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Thrombocytopenia is, after anemia, the most frequent hematological problem among sick neonates. In this population, thrombocytopenia has traditionally been defined as a platelet count 9 /L, and has been classified as mild (100–150 × 10 9 /L), moderate (50–99 × 10 9 /L), and severe ( 9 /L). However, large population-based studies have shown that platelet counts increase with advancing gestational age, and platelet counts between 100 and 150 × 10 9 /L are more frequent among otherwise healthy extremely preterm infants than among full term neonates or older children. This suggests that different definitions of thrombocytopenia and thrombocytosis should be applied to preterm infants. The diagnostic approach to a thrombocytopenic neonate is facilitated if the thrombocytopenia is categorized as “early onset” (within the first 72 hours of life, usually secondary to congenital or intrauterine abnormalities) or “late onset” (after 72 hours, usually due to acquired conditions). Importantly, infection/sepsis should always be considered near the top of the differential diagnosis, as any delay in diagnosis and treatment can have life-threatening consequences. While in vitro studies have clearly shown that neonatal platelets are hyporesponsive to most agonists, this platelet hyporeactivity is well compensated by factors in neonatal blood that increase clotting (i.e. high hematocrit, high VWF concentrations), resulting in adequate primary hemostasis. The risk of bleeding in thrombocytopenic neonates is poorly predicted by the platelet count; gestational age

A 3-month-old, full term female infant, adequate for gestational age, and exclusively breastfed, was admitted with a 10 day history of generalised scaling erythematous dermatitis, affecting the face (perinasal, nasolabial folds and periauricular), acral and intertriginous areas, with irritability and failure to thrive. Her mother had been treated with isoniazid since the third trimester because of family contact with tuberculosis. Based on a diagnosis of suspected impetiginised eczema, the infant was treated with flucloxacillin and prednisolone, and maternal isoniazid was suspended, with no improvement. Investigations found low serum zinc levels in the infant (33 μg/dL; normal range (NR) >60 μg/dL), normal plasma zinc levels in the mother (111.3 μg/dL; NR 68–120 μg/dL) and lower than the normal range of zinc levels in breast milk (270μg/L; NR 1000–2500 μg/L), suggesting acrodermatitis caused by zinc deficiency. Oral zinc supplementation (3 mg/kg/day) was started with a marked improvement in skin lesions, as well as good weight gain. At the age of 6 months, after food diversification, supplementation was suspended, without any recurrence of symptoms.

The average weights of submandibular glands of group I, II & III were 23.5mg, 54.6mg & 109.7mg respectively. The increase in ductal proliferation, lobulation and connective tissue septa formation caused an increase in the size and weight of the gland from 12 weeks to full term was observed. In the present study, in group I the gland was just behind the mylohyoid, group II the mylohyoid muscle just entering the interlobular fissure and in group III the muscle occupies half of the interlobular fissure. . About 15 to 18 tubules were found in the form of small round cluster of cells. Until the 10th week, no lobulation, no organised duct pattern and no canalised acini were seen. Canalisation of tubules starts at 12th week and reached maximum in 16th week (group I). Connective tissue was more prominent. Increase in canalised tubules from 75% to 90% in this group, also proved the fact that the ductal proliferation was more.

