The objective of the study was to evaluate the effects of antenatal corticosteroid therapy in multiple pregnancy on the incidence and severity of respiratory distress syndrome (RDS). Twenty-two women with twin, 12 with triplet and 2 with quadruplet pregnancies and an emergency group of 20 mothers with twin pregnancies, who only had one course of dexamethasone, were compared with controls. Corticosteroid therapy was associated with a reduction in moderate to severe RDS in all groups (twins p < 0.01, triplets and quadruplets p < 0.008) and the emergency group with dexamethasone therapy (p < 0.036) when compared to their individual controls. Dexamethasone reduced the duration of stay in the neonatal intensive care unit of the emergency twin group (p < 0.01). Neonatal birth weights were significantly less in all groups treated with repeated doses in comparison to the controls.

Retinopathy of prematurity (ROP) is a disease characterized by retinal neovascularization, possibly leading to retinal detachment and finally blindness. In a proportion of ROP cases, the disease progresses to advanced stages despite rigorous intervention. Missense mutations of the Norrie disease (ND) gene have been associated with progression of the disease in ROP cases from the USA. We have investigated the presence of ND gene mutations in 102 premature newborns of Kuwaiti Arab origin to replicate this finding in a different population/racial group. 56 (55%) of these newborns had normal eyes and served as controls. In 35 (34%) cases, the ROP regressed spontaneously during stage 1–3. In 11 (11%) cases, ROP progressed to advanced stages. A PCR-RFLP method was used to detect the mutations in exon 3 of the ND gene and confirmed the DNA sequence by direct sequencing of the PCR product. The [R121W] mutation of the ND gene was not detected in the premature newborns screened from our Kuwaiti population/group. For the second mutation [L108P], a genotype (PP) was present in 98% of the premature newborns screened and only in 1 of 56 normal infants was the (LL) genotype detected. Our population is genetically homogenous in that genotype (PP) was detected at codon 108 in almost all controls and ROP cases. We did not find an association between the presence or absence of missense mutations of the ND gene and the risk of severe ROP.

Background:The aim of this study was to review the maternal and neonatal risk factors associated with retinopathy of prematurity (ROP) and the threshold stage of the disease. Patients and Methods: In this prospective cohort study, all preterm infants of less than 1501 g birth weight were screened for ROP between January 1996 and December 1997 at the neonatal unit of the Maternity Hospital in Kuwait. The rate of the threshold stage of ROP, as well as risk factors associated with the disease, were identified. Results: A total of 234 babies were screened for ROP, of which 151 (64.5%) developed the disease and 34 (14.5%) had the threshold stage of ROP. Several factors were found to be associated with ROP and threshold ROP. Stepwise regression analysis revealed that low birth weight (P<0.002) and exposure to high oxygen concentration (P<0.0001) were independently associated with ROP. In addition, low birth weight (P<0.006), high oxygen concentration (P<0.003), and culture-proven sepsis (P<0.04) were found to be independent predictors of threshold ROP. Conclusion: Apart from low birth weight and exposure to high oxygen therapy, which are well-documented risk factors of ROP, septicemia was also found to be associated with the threshold stage of ROP.

Unlike data from the US, our findings from a Kuwaiti cohort of ROP cases and controls suggest a lack of association between the two ND gene mutations (A105T and Val60Glu) and ROP and the risk of progression of the disease to advanced stages.

Objectives: To document the usefulness and safety of inserting a second umbilical venous catheter in ill neonates, while a previously misplaced first catheter was still in its place. Subjects and Methods:The case series involved 25 newborn babies who were admitted to the Neonatal Intensive Care Unit, Maternity Hospital, Kuwait, over a 3-year period from 1999 to 2002. The umbilical venous catheter of the babies was misplaced and diverted to the liver, necessitating insertion of a second catheter while the previous one was still in place. The characteristics of the babies and possible catheter-related complications were recorded. Results:Of the 25 babies, 19 had the second catheter properly placed in the right atrium, while in the remaining 6 neonates, the catheter was still misplaced. Misplacement occurred mostly in full-term babies or the catheter was inserted at a later stage. No life-threatening complication was observed during the procedure. Conclusion:Insertion of a second umbilical venous catheter with the misplaced first catheter in situ is a useful and safe procedure.