Interleukins in diagnosis of perinatal asphyxia: A systematic review

Background: Biochemical markers including interleukins (ILs) has been proposed for early diagnosis of asphyxia. Objective: This study has aimed to systematically review the significance of IL measurements in the diagnosis of perinatal asphyxia. Materials and Methods: PubMed, Cochrane Library, Web of Science, Embase, and Scopus databases before 2017 were searched for the following keywords: asphyxia, neonatal, interleukin, and diagnosis. A total of 13 out of 300 searched papers were finally selected for evaluation. Interleukins under study were IL6 and interleukin 1β (IL-1β). Interleukins had been measured in 10 studies by serum samples, 2 studies by samples of Cerebro Spinal Fluid (CSF), and 1 study by sample of umbilical cord blood. The inclusion criteria were: studies on neonates, with adequate information from the test results and studies using markers other than ILs to detect asphyxia; however, studies with only abstracts available were excluded. Results: Research on the issue suggests that IL6 > 41 Pg/dl has the sensitivity of 84.88% and the specificity of 85.43%, whereas IL-1β > 4.7 Pg/dl has the sensitivity of 78% and specificity of 83% in the diagnosis of neonatal asphyxia. Among diagnostic ILs for neonatal asphyxia, combination of IL6 and IL-1β had the highest sensitivity, that is, 92.9%. Conclusion: IL6 and IL-1β of serum samples were used in the early diagnosis of perinatal asphyxia and are useful predictors for the outcomes of perinatal asphyxia and its intensity. In addition, simultaneous evaluation of IL-1β and IL6 can improve the sensitivity of the early diagnosis of perinatal asphyxia

Comparison of new Biomarkers in the Diagnosis of Perinatal Asphyxia

  Objectives Precise and early diagnosis of neonatal asphyxia may improve its outcomes. New studies aim to identify diagnostic biomarkers in neonates at risk for brain damage. The current study was designed to evaluate the diagnostic value of new biomarkers neonatal asphyxia. Materials & Methods This prospective study was conducted with an available sampling of infants upper 35 weeks of gestational age, including neonates with asphyxia (case group) and healthy controls, 2014-2022, in Ghaem Hospital, Mashhad, Iran. Data collection was performed utilizing a researcher-made questionnaire, including maternal and neonatalcharacteristics, as well as clinical and laboratory evaluation. Serum umbilical cord levels of interleukin-6 (IL6), interleukin-1-beta (IL- 1β), pro-oxidant-antioxidant balance (PAB), and heat shock protein-70 (HSP70), as well as nucleated red blood cells count (NRBC), were determined. Data were analyzed by t-test, Chi-square, receiver operating characteristic (ROC), and regression models. Results Variables interleukin-6(IL6) (P<0.0001), IL1β (P<0.0001), PAB (P<0.0001), NRBC/100WBC (P<0.0001) and HSP70 (P<0.0001) in the two groups, the difference was statistically significant. In the diagnosis of asphyxia, the most sensitive marker (89%) was IL1β more than 2.39 pg/ml and HSP 70 upper than 0.23 ng/ml while IL6 higher than 9pg/ml determined as the most specific marker (85%). For the diagnosis of asphyxia, combination of HSP + PAB and IL6 + lL1b + PAB + NRBC/100WBC possesses the prediction power of 93.2% and 87.3% respectively. Conclusion According to data analysis, the combination of new biochemical markers (NRBC count, IL6, IL1β, PAB, HSP 70) could be a reliable marker for the diagnosis of infants with asphyxia. The composition of the HSP + PAB indicators is more valid predictions 93.2% compared to the other combined indicators for the diagnosis of asphyxiated neonates. PAB values correlate with the severity of asphyxia. &nbsp

The Knowledge and Attitudes towards Breastfeeding of Iranian Mothers during the First Year after Delivery in 2013