Background We aimed to evaluate the gastric volume and contents after an 8-h fasting period in full-term, non-laboring, pregnant women following a standardized meal. Methods In this prospective observational study, we included full-term pregnant women scheduled for elective cesarean delivery. The participants were instructed to fast after a standardized meal (apple juice, bread, and cheese). Participants were scanned in the semi-recumbent and right-lateral positions 8 h after the standardized meal. The primary outcome was the proportion of patients with gastric volume > 1.5 mL kg-1 calculated by two equations. Secondary outcomes included the antral cross-sectional area and gastric volume. Data are expressed as frequency (%, 95% confidence interval [CI]), mean ± standard deviation (95% CI of the mean), or median (quartiles) as appropriate. Results Forty-one women were available for the final analysis. For the primary outcome, one participant (2.4%, 95% CI of 0.06 to 12.8%) had gastric volume > 1.5 mL kg-1, and none had solids in the antrum. For the secondary outcomes, the mean (95% CI of the mean) of the antral cross-sectional area was 2.11 ± 0.72 (1.88 to 2.34) cm2 and 4.08 ± 1.80 (3.51 to 4.65) cm2 during the semi-recumbent and right-lateral position, respectively. The median (quartiles) gastric volume was 0.53 (0.32, 0.66) mL kg-1 and 0.33 (0.13, 0.52) mL kg-1 as estimated by Perlas et al. and Roukhomovsky et al. equations, respectively. Conclusion After 8-h fasting following a standardized meal, full-term pregnant non-laboring women are less likely to have a high residual gastric volume.

This study comprehensively examines clinical symptoms, laboratory findings, and placental pathology in 40 cases of singleton full-term SARS-CoV-2 negative neonates. Their mothers, previously healthy, with uncomplicated pregnancies, were infected peripartum and presented COVID-19 symptoms of various severity. Neonates had predominately diarrhea, the yet unreported absent sucking reflex, elevated COVID-19 inflammatory and ischemia/asphyxia markers as serum ferritin, interleukin-6 and cardiac troponin-T, while placentas demonstrated mild vascular and/or inflammatory lesions. We hypothesize that the above placental lesions may be associated with transient perinatal hypoxia resulting in absent sucking reflex, as well as with inflammatory cytokines transfer causing diarrhea.

BACKGROUND Maternal pre-pregnancy body mass index (BMI) is strongly associated with infant birthweight and the risk differs in pregnancies complicated by gestational diabetes (GDM). OBJECTIVES To examine the risk of large for gestational age (LGA) (≥97th percentile) singleton births at early term, full term and late term in relation to maternal pre-pregnancy BMI status mediated through GDM. METHODS We analysed data from the 2018 U.S. National Vital Statistics Natality File restricted to singleton term births (N = 3,229,783). In counterfactual models for causal inference, we estimated the total effect (TE), natural direct effect (NDE) and natural indirect effect (NIE) for the association of pre-pregnancy BMI with subcategories of LGA births at early, full and late term mediated through GDM, using log-binomial regression and adjusting for race/ethnicity, age, education, parity and infant sex. Proportion mediated was calculated on the risk difference scale and potential unmeasured confounders were assessed using the E-value. RESULTS Overall, 6.4% of women had GDM, and there were 3.6% LGA singleton term births. The highest prevalence of GDM was among pre-gestational overweight/obesity that also had the highest rates of LGA births at term. The TE estimates for the risk of LGA births were the strongest across women with higher pre-pregnancy BMI compared to women with normal pre-pregnancy BMI. The NDE estimates were higher than the NIE estimates for overweight/obese BMI status. The proportion mediated, which answers the causal question to what extent the total effect of the association between pre-pregnancy BMI and LGA births is accounted for through GDM, was the highest (up to 16%) for early term births. CONCLUSIONS Term singleton births make up the largest proportion in a cohort of newborns. While the percentage mediated through GDM was relatively small, health risks arising from pre-pregnancy overweight, and obesity can be substantial to both mothers and their offspring.

