Journal of Neonatal-Perinatal Medicine - Volume 12, issue 2

Authors: Babgi, Mohammed A. | Al-Jifree, Hatim M. | AlShehri, Omar A. | Khan, Muhammad A. | Khogeer, Ahmad N. | Alqurashi, Mansour A.

Article Type: Research Article

Abstract: BACKGROUND: Neural tube defects (NTDs) are among the most common congenital anomalies worldwide with an incidence of 300,000/year. Spina bifida, which is the most prevalent NTD, has an incidence of 1.2/1000 live births in Saudi Arabia. Our study aimed to assess the awareness of NTDs and the implementation of preventative measures against them. In addition, to gauge public opinion regarding abortion following early diagnosis of NTDs. METHODS: This was a cross-sectional study in which questionnaires were distributed using non-probability convenient sampling technique and data was collected in a face-to-face interview. Subjects were approached in an outpatient clinic and …in a shopping mall in Jeddah city, Saudi Arabia. RESULTS: Out of 353 subjects, 35.7% were males, 64.3% females (33% pregnant), and the median age was 34 (IQR = 14) years. Of subjects, 66.3% were not aware of NTDs, and regarding folic acid 54% believed that it helps in preventing NTDs, and only 25% agreed on starting it before pregnancy. However, only 19% agreed on all points, which even dropped to 9% after considering planned pregnancies. Gender differences were extremely significant (p -value <0.001) as females were more aware. Interestingly, 62% would abort in early-diagnosed NTD cases. Of pregnant women, only 20% started taking folic acid before pregnancy. CONCLUSIONS: The data shows that the majority of the study’s population are in favor of terminating the pregnancy in justified NTD cases. There is a need for increasing public awareness, especially to males, and should be provided through all channels of knowledge. Show more

Keywords: Neural tube defects, folic acid, pregnancy termination, periconceptional use, Saudi Arabia

DOI: 10.3233/NPM-17165

Citation: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 2, pp. 195-201, 2019

Authors: Cantú-Reyna, C. | Santos-Guzmán, J. | Cruz-Camino, H. | Vazquez Cantu, D.L. | Gómez-Gutiérrez, R. | Góngora-Cortéz, J.J. | Gutiérrez-Castillo, A.

Article Type: Research Article

Abstract: Glucose-6-phosphate dehydrogenase deficiency (D-G6PD) is a common erythroenzymopathy that needs to be addressed as an important public health issue. Proper population monitoring is needed to anticipate clinical complications. A joint venture between Genomi-k (a Mexican company focused on newborn screening) and several university researchers conducted a retrospetive study for D-G6PD based on 156,152 newborn screening reports belonging to the Mexican population comprising a period of 10 years. We identified 540 male newborns affected with this deficiency, representing an incidence of 6.78 cases per 1,000 newborn males. A single double mutation of G202A:A376G was detected in 97.22% of cases. In regions …where there is an absence of a national centralized health data for D-G6PD, information from a non-probabilistic large population sample can be used as a national incidence subrogate. Show more

Keywords: G6PD, incidence, Mexico, newborn screening

DOI: 10.3233/NPM-1831

Citation: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 2, pp. 203-207, 2019

Authors: Rabiepoor, S. | Abedi, M. | Saboory, E. | Khalkhali, H.R.

Article Type: Research Article

Abstract: BACKGROUND: The present study aimed to determine the effect of perceived stress during pregnancy on neonatal outcomes and cortisol and leptin levels in mothers and their newborns. METHODS: This longitudinal study was carried out on 110 pregnant women in Miandoab city, Iran. Mothers, who had singleton pregnancies and gestational age of 24 to 28 weeks, were included in the study. The participants were asked to fill out Cohen’s Perceived Stress Scale (PSS). The mothers were then tracked in gestational ages of 28–32 weeks, 32–36 weeks, and the time of delivery. The maternal and umbilical cord blood samples were …obtained during labor in order to measure leptin and cortisol levels. RESULTS: Umbilical cortisol level was significantly higher in newborns who had meconium stained amniotic fluid than those who did not. Maternal blood leptin levels at delivery were significantly higher in the mothers whose neonates had respiratory distress, low birth weight, low head circumference, low Apgar score, and were premature than those whose neonates did not have such problems. The level of leptin in umbilical cord blood was significantly higher in neonates who had respiratory distress than those who did not. The results also showed a significant correlation between maternal cortisol levels and PSS during weeks 24–28 and the entire pregnancy. A significant relationship was observed between umbilical leptin and maternal leptin levels. CONCLUSIONS: It can be concluded that stress during pregnancy is accompanied by fetal distress. The probable reason for newborns distress may be related to increased maternal leptin levels. Show more

