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PP-11 Immediate management of growth restricted infant
S22
Abstracts
Conclusions Early discharge from Maternity hospital is recommended with well organised home care, that should prevent hyperbilirubinaemia including the dangerously high values.
PP-10. Outcomes of infants with gestational age less than 28 weeks and birth weight less than 800 g Atalay Demirel, Zeynep İnce, Asuman Coban, Sukru Cekic, Sukran Yıldırım, Gulay Can Istanbul University, Istanbul Medical Faculty, Department of Pediatrics, Division of Neonatology, Turkey
doi:10.1016/j.earlhumdev.2010.09.061 Aim
PP-09. Total oxidant status and antioxidant capacity related to being small gestational age in preterm and term infants
This study aims to review early morbidities in infants with birth weight less than 800 g or gestational age less than 28 weeks. Materials and methods
Gonca Sandal, Nurdan Uras, Tulin Gokmen, Omer Erdeve, Serife Suna Oguz, Ugur Dilmen Zekai Tahir Burak Maternity Education Hospital, Neonatal Intensive Care Unit, Turkey
Data were collected retrospectively from files of 115 infants who were born in İstanbul Medical Faculty with gestational age less than 28 weeks (group 1) and birth weight less than 800 g (group 2) in 2008 and 2009.
Aim
Results
Although intrauterine growth restriction (IUGR) has been suggested to involve oxidative stress, the relation of total oxidant status and antioxidant capacity with being small gestational age (SGA) in preterm and term infants has not been evaluated yet. In a prospective-controlled study, we aimed to determine the oxidant status of appropriate for gestational age (AGA) and SGA term and preterm infants and compare its relation with IUGR.
The range of gestational age of 115 infants was 23–33 weeks and birth weight was 420–1418 g. In the total group 53 infants (46%) were small for gestational age (SGA), 61 infants (53%) were appropriate-for-gestational-age (AGA), and one infant (1%) was large for gestational age (LGA). There were 87 patients (F/M: 42/45) in group 1 with birth weight of 420–1418 g and 72 patients (F/M: 37/ 35) in group 2 with birth weight of 420–800 g. AGA infants (69%) in group 1, and SGA infants (70%) in group 2 were significantly predominant. In group 1, respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) were seen in 86% (n: 75) and 33% (n: 29) of patients, and in group 2, 82% (n: 59) and 33% (n: 24) of patients respectively. In the total group BPD was seen in 38 infants (33%). There were no significant difference in retinopathy (27% vs 29%), patent ductus arteriosus (PDA) (24% vs 22%), IVH (12% vs 15%), NEC (6% vs 8%) and sepsis (16% vs 18%) in both groups and the ratios of retinopathy of prematurity (ROP), PDA, intraventricular hemorrage (IVH), NEC and sepsis in the total group, which were similar to both group, were 37%, 21%, 12%, 7% and 16% respectively. Twentyone patients (24%) in group 1 and 18 patients (25%) in group 2 were dead.
Materials and methods 184 infants were enrolled in the study and patients were classified into four groups: term appropriate for gestational age (T-AGA), term small for gestational age (T-SGA), preterm appropriate for gestational age (PM-AGA), and preterm small for gestational age (PM-SGA). TAC (total antioxidant capacity), TOS (total oxidant status) and OSI (oxidative stress index) levels were obtained in the first day of life. Results There were 46, 46, 47, and 45 patients in T-AGA, T-SGA, PM-AGA, and PM-SGA groups, respectively. Mean age of the mothers and mean gestational age of infants were 27.6 ± 4.8 years and 36.4 ± 3 weeks respectively. The mean birth weight of infants was 2361 ± 761 g. Although all groups were compared to each other, the only significant difference in TAC, TOS and OSI levels was obtained between T-AGA and T-SGA patients. The mean TAC level was lower (p = 0.01) and TOS and OSI levels were significantly higher in the T-SGA group(p = 0.00; p = 0.00, respectively).