OBJECTIVE: Globally less than 40% of infants less than six months of age are exclusively breastfed. Adequate breastfeeding support for mothers and families could save many young lives. This study aimed to determine knowledge and attitudes of mothers toward breastfeeding in Tonekabon, Iran.METHODS: This study was a descriptive-analytical cross sectional study with convenience sampling. The sample consisted of 200 nursing mothers who have including criteria of the study. Data was collected by a questionnaire including demographic data and questions about knowledge and attitude toward breastfeeding. Data analysis performed by using of SPSS (11.5) and appropriate statistical tests.RESULTS: Most of them (73.5%) were 21-30 age group. 50.5% of them had a diploma education. 46% of them reported the essential information about breastfeeding obtained from medical- health centers. 5% of them had poor and 42% had a medium knowledge about breastfeeding while 53% of them had good knowledge about it. Most of the mothers (79.5%) had positive attitude regarding breast feeding.CONCLUSION: According to most of the mothers had good knowledge and positive attitude about breastfeeding, with proper planning to increase awareness and promote a positive attitude towards breastfeeding can be tried for child survival

Interleukin-6 as A Prognostic Biomarker in Perinatal Asphyxia

Abstract Objective Early diagnosis is considered as a priority for prevention and treatment of asphyxia-related complications. The main aim of the present study was to evaluate the prognostic value of interleukin-6 (IL-6) and hypoxic ischemic encephalopathy grade in prediction mortality and developmental status of neonates affected by prenatal asphyxia. Materials & Method The cohort study was conducted on 38 term asphyxiated infants at Ghaem hospital, Mashhad, Iran, during 2013-2017. The HIE grade and serum IL-6 levels were determined at the time of birth. The developmental status was determined using the Denver II test at the end of two-year follow-up. Results  HIE grade 3 resulted in 83% mortality rate and developmental delay in all the survivors. The average IL-6 level was 2.7 ng/ml in the control group (not affected HIE) which increased up to 29, 175 and 136 ng/ml in those with HIE grades 1, 2 and 3, respectively. Roc curve analysis revealed the cut-off levels 24 pg/ml to predict the developmental delay with sensitivity and specificity of 96 and 92%, respectively. Conclusion  The IL-6 level and HIE grade are the potential prognostic biomarkers for determination of mortality and morbidity rate in the asphyxiated neonate

The effect of maternal hospitalization duration on neonatal bilirubin level

Background: The length of maternal hospitalization in uncomplicated delivery has declined and it has become common event around the world. With the expansion of early maternal discharge from hospital in recent years, the identification, follow-up and proper treatment of neonatal problems such as jaundice have been confronted with challenges. Hyperbilirubinemia is the most common disease among neonates especially preterm neonates during the first week of life. This study was performed aiming to investigate maternal hospitalization duration after delivery and its effect on neonatal jaundice level. Methods: In this descriptive-analytical study, 1347 newborns with the jaundice hospitalized in neonatal clinic or emergency unit or neonatal intensive units of Ghaem Hospital, Mashhad, during May 2011 to November 2017 were investigated. The data collection tool was a researcher-made questionnaire containing three parts. First part was maternal demographic information (age, long hospitalization, and mode of delivery), Second part was neonatal information (serum bilirubin, hematocrit and platelet) and third part was laboratory information (serum bilirubin, hematocrit, and platelet). The relationship between the severity of jaundice in hospitalized infants and maternal hospitalization duration were evaluated. Values were expressed as mean±SD. Student t-test, chi-square and Pearson coefficient tests were used as appropriate. P-value less than 0.05 was considered significant. Results: 752 (fifty six percent) of mothers are discharged from the hospital at the end of first day. The mean maternal hospitalization duration was 1.31±0.57 days in normal delivery and 1.73±0.65 days in cesarean delivery (P=0.000). Pearson correlation test showed that increasing the duration of maternal hospitalization, some issues were observed including as decreasing serum bilirubin level (P=0.000) in newborns, increasing the admission age in hospital (P=0.045), decreasing daily weight loss rate (P=0.012) and decreasing the percentage of daily weight loss (P=0.002). Conclusion: By increasing the hospitalization duration of the mother in hospital, serum bilirubin level, rate and percentage of daily weight loss in the newborns would be decreased