Background: In full term newborns, the Ductus arteriosus closes functionally within of birth, and it normally closes structurally between 2 to 8 weeks. Complete conclusion of the ductus in untimely babies may not happen until a half year old enough, and in exceptional cases may not happen until adulthood. Is medical term that afterwards birth, the ductus arteriosus fails to close, allowing oxygenated blood to travel back to the lungs from the left heart Changed Word Structural Changes Thesaurus via the pulmonary artery, which has a higher pressure. Increased laboured breathing and failure to gain weight at a normal rate are frequent later in the first year of life. A patent ductus arteriosus (PDA) can lead to pulmonary hypertension and right-sided heart failure if left untreated. Case Report Information: A 2 years 6 months old child brought by the parents in Aacharya Vinoba Bhave Rural Hospital on 22/12/2020. An patients parent’s verbalization, the child was apparently alright at 8 months of age. When he started having fever, cold and cough and decreased feed intake. Then they took the child to local doctor where 2D ECHO was done. Suggestive of patent ductus arteriosus. Patient is referred to Aacharya Vinoba Bhave hospital for further management. Conclusion: The patient was admitted in AVBRH with complaints of fever, cold and cough, decreased feed intake. Then the report mainly focused on surgical management and quality nursing care due to which patient was discharged without any further complication and satisfaction.

The eff ectiveness of applying osteopathic methods to patients with amniorrhea in case of full-term pregnancy was evaluated. 40 pregnant women with singleton full-term pregnancy without severe somatic and obstetric pathologies, with preterm amniorrheaunder the absence of regular labor activity were included into the study. The main group (n = 20) included women who underwent treatmentwith osteopathic methods. In the control group (n = 20) the labor was managed in accordance with the labor management protocol in case of amniorrhea. The osteopathic examination, which was performed in the course of the study, showed that all patients had biomechanical disorders at the pelvis level. The women in labor, who underwent osteopathic correction, started to deliver on their own in a greater percentage of cases as compared with the control group; there was a signifi cant decrease of frequency of labor anomalies and the total number of complications in labor and, as a consequence, a signifi cant decrease of obstetric aids and frequency of the emergency deliveryby cesarian section. A decrease in the frequency of episiotomy was noted. A decrease in the duration of the rupture-to-delivery interval was also noted.

BackgroundThe composition of the infant gastrointestinal (GI) microbiome has been linked to adverse long-term health outcomes and neonatal sepsis. Several factors are known to impact the composition of the microbiome, including mode of delivery, gestational age, feeding method and exposure to antibiotics. The impact of intrapartum antibiotics (IPAs) on the infant microbiome requires further research.ObjectiveWe aimed to evaluate the impact of IPAs on the infant GI microbiome.MethodsWe searched Ovid MEDLINE and Embase Classic+Embase for articles in English reporting on the microbiome of infants exposed to IPAs from the date of inception to 3 January 2021. Primary outcomes included abundance and colonisation ofBifidobacteriumandLactobacillus, as well as alpha and beta diversity.Results30 papers were included in this review. In the first year of life, following exposure to IPAs, 30% (6/20) of infant cohorts displayed significantly reducedBifidobacterium, 89% (17/19) did not display any significant differences inLactobacilluscolonisation, 21% (7/34) displayed significantly reduced alpha diversity and 35% (12/34) displayed alterations in beta diversity. Results were further stratified by delivery, gestational age (preterm or full term) and feeding method.ConclusionsIPAs impact the composition of the infant GI microbiome, resulting in possible reductionsBifidobacteriumand alpha diversity, and possible alterations in beta diversity. Our findings may have implications for maternal and neonatal health, including interventions to prevent reductions in health-promoting bacteria (eg, probiotics) and IPA class selection.

BACKGROUND Children born preterm may be less physically active than children born term because of neurocognitive problems, reduced lung function, and poor physical fitness. We evaluated sports participation of children and adolescents who had been born preterm (

Pregnancy complicated with juvenile granulosa cell tumor (JGCT) is very rare; thus, the experience on clinical diagnosis and management is limited. Two patients presented with abdominal pain, two were incidentally discovered, one by ultrasonography, and one during a caesarian section. One case received an emergency caesarian section because of tumor rupture at 38th week’s gestation, the rest were treated at full term and no abnormalities were detected in the newborns. Three cases received further staging surgery, two of which received postoperative adjuvant chemotherapy. No patient had recurrent disease after a follow-up period spanning from 13 to 57 months. In the absence of emergency, surgery can be delayed without affecting the fetus. More research is needed to determine the value of chemotherapy in FIGO stage I patients.