Conclusions Recent developments in perinatology and neonatology resulted in increased survival rates of extremely low birth weight and gestational age infants. But this increase is associated with severe morbidities. doi:10.1016/j.earlhumdev.2010.09.063
Conclusions PP-11 Immediate management of growth restricted infant The insignificant difference in preterm infants may be due to increased effect of oxidative stress in preterms as they are more prone to have infections, respiratory distress syndrome and have reduced antioxidant defense. The significant difference related to being SGA in term infants suggests that these patients should be followed for oxidative stress related situations starting from early life.
doi:10.1016/j.earlhumdev.2010.09.062
Elizabeta Petkovskaa, Snezana Jancevskab a Department of Neonatal Intensive Care and Therapy, Republic of Macedonia b Neonatal Department, University Clinic of Gynecology and Obstetrics, Republic of Macedonia Aim Intrauterine growth restriction (IUGR) is characterized by fetal growth less than normal for the population and growth potential of a given infant. The decreased fetal growth rate in IUGR is an adaptation
Abstracts
to an unfavorable intrauterine environment and may result in permanent alterations in metabolism, growth and development. The acute neonatal consequences of IUGR are perinatal asphyxia and neonatal adaptive problems. Materials and methods During the period of 3 years, immediate management of 160 infants from fetal growth restricted pregnancies was studied. We used SPSS 1.1 and Statgraph for Win 2.1 statistical programs. Results were compared by Person Chi-Square (<0.05) and logistic regression analyses. Results Compared with normally grown infants, those who were growth restricted had increase risk for fetal distress (OR 16.47; 95%CI 6.86– 39.55), operative way of delivery (OR 4.25; 95%CI 2.72–6.64), perinatal asphyxia (OR 3.26; 95%CI 1.96–5.43), need for resuscitation (OR 2.81; 95%CI 2.83–4.32) and transfer to NICU (OR 2.38; 95%CI 1.56–3.65). Conclusions Perinatal asphyxia is the initial concern in IUGR fetus. Careful obstetric surveillance and timely delivery can prevent perinatal asphyxia and its clinical consequences. A neonatal resuscitation team should be available at the delivery room to improve neonatal outcome. Immediate management in the delivery room should focus on anticipation of a depressed infant, adequate resuscitation and insuring a normal physiologic transition.
S23
immunity indicators: T and B lymphocytes, markers CD3+ %, CD4+ %, CD19+ %, three main category of immunoglobulin at the blood serum Ig A, Ig M, Ig G quantity, have been revealed. Indicators of the status of cytokine in blood have been studied with the help of the immunoenzyme method. Anthropometric data of infants with syndrome intrauterine growth retardation have been studied using the Dementeva table (physical development according to gestation age) for definitions of deficiency of weight of a body and growth of newborns in comparison with healthy babies. Results Thus results of the spent researches of children with intrauterine infection allow to organise modern actions for prophylactic medical examination. Conclusions The frequency of occurrence of intrauterine infection was 45% at children concerning group of risk with syndrome intrauterine growth retardation (SIGR) born from mothers with the burdened gynecologic anamnesis. According to the research diseases of CNS, respiratory and hepatobiliary systems were observed at babies with syndrome intrauterine growth retardation. The heaviest and sustainable lesions of bodies and their systems were observed at children (SIGR) with morpho-functional underdevelopment. The most expressed changes of immunity, status of cytokine and cytomegalovirus mixed infection have been revealed in early catamnesis. doi:10.1016/j.earlhumdev.2010.09.065
doi:10.1016/j.earlhumdev.2010.09.064
PP-13. Late preterm birth associated or not with intrauterine growth restriction: Morbidity risk comparison
PP-12. Catamnesis of babies, born with syndrome of intrauterine growth retardation and had an intrauterine infection in a new birth period Nergiz Mustafayeva Scientific Research Institute of Pediatrics Named After K. Farajova, Azerbaijan
Marta Santalhaa, Ricardo Santosb, Ricardo Santosc, Clara Paz Diasa, Maria Jose Valea a Department of Neonatology, Portugal b Department of Obstetrics and Gynecology, Centro Hospitalar Do Alto Ave-Guimarães, Portugal c Cintesis, Faculdade De Medicina, Universidade Do Porto, Portugal
Aim
Aim
This study aims to study the state of health of babies, born with syndrome of intrauterine growth retardation and had an intrauterine infection in a new birth period.
