسفاتاز في سخد الحمل المنتهى قبل الحد الطبيعي للمخاض والمصاحب لحدوث مقدمة الارتعاج

Author: LUMA I.K. AL-ALLAF لقمان العلاف
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2009 Volume: 3 Issue: 2 Pages: 52-66
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background Disruption of normal placental morphology and function might correlate with several pregnancy disorders as preeclampsia and preterm labor. Many studies tried to localize placental alkaline phosphatase, and placental acid phosphatase in placentas of mothers with complicated pregnancy and try to find out whether the changes in their pattern have a direct bearing on functional and morphological integrity of the placental tissue and on the fetal growth and development.Objectives This study aims to find the difference in localization or intensity of placental alkaline phosphatase, and placental acid phosphatase in a group of preterm preeclampsia and in placentae of normotensive preterm ones, compared with normotensive term mothers. Methods This study examined placentae obtained from 61 singleton pregnant women and it was performed over a period of three months started form 1st April 2008 till 30th June 2008 and conducted at Al-Batool Maternity Teaching hospital in Mosul city in northern Iraq. Smokers, Rh negative mothers, and cases of diabetes mellitus were excluded. The study sample was divided into 3 groups after recording of medical reports of the history and clinical examination and accurate assignment of gestational age. Group 1: This group consisted of 25 normotensive women who delivered at term (between 38 and 42 weeks’ gestation). Group2: This group consisted of 23 normotensive women who delivered before 37 weeks’ gestation spontaneously. Group3: This group consisted of 13 women with positive history of blood pressure equal to140/90 mm Hg after 20 weeks of gestation and proteinuria 300 mg/ 24 hrs or ³ 1+ dipstick and delivered before 37 weeks’ gestation . All placental sections of the three study groups were stained using alkaline phosphatase stain (Gomori's method-cobalt) &acid phosphatase stain (Gomori's method-lead) and submitted for light microscopic examination in Laboratory of Postgraduate Studies at the Department of Anatomy, Histology and Embryology in Mosul College of Medicine.Results This study revealed that most sections obtained from normotensive term group showed discrete localization of acid phosphatase P-ACP in all cellular elements of the placenta. Placental sections obtained from cases of preterm preeclampsia (group 3) and those obtained from spontaneous preterm labor (group 2) showed more intense acid phosphatase activity which was arranged in focal distribution. On the other hand, most sections obtained from normotensive term group revealed that alkaline phosphatase P-ALP was localized mostly in the syncytiotrophoblast, moderate reaction of the maternal deciduas, while villous stroma showed weak activity. Sections obtained from placentas of group 2 and group 3 women showed that very strong alkaline phosphatase activity expressed in syncytiotrophoblast, moderate to intense alkaline phosphatase activity in villous stroma and maternal deciduas. Conclusion The present study demonstrated that the placental tissue in cases of preterm preeclampsia and in cases of spontaneous prematurity exhibits changes in the activity patterns of acid phosphatase and alkaline phosphatase in comparison to that in cases of normotensive term group .These changes may represent functional alterations either preceding or running concurrently with morphological damage in the placenta