A nulliparous non-descript mare presented at full term with a history of straining (utero-abdominal contractions) for the last 24 hours. Vaginal examination revealed a dead foal in posterior presentation with bilateral hip flexion and dorso-iliac left position. Pre-operatively, 5 mL Tetanus toxoid as intramuscular injection, 3g Ceftriaxone and 4 mL Dexamethasone in 3L 5% Dextrose normal saline (DNS) as intravenous infusion (i/v) was administered. The per-vaginal delivery of the foal could not be attempted due to breech presentation, therefore, caesarean section was planned. Local anaesthetic infiltration along with sedation was done for carrying out the caesarean by employing an oblique ventro-lateral approach in lateral recumbency. Intravenous fluids, anti-inflammatory drugs and daily antiseptic dressing were included in post-operative management and led to uneventful recovery of mare. The authors would like to perorate the case as a rare breech presentation induced dystocia in equine and emergency caesarean by employing an oblique ventro-lateral approach under local anaesthesia and sedation.

Because of chronic anemia, hypogonadotropic hypogonadism, and iron chelation, pregnancy in homozygous and heterozygous compound beta-thalassemia patients stays a challenge. Pregnancies of transfused beta-thalassemia women registered in the French National Registry, conducted between 1995 and 2015, are described. These pregnancies were compared with pregnancies in healthy women and to data previously published in the literature. Fifty-six pregnancies of 37 women were studied. There were 5 twin pregnancies. Assisted reproductive technologies (ART) were used in 9 pregnancies. Median term at delivery was 39 amenorrhea weeks, and median weight at birth was 2780 g. Cesarean section was performed in 53.6% of the pregnancies. There were 6 thromboembolic events, 6 serious infections, 6 pregnancy-induced hypertensions (PIH), 6 intrauterine growth retardations (IUGR), 5 severe hemorrhages, 4 gestational diabetes, 3 alloimmunizations, 2 heart diseases, and 1 pre-eclampsia. There were 5 infections and 4 osteoporosis in the first year of post-partum. ART and cesarean sections were more often used in the beta-thalassemia group, compared to control subjects. Thromboembolic events, PIH, hemorrhage at delivery, and IUGR were more frequent in the beta-thalassemia group. Time to delivery was not different, but infant weight at birth was significantly smaller in the beta-thalassemia group. In the post-partum period, global maternal complications were more frequent in the beta-thalassemia group. Pregnancy in transfused beta-thalassemia women is safe with rare obstetrical and fetal complications. Cesarean section remains often chosen, and infant weight at birth remains smaller than that in the general population, despite delivery at full term.

There are conflicting data on how delivery location impacts outcomes in neonates with ductal-dependent heart disease. Our goal was to evaluate the impact of delivery location on hospital length of stay and survival in infants with prenatally diagnosed hypoplastic left heart syndrome (HLHS) after stage 1 palliation (S1P). A multicenter cohort study was performed utilizing the National Pediatric Cardiology Quality Improvement Collaborative dataset for infants with prenatally diagnosed HLHS who underwent S1P from August 2016 to December 2018. Univariate comparisons of demographics, clinical, and outcome data were made and multivariable logistic regression was performed between groups stratified by distance from surgical center. A total of 790 patients from 33 centers were analyzed: 85% were born

