Iranian Journal of Neonatology
Volume:4 Issue: 1, Spring 2013

Deafness is one of the most important sensory disturbances at birth. Hearing loss can affect the development of speaking and learning during life. Early diagnosis and intervention improve language outcome. The current study aimed to determine the frequency of profound congenital hearing loss in healthy newborn infants in Fars province. In a multicenter prospective study, from August 2010 to August 2011, 12573 newborns were screened for hearing loss prior to discharge from the wellborn nursery at nine teaching and private hospitals in Fars province. A three-stage hearing screening protocol using transient evoked otoacoustic emissions (TEOAE) screening with referral for diagnostic second TEOAE and auditory brainstem evoked response (ABER) assessment was employed. All neonates with abnormal initial TEOAE screening, followed with phone call for language outcome after one year. Newborns with hospital admission or drug administration excluded from the study. The overall pass rate in the initial screening was 91.8%, thus 1019(8.1/1000) neonates referred for diagnostic audiological assessments. Out of 1019 infants scheduled for follow-up study, only 619 neonates returned. Using follow-up letters and phone calls, it was managed to improve the response rate for language outcome after one year. Two infants were identified with profound bilateral congenital hearing impairment. These infants were immediately referred for cochlear implantation. Findings of the current study showed that the frequency of profound congenital hearing loss is 0.159/1000 normal newborn infants in Fars province. The initial TEOAE has high false positive that may be due to occlusion of external ear canal by vernix in the early postnatal period.

Group B streptococcus is the main reason of neonatal infection in developed countries and causes a widespread clinical indications. In developing countries such as Iran, its rate of appearance is not determined. With regard to colonization and the relative high epithelia of group B streptococcus, it is likely that the incidence of group B streptococcus in neonatal sepsis is so high.In the present study, we attempted to use the molecular methods to identify this bacterium and develop the culture environments as well. In the present study, a hundred below three months year old infants with sepsis hospitalized in ICU sector of Ghaem hospital for one year were studied since Khordad 1388 (June 2010). After getting consent from the infants’ parents, three blood samples of these patients in the sterile container with lid were transferred to the laboratory (two samples for culturing in normal environment and the other for PRC). All of the information was filled out by doctors in the incidence. SPSS 11.5 and descriptive-analytic tests were used for data analysis. 100 infants less than three month, with clinical signs of sepsis were enrolled. Group B Streptococcus did not grow in none of the cultures three infants had positive PCR for Group B Streptococcus, 5 cases had positive normal and developed culture and 6 cases had negative normal and developed culture. 64 percent of pregnant women have taken antibiotic before delivery. With regard to the high rate of anti-biotic consumption by mothers before delivery, it is necessary to use more sensitive methods like PCR to identify th e Group B Streptococcus.

Low birth weight (LBW) is the most common cause of neonatal death in developing countries. The objective of our study was to determine the prevalence and risk factors associated with low birth weight in Ardabil, Iranfrom 2010 to 2011. In a case–control study all live newborns were weighted without clothing using a standard calibrated scale. Gestational age was calculated using either the first day of the last normal menstrual period or estimated by obstetric sonography. 358 neonates with birth weight of less than 2500 g were considered as case and 705 normal weight neonates as control groups. Data were collected through a self-designed questionnaire from review of prenatal and hospital delivery records. Kruskal –wallis, chi-square, and logistic regression were applied to analyze data using SPSS version 16. Incidence of LBW was 6.3% and among these, 84.2% were preterm and 15.8% had intrauterine growth retardation. Hypertension (OR:8.64, CI: 2.63-28.31), multiple pregnancy (OR: 7.62, CI:3.09-13.32), leakage (OR:4.46, CI: 2.11-9.42), Oligohydramnios(OR:4.28, CI:1.90-9.76),history of preterm birth (OR:2.84, CI: 1.20-6.71), bleeding or spotting during pregnancy (OR:2.36,CI:1.41-3.95) were determined as important risk factors for preterm LBW. Risk of low birth weight in term infants increased by multiple pregnancy (OR:3.77, CI: 1.41-10.0), bleeding and spotting(OR:2.23, CI:1.22- 4.07),and urinary tract infection in weeks 26-30 of pregnancy (OR:2.42, CI: 1.11-5.26). Delivering quality health care for all pregnant women and early diagnosis and control of hypertension, urinary tract infection, and bleeding or spotting and leakage during pregnancy may significantly reduce the rate of low birth weight and improve public health in this area.

