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Neonatal Perinatal Asphyxia

Christabel C Enweronu-Laryea, Hilary D Andoh, Audrey Frimpong-Barfi, Francis M Asenso-Boadi
The major causes of newborn deaths in sub-Saharan Africa are well-known and countries are gradually implementing evidence-based interventions and strategies to reduce these deaths. Facility-based care provides the best outcome for sick and or small babies; however, little is known about the cost and burden of hospital-based neonatal services on parents in West Africa, the sub-region with the highest global neonatal death burden. To estimate the actual costs borne by parents of newborns hospitalised with birth-associated brain injury (perinatal asphyxia) and preterm/low birth weight, this study examined economic costs using micro-costing bottom-up approach in two referral hospitals operating under the nationwide social health insurance scheme in an urban setting in Ghana...
2018: PloS One
Vânia Oliveira, Rui Martins, Natasha Liow, Justinas Teiserskas, Wilhelm von Rosenberg, Tricia Adjei, Vijayakumar Shivamurthappa, Peter J Lally, Danilo Mandic, Sudhin Thayyil
BACKGROUND: Heart rate variability analysis offers real-time quantification of autonomic disturbance after perinatal asphyxia, and may therefore aid in disease stratification and prognostication after neonatal encephalopathy (NE). OBJECTIVE: To systematically review the existing literature on the accuracy of early heart rate variability (HRV) to predict brain injury and adverse neurodevelopmental outcomes after NE. DESIGN/METHODS: We systematically searched the literature published between May 1947 and May 2018...
October 9, 2018: Neonatology
Joep C Kortekaas, Anke C Scheuer, Esteriek de Miranda, Aimée E van Dijk, Judit K J Keulen, Aafke Bruinsma, Ben W J Mol, Frank P H A Vandenbussche, Jeroen van Dillen
BACKGROUND: Late- and postterm pregnancy are associated with adverse perinatal outcomes, like perinatal death. We evaluated causes of death and substandard care factors (SSFs) in term and postterm perinatal death. METHODS: We used data from the Perinatal Audit Registry of the Netherlands (PARS). Women with a term perinatal death registered in PARS were stratified by gestational age into early-/full-term (37.0-40.6) and late-/postterm (≥41.0 weeks) death. Cause of death and SSFs ≥41 weeks were scored and classified by the local perinatal audit teams...
September 20, 2018: BMC Pregnancy and Childbirth
Mariya Mukhtar-Yola, Lamidi Isah Audu, Oluyinka Olaniyan, Henry T Akinbi, Adekunle Dawodu, Edward F Donovan
The neonatal period is a critical time for survival of the child. A disproportionate amount of neonatal deaths occur in low-resource countries and are attributable to perinatal events, especially birth asphyxia. This project aimed to reduce the incidence of birth asphyxia by 20% by June 2014 through training in neonatal resuscitation and improving the availability of resuscitation equipment in the delivery room in the National Hospital Abuja, Nigeria. A prospective, longitudinal study using statistical process control analytical methods was done enrolling babies delivered at the National Hospital Abuja...
2018: BMJ open quality
A M Looney, M P O'Sullivan, C E Ahearne, M Finder, U Felderhoff-Mueser, G B Boylan, B Hallberg, Deirdre M Murray
Hypoxic-ischaemic encephalopathy (HIE) remains one of the leading causes of neurological disability worldwide. No blood biomarker capable of early detection and classification of injury severity in HIE has been identified. This study aimed to investigate the potential of miRNA-181b (miR-181b) and its downstream target, ubiquitin C-terminal hydrolase-L1 (UCH-L1), to predict the severity of HIE. Full-term infants with perinatal asphyxia were recruited at birth and observed for the development of HIE, along with healthy controls...
September 3, 2018: Molecular Neurobiology
Payam Vali, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Praveen Chandrasekharan, Munmun Rawat, Satyan Lakshminrusimha, Jayasree Nair
Birth asphyxia accounts for nearly one million deaths worldwide each year, and is one of the primary causes of early neonatal morbidity and mortality. Many aspects of the current neonatal resuscitation guidelines remain controversial given the difficulties in conducting randomized clinical trials owing to the infrequent and often unpredictable need for extensive resuscitation. Most studies on neonatal resuscitation stem from manikin models that fail to truly reflect physiologic changes or piglet models that have cleared their lung fluid and that have completed the transition from fetal to neonatal circulation...
August 15, 2018: Journal of Visualized Experiments: JoVE
Raymond C Koehler, Zeng-Jin Yang, Jennifer K Lee, Lee J Martin
Perinatal hypoxia-ischemia resulting in death or lifelong disabilities remains a major clinical disorder. Neonatal models of hypoxia-ischemia in rodents have enhanced our understanding of cellular mechanisms of neural injury in developing brain, but have limitations in simulating the range, accuracy, and physiology of clinical hypoxia-ischemia and the relevant systems neuropathology that contribute to the human brain injury pattern. Large animal models of perinatal hypoxia-ischemia, such as partial or complete asphyxia at the time of delivery of fetal monkeys, umbilical cord occlusion and cerebral hypoperfusion at different stages of gestation in fetal sheep, and severe hypoxia and hypoperfusion in newborn piglets, have largely overcome these limitations...