Studies on preterm infants usually exclude high-risk neonatal infants with neurological problems. However, it is important to study high-risk preterm infants to better understand later developmental problems. Therefore, this cross-sectional study aimed to compare the cognitive, motor, language, and social-emotional development of high-risk preterm (PT) infants with infants born full-term (FT) with no biological vulnerabilities during early development (up to the first 15 months of age). The sample comprised 133 infants (54 born PT and 79 born FT) assessed in independent subsamples at 6-8 and 12-15 months of age, considering the corrected age for prematurity in the PT infants. Infant development (cognitive, motor, language, and social-emotional) was evaluated using the Bayley-III Scales. Medical charts were reviewed to obtain the clinical history. A multivariate analysis of variance and analysis of variance tests were performed to examine the differences between groups related to infant developmental indicators, controlling for age and socioeconomic variables. Although the PT infants performed significantly more poorly than their FT counterparts, the scores of the PT group were still within the normal range on all Bayley-III domains (cognitive, language, motor, and social-emotional) than their FT counterparts. The findings of the present study provide a better understanding of the developmental prognosis of high-risk PT infants and extend support for preventive intervention programs to improve early childhood development.

Background: Vitamin D is a hormone that affects a wide range of functions within the body. Neonatal hypoxic ischemic encephalopathy (HIE) is a serious disease that may lead to permanent brain injury. Objective: The present study aimed to study vitamin D status in hypoxic ischemic in encephalopathy. Patients and methods: A case control study carried out in newborn intensive care unit (NICU) of Zagazig University Children Hospitals. Total number of cases that met the inclusion and exclusion criteria was 49 full term neonates with HIE divided according to Sarnat stages: stage I; 20 full term neonates, stage II; 15 full term neonates and stage III; 14 full term neonates. Cases were compared to 16 healthy controls. Results: There was a statistical significant increase in Apgar score 1, 5, 10 in control group compared to all cases groups. There were no statistical significant differences between the studied groups in relation to CBC results. There was a statistical significant difference between the different stages of HIE in CRP and pH.There was a statistical significant increase in frequency of hypoxic change in stage III compared to stage II and I. All stages of HIE showed statistical significant increase in frequency of vitamin D deficiency compared to control group. Stage III had statistical significant increase in frequency of vitamin D deficiency compared to stage I and II. Conclusion: Serum 25(OH) vitamin D insufficiency is present in the majority of term HIE neonates. 25 (OH) vitamin D was significantly deficient in stage III more than stage I and II.

Objectives Knowledge gaps exist in the use of biologics for pregnant patients with Crohn's disease (CD), especially the usage of ustekinumab (UST) and infliximab (IFX) infusion during the late gestation period. In this case series, we investigated perinatal and neonatal outcomes and pharmacokinetics of these biologics in pregnant CD patients. Methods Pregnant CD patients under treatment with IFX or UST during January 2017 to December 2019 were monitored. Growth and development of their babies were followed up to six months. Drug concentrations were measured in maternal peripheral and cord blood at delivery and infants' blood at six months of age. Results Four cases were kept IFX treatment until late gestation (median last dose: 31.2 weeks). One case received UST until 23 weeks of gestation. All cases were in clinical remission but moderately undernourished. Babies were delivered by cesarean section at full term without any complications or congenital abnormalities. No growth or developmental defects and no susceptibility to infections were observed by six months. However, two babies whose mothers received IFX after 30 weeks of gestation were detected IFX in their blood at six months of age (0.94 and 0.24 pg/ml). Concentrations of UST in maternal and cord blood were 267.7 and 756.5 ng/ml, respectively. UST was not detected in the infant at six months of age. Conclusions Administration of UST or IFX to pregnant patients with CD is safe, particularly IFX to be given in the late gestation period. Understanding of the pharmacokinetics of biologics in maternal-infant interactions may improve the management of pregnant CD patients.