الخلفية: ان الاختلال فى تركيب ووظيفة السخد الطبيعية ممكن ان يرتبط بعدة اضطرابات مصاحبة للحمل مثل الولادة المبكرة عن الاوان السوى للمخاض ومقدمة الارتعاج.دراسات عديدة حاولت ان تحدد تفحص نمط توزيع انزيمي الفوسفاتاز الحامضى والقاعدى لمشيمة الحمل المتاتى عن حدوث شتى المضاعفات فى محاولة لمعرفة مااذا كان لتلك التغييرات فى نمط التوزيع اى تاثير على الكمال الوظيفى والتركيبى لنسيج المشيمة او السخد. هدف الدراسة: مناقشة نمط توزيع انزيمي الفوسفاتاز الحامضى والقاعدى للمشيمة الماخوذة من الولادة المتاتية عن الحمل المنتهى قبل الاوان السوى للمخاض مع حدوث مقدمة الارتعاج وكذلك لمشيمة الولادة المتاتية عن الحمل المنتهى قبل الاوان السوى للمخاض وبدون حدوث مقدمة الارتعاج بالمقارنة مع نمط التوزيع فى مشيمة الحمل سوي توقيت المخاض والغير مصاحب لحدوث مقدمة الارتعاج.طريقة الدراسة: تم فحص احدى وستون مشيمة ، كلُ من نتاج حمل مفرد (غير توأم) لنساء غير مدخنات ، غير سكريات، لديهن العامل الرئيسي في الدم ، واللاتي تم تصنيفهن إلى ثلاث مجاميع اعتماداً على التحديد الدقيق لمدد حملهن مع الاعتماد على التقارير الطبية الكاملة واجراء الفحوصات الشاملة لهن . المجموعة الاولى : وتضم النساء الحوامل اللواتي ولدن ما بين الاسبوعين الثامن والثلاثين والحادي والاربعين من مدة الحمل (العدد =25) ، المجموعة الثانية : وتضم اللواتي ولدن قبل الاسبوع السابع والثلاثين من مدة الحمل وبصورة تلقائية (العدد =23) ، والمجموعة الثالثة : وتضم اللواتي ولدن قبل الاسبوع السابع والثلاثين من مدة الحمل مع حدوث ارتفاع فى ضغط الدم الشريانى من بعد الاسبوع العشرين من حدوث الحمل ووجود الزلال فى بولهن (العدد =13).اخدت عينات نسيجية من سطحى القرص المشيمى (الجنينى ,والدى له علاقة بالام) وتم تحضير الشرائح البارافينية وصبغها بالصبغات الكيميائية النسيجية الخاصة بانزيمى الفوسفاتاز القاعدى والحامضى ,واخضعت بعدها للفحص بالمجهر الضوئى. النتائج: لوحظت زيادة فاعلية انزيم الفوسفاتاز القاعدي في خلايا الطبقة الجبلية المحببة وسداة الزغابة والساقط القاعدي للمشيمات المنتمية إلى المجموعتين الثانية والثالثة مقارنة بالاولى ، بينما كانت فاعلية هذا الانزيم متوسطة في الساقط القاعدي للمجموعة الأولى ، بالإضافة إلى ذلك حدوث الزيادة فى فاعلية انزيم الفوسفاتاز الحامضى فى خلايا الطبقة الجبلية المحببة وسداة الزغابة وايضا فى الساقط القاعدى للمشيمات المنتمية الى المجموعتين الثانية والثالثة مقارنة بالاولى.الاستنتاجات: لقد لوحظت زيادة فى فاعلية انزيم الفوساتاز القاعدى و فى فاعلية انزيم الفوسفاتاز الحامضى فى مشيمات الحمل المنتهى قبل الاوان السوى للمخاض وكذلك فى فى مشيمات الحمل المنتهى قبل الاوان السوى للمخاض والمصاحب لحدوث مقدمة فى الارتعاج مما يدل على ان تلك التغييرات قد تمثل تغيرات وظيفية فى سخود او مشيمات تلك النسوة.


Article
Causes of Death in Children under- Five Years Old at AL-Batool Teaching Hospital
أسباب الوفيات لدى الأطفال دون الخامسة من العمر في مستشفى البتول التعليمي

Author: Aseel Jasim Muhammad أسيل جاسم محمد
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2018 Volume: 15 Issue: 1 Pages: 79-84
Publisher: Diyala University جامعة ديالى

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Background: Child mortality is usually used as appointer of community health. A decreasing in mortality is possible with increasing the interventions that targeting the important causes of death. Objective: To assess death causes in children below five years old.Patients and Methods: A descriptive retrospect study depend on revision of files in AL- Batool teaching hospital. data was collected during a period of 30 months from 1st of February ,2013 to 30th of November, 2015.by using a well structured questionnaire designed for the study. Date of death, sex and age, and the cause of death were collected. the recorded .Death causes were classified according to the International Classification of Disease version10 (ICD-10). Stillbirths were excluded.Results: A 500 deaths were listed, ( 254 boys and 246girls ). About 198 (39.6%) of deaths were listed as infants death (29 days-11months),while 172(39.4%)recorded as neonatal deaths(0-28days),and 130(26%)as children deaths(1-4years). For the neonate , prematurity/LBW(65)37.79% and neonatal sepsis(47)27.32% were the most important causes of death.For the infants, pneumonia(64)32.23% and sepsis(53)26.76%were the most important causes of death and in the children age group, diarrhea(46)35. 38%and pneumonia (29) 22.30%. were the leading causes of death.Conclusion: Together death causes in children below five years old were pneumonia &sepsis.

