Klinički i ehokardiografski nalazi u novorođenčadi dijabetičnih majki

The aim of the study was to assess the use of echocardiographic measurements in newborns of diabetic mothers. Maternal diabetes is associated with an increased risk of morbidity and mortality in pregnancy and in perinatal period. Thirty-five newborns of diabetic mothers (pregestational or gestational diabetes; case group) and thirty-five controls (control group), born between January 2009 and December 2012 in Cluj-Napoca (north-west of Romania), were included in this study. A Logiq e ultrasound with an 8 MHz transducer was used to measure echocardiographic parameters. The interventricular septal thickness in case group was higher as compared with control group (at end systole = 6.61±1.64 mm vs. 5.75±0.95 mm, p=0.0371; at end diastole = 4.61±1.59 mm vs. 3.42±0.70 mm, p=0.0001). A risk ratio of 2.333 (0.656, 8.298) was obtained for septal hypertrophy. A higher proportion of septal hypertrophy was identified in the newborns of mothers with gestational diabetes compared to the newborns of pregestational diabetes mothers (p=0.0058). The mean birth weight was significantly higher in newborns of diabetic mothers (3695.57±738.63) as compared with controls (3276.14±496.51; p=0.0071). Infants born to mothers with diabetes proved to be at a high risk of septal hypertrophy.Cilj je bio procijeniti primjenu ehokardiografskih mjerenja u novorođenčadi dijabetičnih majki. Majčin dijabetes udružen je s povećanim rizikom pobola i smrtnosti u trudnoći i tijekom perinatalnog razdoblja. U ispitivanje je bilo uključeno 35 novorođenčadi dijabetičnih majki (predgestacijski ili gestacijski dijabetes; ispitna skupina) i 35 kontrolne novorođenčadi (kontrolna skupina) rođene između siječnja 2009. i prosinca 2012. godine u području Cluj-Napoca (sjeverozapadna Rumunjska). Ehokardiografski parametri mjereni su pomoću ultrazvučnog uređaja Logiq e s pretvornikom od 8 MHz. Debljina interventrikulskog septuma bila je viša u ispitnoj skupini u usporedbi s kontrolnom skupinom (na kraju sistole = 6,61±1,64 mm prema 5,75±0,95 mm, p=0,0371; na kraju dijastole = 4,61±1,59 mm prema 3,42±0,70 mm, p=0,0001). Omjer rizika za septalnu hipertrofiju bio je 2,333 (0,656; 8,298). U novorođenčadi majki s gestacijskim dijabetesom zabilježen je veći udio hipertrofije septuma u usporedbi s novorođenčadi majki s predgestacijskim dijabetesom (p=0,0058). Srednja porođajna težina novorođenčadi dijabetičnih majki (3695,57±738,63) bila je značajno viša u usporedbi s kontrolnom skupinom (3276,14±496,51; p=0,0071). Kod novorođenčadi majki s dijabetesom utvrđen je visok rizik od hipertrofije septuma

Clinical and echocardiographic findings in newborns of diabetic mothers

The aim of the study was to assess the use of echocardiographic measurements in newborns of diabetic mothers. Maternal diabetes is associated with an increased risk of morbidity and mortality in pregnancy and in perinatal period. Thirty-five newborns of diabetic mothers (pregestational or gestational diabetes; case group) and thirty-five controls (control group), born between January 2009 and December 2012 in Cluj-Napoca (north-west of Romania), were included in this study. A Logiq e ultrasound with an 8 MHz transducer was used to measure echocardiographic parameters. The interventricular septal thickness in case group was higher as compared with control group (at end systole = 6.61±1.64 mm vs. 5.75±0.95 mm, p=0.0371; at end diastole = 4.61±1.59 mm vs. 3.42±0.70 mm, p=0.0001). A risk ratio of 2.333 (0.656, 8.298) was obtained for septal hypertrophy. A higher proportion of septal hypertrophy was identified in the newborns of mothers with gestational diabetes compared to the newborns of pregestational diabetes mothers (p=0.0058). The mean birth weight was significantly higher in newborns of diabetic mothers (3695.57±738.63) as compared with controls (3276.14±496.51; p=0.0071). Infants born to mothers with diabetes proved to be at a high risk of septal hypertrophy