Актуальність. Новонароджені та діти перших місяців життя, особливо ті, які знаходяться на грудному вигодовуванні, природним чином схильні до дефіциту вітаміну К. Метою нашого дослідження було уточнення частоти виявлення дітей перших шести місяців життя української популяції, які знаходяться виключно на грудному вигодовуванні, із підвищеними концентраціями protein induced by vitamin K absence (PIVKA II) для вивчення сучасних умов формування дефіциту вітаміну К. Матеріали та методи. Об’єктом дослідження стали зразки донорської сироватки 180 дітей віком від 1 доби до 6 місяців, які народилися в строк із масою тіла від 2800 до 4200 г і оцінкою за шкалою Апгар 7–10 балів. Усі діти перебували на грудному вигодовуванні з моменту народження. Результати. Як показали наші спостереження, вітамін-К-дефіцитний стан відмічається в більше ніж 50 % новонароджених за даними виявлення позитивного тесту ELISA, що вказує на недостатній рівень карбоксильованого протромбіну (PIVKA II) у сироватці крові. Найбільше число позитивних за тестом PIVKA II немовлят відмічається в ранній неонатальний період, що свідчить про те, що гіповітаміноз формується внутрішньоутробно. Висновки. Забезпеченість вітамінами групи К, необхідними для синтезу цілого ряду незамінних протеїнів організму дитини, у більше ніж половини здорових народжених у строк новонароджених субпопуляції півдня України недостатня. Причинами цього явища є ідіопатичні внутрішньоутробні фактори, невиконання профілактичної ін’єкції вітаміну К після народження, виключно грудне вигодовування, дефіцитне за філо- та меноквінонами, а також порушення стану товстокишкового мікробіоценозу бактерій, що важливо для створення пулу ендогенних меноквінонів, які забезпечують подолання вітаміндефіцитного стану в ранньому дитинстві.

After pregnancy, Diastasis Recti is fairly frequent in women. It happens when the rectus abdominis muscles separate along the linea alba, causing the linea alba to expand. Diastasis recti is caused by a number of reasons. Multiple pregnancies and hormonal factors are the first and most apparent. Because of the elevated levels of relaxin, progesterone, and oestrogen during pregnancy, the linea alba weakens due to connective tissue softening. Diastasis recti should be treated as soon as possible in women. Dial calipers are used to assess diastasis recti in women who have just given birth. A dial caliper is a basic and quick measurement tool. The aim of the present study was to find out “Prevalence of Diastasis Recti in Primipara and Multipara Undergone Full Term Normal Delivery”. This study was carried out in Physiotherapy OPD, Ravi Nair Physiotherapy College and AVBRH, (Sawangi) Wardha. Diastasis recti was evaluated in full term normal delivery females. Diastasis recti was compared in primipara and multipara using dial calliper. The total number of full term normal delivery females in this study was 80 from the age group 22-37, of which 36 were primipara and 44 were multipara, and it showed that inter-rectal distance is greater in multipara while it was less in primipara.. From the present study we can conclude that there is presence of diastasis recti more in multipara than compared to primipara undergone full term normal delivery

According to the World Health Organization, 15 % of children under the age of five died of pneumonia worldwide in 2017. Objective: to create a mathematical model for determining the probability of developing congenital pneumonia in full-term newborns using the express method. A comprehensive examination was conducted in 116 full-term newborn infants, who were admitted to pediatric ward for newborn children and maternity physiological department of the State Institution “Republican Scientific Practical Center “Mother and Child” during the period from 2017 to 2019. A comparative analysis of 174 life history data, outcomes of previous pregnancies, complications of current pregnancy in mothers, clinical and routine laboratory methods used in newborns on day 1–2 of life was performed. Subsequently, the most significant factors associated with the development of congenital pneumonia in full-term newborns were determined. Based on binary logistic regression and receiver operating characteristic (ROC) analysis, a mathematical analysis of 387.4 million variable relationships was performed. The survey determined the most significant factors associated with the development of congenital pneumonia in full-term newborns: from the past obstetric-gynecologic and somatic history of the mother — a spontaneous abortion; complications of pregnancy — chronic intrauterine fetal hypoxia and chronic fetoplacental insufficiency; the results of clinical manifestations in the first days of life — the presence of respiratory failure. Based on the obtained data, a model was developed with a sensitivity of 90.6 %, specificity of 92.1 % and the area under the ROC curve = 0.930 ± 0.054, p < 0.001 (95% confidence interval 0.88–0.98). Threshold values were calculated using a predictive model: for spontaneous abortion — 0.836; for chronic intrauterine fetal hypoxia — 0.537; for chronic fetoplacental insufficiency — 0.533; the presence of respiratory failure — 0.939, which at threshold values of ≥ 0.53 of the ROC curve makes it possible to identify a group at high risk of developing congenital pneumonia among full-term newborns. The current mathematical model for determining the probability of developing congenital pneumonia in full-term newborns using the express method can be found on the website http://pneu.bsmu.by or https://www.bsmu.by (at the bottom of the page, there is Doctor/Pharmacist: Diagnosis of Congenital Pneumonia menu).