خلفية الدراسة: كثيرا ما تستخدم وفيات الاطفال كمؤشرا على صحة السكان .اهداف الدراسة: هدفت هذه الدراسة الى تقييم أسباب الوفاة لدى الأطفال دون سن الخامسة.المرضى والطرائق: دراسة وصفية استعادية تستند إلى مراجعة السجلات في مستشفى البتول التعليمي. تم جمع البيانات لمدة 30 شهرا من 1 يناير 2013 إلى 31 ديسمبر 2015. تم جمع البيانات باستخدام نموذج جمع البيانات المصمم للدراسة. تاريخ الوفاة، نوع الجنس والعمر للمتوفى، وتم جمع سبب الوفاة. تم تصنيف الأسباب المسجلة للوفاة وفقا للتصنيف الدولي للأمراض الإصدار (ICD-10). واستبعدت حالات الولادات الميتة من الدراسة.النتائج: تم تسجيل ما مجموعه 500 حالة وفاة (254 ذكر و 246انثى). تم إدراج حوالي 198 حالة وفاة (39.6٪) كوفاة للرضع (29 يوما -11 شهر)، و 172 (39.4٪) تم تسجيلهم كوفاة حديثي الولادة (0-28 يوما)، و 130 (26٪) وفيات الأطفال (1-4 سنوات) . وبالنسبة لحديثي الولادة، كانت الأسباب الرئيسية للوفاة هي الخداج / انخفاض الوزن عند الولادة(65) 37.79٪ والإنتان الوليدي (47) 27.32٪. وبالنسبة لمجموعة وفيات الرضع، كانت الأسباب الرئيسية للوفاة هي الالتهاب الرئوي (64) 32.23٪ والإنتان (53) 26.76٪ وفي الفئة العمرية للأطفال، كانت الأسباب الرئيسية للوفاة إلاسهال (46) 35. 38٪ والالتهاب الرئوي. (29) 22.30٪.الاستنتاجات : مع الأسباب الأكثر شيوعا للوفاة في أقل من خمسة سنوات من العمر الأطفال هم الالتهاب الرئوي /الانتان.


Article
Neonatal Death in Low Birth Weight Infants in Basrah Maternity & Children Hospital at 2008
دراسة حول وفيات الاطفال ناقصي الوزن في ردهات الخدج في مستشفى البصرة للنسائية والاطفال لعام 2008

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Background :Low birth weight) less than 2500 grams) that includes preterm birth and small for gestational age, is regarded as important causes of neonatal deaths and contributes to 60% to 80% of all neonatal deaths.Objectives :to assess the frequency of deaths in low birth weight neonates and it’s relation to selected neonatal, labour and maternal characteristics.Patients and Methods :A prospective study was carried out on low birth weight newborns admitted to neonatal care units in Basrah Maternity and Children Hospital for four months( from 1st of February till the end of the May 2008) on 508 newborns with low birth weight out of 1338 neonates admitted during the study period. One hundered-ninty one (191) neonates with low birth weight died, their death was studied in relation to neonatal, labour, delivery and maternal characteristics from data collection by special questionnaire.Results :It was found that (68.95%) of total deaths had low birth weight, male to female ratio was (1.4:1). The death was significantly related to gestational age, weight, growth status (being small for gestational age) and male sex. (P value was<0.001). The most common causes of deaths were respiratory distress syndrome (54.97%) followed by sepsis (19.37%. Other neonatal characteristics like postnatal referral, early death, and hospitalization period of less than seven days, need for resuscitation at time of birth and multiple pregnancies were associated with increased risk of death. (P value <0.001).Hospital delivery, non-complicated delivery and normal vaginal deliveries were associated with decreasing neonatal mortalities.(P value <.001).Young age mothers (less than twenty years), Primgravidae, those who had anemia in pregnancy or had poor antenatal care were more liable to have neonatal death ,while mortality rate was significantly lower among breastfed neonates compared to formula fed babies.Conclusions :The frequency of low birth weight and their deaths were high, the death was related to weight, gestational age, growth status, early neonatal period, complicated labour, caesarean section, young primi mother and maternal anemia. Prevention of prematurity and intrauterine growth retardation causes by good antenatal care, skilled attendance at births, and availability of surfactant therapy can reduce mortality.


