scholarly journals Risk Factors for the Development of Delayed TSH Elevation in Neonatal Intensive Care Unit Newborns

2017 ◽  
Vol 102 (8) ◽  
pp. 3050-3055 ◽  
Author(s):  
Amnon Zung ◽  
Rachel Bier Palmon ◽  
Agneta Golan ◽  
Mara Troitzky ◽  
Smadar Eventov-Friedman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Multivariate Analysis ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Univariate Analysis ◽  
Packed Red Blood Cells

Abstract Context Delayed thyrotropin (TSH) elevation (dTSH) is defined as elevated TSH at the second neonatal screening (after normal TSH levels at the initial screening) in premature, low-birth-weight, and ill newborns, mostly in the neonatal intensive care unit (NICU) setting. The pathogenesis of dTSH is elusive. Objective To identify the risk factors for dTSH development among newborns in the NICU. Design, Setting, and Patients A retrospective medical record review of neonates with dTSH was conducted in eight university-affiliated NICUs. Two controls were selected for each patient, matched for sex and birth weight. The risk factors for dTSH were identified by univariate analysis, followed by multivariate analysis. Main Outcome Measures Maternal variables, types of NICU treatments and procedures, syndromes, and various medical conditions were compared between dTSH patients and their matched controls. Results We enrolled 100 dTSH patients and 200 matched controls and 46 variables were compared between the two groups. Twelve risk factors for dTSH were identified on univariate analysis: cesarean section, mechanical ventilation, patent ductus arteriosus (PDA), pneumothorax, and administration of cefotaxime, vancomycin, fluconazole, dopamine, ibuprofen, furosemide, insulin, and packed red blood cells. On multivariate analysis, four risk factors were identified: PDA and vancomycin, insulin, and furosemide administration. In 26 twin pairs, in which one twin had dTSH, all variables presented similarly in both twins. Conclusions Although some variables had direct effects on pituitary–thyroid axis dysfunction, these variables, altogether, reflect the severity of the clinical conditions in the NICU, which is the common basis for dTSH.

scholarly journals FACTORES DE RIESGO ASOCIADOS A LA MORTALIDAD Y PESO AL NACER DE PACIENTES NEONATOS, CASO DE ESTUDIO: HOSPITAL PEDIÁTRICO BACA ORTIZ

2022 ◽  
Vol 7 (1) ◽  
pp. 17
Author(s):  
Margaret Jaraiseh Abcarius ◽  
Berly Alejandra Zambrano Bravo ◽  
Manuel Eugenio Morocho-Cayamcela ◽  
Ana Belén Tulcanaza-Prieto
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Mortality ◽  
Neonatal Intensive Care ◽  
Pediatric Hospital ◽  
Factors Associated ◽  
Factores De Riesgo