Introduction: Newborns having a gestational age between 37 to 416/7 weeks are defined as term newborn. The aim of the study was to investigate the rates and causes of hospitalization, and the differences in neonatal morbidities between early-term and full-term infants as a single-center experience in our hospital. Materials and Methods: This retrospective study was carried out in a tertiary neonatal intensive care unit between January 2013 and December 2014. Maternal characteristics and comorbidities; neonatal characteristics, length of hospital stay, and neonatal morbidities were recorded. Primary outcome measure was need for neonatal intensive care unit (NICU) admission. Results: Maternal comorbidities, ceserean delivery, low birth weight, SGA and multiple gestations were found to be higher in early-term infants and earlyterm infants were at higher risk for respiratory morbidities, respiratory support requirement, hypoglycemia and intravenous antibiotic therapy. After multivariate logistic regression analyses, only higher risk for respiratory morbidity persisted (OR:1.28 [1.02-1.59]; p=0.02). In contrast to that, full-term infants was found to be at higher risk for hypernatremia compared to early-term infants. Conclusions: Early term birth is associated with a higher neonatal morbidity and NICU admissions, and gestational age is known to be the most important determinant of this situation. With advanced maternal care and better understanding of the factors causing early term birth will lead to prevention and successfull management of this risk group. Giriş: Gestasyonel yaşı 37 ile 416/7 hafta arasında olan bebekler term yenidoğan olarak tanımlanır. Bu çalışmada, hastanemizde doğan ve izlenen erken term ve tam zamanlı term yenidoğanların neonatal morbiditeler, hastaneye yatış oranları ve nedenleri açısından karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Retrospektif olarak yürütülen bu çalışmada Ocak 2013 ile Aralık 2014 tarihleri arasında 3. basamak yenidoğan yoğun bakım (YDYB) servisinde yatırılarak izlenen term yenidoğanlar değerlendirilmiştir. Anneye ait özellikler, eşlik eden hastalıklar, yenidoğanların demografik özellikleri, hastane yatış süresi ve neonatal morbiditeler kayıt altına alınmış olup, çalışmanın birincil sonucu yenidoğan yoğun bakım ünitesine yatış gereksinimidir. Bulgular: Maternal eşlik eden hastalıklar, sezaryen doğum, düşük doğum ağırlığı, gestasyon yaşına göre küçük yenidoğanlar ve çoğul gebelikler erken term grubunda daha yüksek saptanmış olup, solunumsal morbiditeler, solunum desteği gereksinimi, hipoglisemi ve intravenöz antibiyotik gereksinimi açısından erken term grubunda daha yüksek saptanmıştır. Çoklu regresyon analizi sonrası sadece solunumsal morbiditeler açısından yüksek riskin devam ettiği görüldü (RR:1.28 [1.02-1.59]; p=0.02). Buna karşın, hipernatremi tam zamanlı term grubunda erken term grubuna göre daha yüksek saptandı. Sonuç: Erken termde doğum daha yüksek oranda neonatal morbidite ve YDYB yatışı ile ilişkili olup gestasyonel yaş bu durumu belirleyen en önemli faktördür. Daha iyi maternal bakım ve erken doğuma yol açabilecek faktörlerin belirlenmesi bu riskli grupta olası sorunların önlenmesini ve başarılı şekilde yönetilmesini sağlayacaktır.