Intra-uterine growth restriction (IUGR) is the term used to designate a fetus that has not reached its growth potential. Preterm IUGR is strongly associated with increased mortality and morbidity as complications of preterm birth can be amplified by the effect of suboptimal fetal growth. Objective: To compare neonatal morbidity and mortality between late preterm IUGR and appropriate-forgestational-age (AGA) infants.
Materials and methods Objects of research were 280 full-term infants with intrauterine infections (toxoplasmosis, cytomegalovirus, and clamidiosis). We detected mixed infection at seventy (25%) infants. We have also found out intrauterine infection in fifty six children (20%) together with periventricular leukomalacia. Catamnesis included by infancy period. Neurologist, ophthalmologist, otorhinolaryngologist and surgeon (if needed) participated in the clinical (therapeutic) inspection. Ultrasonic, neuro-sonography, and Doppler researches have been carried out. The general analyses of blood, urine, and stool have been made; serological, biochemical researches and also an Xray investigation have been conducted. Both cellular and humoral immunity indicators and status of cytokine have been studied. The Bordet–Gengou test, indirect immunofluorescence test, and immuneenzyme analysis are applied for diagnostics of intrauterine infection. For an estimation of the immune status of cellular and humoral
Materials and methods Retrospective analysis of all late preterm, born between March 1st 2008 and March 1st 2010, in our center. Variables: gestational age (GA), sex, weight, mode of delivery, Apgar score, neonatal complications, place and duration of hospitalization. Exclusion criteria: infants with congenital anomalies and with uncertain GA. Data were analyzed using Student's t, X2 and Fisher's exact test. Results 324 late preterm infants were included, 27 IUGR and 297 AGA. Mean birth weight (+SD) was 1929.8 + 371.8 g and 2483.3 + 364.2 g
Abstracts
Conclusions Early discharge from Maternity hospital is recommended with well organised home care, that should prevent hyperbilirubinaemia including the dangerously high values.
PP-10. Outcomes of infants with gestational age less than 28 weeks and birth weight less than 800 g Atalay Demirel, Zeynep İnce, Asuman Coban, Sukru Cekic, Sukran Yıldırım, Gulay Can Istanbul University, Istanbul Medical Faculty, Department of Pediatrics, Division of Neonatology, Turkey
doi:10.1016/j.earlhumdev.2010.09.061 Aim
PP-09. Total oxidant status and antioxidant capacity related to being small gestational age in preterm and term infants
This study aims to review early morbidities in infants with birth weight less than 800 g or gestational age less than 28 weeks. Materials and methods
Gonca Sandal, Nurdan Uras, Tulin Gokmen, Omer Erdeve, Serife Suna Oguz, Ugur Dilmen Zekai Tahir Burak Maternity Education Hospital, Neonatal Intensive Care Unit, Turkey
Data were collected retrospectively from files of 115 infants who were born in İstanbul Medical Faculty with gestational age less than 28 weeks (group 1) and birth weight less than 800 g (group 2) in 2008 and 2009.
Aim
Results
Although intrauterine growth restriction (IUGR) has been suggested to involve oxidative stress, the relation of total oxidant status and antioxidant capacity with being small gestational age (SGA) in preterm and term infants has not been evaluated yet. In a prospective-controlled study, we aimed to determine the oxidant status of appropriate for gestational age (AGA) and SGA term and preterm infants and compare its relation with IUGR.