Article
Transvaginal Cervical Length and Amniotic Fluid Index: Can it Predict Delivery Latency Following Preterm Premature Rupture of Membrane?

Author: Amal Muneer Mubarak
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 1 Pages: 78-82
Publisher: Babylon University جامعة بابل

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Background: This study was performed to determine whether transvaginal cervical length (TVCL), amniotic fluid index (AFI), or acombination of both can predict delivery latency within 7 days in women presenting with preterm premature rupture of membranes (PPROMs).Materials and Methods: This was a prospective observational study of TVCL measurements in eighty singleton pregnancies with PPROMbetween 24–34 weeks. Transvaginal ultrasonography was performed to measure the CL and AFI. Delivery latency was defined as the periodfrom the initial TVCL after PPROM to delivery of the baby, with our primary outcome being delivery within 7 days of TVCL. Sensitivity,specificity, and predictive values were used to test whether the presence of a short TVCL, AFI, or a combination of both affected the risk ofdelivery within 7 days. Results: The study showed that the validity of CL alone in predicting labor when the cutoff value = 2 cm, the sensitivity= 52.6%, specificity = 69%, positive predictive value (PPV) = 60.6%, negative predictive value (NPV) = 61.7%, and accuracy = 61.25%. Thevalidity of AFI alone when the cutoff value = 5 cm, the sensitivity = 71.1%, specificity = 50%, PPV = 56.3%, NPV = 65.6%, and accuracy =60%. With a combination of CL and AFI in predicting time of labor after PPROM, the following results were found: sensitivity = 50%, specificity= 92.8%, PPV = 86.4%, NPV = 67.2%, and accuracy = 72.5%. In women with PPROM, we found the ratio of gestational age (GA) ≤30 weekswho labored within 7 days as 44.7% and those labored more than 7 days as 55.3%. Conclusion: Our study showed that there was an increasein PPV when combining AFI and CL in the prediction of time of labor, so women with AFI ≤5 and CL ≤2 had 86.4% risk of delivery within7 days after PROM. Furthermore, we found that there was no significant association between GA and parity with the prediction time of labor.


Article
Bacterial Infection in the Neonatal Unit of the Maternity and Pediatrics Hospital in Diyala Iraq
الاخماج البكتيرية في وحدة الخدج في مستشفى الولادة في ديالى- العراق

Authors: Bushra I. AbdulLatif بشرى ابراهيم --- Jawad K. Al-Diwan جواد كاظم --- Tariq S. Al-Hadithi طارق سلمان --- Abdul Hussein M. Al-Hadi عبد الحسين
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 4 Pages: 298-301
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:Objective: This study was carried out to find out the factors associated with neonatal infection among neonates to the special baby care unit (SBCU) at the Maternity and Paediatrics Hospital in Diyala governorate.Methods: All admitted neonates (533) to the SBCU for the period 20th Dec. 1999 to 20th June 2000 were included in the study. Demographic and medical data of the mothers, birth weight of neonates, delivery place and delivery attendant were obtained. Multiple logistic regressions were used to study the association between neonatal infection and the studied factors.Results: Out of the total neonates, there were 176 (33%) neonates with bacterial infection. Birth weight, gestational age, maternal age, maternal education, hypertension, UTI, delivery place and delivery attendants were significantly associated with neonatal infection. Antenatal care was not associated with neonatal infection.Conclusion: Several variables were found to be associated with in the SBCU. These findings were discussed in the view of the effects of gulf wars and economic sanctions on neonatal health.

