فهرست مطالب

Iranian Journal of Neonatology
Volume:5 Issue: 2, Summer 2014

  • تاریخ انتشار: 1393/03/01
  • تعداد عناوین: 10
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  • Shahnaz Pourarian, Bahia Namavar Jahromi, Faranak Takmil Pages 1-6
    Introduction
    There is a great deal of controversy regarding the effect of gestational magnesium (Mg) deficiency on fetal growth and the incidence of low birth weight (LBW) in infants. Therefore, this study aimed to delineate the possible relationship between maternal Mg level and infant LBW.
    Methods
    This case-control study was conducted on 180 mothers in Shiraz, Iran. Fasting blood samples were obtained for magnesium after delivery. Maternal and neonatal demographic data were recorded, and the mothers were divided into two groups: the control group including mothers with normal-weight infants (≥2500 g), and the case group consisting of mothers with LBW infants (<2500 g).
    Results
    Out of 90 samples obtained in each group, there was neither a statistical association between the mean maternal magnesium level and neonatal sex (P=0.43) or gestational age (P=0.56), nor a correlation between serum magnesium level and maternal parity (P=0.52), education (P=0.75), or occupation (P=0.59) in the groups. In addition, no significant relationship was observed between maternal serum magnesium level and birth weight in each group (P=0.79).
    Conclusion
    Due to lack of a statistically significant relationship between magnesium level and birth weight, and considering the contribution of various factors for LBW, more studies are required to investigate the role of other nutrients in infant LBW.
    Keywords: Low birth weight, Maternal magnesium, Neonate
  • Amin Khaleghparast, Sharif Khaleghparast, Hossein Khaleghparast Pages 7-11
    Introduction
    A factor known to cause thrombophilia in women with recurrent pregnancy loss (RPL) is the A1298C polymorphism of methylenetetrahydrofolate reductase gene (MTHFR). This study aimed to determine the association between RPL and this polymorphism in Iranian patients.
    Methods
    In this case-control study, 30 patients with a previous history of two or more consecutive unexplained abortions and 10 women with at least two live births without a miscarriage, who referred to Baqiyatallah Hospital and Avicenna Infertility Clinic, were analyzed for MTHFR A1298C polymorphism using PCR-RFLP method. The results obtained via estimating the genotype of each polymorphism were analyzed using SPSS v16.
    Results
    Thirteen subjects (43.3 %) with RPL and 6 women (20 %) in the control group were heterozygous for MTHFR A1298C polymorphism. C allele frequency in the patient group was higher than the control group (41.7% and 40% for the patient and control groups, respectively).
    Conclusion
    The prevalence of MTHFR A1298C polymorphism was slightly higher in RPL patients compared to the controls. This finding failed to support the relationship between this polymorphism and the increasing risk of RPL in the evaluated Iranian women.
    Keywords: Methylenetetrahydrofolate reductase (NADPH2), Polymorphism (genetic), Spontaneous abortion, Thrombophilia
  • Mitra Basiratnia*, Narjes Pishva, Azimeh Dehghani Pages 12-16
    Introduction
    This study aimed to assess the incidence of breastfeeding-associated hypernatremia and related risk factors among hospitalized hyperbilirubinemic neonates.
    Methods
    This prospective study was conducted at Nemazee Hospital affiliated to Shiraz University of Medical Sciences during one year to determine the association between hypernatremia (serum sodium concentration of >150 mEq/L) and exclusive breastfeeding of the neonates. During the study period، 122 neonates were recruited and the patients’ history was taken through using the medical records (regarding child delivery) and asking the mother. Laboratory data including total and direct bilirubin levels، serum sodium level and blood urea nitrogen (BUN) were recorded. P-value<0. 05 was considered statistically significant.
    Results
    The study was carried out on 86 exclusively breastfed neonates (EBFN) and 36 neonates with mixed type of feeding. The incidence of hypernatremia among the EBFN and non-exclusively breastfed neonates (non-EBFN) was 9. 3% and 2. 7%، respectively. Moreover، 55% of the neonates with hypernatremia had a significant weight loss (>10% cummulative weight loss). A significant correlation was observed between hypernatremia and weight loss (P=0. 008). Also، in spring and autumn، no hypernatremia was observed among 53 cases، and during summer and winter، 9 out of 69 neonates (13%) presented with hypernatremia (P=0. 042).
    Conclusion
    Hypernatremic dehydration is relatively common among EBFN. Regular weight monitoring، proper breastfeeding and environmental temperature control should be encouraged for preventing breastfeeding-associated hypernatremia.