The range of gestational age of 115 infants was 23–33 weeks and birth weight was 420–1418 g. In the total group 53 infants (46%) were small for gestational age (SGA), 61 infants (53%) were appropriate-for-gestational-age (AGA), and one infant (1%) was large for gestational age (LGA). There were 87 patients (F/M: 42/45) in group 1 with birth weight of 420–1418 g and 72 patients (F/M: 37/ 35) in group 2 with birth weight of 420–800 g. AGA infants (69%) in group 1, and SGA infants (70%) in group 2 were significantly predominant. In group 1, respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) were seen in 86% (n: 75) and 33% (n: 29) of patients, and in group 2, 82% (n: 59) and 33% (n: 24) of patients respectively. In the total group BPD was seen in 38 infants (33%). There were no significant difference in retinopathy (27% vs 29%), patent ductus arteriosus (PDA) (24% vs 22%), IVH (12% vs 15%), NEC (6% vs 8%) and sepsis (16% vs 18%) in both groups and the ratios of retinopathy of prematurity (ROP), PDA, intraventricular hemorrage (IVH), NEC and sepsis in the total group, which were similar to both group, were 37%, 21%, 12%, 7% and 16% respectively. Twentyone patients (24%) in group 1 and 18 patients (25%) in group 2 were dead.
Materials and methods 184 infants were enrolled in the study and patients were classified into four groups: term appropriate for gestational age (T-AGA), term small for gestational age (T-SGA), preterm appropriate for gestational age (PM-AGA), and preterm small for gestational age (PM-SGA). TAC (total antioxidant capacity), TOS (total oxidant status) and OSI (oxidative stress index) levels were obtained in the first day of life. Results There were 46, 46, 47, and 45 patients in T-AGA, T-SGA, PM-AGA, and PM-SGA groups, respectively. Mean age of the mothers and mean gestational age of infants were 27.6 ± 4.8 years and 36.4 ± 3 weeks respectively. The mean birth weight of infants was 2361 ± 761 g. Although all groups were compared to each other, the only significant difference in TAC, TOS and OSI levels was obtained between T-AGA and T-SGA patients. The mean TAC level was lower (p = 0.01) and TOS and OSI levels were significantly higher in the T-SGA group(p = 0.00; p = 0.00, respectively).
Conclusions Recent developments in perinatology and neonatology resulted in increased survival rates of extremely low birth weight and gestational age infants. But this increase is associated with severe morbidities. doi:10.1016/j.earlhumdev.2010.09.063
Conclusions PP-11 Immediate management of growth restricted infant The insignificant difference in preterm infants may be due to increased effect of oxidative stress in preterms as they are more prone to have infections, respiratory distress syndrome and have reduced antioxidant defense. The significant difference related to being SGA in term infants suggests that these patients should be followed for oxidative stress related situations starting from early life.
doi:10.1016/j.earlhumdev.2010.09.062
Elizabeta Petkovskaa, Snezana Jancevskab a Department of Neonatal Intensive Care and Therapy, Republic of Macedonia b Neonatal Department, University Clinic of Gynecology and Obstetrics, Republic of Macedonia Aim Intrauterine growth restriction (IUGR) is characterized by fetal growth less than normal for the population and growth potential of a given infant. The decreased fetal growth rate in IUGR is an adaptation
Abstracts
to an unfavorable intrauterine environment and may result in permanent alterations in metabolism, growth and development. The acute neonatal consequences of IUGR are perinatal asphyxia and neonatal adaptive problems. Materials and methods During the period of 3 years, immediate management of 160 infants from fetal growth restricted pregnancies was studied. We used SPSS 1.1 and Statgraph for Win 2.1 statistical programs. Results were compared by Person Chi-Square (<0.05) and logistic regression analyses. Results Compared with normally grown infants, those who were growth restricted had increase risk for fetal distress (OR 16.47; 95%CI 6.86– 39.55), operative way of delivery (OR 4.25; 95%CI 2.72–6.64), perinatal asphyxia (OR 3.26; 95%CI 1.96–5.43), need for resuscitation (OR 2.81; 95%CI 2.83–4.32) and transfer to NICU (OR 2.38; 95%CI 1.56–3.65). Conclusions Perinatal asphyxia is the initial concern in IUGR fetus. Careful obstetric surveillance and timely delivery can prevent perinatal asphyxia and its clinical consequences. A neonatal resuscitation team should be available at the delivery room to improve neonatal outcome. Immediate management in the delivery room should focus on anticipation of a depressed infant, adequate resuscitation and insuring a normal physiologic transition.
