Correlation between Lead in Maternal Blood, Umbilical Cord Blood, and Breast Milk with Newborn Anthro-pometric Characteristics

Background: Breast milk can be a source of toxic material, along with the transfer of nutrients needed for infant growth. This study was conducted to measure the level of lead in maternal and neonatal blood and breast milk in Tehran, Iran.Methods: In this cross-sectional study, 150 mothers and their infants were studied. Samples of maternal blood, fetal umbilical cord blood, breast milk, and amount of lead measured by atomic absorption method were collected. Correlations between lead levels and demographic characteristics of mother and infants were assessed.Results: The mean levels of lead in maternal and neonatal blood and breast milk were 9.79±4.31, 8.29±4.83, and 8.65±3.67 μg/dl, respectively. The different levels of lead were associated with cord blood, maternal blood, and breast milk. No significant relationship was found between lead levels and neonatal parameters (i.e., weight, height, and head circumference). The Spearman's correlation also showed the association between different levels of lead with cord blood, maternal blood, and breast milk. Linear regression also did not show any relationship between lead levels in cord blood, milk, and mother blood with newborn growth parameters.Conclusion: The present study failed to find a significant correlation between lead and newborn birth parameters. In our study, lead levels in maternal blood, breast milk, and cord blood were lower, compared those of the previous years in Iran; however, it needs to decrease, because lead even at very low concentrations may also have adverse effects

Determination of Predictive Power of CRIB-II and SNAPPE-II in Mortality Risk of Neonates with Low Gestational Age or Birth Weight Admitted to the Neonatal Intensive Care Unit

Background: Risk scoring systems evaluate neonatal outcomes using perinatal and neonatal status. The present study aimed to predict the mortality risk of preterm or low birth weight infants using the Clinical Risk Index for Babies (CRIB-II) and Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE-II) scoring systems.Methods: This prospective cohort study investigated the preterm neonates admitted to the Neonatal Intensive Care Unit (NICU) of Vali-e-Asr Hospital, Tehran, Iran, with the birth weight of ˂1500g or a gestational age˂32weeks using the CRIB-II and SNAPPE-II scoring systems within the first 12 h after birth. The area under the curve, sensitivity, specificity, positive and negative predictive values of the scoring systems, as well as the association between neonate factors and neonatal death were calculated in this study.Results: Out of 344 neonates under study, 253casessurvived after24hof birth and 91 newborns died. The total CRIB-II scores in survived and deceased infants were 6.12 and 10.28, respectively. The area under the receiver operating characteristic (ROC) curve with a cut-off point of 8.5 was obtained at 0.838. Moreover, the sensitivity, specificity, positive predictive value, and negative predictive value were estimated at 74.4%, 78.65%, 55.37%, and 89.68%, respectively, for the CRIB-II system. Total scores of SNAPPE-II in survived and deceased infants were 16.9 and 51.6, respectively. The area under the ROC curve with a cut-off point of 27.5 was determined at 0.887. Sensitivity (84.44%) and specificity (79.05%) were calculated for the SNAPPE-II. Furthermore, positive and negative predictive values were 58.91% and 93.46%, respectively.Conclusion: This study demonstrated that the CRIB-II and SNAPPE-II scoring systems can be useful mortality predictors for at-risk neonates

Risk factors of hearing loss in neonates older than 6 months with history of hospitalization in intensive care unit

Objectives: Hearing loss is one of the most important disabilities in neonates. Delay in detection of hearing loss leads to impaired development and may prevent the acquisition of speech. The present study was designed to determine the risk factors associated with hearing loss in neonatal patients aged more than 6 months with history of hospitalization in Neonatal Intensive Care Unit (NICU).Methods: In this case-control study, screening for hearing loss was carried out on 325 neonates aged 6-12 months who referred to pediatric neurology office of  Vali-e-Asr hospital, Tehran, iran. Hearing loss has confirmed using Acoustic Brain Audiometry (ABR) screening test.Results: The prevalence of hearing loss in neonates was determined about 3.6%. The most significant risk factors for hearing loss in neonates were neonatal icterus associated with phototherapy, respiratory distress syndrome (RDS) and lower Apgar score.Conclusion: Considering significant prevalence of hearing loss among studied neonates, screening all newborns is still seems valuable and cost effective