MEDICAL AND SOCIAL IMPLICATIONS OF TEENAGE PREGNANCY

Pregnancy in adolescence is a special situation, especially among teenagers who do not benefit from family support, being at risk of not receiving adequate prenatal care during pregnancy, of having complications during pregnancy and birth for the mother and especially for the newborn. Aim. The purpose of this paper is to present the pathology and complications associated to the newborn of teenage mothers. Material and method. Retrospective study of patients hospitalized during January 2013 – December 2014, the study inclusion criteria being maternal age up to 17 years. Results. 66.67% of the newborn in the study were preterm babies and 33.33% were newborn at term. Postpartum complications were more frequent and severe in the preterm newborns versus the newborn at term group. Correlating data about pathology, gestational age and birth weight with biological age of the mother reveals that mothers aged 13-15 years gave birth mostly to premature newborn as opposed to mothers aged 16 to 17 years. Mothers of preterm newborn that had extremely low and low birth weight were aged between 13-15 years. Conclusions. Pregnancy in adolescence is associated most frequently with giving birth to preterm newborn. The lower the biological age of the mother is, the higher the risk of a premature birth, the more severe complications being associated with lower gestational age and lower birth weight of the premature baby

IMPLICAŢIILE MEDICO-SOCIALE ALE SARCINII LA MAME MINORE

Sarcina la vârsta adolescenţei reprezintă o situaţie specială mai ales în rândul adolescentelor care nu beneficiază de susţinere familială, fiind expuse riscului de a nu primi îngrijiri prenatale corespunzătoare, cu complicaţii pe durata sarcinii şi în timpul naşterii atât pentru mamă, cât mai ales pentru nou-născut. Obiectiv. Scopul lucrării de faţă este de a prezenta patologia şi complicaţiile asociate nou-născuţilor proveniţi din mame adolescente. Material şi metodă. Studiu retrospectiv cuprizând pacienţii internaţi în perioada ianuarie 2013-decembrie 2014, criteriul de includere în studiu fiind vârsta mamei de maximum 17 ani. Rezultate. 66,67% dintre nou-născuţii din studiu au fost prematuri şi 33,33% au fost nou-născuţi la termen. Complicaţiile postpartum au fost mai frecvente şi mai severe în grupul prematurilor comparativ cu nou-născuţii la termen. Corelarea datelor obţinute despre patologia, vârsta de gestaţie şi greutatea la naştere a cazurilor cu vârsta biologică a mamei relevă că mamele cu vârsta de 13-15 ani au născut predominant prematuri comparativ cu cele cu vârsta de 16 şi 17 ani. Mamele prematurilor cu greutate la naştere extrem de mică şi foarte mică au vârsta cuprinsă între 13-15 ani. Concluzii. Sarcina la adolescenţă se asociază cel mai frecvent cu naşterea de copii prematuri. Cu cât vârsta biologică a mamei este mai mică, cu atât riscul de a naşte un prematur este mai mare, complicaţiile asociate fiind mai severe cu cât vârsta de gestaţie şi greutatea la naştere ale prematurului sunt mai mici

Clinical Factors Associated with COVID-19 Severity in Chronic Hospitalized Infants and Toddlers: Data from a Center in the West Part of Romania

Background: The risk factors for developing a severe form of COVID-19 in young children are poorly understood. Methods: A single-center retrospective study was conducted to quantify and analyze the clinical risk profile of children admitted to the Pediatric Clinic for Nutritional Recovery. Results: Overall, 51.5% (n = 17) of children were infected with SARS-CoV-2, all symptomatic, and five of them (29.4%) developed a severe form. A positive clinical pulmonary exam was only associated with the severe outcome (OR: 2.00; 95% CI, 0.33–5.66; p = 0.02). Other factors such as age under 3 months, prematurity, birth weight, malnutrition or positive history of congenital cardiac, neurodevelopmental, or genetic diseases, fever, temperature, cough, and digestive symptoms were not found to be significant risk factors. Conclusions: Clinical guidelines based on risk stratification for SARS-CoV-2 infection in children are needed in order to manage, monitor and establish priority access for some groups to high medical care

PNEUMOTHORAX – RISK FACTORS IN NEWBORN INFANTS

Aim. The main purpose is to evaluate the predisposing factors, the evolution and the associated pathology of the pneumothorax in the neonatal period. Materials and methods. Retrospective study over two years between 2014 and 2015 on 11 patients hospitalized in the Neonatology departement of “Louis Turcanu” Children’s Emergency Hospital, Timisoara, diagnosed with pneumothorax. Results. From 1689 newborn infants admitted, 11 patients developed pneumothorax, the incidence was 0.65%. 8 patients (73%) were males and 3 (27%) were females. 4 out of those 11 patients were term newborn infants (gestational age >37 weeks) and 7 patients were premature newborns (<37 weeks of gestational age). Based on the birth weight 4 patients had over 2,500 grams and 7 under 2,500 grams. The main cause of the pneumothorax in the study group was the respiratory distress syndrome (45,4%). Conclusions. Pneumothorax represents an important condition in the neonatal pathology, it is essential to recognize and initiate the treatment from early stages to reduce the complications

The Value of Imagistics in Early Diagnosis of Tuberous Sclerosis

Tuberous sclerosis complex is a multisystemic genetic disorder with high phenotypical variability. Its progress frequently brings along autism (61%), epilepsy, intellectual disability (45%), and neurocognitive impairment (Gipson and Johnston, 2017). We are considering the case of an infant suspected with tuberous sclerosis complex by imagistic investigation in the prenatal period. The pre- and postnatal ultrasound, fetal MRI, ophthalmoscopy, and dermatological and neurological examinations were used for diagnosis and follow-up. The seven major and minor criteria were regarded as sufficient for accurate diagnosis

Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) &lt; 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p &lt; 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p &lt; 0.001 and p &lt; 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p &lt; 0.05 and p &lt; 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p &lt; 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models

A Case of COVID-19 Pregnancy Complicated with Hydrops Fetalis and Intrauterine Death

Coronavirus disease 2019 (COVID-19) has rapidly evolved into a worldwide pandemic causing a serious global public health problem. The risk of vertical transmission of SARS-CoV-2 is still debated, and the consequences of this virus on pregnant women and their fetuses remain unknown. We report a case of pregnancy complicated with hydrops fetalis that developed 7 weeks after recovery from a mild SARS-CoV-2 infection, leading to intrauterine death of the foetus. Evidence of SARS-CoV-2 placentitis was demonstrated by the presence of viral particles in the placenta identified by immunohistochemistry. As we excluded all possible etiological factors for non-immunologic hydrops fetalis, we believe that the fetal consequences of our case are related to vertical transmission of SARS-CoV-2 virus. To the best of our knowledge, this is the second reported case in the literature of COVID-19 infection complicated with hydrops fetalis and intrauterine fetal demise

The Benefits of Vaccination against SARS-CoV-2 during Pregnancy in Favor of the Mother/Newborn Dyad

When the first vaccines against SARS-CoV-2 emerged, pregnant women were excluded from clinical trials, so vaccine recommendations were initially adjourned, with late initiation for this populational category. The present study aims to quantify the serum and breastmilk values of SARS-CoV-2 spike protein antibodies in both the mother and her newborn after complete vaccination during pregnancy. Ninety-one vaccinated patients were included, some of whom presented COVID-19 infection during pregnancy. In the delivery room, venous blood was collected from the mother and umbilical cord blood from her offspring. All samples were processed using the ECLIA (electrochemiluminescence) method. Breastmilk was collected and tested during the third postnatal day. The highest maternal serum values were 19,523 U/mL (detection limit &gt; 0.8 U/mL) and in breastmilk, 206.7 U/mL. Every single newborn had antibody values higher than 0, with a mean serum value (M = 5288.37, SD = 5661.49) significantly higher than 0, t(90) = 8.91, p &lt; 0.001. Consequently, this study intents to emphasize the importance of vaccination against SARS-CoV-2 during pregnancy. This double kind of neonatal protection, attained by placental and breastmilk transfer, can be accomplished by encouraging vaccination, breastfeeding, bonding, and providing maternal empowerment to participate in her infant&rsquo;s care

Comparative Analysis of Hematological and Biochemical Changes in Neonates among Women with and without COVID-19 Infection during Pregnancy

The aim of this study is to evaluate the test results of neonates delivered by COVID-19-positive mothers during pregnancy with those of neonates born to unvaccinated mothers who are COVID-19-free. A cohort study was conducted on 367 pregnant women who gave birth at Premiere Hospital, Timisoara, Romania, between May 2021 and February 2022. Two groups were established: Group 1, with 167 pregnant women infected with COVID-19, and Group 2, with 200 pregnant women who were not affected by COVID-19 during pregnancy. Maternal laboratory examination did not exhibit significant variations except for platelet count. In neonatal blood tests, WBC had a significantly lower median value in the group born to COVID-19-free mothers. Neonatal anemia and leukocytosis showed slightly higher prevalence in Group 1, but the differences were not statistically significant. This study suggests that maternal COVID-19 infection during pregnancy does not have significant associations with most maternal and neonatal characteristics

The Influence of Maternal Psychological Manifestations on the Mother–Child Couple during the Early COVID-19 Pandemic in Two Hospitals in Timisoara, Romania

Background and objectives: The postpartum maternal physical and psychological state played a fundamental role in the mother–child relationship at the beginning of the COVID-19 pandemic. The aim of the study is to analyze the influence of maternal psychological manifestations on the mother–child couple through three objectives (briefly expressed): (I) Determination of the main acute and chronic conditions of newborns/infants. (II) Verification of the hypothesis of the existence of a link between the following neonatal variables: gestational age, birth weight, number of days of hospitalization, and specific neonatal therapies (oxygen, surfactant, and blood products’ transfusion). (III) Verification of the influence of postpartum maternal psychological status on the mother–child couple through three hypotheses. Materials and methods: This cross-sectional study was conducted in two hospitals in Timișoara, Romania, between 1 March and 1 September 2020, and included 165 mothers and their 175 newborns. Mothers answered the Edinburgh Postnatal Depression Scale, Spielberger’s Inventory of State-Trait Anxiety, and the Collins and Read Revised Adult Attachment Scale. Results: (I) The acute and chronic pathology of the infants in the study group was polymorphic. (II) Large correlations were identified between the following infant variables: gestational age with birth weight, and number of hospitalization days with birth weight, gestational age, and use of blood product transfusion (all p p = 0.037), number of acute disorders (p = 0.028), and number of infant chronic diseases (p = 0.037). (2) Maternal depressive symptoms were the only predictor of postpartum maternal attachment (p = 0.018). (3) Depressive symptoms, state, and trait anxiety were non-significant in all models studied (all p > 0.05). Conclusions: Postpartum maternal physical and psychological state plays a fundamental role on the mother–child relationship in the new social and complex family conditions