Introducción: El peso al nacer es uno de los principales indicadores pronóstico de mortalidad neonatal, en el que influyen factores asociados con la madre, el neonato, y también con las características socioeconómicas del núcleo familiar. Los factores de riesgo implican comorbilidades al momento del nacimiento, por lo que, la intervención adecuada y el oportuno acceso a los servicios de salud constituyen elementos primordiales para la reducción de la mortalidad neonatal. Objetivo: establecer los factores de riesgo asociados a la mortalidad y peso al nacer de pacientes neonatos, de la Unidad de Cuidados Intensivos Neonatales del Hospital Pediátrico Baca Ortiz. Métodos: Se realizó una investigación de diseño observacional, transversal de tipo descriptivo que con una muestra de 204 recién nacidos ingresados en la Unidad de Cuidados Intensivos Neonatales del Hospital Pediátrico Baca Ortiz en la ciudad de Quito, Ecuador, durante el año 2019.  Resultados: El peso al nacimiento tiene una asociación lineal negativa significativa con la mortalidad neonatal, siendo los neonatos de género masculino los más susceptibles a fallecer. También, existe mayor frecuencia de mortalidad neonatal en las madres que residen en el área urbana de la sierra ecuatoriana. Conclusiones: El peso al nacer es una variable de gran influencia en la salud y supervivencia infantil, debido a que los datos epidemiológicos muestran que un niño que nace con un peso por debajo de los límites normales tiene un mayor riesgo de fallecer, en comparación con los niños nacidos con un peso dentro del rango considerado normal.   Palabras clave: Mortalidad infantil, factores de riesgo, recién nacido de bajo peso, enfermería neonatal, mortalidad neonatal.  Abstract Introduction: Birth weight is one of the main prognostic indicators of neonatal mortality, which is influenced by factors associated with the mother, the neonate, and the socioeconomic characteristics of the family. Moreover, the risk factors imply comorbidities at birth. Therefore, adequate intervention and timely access to health services constitute essential elements to reduce neonatal mortality. Objective: establish the risk factors associated with mortality and birth weight of neonatal patients, from the Neonatal Intensive Care Unit of the Baca Ortiz Pediatric Hospital. Methods: An observational, cross-sectional, descriptive research was carried out with a sample of 204 newborns admitted to the Neonatal Intensive Care Unit of the Baca Ortiz Pediatric Hospital in the city of Quito, Ecuador, during the year 2019. Results: The birth weight shows a significant negative linear association with neonatal mortality, where the male infants are the most susceptible to death. Furthermore, there is a higher frequency of neonatal mortality in mothers who live in the urban area of ​​the Ecuadorian highlands. Conclusions: The birth weight is a highly influential variable for child health and survival since epidemiological data show that a newborn with a weight below the range considered normal, has a higher risk of death as compared to children with a normal weight. Keywords: Infant mortality, risk factors, low birth weight, neonatal nursing, neonatal mortality.

scholarly journals Retinopathy of prematurity- clinical profile on incidence, risk factors and outcome

2020 ◽  
Vol 7 (11) ◽  
pp. 2189
Author(s):  
Purva Shah ◽  
Ketan Gadhvi ◽  
Bharat Muliya
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Tertiary Hospital ◽  
Antenatal Steroids

Background: Retinopathy of prematurity is one of the important causes of preventable blindness in the world. Thereby timely screening, diagnosis and hence treatment is of utmost importance.Methods: This study was done in the neonatal intensive care unit of tertiary hospital, Surendranagar. Study design being observational, data collected from clinical examination and records of the preterm babies <34 weeks and low birth weight babies <1.5 kg and further screened them for retinopathy of prematurity. The incidence of ROP in the neonatal intensive care unit (NICU), risk factors which predispose to ROP (Retinopathy of prematurity) and outcome of these cases were analysed.Results: As per this study, ROP was found to be more common in <30 weeks gestation and<1 kg neonate, and found to be associated with oxygen exposure, blood product use, antenatal steroids and surfactant.Conclusions: The analysis of the incidence and risk factors, will henceforth help in identifying and acting on time, thereby improving overall outcome of the preterm and low birth weight new-borns.

Neontal Intensive Care Unit Hospitalization of Very Low Birth Weight Japanese Infants with Congenital Heart Disease.

2004 ◽  
Vol 43 (151) ◽  
pp. 28-30
Author(s):  
Narayan Bahadur Basnet ◽  
S Noma ◽  
S B Bashnet ◽  
T Igarashi
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Congenital Heart ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus

The lack of study regarding the duration of neonatal intensive care unit (NICU) hospitalization of very lowbirth weight (VLBW) infants (< 1500g) with congenital heart disease (CHD) necessitated this study.Retrospective data of all infants weighing <1500 g with a gestational age (GA) < 37 weeks at birth wereobtained from the NICU of Tokyo Metropolitan Hachioji Children’s Hospital in Tokyo, from January, 1997to December, 2001. Of 1515 admissions, 189 (12.5%) weighed <1500 g at birth, with weight ranging from377 g to 1496 g (mean 1060.6 g, 283.3 SD). CHD was diagnosed in 20 (10.6%) of infants. The male to femaleratio was 1:1.5. In CHD patients, birth weight ranged from 554 g to 1473 g (mean 1029.8 g, 243.5 SD), GAranged from 24 to 36 weeks (mean 29.4, 3.5 SD) and the length of hospitalization ranged from 3 to 154 days(mean 74.6 days, 43.8 SD; median 68 days). Patent ductus arteriosus was diagnosed in all infants with GA<27 weeks. Three infants (16.7%) with CHD died in NICU. Establishment of the mean duration of NICUhospitalization in CHD infants may help to improve the planning and management of resources requiredfor NICU care and counseling of parents.Key Words: Neonatal intensive care unit (NICU) hospitalization, congenital heart disease (CHD), Japan

scholarly journals Risk factors associated with retinopathy of prematurity among neonates in a tertiary care hospital in Nepal

2017 ◽  
Vol 5 (1) ◽  
pp. 28-33
Author(s):  
Jyoti Baba Shrestha ◽  
Reena Yadav ◽  
Jeevan Kumar Shrestha ◽  
Laxman Shrestha ◽  
Raman Prasad Sah
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Multiple Gestation ◽  
Factors Associated

Background: Retinopathy of prematurity is a vascular retinal disease that can cause blindness in premature new born babies. Several risk factors are associated with the incidence of ROP. Information and data on risk factors associated with ROP in context to Nepalese population is scarcely documented in literature.Objectives: The purpose of this study was to evaluate the risk factors of retinopathy of prematurity in premature infants admitted in the neonatal intensive care unit of Tribhuvan University Teaching Hospital.Methods: Neonates with gestational age of 36 weeks or less and birth weight of 2000 gram or less admitted to neonatal intensive care unit (NICU), during 2013 to 2015 were screened for retinopathy of prematurity. Risk factors and severity of retinopathy of prematurity were evaluated. The initial examination was carried out at 4-6 weeks after birth by indirect ophthalmoscope and retinopathy of prematurity positive and negative infants were compared subsequently. The Chisquare and independent t-tests were used for statistical analysis. A p value less than 0.05 was considered statistically signifi cant.Results: The incidence of retinopathy of prematurity was 22.6% and severe retinopathy of prematurity requiring treatment was observed in 3.2% of 93 neonates who had eye examinations. There was a signifi cant relationship between the occurrence of ROP and birth weight (p=0.000), gestational age (p=0.000), duration of oxygen therapy (p=0.009) and sepsis (p=0.002). However, insignifi cant relationship was observed between the occurrence of retinopathy of prematurity and gender, type of delivery, multiple gestation, premature rupture of foetal membrane, respiratory distress syndrome and hyperbilirubinaemia.Conclusion: The risk factors contributing to development of retinopathy of prematurity showed signifi cant relationship with immaturity, duration of oxygen supplementation and septicaemia.Journal of Kathmandu Medical CollegeVol. 5, No. 1, Issue 15, Jan.-Mar., 2016,page: 28-33

scholarly journals Study of respiratory distress in newborn

2017 ◽  
Vol 4 (2) ◽  
pp. 490
Author(s):  
Ankush Kommawar ◽  
Rajendra Borkar ◽  
Jayant Vagha ◽  
Bhavana Lakhkar ◽  
Rewat Meshram ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Caesarean Section ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Female Ratio ◽  
Neonatal Respiratory Distress