    Keywords: Dehydration, Exclusively breast, fed, Hyperbilirubinemia, Hypernatremia, Neonate
  • Ahmad Shah Farhat*, Mohammad Mahdi Ghasemi, Javad Akhondian, Ashraf Mohamadzadeh, Habibollah Esmaeili, Rana Amiri, Mohammad Reza Tale, Faezeh Madani Sani Pages 17-20
    Introduction
    The prevalence of hearing loss in neonates is 2-5 out of every 1,000 live births. Global Health Committee, American Academy of Otolaryngology, and American Academy of Pediatrics have recommended that hearing loss in infants be identified, and treated when possible, prior to 6 months of age. This study was designed with the aim to screen the hearing of neonates in Mashhad, Iran.
    Methods
    All neonates born in Imam Reza, Om-Albanin and Ghaem Hospitals from November 2008 to November 2010 were screened by Otoacoustic Emission (OAE) test at the time of discharge, followed by a secondary OAE test in case of the failure of the first test; also, a confirmatory Auditory Steady State Response (ASSR) test was performed in 3 weeks to evaluate the type of hearing loss. After data analysis, the frequency of hearing loss in neonates and different risk factors were assessed.
    Results
    In the present study, 8,987 neonates were analyzed. Thirty one neonates (3.5 per 1000) failed the ASSR test; among these neonates, 6.5%, 25.8%, 25.8% and 19.2% had slight, mild, moderate, and moderate to severe hearing loss, respectively. Also, 16.1% had profound deafness and 6.5% presented with sensorineural involvement. Positive family history of hearing impairments, craniofacial anomalies, hyperbilirubinemia and different hearing syndromes were significantly different between the case and control groups (P<0.05).
    Conclusion
    In this study, 3.5 neonates out of 1,000 live births had different types of hearing impairments; therefore, it is recommended that screening be performed before discharge.
    Keywords: Auditory Steady State Response, Hearing Impairment, Neonates, Otoacoustic Emission, Prevalence
  • Maryam Hassanzadeh Bashtian*, Mohammad Reza Armat, Ali Khakshour Pages 21-24
    Introduction
    According to Millennium Development Goal (MDG) number 4, child mortality should be reduced by two thirds by 2015. The focus has been on decreasing neonatal deaths in high-mortality countries. In this study, we assessed the recorded causes of neonatal hospitalization in the neonatal intensive care unit (NICU) and infant care wards.
    Methods
    The present cross-sectional study was carried out in two hospitals (Bentolhoda hospital and Emam Reza hospital) of North Khorasan University of Medical Sciences, Bojnord in 2011-2012. We assessed different variables such as maternal age at infant’s birth, gestational age, first and fifth minute Apgar scores, and hospitalization etiology. Chi-square and Kruskal-Wallis tests were used for the statistical analysis.
    Results
    In this study, the most common cause of neonatal admission was icterus. Most of the infants'' birth weight was higher than 2,500 gr.There was a relationship between Apgar score in the first and fifth minutes and causes of hospitalization (P<0.001). Infants'' gender and maternal mode of delivery had no significant relationship with the cause hospitalization (P<0.06). However, birth weight and gestational age were significantly related to the causes of admission in hospitals (P<0.0001).
    Conclusion
    Identifying the factors which influence the hospitalization of infants can help control these risk factors.It can also lead to the decrease of neonatal mortality, which is a reflection of nations’ socio-economic status.
    Keywords: Disease, Etiology, Infant, Maternal, Neonatal hospitalization
  • Minoo Fallahi*, Gelavizh Keshtmand, Mahta Fatemeh Bassir Pages 25-28
    Introduction
    The risk of morbidity and mortality increases in neonates admitted to the neonatal intensive care units (NICUs). Various factors contribute to the prognosis of these newborns. In the current study, we aimed to investigate the role of mode of delivery on short-term neonatal outcomes.
    Methods
    This retrospective study was conducted on 215 neonates admitted to the NICU of Shohada-e-Tajrish Hospital in 2007 and 2008. The respiratory distress syndrome (RDS), mortality, birth weight, gestational age, and Apgar score were compared between two groups born via natural vaginal delivery (NVD) and c-section (CS), respectively.
    Results
    In the current study, of 126 CS cases, 46.8% had a gestational age of more than 37 weeks, 52.4% were low birth weight (LBW) infants, 29.3% had severe RDS, 17.7% had an Apgar score less than 7, and 9.7% of the infants passed away. Of 89 NVD cases, 44.9% had a gestational age of more than 37 weeks, 48.3% were LBW infants, 18.4% had an Apgar score less than 7, 27.9% had severe RDS, and 10.1% of the infants passed away. The mean length of hospital stay was 8.39 and 7.84 days in CS and NVD groups, respectively. In CS and NVD groups, 27.8% and 22.5% had markers of infection. These factors had no significant association with the mode of delivery.
    Conclusion
    Mode of delivery has no impact on the Apgar score, mortality, length of hospital stay, RDS, and infection markers in neonates admitted to the NICU.