الملخص:الغاية: تم اجراء هذه الدراسة لتحديد عوامل التي تؤثر على الخمج في وحدة العناية الخاصة بالاطفال في مستشفى النسائية والاطفال في ديالى.طرق العمل: شملت الدراسة حديثي الولادة الذين تم ادخالهم لوحدة العناية الخاصة من 20 / 12 / 1999 ولغاية 20 / 6 / 2000 (533 حديث ولادة) . تم الحصول على المعلومات الديموغرافية والطبية للامهات ووزن حديث الولادة ومكان الولادة ومن اشرف على الولادة. تم استخدام الانحدار المتعدد لتحديد العوامل التي ترتبط بالخمج في ردهة العناية المركزة.النتائج: كان هناك 176 (33%) حديث ولادة مصابا بالخمج البكتيري من العدد الكلي لحديثي الولادة. الوزن غند الولادة وفترة الحمل وعمر الام والمستوى التعليمي للام والاصابة بارتفاع ضغط الدم والتهاب المجاري البولية ومكان الولادة والمشرف غلى الولادة كانت ترتبط معنويا بالخمج. لم يكن لرعاية الحوامل تاثير في الخمج.الاستنتاج: كانت هنالك عدة متغيرات ترتبط في الخمج في وحدة العناية الخاصة. تم مناقشة النتائج في ضوء تاثير حروب الخليج والحصار الاقتصادي على صحة حديثي الولادة.


Article
Trends of Neonatal Mortality and Factors Related with Neonatal Mortality Among Neonates admitted to the Neonatal Care Unit of Fatima Al Zahraa Hospital in Baghdad During 2017

Author: Kholod Dhaher Habib, Malik Jamel Kanoon, Ahmed Salih Marzoog, Wafaa Toma Hurmiz
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 4 Pages: 348-354
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACK GROUND:The neonatal mortality rate is a key outcome indicator for newborn care and directly reflectsprenatal, natal, and postnatal care. Early neonatal deaths are more closely associated withpregnancy related factors and maternal health, whereas late neonatal deaths are associatedmore with factors in the newborn`s environment.OBJECTIVE:To find out the neonatal mortality rate and to identify the factors related with neonatalmortality among neonates admitted in the Aseptic Neonatal Care Unit of Fatema AL ZahraaHospital.METHODS:A cross - sectional hospital-based study was done depending on data collected from records ofthe Aseptic Neonatal Care Unit (ANCU) of Fatema AL Zahraa Hospital in Baghdad, to findout the number of deaths within the neonatal period (0-28 days) that was conducted from 1st ofJan 2017 to 31st of Dec 2017. Data was also, collected from Obstetrical Ward to determine thenumber of live births for the same period. The data was collected by using special formincluding; the number of deaths in neonatal period, cause of death, neonatal gender, gestationalage, birth weight, mother`s age, educational level, history of congenital anomaly in previouspregnancy , antenatal care, parity, consanguinity, type of delivery, pregnancy outcome, totalnumber of live births, and history of medical disease during pregnancy .RESULTS:The Neonatal Mortality Rate (NMR) was 14.37 per 1000 live birth. NMR was very highamong low-birth-weight preterm infants, (50%) of mothers completed the primary school,(71.89 %) of mothers had positive history for Consanguinity,15% of mothers had positivehistory of congenital anomaly in previous pregnancy,(70.41%) of mothers were in the (20-35years) age group. Normal vaginal delivery (NVD) in (63.01%) of cases. The most commoncause of neonatal deaths in the preterm delivery was respiratory distress syndrome (RDS), andin the full term delivery was asphyxia.CONCLUSION:The neonatal mortality rate was 14.37 per 1000 live birth. The maternal and neonataldemographic data that were related with increased NMR were prematurity, lack of antenatalcare, multipara mother, repeated CS, mother`s hypertension, and consanguineous marriage..