Parental factors associated with intrauterine growth restriction

Introduction. Linear growth failure is caused by multiple factors including parental factors. Objective. The aim of this study was to evaluate parental risk factors for intrauterine growth restriction (IUGR) on a population of Romanian newborn infants in a tertiary level maternity facility for a period of 2.5 years. Methods. A retrospective matched case-control study was conducted in the Emergency County Hospital of Cluj-Napoca, a university hospital in North-Western Romania. The sample was selected from 4,790 infants admitted to the Neonatal Ward at 1st Gynecology Clinic between January 2012 and June 2014. Results. The age of mothers was significantly lower in the IUGR group compared to controls (p=0.041). A significantly higher percentage of mothers had hypertension in the IUGR group compared to those in the control group (p<0.05). No other significant differences were identified with regard to the investigated characteristics of mothers between IUGR infants compared to controls (p>0.13). The age of fathers of infants with IUGR proved significantly lower compared to controls (p=0.0278). The analysis of infants’ comorbidities revealed no significant difference between groups for respiratory distress, hyperbilirubinemia, hypocalcaemia, and heart failure (p>0.27). Intracranial hemorrhage, necrotizing enterocolitis and hypoglycemia were significantly higher in the IUGR group compared to controls. The logistic regression identified hypertension as a significant risk factor for IUGR (OR=2.4, 95% CI [1.3-4.5]). Conclusion. Although the age of the mothers and fathers proved significantly lower in the IUGR group compared to controls, only hypertension in the mothers proved significant risk factors for IUGR

Design and Implementation of Data Collection Instruments for Neonatology Research

im: The aim of our research was to design and implement data collection instruments to be use in context of an observational prospective clinical study with follow-up conducted on new born with intrauterine growth restriction. Methods: The structure of the data collection forms (paper based and electronic based) was first identified and for each variable the best type to accomplish the research aim was established. The code for categorical variables has also been decided as well as the units of measurements for quantitative variables. In respect of good practice, a set of confounding factors (as gender, date of birth, etc.) have also been identified and integrated in data collection instruments. Data-entry validation rules were implemented for each variable to reduce data input errors when the electronic data collection instrument was created. Results: Two data collection instruments have been developed and successfully implemented: a paper-based form and an electronic data collection instrument. The developed forms included demographics, neonatal complications (as hypoglycemia, hypocalcemia, etc.), biochemical data at birth and follow-up, immunological data, as well as basal and follow-up echocardiographic data. Data-entry validation criteria have been implemented in electronic data collection instrument to assure validity and precision when paper-based data are translated in electronic form. Furthermore, to assure subject’s confidentiality a careful attention was given to HIPPA identifiers when electronic data collection instrument was developed. Conclusion: Data collection instruments were successfully developed and implemented as an a priori step in a clinical research for assisting data collection and management in a case of an observational prospective study with follow-up visits

Association of Parental Factors and Insulin-like Growth Factor 2 Polymorphism with Intrauterine Growth Restriction

Polymorphism of insulin-like growth factor 2 (IGF2) is known to play a role in cell development. Only the paternal IGF2 copy is active, while the copy inherited from the mother is inactive. This study aimed to explore whether maternal and paternal factors influence IGF2 polymorphism in newborns with intrauterine growth restriction (IUGR) compared to appropriate for gestational age (AGA). A cross-sectional exploratory study was conducted from June 2014 to November 2015 at the Neonatology, Gynecology 1 Clinic, Cluj-Napoca, Romania. The ApaI IGF2 genotypes and allele frequencies were similar in the IUGR and AGA groups (p-value &gt; 0.10). The IUGR babies with a protective IGF2 genetic profile had significantly younger parents (a difference in the median age of 8 years for mothers and 9 years for fathers; p-value &lt; 0.009). The IUGR babies had parents with lower birth weights than AGA babies (mothers&rsquo; medians: 2800 g vs. 3100 g; fathers&rsquo; medians: 3000 g vs. 3400 g; p-value &lt; 0.02). In univariable regression analysis, the mother&rsquo;s and father&rsquo;s birth weight proved to be associated with IUGR. The father&rsquo;s birth weight proved to be the only factor significantly associated with IUGR, independent of the mother&rsquo;s birth weight or the presence of a protective IGF2 genetic profile (odd ratio = 0.998 [0.996 to 1.000], p-value = 0.032)