Assessment of Maternal Risk Factors Associated with Mortality in Preterm Infants

Background & Aims: Detection of maternal risk factors associated with neonatal mortality helps to identify high-risk infants and prevent neonatal death. It can also contribute to the design more effective prenatal care. This study was performed aiming to evaluate the maternal risk factors associated with mortality in preterm infants in Mashhad Ghaem Hospital, Iran, during 2009-2014. Methods: This cross-sectional study was performed on 335 dead infants (23 to 40 weeks of gestation). The infants were divided into two groups, according to the history of maternal risk factors: 185 cases (55.20%) with a previous history of normal pregnancy and 150 infants (44.80%) with a history of maternal risk factors. The researcher-made questionnaire containing maternal information, neonatal characteristics, and maternal risk factors was completed. The causes of infants' death were confirmed by the hospital mortality technical committee. Data were analyzed using t and chi-square test via SPSS19.5 software. P-value less than 0.05 was considered statistically significant. Results: There was a statistically significant difference between the two groups in terms of age, weight, height, head circumference, length of hospital stay, being a twin, gestational age, maternal age, and mode of delivery (P < 0.05 for all). There was history of maternal risk factors in 45% of cases. The most common maternal disease was preeclampsia (14%). Asphyxia in infants with previous history of maternal risk factors, and congenital anomalies in infants with normal pregnancy, were the most common causes of death. Conclusion: As the results indicated, maternal risk factors including preeclampsia, diabetes and placental abruption were involved in neonatal mortality. Maternal risk factors were identified in about half of the infants, who had died within the first week after the birth. Therefore, when these factors are identified during pregnancy, caring of infants during the first week after delivery is recommended. Keywords: Congenital abnormalities, Infant death, Pregnancy complications, Diabetes mellitus, Preeclampsi

Evaluate the diagnosis of neonatal sepsis by measuring interleukins: A systematic review

Neonatal sepsis is a dangerous and common disease among infants which is associated with high morbidity and mortality. Interleukins may be helpful for diagnosis of neonatal sepsis. Therefore, this study is conducted to investigate the role of interleukins in the diagnosis of neonatal sepsis. In this study, databases including PubMed, Cochrane Library, ISI and Google Scholar were searched up to 2016. Keywords were: Sepsis, neonatal, interleukins, prediction and diagnosis. Study inclusion criteria were: Articles about the relationship between the diagnosis of neonatal sepsis and interleukins; studies on babies; English and Persian articles and enough information from test results. Articles that had focused on adult sepsis or had used other markers except ILs or just their abstracts were available were excluded from the study. Of 100 searched studies, eventually, 16 articles were considered including 12 prospective studies, 3 cross-sectional studies and 1 retrospective study. IL6 has been studied more than other interleukins (50% of articles). ILs 6, 8 and 10 are among the initial markers of neonatal sepsis diagnosis. IL6 above 68 pg/ml had 85% sensitivity and 80% specificity, IL8 above 269.51 pg/ml had 80% sensitivity and 50% specificity, IL10 above 27 pg/ml had 60% sensitivity and 87% specificity and combined interleukins above 186.83 pg/ml had 75.63% sensitivity and 71.49% specificity in sepsis diagnosis. Interleukins can be helpful in the diagnosis of neonatal sepsis based on the results of this study. IL6 had the most sensitivity and IL10 had the most specificity for diagnosis of sepsis. Key Words: diagnosis, interleukins, neonatal, sepsi

