Neonatal mortality in a tertiary care private set up in Saudi Arabia

To ascertain Neonatal Mortality Rate (NMR), Early NMR (ENMR), Late NMR (LNMR), Corrected NMR (cNMR), and causes of neonatal mortality in a major tertiary care private maternity and Neonatal Intensive Care Unit (NICU) set up in Saudi Arabia. This was a retrospective analysis of hospital data. We ascertained 1-year data (from January 1, 2017 to December 31, 2017) from the electronic patient medical records database as well as the annual reports of four tertiary care labor and delivery rooms and NICU’s of Sulaiman Al Habib Medical Group (HMG). We obtained the total number of deliveries and neonatal outcomes and calculated overall NMR, ENMR, and LNMR rates per 1000 live births and stratified them by Sociodemographic Index (SDI). We analyzed the data using Microsoft Excel. The electronic patient records included data on 14,339 deliveries and 14,543 births (including twins and multiple births). We observed a total of 51 neonatal deaths (30: early, 21: late) resulting in NMR of 3.5/1000, ENMR of 2.06/1000, and LNMR of 1.44/1000. The deaths due to futility were 24 (47%), giving a cNMR of 1.8/1000. We found complications of extreme prematurity and congenital anomalies incompatible with life as the two major causes of death in our dataset. There was no death due to perinatal asphyxia. The NMR and cNMR were comparable to the most recent global, regional, and national data. The cNMR of a select population with high SDI served by a major private tertiary care set up was lower than the NMR of the global high SDI group. The high incidence of major and futile congenital anomalies warrants further study

Probiotics for infantile colic: a systematic review

BACKGROUND: Infantile colic is a common paediatric condition which causes significant parental distress. Increased intestinal coliform colonization in addition to alteration in Lactobacillus abundance and distribution may play an important role in its pathogenesis. The objectives of this systematic review are to evaluate the efficacy of probiotic supplementation in the reduction of crying time and successful treatment of infantile colic. METHODS: Literature searches were conducted of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. Only randomized controlled trials enrolling term, healthy infants with colic were included. A meta-analysis of included trials was performed utilizing the Cochrane Collaboration methodology. RESULTS: Three trials that enrolled 220 breastfed infants met inclusion criteria, of which 209 infants were available for analysis. Two of the studies were assessed as good quality. Lactobacillus reuteri (strains-American Type Culture Collection Strain 55730 and DSM 17 938) was the only species utilized in the therapeutic intervention. Two of the trials were industry funded. Probiotic supplementation compared to simethicone or placebo significantly and progressively shortened crying times to 7 days reaching a plateau at three weeks post initiation of therapy [mean difference −56.03 minutes; 95% CI (−59.92, -52.15)]. Similarly, probiotics compared to placebo significantly increased the treatment success of infantile colic with a relative risk (RR) of 0.06; 95% CI (0.01, 0.25) and a number needed to treat of 2. CONCLUSIONS: Although L. reuteri may be effective as a treatment strategy for crying in exclusively breastfed infants with colic, the evidence supporting probiotic use for the treatment of infant colic or crying in formula-fed infants remains unresolved. Results from larger rigorously designed studies will help draw more definitive conclusions