E-learning is there to enhance knowledge of patients and can provide an efficient way to enhance personnel-patient interaction and provide patient-specific education. So the aim of this study was to Compare the effect of two educational methods, e-learning (multimedia) and painted booklet on Primipar Women’s Knowledge about neonatal care. This was a quasi-experimental study based on pre- and post- tests that were carried out on 100 primipar women in Isfahan during the years 2012-2013. Participants were divided into two groups of e-learning or painted booklet learning, randomly. Participants’ knowledge scores were collected via a researcher-made questionnaire. SPSS version 11.5 was used to conduct statistical tests such as independent t-test and paired t-test for analyzing the data. The significance level was considered less than 0.05. Before training, the mean score of knowledge of the e-learning education group was 5.4±1.2 and 5.5±1.2 for the painted booklet group; the difference between mean scores was not significant. At the end of the study, this score was 9.54±1.1 for the e-learning group and 6.5±1.2 for the painted booklet group and the difference was statistically significant (P< 0.01). Also increase in the rate of knowledge in the e-learning group and the painted booklet group was 56% and 30%, respectively. This study showed that passing the e-learning training course could better improve knowledge of mothers about neonatal care than the painted booklet. So, different aspects of e-learning, including computer literacy, infrastructure of telecommunications should be revisited.

99% of 4million neonatal mortality occur in developing countries every year. Mortality rate of ewborns accounts for 18.3 per 1000 live birth that comprised 69% of IMR and 56% of Under 5 ortality in IRAN. A Comparison of statistical trend between infant and newborn rate from 1988 to 001 revealed a considerable decrease in IMR but slightly decrease in NMR. training postnatal mothers nd Preventing neonatal mortality rate is effective. This study has been carried out for assessing the nowledge regarding to neonatal care among postnatal mothers. In this cross-sectional study, from target population of mothers of referral neonates into Ravar/Kerman edical health center. A sample was chosen with convenient sampling method. Then a questionnaire consisting of questions regarding to assessing generalized surveillance during neonatal and Icter eriod and Umbilical cord surveillance were collected. Data were analyzed using SPSS 19. T test and NOVA were used for analyzing the relationship. 316 mothers with mean age of 25.87 were studied. 8.2% of mothers had poor knowledge, 78.5% oderate and 13.3% had good knowledge. Also urbanmothers less than 24 year of age with 2 or 3 children and higher level of education obtained significantly higher knowledge score.The results showed that Knowledge levels of 78.5% of mothers were moderate. So it is imperative to provide comprehensive training in the field of newborn and infant care for mothers.

The increase in the use of breast feeding and the decrease in mother's hospitalization in the past few years have caused an increase in the infant bilirubin level, so it is necessary to introduce methods which can identify infants with higher risks of hyperbiliru binemia. The aim of this study is to determine the predictive value of measuring the umbilical cord bilirubin for pathologic hyperbilirubinemia, that is the bilirubin more than 15mg /dl. This prospective study was performed from November 2009 to December 2010 on the umbilical cord serum of 274 newborns who were born in Iran-Mashhad Razavi Hospital. The neonates’ Apgar scores were above 7, weights more than 2.5 kg and gestational ages above 37 weeks. Once again their bilirubin level was measured via skin during the third to fifth day. Using the Smirnov test,, one-sample Kolmogorov test, t-test, and Man Whitney test, we analyzed the data. P< 0.05 was considered significant. Out of 274 newborns, 178 cases were followed up. Ninety-three infants of the monitored cases had hyperbilirubinemia (total bilirubin ≥ 15 mg/dl or group A, 85 of the infants did not have pathologic hyperbilirubinmia (total bilirubin < 15 mg/dl or group B). The average umbilical cord bilirubin for group A was 2.32 ± 0.78 mg/dl, and for group B was 1.98 ± 0.72 mg/dl; so statistically, there is a significant difference. At the cut-off point of 2 mg/dl for umbilical cord bilirubin, sensitivity was obtained to be 68.86% and the specificity was obtained to be 61.18%. If the amount of bilirubin in the umbilical cord is more than 2 mg/dl, it can be considered as a contributing factor among other risk factors in the prediction of the infant’s pathologic hyperbilirubinemia.

This case is a bout a neonate with respiratory distress and primary diagnosis of Pneumothorax who had Congenital Lobar Emphysema. This case was the basis to review the topic of Congenital Lobar Emphysema (CLE) and the corresponding literature, considering that this is an uncommon disease and although congenital lobar emphysema is rare, clinical awareness of this condition is important for early diagnosis and effective surgical treatment. Due to the severity of respiratory symptoms, congenital lobar emphysema often requires surgical treatment in the early stages of life.

Nephrolithiasis and nephrocalcinosis are common in both term and premature infants who have had difficult neonatal courses. Multiple factors may contribute and being born from a diabetic mother Is one of them. This case is about a neonate with nephrocalcinosis. she is followed to 9months and remained healthy during a 9 month follow up.