Keywords: Perceived stress, pregnancy, cortisol, leptin, umbilical cord, fetal growth

DOI: 10.3233/NPM-1818

Citation: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 2, pp. 209-219, 2019

Authors: Kratimenos, Panagiotis | Christidis, Panagiotis | Kehinde, Folasade | Koutroulis, Ioannis | Santana, Stephanie | Mossabeb, Roschanak | Fleishman, Rachel

Article Type: Research Article

Abstract: BACKGROUND: Premature neonates are often subjected to multiple transfusions with red blood cells during their hospitalization in the neonatal intensive care unit (NICU). The hemoglobin threshold for transfusion prior to discharge from the NICU varies significantly among different centers. The aim of the present study is to investigate the association between hemoglobin concentration at discharge with neurodevelopmental outcomes in premature neonates. METHODS: Retrospective observation study with regression analysis was performed with follow up assessment in the neuro-developmental outpatient clinic at 30 months of adjusted age. RESULTS: Data from 357 neonates born at less than 37 weeks’ …gestation were analyzed. Sensory and motor neurodevelopment at 30 months of adjusted age, were not associated with the hemoglobin concentration at discharge (p=0.5891 and p=0.4575, respectively). There was no association between the hemoglobin concentration at discharge with fine or gross motor development (p=0.1582 and p=0.3805, respectively). Hemoglobin concentration at discharge was not associated with poor neurodevelopmental outcomes up until 30 months of adjusted age. CONCLUSIONS: The data of the present study indicate that the hemoglobin concentration of premature neonates at the time of discharge is not associated with poorer markers of neurodevelopmental outcomes at 30 months of adjusted age. Comorbidities such as BPD and IVH that are present to premature neonates were identified as potential risk factors for certain aspects of the neurodevelopment. Show more

Keywords: Hemoglobin, discharge, neurodevelopment, transfusion, NEC, premature neonates, NICU

DOI: 10.3233/NPM-1822

Citation: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 2, pp. 221-230, 2019

Authors: Kumar, D. | Vachharajani, A.J. | Wertheimer, F. | Vergales, B. | Glass, K. | Dannaway, D. | Winter, L. | Delaney, H. | Ganster, A. | Arnold, J. | Urban, A. | Johnston, L. | Bruno, C. | Gray, M.M. | Sawyer, T. | for the Organization of Neonatal Training Program Directors Task Force on Simulation

Article Type: Research Article

Abstract: BACKGROUND: Simulation is widely used in graduate medical education. A prior survey showed that 80% of Neonatal-Perinatal Medicine (NPM) fellowship programs in the U.S. use simulation. There are multiple ways to provide simulation-based education. One such method is through intensive simulation-based education sessions held at the beginning of a training program, common called ‘boot camps’. The aim of this study was to describe the use of simulation-based boot camps in NPM fellowship programs. METHODS: Survey study of Accreditation Council for Graduate Medical Education (ACGME) accredited NPM fellowships in the U.S. RESULTS: Fifty-nine of 98 programs (60%) …responded. Thirty six (61%) participated in 1st year fellow boot camps, which focused on procedural skills and newborn resuscitation. Nearly half of programs participated in regional boot camps. Most boot camps were one or two days long. Eleven programs (19%) held 2nd or 3rd year fellow boot camps, which focused on advanced resuscitation and communication. Barriers included lack of faculty protected time (57%), funding (39%), and lack of faculty experience (31%). CONCLUSIONS: A majority of ACGME accredited NPM fellowships participate in 1st year fellows’ boot camps. Many participate in regional boot camps. A few programs have 2nd or 3rd year fellow boot camps. Lack of time, funding, and faculty experience were common barriers. Show more

Keywords: Boot camp, simulation, Neonatal-perinatal medicine, neonatal fellowship

DOI: 10.3233/NPM-18117

Citation: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 2, pp. 231-237, 2019