August 28, 2018: Journal of Cerebral Blood Flow and Metabolism
V Demeulemeester, H V Hauthem, F Cools, J Lefevere
Neonatal seizures are frequent in neonatal intensive care and the most common cause is perinatal asphyxia. Among other causes, toxin exposure is rare.We present a boy with an uneventful vaginal birth, who presented one hour after birth with apnea, hypotonia, mydriasis, tongue fasciculation, and tonic seizures. There was no hypoxic ischemic encephalopathy and brain imaging was normal. Toxicology screening revealed a toxic concentration of lidocaine in his blood. The intoxication was transplacental, as a cord blood sample confirmed the toxic level...
August 21, 2018: Journal of Neonatal-perinatal Medicine
Ingrid Brucknerová, Michal Dubovický, Eduard Ujházy
Despite modern approaches in molecular biology and genetics, we are still not able to identify the actual cause in more than 50% of all congenital defects. One-half of the unidentified cases is referred to as "multifactorial". Detailed prenatal investigation of the fetus can discover the presence of congenital abnormality, which can worsen the process of postnatal adaptation. Retrospective analysis of newborns admitted to the Neonatal Department of Intensive Medicine (NDIM) in 2012-2016 with the aim to analyze how the process of postnatal adaptation can be changed by the presence of congenital abnormalities of lip and palate...
December 2017: Interdisciplinary Toxicology
Tal Weissbach, Ishai Heusler, Michal Ovadia, Liron David, Yair Daykan, Faye Schreiber, Tal Biron-Shental
OBJECTIVE: To correlate the duration of Category II cardiotocograms (CTG) with adverse neonatal outcomes associated with perinatal asphyxia and determine the duration before fetal compromise. STUDY DESIGN: This retrospective, observational study used electronic medical record data from a cohort of 271 patients, delivered by C-section due to non-reassuring fetal heart rate, at a tertiary medical center, from 2015 through 2017. Duration of Category II CTG, variability, tachycardia and deceleration frequency were analyzed and correlated to immediate postnatal outcomes...
October 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Kristin Leifsdottir, Huseyin Mehmet, Staffan Eksborg, Eric Herlenius
BACKGROUND: Cerebral ischemia generates neuroinflammation that can induce neural cell death. This cohort study assessed whether Fas-ligand (FasL) and interleukin (IL)-6 levels in the cerebrospinal fluid (CSF) after hypoxic-ischemic encephalopathy (HIE) can serve as biomarkers of hypoxic brain injury in neonates. METHODS: Term infants (> 37-week gestational age) who were admitted to the neonatal intensive care unit of Karolinska University Hospital in years 2002 to 2004 with perinatal asphyxia were enrolled prospectively...
August 8, 2018: Journal of Neuroinflammation
Cynara Maria Pereira, Rodolfo Carvalho Pacagnella, Mary Angela Parpinelli, Carla Betina Andreucci, Dulce Maria Zanardi, Renato Souza, Carina Robles Angelini, Carla Silveira, José Guilherme Cecatti
OBJECTIVE:  To assess the relationship between the use of psychoactive substances during pregnancy and the occurrence of severe maternal morbidity (SMM), perinatal outcomes and repercussions on the neuropsychomotor development of exposed children. METHODS:  A case-control study nested within a cohort of severe maternal morbidity (COMMAG) was performed. Women with SMM were considered cases. Controls were those with low-risk pregnancy, without SMM and admitted during the same time period as the cases...
September 2018: Revista Brasileira de Ginecologia e Obstetrícia
Adeyemi A Labaeka, Olukemi O Tongo, Babatunde O Ogunbosi, James A Fasunla
The burden of severe hearing impairment is increasing with two-thirds of these hearing impaired people residing in developing countries. Newborn hearing screening helps to identify early, babies who need intervention in order to prevent future disability. Neither universal nor targeted hearing screening programme is available in Nigeria. Objectives: This study was carried out to assess the prevalence of hearing impairment among high-risk newborns in UCH and the associated risk factors. Materials and Methods: Two hundred one newborns in the neonatal unit of UCH with risk factors for hearing impairment had hearing screening done using automated auditory brainstem response (AABR) at 30, 45, and 70 dB at admission and discharge, and those that failed screening at discharge were rescreened at 6 weeks post-discharge...
2018: Frontiers in Pediatrics
Ioannis Bellos, Georgia Fitrou, Georgios Daskalakis, Despina N Perrea, Vasilios Pergialiotis
There is growing evidence that neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker of acute kidney injury. The objective of this meta-analysis is to determine the accuracy of serum and urinary NGAL in the detection of acute kidney injury in neonates with perinatal asphyxia. Medline (1966-2018), Scopus (2004-2018), EMBASE (1980-2018), (2008-2018), and Google Scholar (2004-2018) databases, along with the reference lists of the electronically retrieved articles, were systematically searched...
