Early neonatal outcome in late preterms compared with term neonates

Introduction: Neonates born between 34 weeks and 36 weeks 6 days of gestational age (GA) are known as late preterm neonates. These late preterm neonates are the largest subgroup of preterm neonates. There have been few studies regarding the early morbidity in this cohort of neonates when compared to neonates born at term. Objectives: The objectives of the study were to study the incidence and various causes of early morbidities and mortality in late preterm neonates and to compare with term neonates. Materials and Methods: This prospective cohort study was conducted at a tertiary care teaching institution of Bengaluru. All late preterm and term neonates born between December 2016 and July 2018 were enrolled in the study. Data regarding parity, mode of delivery, sex, GA, birth weight, predefined neonatal morbidities, and maternal risk factors were all entered in the pre-designed pro forma. The morbidities and mortality of these late preterm neonates were compared with the term neonates. Results: A total of 408 late preterms and 1660 term neonates were enrolled in this study. These late preterm neonates were at significantly higher risk of overall morbidity due to any cause (85.3%, p<0.001, adjusted odds ratio [OR]: 1.4, 95% confident interval [CI]=0.8–2.4). They were also at higher risk of developing respiratory distress (23.5%, p<0.001, adjusted OR: 1.5, 95% CI: 1.1–2.2), need for ventilation ([Nasal continuous positive airway pressure – 8.6%] [synchronized intermittent mandatory ventilation [SIMV] – 3.7%], p<0.001), and neonatal sepsis (9.1%, p=0.003, adjusted OR: 1.3, 95% CI=0.3–3.3) when compared with term neonates. Conclusion: Gestational maturity is the most important determinant of the outcome in newborns. Late preterm neonates are not the same as term neonates as evidenced by the high incidence of complications in late preterm compared to term infants

Clinical profile and outcome of perinatal asphyxia in a tertiary care centre

Abstract The aim was to study the clinical profile and outcome of term asphyxiated newborns admitted to our hospital. This was a retrospective observational study conducted from July 2013 to August 2014. Sixty newborn babies, who fulfilled the selection criteria, were included in the study. Out of 1167 admissions, 60 cases (5.1%) were diagnosed of birth asphyxia with APGAR score of </=6 at 5 minutes. Thirty four babies (56.66%) were inborn and 26 babies (43%) were outborn. Forty two babies (70%) were found to be males and 18 (30%) were females. Majority of the babies i.e. 80% (48cases) were appropriate for gestational age, 16% (10 babies) were IUGR babies and 3% (2 babies) were large for gestational age. Majority of them (70%) were delivered vaginally, 15 babies (25%) by caesarian section and 3 babies (5%) by instrumental delivery. Out of the total, it was found that 40% had meconium stained liquor, 13.3% mothers had PIH, 11.6% had PROM and 3 (5%) had cord prolapse. Of the total, hypoxic ischaemic encephalopathy (HIE) was diagnosed in 31.7%, with stage I in 52.6%, stage II in 31.5% babies and stage III in 15.7% babies. ABG analysis showed moderate acidemia in 65% and severe in 35%. The mortality was 8% (5 babies). All the three HIE stage III cases died and the remaining 2 cases died of MAS with early onset sepsis. Keywords: HIE (hypoxic ischaemic encephalopathy), ABG (arterial blood gases), MSAF (meconium stained amniotic fluid), PROM (premature rupture of membranes), PIH (pregnancy induced hypertension