Relationship between Nausea and Pregnancy Vomiting and Fetus Gender

Introduction One of the most common complaints of pregnant women which is experienced by about 50 to 90 percent of them is vomiting and nausea while. Fetus’s gender is one of triggers of this problem. Therefore, this study aimed to investigate the relationship between these factors. Materials and Methods This cross-sectional study was conducted in 2016 on 300 pregnant women in the first trimester who referred to department of obstetrics of Shahid Rajaee Hospital in Tonekabon. Convenience sampling method was used. The data were collected through an author-made questionnaire containing demographic information of mother. Data analysis was done using descriptive statistics, chi-square test and the SPSS v.16 software. Results It is notable that out of 300 pregnant women referring to Shahid Rajaee Hospital in Tonekabon, faced with pregnancy nausea and vomiting which was observed in almost half of pregnant women (45.7%). There was significant statistical relationship between variable of pregnancy nausea and vomiting and fetus gender (P=0.001). That is, frequency of pregnancy nausea and vomiting was more in pregnant others with female fetus (55.40%) compared to pregnant mothers with male fetus (36.18%). There was no statistical significant relationship between fetus gender and frequency of pregnancy nausea and vomiting (P=0.571), number of pregnancy (P=0.310) and mother age (P=0.194). Conclusion Pregnancy nausea and vomiting was observed in almost half of pregnant women. Thus, in case of pregnancy nausea and vomiting, early diagnosis during prenatal care and effective treatment can reduce its consequences on the health and quality of women’s life

Comparison of the percentage of umbilical cord nucleated red blood cells in preterm neonates during vaginal delivery and emergency cesarean section

Background: There are insufficient and contradictory reports regarding the effect of delivery method on the rate of umbilical cord Nucleated Red Blood Cell (NRBC). Therefore, the present study aimed to compare the percentages of umbilical cord NRBC in vaginal delivery and emergency cesarean section (C-section) in preterm neonates. Materials and Methods: The present cross-sectional study was performed on mothers with vaginal delivery and C-section, from 2020 to 2021. The samples (n = 221) were preterm neonates selected using the convenience sampling method. The percentages of NRBC in neonates born by natural childbirth and by emergency C-section were measured and compared in this research. A researcher-made checklist, which included maternal and neonatal characteristics and laboratory evaluation, was used as a data collection tool. Results: The statistical population of thisresearch included 93 (42.10%) and 128 (57.90%) neonates born by vaginal delivery and by C-section, respectively.The mean (SD) score of gestational ages at birth was 30.75 (2.81) weeks. The mean (SD) score of umbilical cord NRBC level were estimated at 8.01 (5.93) and 25.64 (22.61) for the neonates born by natural childbirth and by emergency C-section, respectively (t=-8.43, df = 150, p<0.001). Statistically significant differences were observed in the gestational age (t=-3.36, df = 218, p = 0.001), fifth-minute Apgar score (t=-2.32, df = 200, p = 0.021), umbilical cord NRBC (t=-8.43, df = 160, p<0.001), and short-term prognosis (p = 0.032) between the two groups. It was also revealed that the number of NRBCs in the dead neonates was about 1.5 times higher than that in the discharged neonates. Conclusions: Based on the results of the present study, emergency C-section increased the mean of umbilical cord NRBC by three times, compared to that of normal delivery. Since an increase in the NRBC raises the risk of infant death, it is advisable to take steps to maintain the health of children by identifying high-risk neonates through umbilical cord NRBC measurement immediately after delivery and special care

Assessment of Umbilical Cord Nucleated Red Blood Cell Count in Discharged and Dead Very Low Birth Weight Infants

Background: Predictive value of the umbilical nucleated red blood cells (NRBCs) at birth for neonatal outcomes has been assessed. Hence, the present study was conducted to compare NRBC between discharged and dead neonates.Methods: This cross-sectional study was performed on preterm newborns with a birth weight of Results: A total of 205 neonates, including 136 discharged neonates (66.03%) and 69 dead neonates (33.7%), were examined in the present study. The results demonstrated a significant difference between the two groups in terms of the first minute Apgar score (P=0.023), fifth minute Apgar score (P=0.010), gestational age (P=0.000), birth weight (P=0.000), WBC (P=0.020), absolute NRBC (P=0.004), NRBC percentage (P=0.001), duration of mechanical ventilation (P=0.029), duration of oxygen therapy (P=0.012).Moreover, mechanical ventilation (P=0.036), type of oxygen therapy (P=0.000), NRBC percentage (P=0.001), and absolute NRBC count (P=0.001) showed a statistically significant relationship with neonatal survival rate.Conclusion: As the findings indicated, mechanical ventilation, type of oxygen therapy, absolute NRBC count, and NRBC percentage can be used as markers for predicting neonatal mortality rate