Background: The association between diabetes and pregnancy is a real public health problem due to the inherent maternal and fetal complications.Aims: To study the clinical and biological features of diabetic pregnancies.Methods: We conducted a retrospective descriptive study including pregnant diabetic women followed at the National Institute of Nutrition of Tunis.Results: We included 100 patients with a mean age of 32.87±5.3 years. In preconception, 63.6% of patients were overweight and had poorly balanced diabetes (HbA1c> 7%). The mean weight gain throughout the pregnancy was 8.62 ± 5.39 kg. Pregnancy was planned in 18% of cases.Significant improvement in HbA1c was observed in the second trimester. The average daily insulin dose increased from 0.68 u/kg/day in the first trimester to 0.87 u/kg/day in the third trimester (p

1.To study the etiology and risk factors of neonatal hyperbilirubinemia in term and near-term infants. 2. To study the clinical course of these infants during NICU stayThe present study was conducted at NICU, Department of Pediatrics, Princess Esra hospital, Deccan Medical College, Hyderabad, India, from October 2019 to October 2020. Term and late preterm infants admitted in NICU with Serum Bilirubin levels more than 12mg/dl were included in the study. The risk factors, etiology and clinical profile of these infants during NICU stay were studied. 210 neonates were admitted in NICU with hyperbilirubinemia (Serum Bilirubin >12mg/dl) during the study period, out of which 118 were male (56.20%) and 92 were female (43.80%). Neonates were further distributed based on gestational age, in which 46 (21.90%) were late pre-terms i.e. between 34-37 weeks and 164 neonates (78.10%) were full term i.e. greater than 37 weeks. The neonates were also classified based on their birth weight, with neonates between 2500-3000 grams having the highest incidence (46.19%). Lastly, the etiological and risk factors were assessed and quantified, with physiological jaundice occurring as the major cause and late prematurity as the most common risk factor associated with neonatal hyperbilirubinemia. The average duration of phototherapy was 2.50 days and 3 babies required Double Volume Exchange Transfusion (DVET) for significant hyperbilirubinemia.None of the babies requiring DVET had clinical features of Bilirubin Induced Neurological Dysfunction (BIND) during NICU stay. 1. Most common cause of neonatal hyperbilirubinemia was found to be Physiological followed by Septicemia and Idiopathic etiologies. Blood group incompatibilities were less common causes. 2. Phototherapy is a cheap and effective way to reduce bilirubin levels in neonatal jaundice. 3. Exchange transfusion is a safe procedure and should be considered when indicated, to decrease the incidence of BIND. All cases requiring DVET were due to blood group incompatibility.

Despite the obstacles of limited education and employment opportunities—and the stress associated with immigration and pregnancy—Mexican immigrant women have low rates of preterm birth (PTB) compared to the US national average for all races and ethnicities. Stressors during pregnancy, and stressors associated with acculturation, may accelerate cellular aging manifested by shortened telomere length (TL) in pregnant women. Our objectives were to: (1) determine whether women with PTBs had shorter telomere lengths compared to women who had full term births; (2) assess the association of acculturation with TL and PTB. This prospective pilot study collected data from 100 self-identified Mexican-origin pregnant women. Survey data included self-administered sociodemographic and acculturation measures and was collected from participants via paper and pen, while biologic data was collected via a single blood draw during a regularly scheduled prenatal visit between 26 and 36 weeks gestation. PTB data was collected from the participant’s medical record after delivery. TL was significantly associated with PTB; the median TL of the women with PTB was less than the median TL for the full sample (p = 0.02). Based on regression analysis for PTB vs acculturation, we found no significant associations between acculturation and PTB or TL. This study provides important evidence of the association between shortened maternal TL and adverse birth outcomes. By linking social, clinical and biologic data, we can enhance our understanding of social determinants that may affect racial and ethnic disparities in preterm birth.