October 2018: European Journal of Pediatrics
Kiattisak Kongwattanakul, Piyamas Saksiriwuttho, Sukanya Chaiyarach, Kaewjai Thepsuthammarat
Objective: To determine the incidence of preeclampsia with severe features among pregnant women and evaluate the characteristics, maternal complications, and perinatal outcomes between nonsevere preeclampsia versus preeclampsia with severe features and hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome. Materials and methods: A retrospective descriptive study was conducted at Khon Kaen University's Srinagarind Hospital, a tertiary care facility in northeast Thailand...
2018: International Journal of Women's Health
Midiã Gomes da Silva Rêgo, Mirella Bezerra Rodrigues Vilela, Conceição Maria de Oliveira, Cristine Vieira do Bonfim
OBJECTIVE: To describe the epidemiological characteristics of perinatal deaths through the actions of the Unified Health System. METHODS: This is a descriptive study of temporal analysis with a population of perinatal deaths of mothers residing in Recife, Brazil, from 2010 to 2014. A list was used to classify the preventable diseases and the variables were analysed using Epi lnfo™ version 7. RESULTS: The perinatal deaths totalled 1,756 (1,019 foetal and 737 neonatal premature) with a reduction of neonatal deaths (-15...
July 23, 2018: Revista Gaúcha de Enfermagem
Narendra K Arora, M K C Nair, Sheffali Gulati, Vaishali Deshmukh, Archisman Mohapatra, Devendra Mishra, Vikram Patel, Ravindra M Pandey, Bhagabati C Das, Gauri Divan, G V S Murthy, Thakur D Sharma, Savita Sapra, Satinder Aneja, Monica Juneja, Sunanda K Reddy, Praveen Suman, Sharmila B Mukherjee, Rajib Dasgupta, Poma Tudu, Manoja K Das, Vinod K Bhutani, Maureen S Durkin, Jennifer Pinto-Martin, Donald H Silberberg, Rajesh Sagar, Faruqueuddin Ahmed, Nandita Babu, Sandeep Bavdekar, Vijay Chandra, Zia Chaudhuri, Tanuj Dada, Rashna Dass, M Gourie-Devi, S Remadevi, Jagdish C Gupta, Kumud K Handa, Veena Kalra, Sunil Karande, Ramesh Konanki, Madhuri Kulkarni, Rashmi Kumar, Arti Maria, Muneer A Masoodi, Manju Mehta, Santosh Kumar Mohanty, Harikumaran Nair, Poonam Natarajan, A K Niswade, Atul Prasad, Sanjay K Rai, Paul S S Russell, Rohit Saxena, Shobha Sharma, Arun K Singh, Gautam B Singh, Leena Sumaraj, Saradha Suresh, Alok Thakar, Sujatha Parthasarathy, Bhadresh Vyas, Ansuman Panigrahi, Munish K Saroch, Rajan Shukla, K V Raghava Rao, Maria P Silveira, Samiksha Singh, Vivek Vajaratkar
BACKGROUND: Neurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden. METHODS AND FINDINGS: We assessed 3,964 children (with almost equal number of boys and girls distributed in 2-<6 and 6-9 year age categories) identified from five geographically diverse populations in India using cluster sampling technique (probability proportionate to population size)...
July 2018: PLoS Medicine
Willemien S Kalteren, Hendrik J Ter Horst, Anne E den Heijer, Leanne de Vetten, Elisabeth M W Kooi, Arend F Bos
BACKGROUND: Perinatal anemia may cause perinatal asphyxia. Its pathophysiology and neurodevelopmental effects are theoretically different from other causes of perinatal asphyxia. OBJECTIVE: The study aimed to determine whether perinatal anemia results in different short-term and long-term outcomes than other causes of perinatal asphyxia treated with therapeutic hypothermia. METHODS: We retrospectively included infants with moderate to severe hypoxic-ischemic encephalopathy, born between May 2009 and October 2015...
July 19, 2018: Neonatology
Elias Merdassa Roro, Mitike Molla Sisay, Lynn M Sibley
BACKGROUND: Statistics indicate that Ethiopia has made remarkable progress in reducing child mortality. It is however estimated that there is high rate of perinatal mortality although there is scarcity of data due to a lack of vital registration in the country. This study was conducted with the purpose of assessing the determinants and causes of perinatal mortality among babies born from cohorts of pregnant women in three selected districts of North Showa Zone, Oromia Region, Ethiopia...
July 18, 2018: BMC Public Health
Stella Y Lee, Chrystelle M Sirieix, Eugene Nattie, Aihua Li
KEY POINTS: Sudden infant death syndrome (SIDS) is one of the leading causes of death during the first year of life and abnormalities linked to serotonin (5-HT) have been identified in many SIDS cases. Cigarette smoking and associated exogenous stressors, e.g. developmental nicotine exposure, may compound these serotonergic defects and any associated defects in cardiorespiratory function. Using neonatal rodent pups subjected to medullary 5-HT deficiency and perinatal nicotine exposure, we examined the impact of this interplay of factors on the neonates' ability to autoresuscitate at specific ages...
July 15, 2018: Journal of Physiology
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