    Keywords: CS, Mode of delivery, Neonates, NVD, RDS
  • Reza Saeedi, Gholamali Mamori, Simin Maghrebi*, Maryam Ziadi Lotfabadi Pages 29-32
    Introduction
    Infections are one of the main causes of death during childhood. Epidemiologic studies in Iran showed that the incidence of neonatal sepsis was 1.8% in 1995. Moreover, the incidence of neonatal meningitis is 0.2 to 0.4 in per 1,000 live births. The aim of this study was to determine the necessity of lumbar puncture (LP) in early neonatal sepsis.
    Methods
    In a retrospective study, after obtaining ethical approval, we evaluated the records of 1,100 neonates, younger than 7 days, who were admitted to the hospital between 2001 and 2007. They were suspected of sepsis and thus, LP was performed. Statistical analyses were performed by SPSS version 16. Nominal variables were compared using Chi-square or Fisher’s exact test. Other parametric and non-parametric tests were used as required.
    Results
    In our study, 1,100 neonates, suspected of sepsis, were evaluated. Of all neonates, 28.3% and 71.7% were older and younger than 3 days, respectively. Male-to-female ratio was 1:5 in 115 neonates. Sepsis was confirmed by positive blood culture, and 21 neonates (2.1%) had positive cerebrospinal fluid (CSF), which was significantly associated with blood culture results.
    Conclusion
    There was a significant relationship between blood culture and CSF culture results. However, regarding the low incidence of positive CSF, LP should be performed for each case, based on clinical manifestations and clinical opinion.
    Keywords: Lumbar puncture, Neonatal sepsis, Neonate
  • Kuti Bankole Peter, Ogundele Tolulope, Adeniyi Adewuyi Temidayo, Kuti Demilade Kehinde Pages 33-36
    Bilirubin induced brain damage is still a common cause of morbidity and mortality in Nigerian infants. No much success has been recorded in decades despite the fact that brain damage from bilirubin toxicity in the newborn is easily preventable with affordable and effective means. We report a case of a newborn with acute bilirubin encephalopathy. This case was considered of interest because the mother of the baby herself had kernicterus as a newborn now manifesting with features of choreoathetoid cerebral palsy. The baby was brought to our facility late just as how the mother was presented late to a health facility 30 years ago. The unfortunate occurence of brain damage from bilirubin toxicity in two successive generations calls for urgent attention. We advocate more aggressive and all-embracing preventive measures including routine home visit of newborns, awareness creation and health education and involvement of all stakeholders to nip this problem in the bud.
    Keywords: Kernicterus, Neonatal jaundice, Preventive measures
  • Reza Sharafi, Setila Dalili*, Afagh Hassanzadeh Rad Pages 37-39
    Neonatal ovarian cysts (NOC) are usually self-limiting structures, however, large or complex cysts may lead to severe complications. Unfortunately, no standard guidelines have been introduced for the management, treatment and follow-up of these cysts. In this report, we aimed to introduce a very large NOC without any pre- and post-natal complications. A 30 year-old mother, gravida 2, para 2, with an unremarkable prenatal course until the 36th week of gestation, delivered an infant. The routine fetal ultrasound revealed a 140x 60 mm echogenic cyst, with debris in the lower fetal abdomen (it may be due to hemorrhage). A healthy female infant, weighing 3,200 gr was born through vaginal delivery at 38 weeks’ gestation. On the first day after birth, the laboratory results showed normal serum concentrations of hormones. Repeated sonography after birth showed a neonatal ovarian cyst which had remained unchanged in size; therefore, clinicians performed an early surgery.
    Keywords: Infant, Ovarian cyst, Prenatal diagnosis, Ultrasound
  • Mehrdad Mirzarahimi, Maryam Hosseini Khotbesara, Mahsa Hosseini Khotbesara, Amin Bagheri Pages 40-42
    Congenital chylothorax is an uncommon cause of respiratory distress and a life-threatening condition in newborns. It is identified by abnormal accumulation of chyle in the pleural space. Herein, we report a male infant who was born by a successful vaginal delivery. After the first three days of life, he had feeding difficulties and cyanotic episodes during breastfeeding. On admission, physical examination showed decreased breath sounds on the right side of the chest and the plain chest X-ray indicated right-sided pleural effusion. This patient was diagnosed with congenital chylothorax, based on the evaluation of pleural fluid via diagnostic and therapeutic thoracentesis and postnatal diagnostic X-rays. Since the effusion was persistent after drainage of pleural space, total parenteral nutrition (TPN) and surgical pleurodesis (on the right side of lung) were performed on the patient. Due to the fact that congenital chylothorax is a life-threatening condition, reporting these cases could be a great assistance to physicians for managing the disease; it can also help with reducing the resultant morbidity and mortality.
    Keywords: Congenital chylothorax, Enteral nutrition, Newborn, Pleurodesis