Article
A Study of Exclusive Breast Feeding in Premature and Low Birth Weight Infants Less than Six Months of Age in Hillah City Babylon Province

Authors: Sijal Fadhil Farhood Makki --- Ihab Raad Abbas Abid Ali
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2018 Volume: 26 Issue: 10 Pages: 58-70
Publisher: Babylon University جامعة بابل

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Abstract

A hospital based descriptive cross-sectional study was conducted to describe the prevalence of exclusive breast feeding in premature and low birth weight infants. The study included 200 infants in Hillah city Babylon Province, whose ages were less than six months. Catchments of these infants was in the neonatal /special care baby units and the general wards in both Hillah General Teaching Hospital and Babil Maternity Teaching Hospital in Babylon Governorate during the period from the first of January 2018 till the end of March 2018.The infants’ mothers came from mixed urban and rural backgrounds. Socio –demographic variables related to infants and their mothers’ obstetric data were recorded. Neonatal data was extracted from the medical records of the labor and neonatal care wards. The study included mothers of all ages, one in six of whom (16%) were teenagers marrying at a young age.52% of the older respondents reported being married during their teenage years. Since all the babies included in the study were either preterm or low birth weight, the mean birth weight was (1894.00±464.15) gm (LBW) and the mean gestational age was (34.42±2.84) weeks (preterm).The study outlined three main groups of reasons in order of frequency for quitting exclusive breast feeding, the first group involved the following reasons (milk was of poor quality, breast milk causes jaundice or diarrhea or a previous child didn't thrive on breast feeding) (53.7%), the second group covered reasons related to (advice from doctor/medical staff, or non-medically qualified person) (22%)and the third group was because of (LBW and prematurity per se)(14.6%).

اجريت دراسة وصفيه مقطعية في مدينة الحلة مركز محافظة بابل وشملت 200 رضيع لدراسة معدل انتشار الرضاعة الطبيعية المطلقة لدى الاطفال الخدج المبتسرين وناقصي الوزن .تراوحت اعمار الاطفال الرضع ما بين اليوم الاول من الولادة الى عمر الستة اشهر.اجريت الدراسة في وحدتي الخدج والعناية بالأطفال حديثي الولادة في مستشفى الحله التعليمي العام ومستشفى بابل التعليمي للنسائيه والاطفال مابين الفتره الممتده من الاول من شهر كانون الثاني 2018 الى نهايه شهر اذار2018.لقد كانت الامهات المشمولات بالدراسة يسكنن الريف والمدينه,وقد تم تدوين العوامل الديموغرافية والاجتماعية المتعلقه بالرضع وكذلك المؤشرات النسائيه لامهاتهم.وقد تم جمع المعلومات المتعلقه بالرضع من الملفات الطبيه في صالات الولاده ووحدات العنايه بالاطفال حديثي الولاده والردهات العامه.لقد شملت الدراسه امهات في مختلف الاعمار وتبين ان واحده من كل سته امهات (16%) كن مراهقات وكذلك تبين ان 52% منهن فوق عمر 20 سنه قد تزوجن في عمر المراهقه.وبما انه جميع الاطفال الرضع كانوا قد ولدوا كاطفال خدج اوناقصي الوزن تراوح معدل اوزانهم(1894 غرام) اي نقص وزن ولادي وان معدل مدة الحمل 34اسبوعا اي اطفال خدج.لقد اوضحت الدراسه ان هناك ثلاثه مجاميع رئيسيه حسب الاهميه للعزوف عن الرضاعه الطبيعيه المطلقه في هذه الفئه من الاطفال الرضع المجموعه الاولى الرئيسيه شملت جمله عوامل متعلقه بحليب الام نفسه(نوعيه الحليب الرديئه,ان حليب الام يسبب اليرقان والاسهال,او ان طفل سابق لم ينموا على الرضاعه الطبيعيه) (53.7%).والمجموعه الثانيه الرئيسيه تضمنت تشجيع للعزوف عن الرضاعه الطبيعيه من قبل الاطباء او الموظفين الصحيين اوحتى من اشخاص لاعلاقه لهم بالطب) (22%) والسبب الثالث الرئيسي هو بسبب (كونهم اطفال خدج اوناقصي الوزن) 14.6%.

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