S23
immunity indicators: T and B lymphocytes, markers CD3+ %, CD4+ %, CD19+ %, three main category of immunoglobulin at the blood serum Ig A, Ig M, Ig G quantity, have been revealed. Indicators of the status of cytokine in blood have been studied with the help of the immunoenzyme method. Anthropometric data of infants with syndrome intrauterine growth retardation have been studied using the Dementeva table (physical development according to gestation age) for definitions of deficiency of weight of a body and growth of newborns in comparison with healthy babies. Results Thus results of the spent researches of children with intrauterine infection allow to organise modern actions for prophylactic medical examination. Conclusions The frequency of occurrence of intrauterine infection was 45% at children concerning group of risk with syndrome intrauterine growth retardation (SIGR) born from mothers with the burdened gynecologic anamnesis. According to the research diseases of CNS, respiratory and hepatobiliary systems were observed at babies with syndrome intrauterine growth retardation. The heaviest and sustainable lesions of bodies and their systems were observed at children (SIGR) with morpho-functional underdevelopment. The most expressed changes of immunity, status of cytokine and cytomegalovirus mixed infection have been revealed in early catamnesis. doi:10.1016/j.earlhumdev.2010.09.065
doi:10.1016/j.earlhumdev.2010.09.064
PP-13. Late preterm birth associated or not with intrauterine growth restriction: Morbidity risk comparison
PP-12. Catamnesis of babies, born with syndrome of intrauterine growth retardation and had an intrauterine infection in a new birth period Nergiz Mustafayeva Scientific Research Institute of Pediatrics Named After K. Farajova, Azerbaijan
Marta Santalhaa, Ricardo Santosb, Ricardo Santosc, Clara Paz Diasa, Maria Jose Valea a Department of Neonatology, Portugal b Department of Obstetrics and Gynecology, Centro Hospitalar Do Alto Ave-Guimarães, Portugal c Cintesis, Faculdade De Medicina, Universidade Do Porto, Portugal
Aim
Aim
This study aims to study the state of health of babies, born with syndrome of intrauterine growth retardation and had an intrauterine infection in a new birth period.
Intra-uterine growth restriction (IUGR) is the term used to designate a fetus that has not reached its growth potential. Preterm IUGR is strongly associated with increased mortality and morbidity as complications of preterm birth can be amplified by the effect of suboptimal fetal growth. Objective: To compare neonatal morbidity and mortality between late preterm IUGR and appropriate-forgestational-age (AGA) infants.
Materials and methods Objects of research were 280 full-term infants with intrauterine infections (toxoplasmosis, cytomegalovirus, and clamidiosis). We detected mixed infection at seventy (25%) infants. We have also found out intrauterine infection in fifty six children (20%) together with periventricular leukomalacia. Catamnesis included by infancy period. Neurologist, ophthalmologist, otorhinolaryngologist and surgeon (if needed) participated in the clinical (therapeutic) inspection. Ultrasonic, neuro-sonography, and Doppler researches have been carried out. The general analyses of blood, urine, and stool have been made; serological, biochemical researches and also an Xray investigation have been conducted. Both cellular and humoral immunity indicators and status of cytokine have been studied. The Bordet–Gengou test, indirect immunofluorescence test, and immuneenzyme analysis are applied for diagnostics of intrauterine infection. For an estimation of the immune status of cellular and humoral
Materials and methods Retrospective analysis of all late preterm, born between March 1st 2008 and March 1st 2010, in our center. Variables: gestational age (GA), sex, weight, mode of delivery, Apgar score, neonatal complications, place and duration of hospitalization. Exclusion criteria: infants with congenital anomalies and with uncertain GA. Data were analyzed using Student's t, X2 and Fisher's exact test. Results 324 late preterm infants were included, 27 IUGR and 297 AGA. Mean birth weight (+SD) was 1929.8 + 371.8 g and 2483.3 + 364.2 g