Background: Respiratory distress is one of the most common reasons an infant is admitted to the neonatal intensive care unit. Fifteen percent of term infants and 29% of late preterm infants admitted to the neonatal intensive care unit develop significant respiratory morbidity; this is even higher for infants born before 34 weeks ‘gestation. Certain risk factors increase the likelihood of neonatal respiratory disease. These factors include prematurity, meconium-stained amniotic fluid (MSAF), caesarean section delivery, gestational diabetes, maternal chorioamnionitis, or prenatal ultrasonographic findings, such as oligohydramnios or structural lung abnormalities. Aim of the study was to study   the, etiology and outcome of respiratory distress in newborns.Methods: The present study was conducted at the Department of Pediatrics, Acharya Vinoba Bhave Rural Hospital, Jawaharlal Nehru Medical College, Sawangi (Meghe),Wardha, Maharashtra, India. Sample size was decided on the basis of prevalence of neonatal respiratory distress in our area. It was conducted for a period of two years from 1st August 2014 to 31st July 2016.Results: maximum admissions on day 1 of life i.e. 309 (77.25%) followed by on day 2 i.e. 90 (22.50%) 231 (57.75%) were males and 169 (42.25%) were females. Male to female ratio was 1.36:1 Out of 400 children 11 were less than 1000 gms, followed by 77 (19.25%) had birth weight between 1000 g - 1499 g, 193 (48.25%) neonates had weight between 1500 g - 2499 gms and 118 (29.5%) neonates had weight between 2500 - 3499 gms and remaining 1 neonate had birth weight > 3500 grams. Out of 400 Neonates with respiratory distress, 281 (70.25%) had low birth weight and remaining 119 (29.75%) neonates had normal birth weight.Conclusions: Respiratory distress was the major cause of admission in our NICU. Caesarean section was the most common predisposing factor associated with the development of respiratory distress in neonates. Antenatal risk factors increase the incidence of RD. The most common causes of respiratory distress were TTN, RDS, MAS, and perinatal asphyxia. The common cause of death was HMD. The outcome of neonatal respiratory distress was found as: a survival rate of 78.5%, mortality rate of 21.5%.

scholarly journals Admission Hypothermia Among Neonates Presented to Neonatal Intensive Care Unit

2013 ◽  
Vol 33 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Shaheen Akter ◽  
Rubiya Parvin ◽  
B.H. Nazma Yasmeen
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Long Distance ◽  
Normal Delivery ◽  
Neonatal Hypothermia

Introduction: In developing countries, thermal protection of the newborn is not properly addressed. Neonates presented to Neonatal intensive care unit (NICU) for admission with various problems are frequently found to be hypothermic. The objective of this study was to determine the incidence and associated risk factors for neonatal hypothermia on admission to NICU. Materials and Methods: This was a prospective observational study carried over a period of three years at Enam Medical College and Hospital (EMCH) among the newborns admitted to NICU. Hypothermia has been defined as axillary temperature <36.5°C (<97.7° F). Temperature was measured at admission. Data were collected regarding perinatal and socio economic factors. Bivariate and multivariate analysis has been done to see the association of risk factors. Result: A total of 2310 babies between 0 and 680 h of age (mean 43± 12 hours) were studied. Thirty four percent (785) of the neonates had hypothermia. Mean gestation was 34±3 weeks and 42.5% were inborn. Significant determinants of neonatal hypothermia at admission included factors like preterm (p=0.03), low birth weight (p=0.005), normal delivery (p=0.012), birth asphyxia (p=0.001) below average socioeconomic status (p=0.001) and long distance (>10 km) travelled by the neonate (p=0.03). Independent variables are resuscitation at birth [p=.001, Odds Ratio (OR), 2.43; Confidence Interval (CI), 1.47 to 4.00], (p=0.001), age less than 24 hours (p=.02; OR 2.25; CI, 1.13 to 4.47), low birth weight (p=0.03; OR,2.0; CI, 1.06 to 3.82), caesarean section(C/S) delivery (p=.006; OR 1.35; CI, 1.18-2.12) and below average economic status (p=0.001; OR, 2.76; CI, 1.56 to 5.90). Conclusion: Incidence of admission hypothermia among neonates in our NICU was 34%. Independent risk factors are resuscitation at birth, very low birth weight, C/S delivery, age less than 24 hours and poor socio-economic condition. Proper thermal care should be provided for neonates both at home and hospitals. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8312   J. Nepal Paediatr. Soc. 2013;33(3):166-171

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