Abstract

BACKGROUNDBirth asphyxia is commonest cause of preventable cerebral injury. It is also important cause of neonatal mortality. Incidence of birth asphyxia however is higher in developing countries and leading cause of neonatal mortality. This work is undertaken to study the incidence, risk factors and outcome of birth asphyxia.

Background: Spontaneous abortion (SAB) is a common early pregnancy complication globally, impacting 15% of clinically recognized pregnancies. The biological pathways leading to SAB are not clearly understood, although early SAB is often attributed to chromosomal abnormalities. Elevated blood pressure (BP) in women of reproductive age predicts cardiovascular disease later in life, but less clear is whether elevated BP during preconception and/or early pregnancy BP elevations can affect prenatal outcomes. Hypothesis: Elevated BP during preconception and the first trimester will be positively associated with SAB. Methods: We conducted a secondary analysis of data collected from 577 primiparous women (15-35 years) who participated in the Longitudinal Indian Family hEalth (LIFE) prospective pregnancy cohort study in Telangana State, India. Resting blood pressure was measured by trained technicians using a standardized study protocol at a preconception registration visit and in the first trimester. Odds ratio (OR) and 95% confidence intervals (CI) of any SAB (<22 weeks of gestation, n=108), early SAB (<8 weeks of gestation, n=25), and late SAB (8 to <22 weeks of gestation n=83) were assessed with a log link binomial distribution. Results: Preconception measurements were assessed at the first study visit, conducted at registration and within a mean±SD of 11±12 months prior to pregnancy. Higher than optimal preconception BP (120/80 mmHg) was not associated with SAB (OR adj 0.82 (95% CI 0.51, 1.32)). In contrast, first trimester elevated BP was associated with a two-fold increased likelihood of SAB, although results were of borderline significance (OR adj 2.12 (95%CI 0.87, 5.14). In addition, we observed an association between elevated first trimester BP and late SAB (OR adj 2.32 (95%CI 0.95, 5.68)); there were no associations between elevated preconception or first trimester BP and early SAB. Conclusions: We found that elevated first trimester but not preconception BP was associated with an increased risk of pregnancy loss, suggesting that dysregulated adaption to pregnancy may impact pregnancy loss more than preconception BP status, especially SABs that occur after 8 weeks gestation. Our findings support the notion that clinical and environmental factors may have a greater impact on later SABs as opposed to earlier losses. The null relationship with early pregnancy loss in our study may be due to an expected genetic mutation etiology for those losses. Studies exploring the trajectory of preconception and prenatal blood pressure changes and impact on pregnancy outcomes are warranted.

Background: Neonatal hyperbilirubinemia is defined as serum bilirubin levels >7 mg/dl around 85% of all term newborns and most of the premature babies develop clinical jaundice and various associated risk factors are involved in NNH and treatment for this condition depends on gestational age, serum bilirubin levels at different time interval during early life of these newborns and treating them with phototherapy or exchange transfusion. Objective of the study was to establish the relation with the NNH and risk factors among newborns and treatment with the phototherapy if required.Methods: The present prospective study was conducted at Karuna Medical College, Chittur Palakkad from January 2019 to December 2019. A total of 40 samples which are born during the study period were included in the study. All types of gestations (preterm, full term, post term), both genders (male and female), new-borns with risk factors, serum bilirubin (TSB) >7 mg/dl at 48 hrs of life were included in the studyResults: In our study, female samples consists of 55% and male samples were 45% during the study period minimum gestational age was 35 weeks and maximum was 40 weeks. 5% sample with a serum bilirubin level of 9 mg/dl,  with risk factor as a Rh(-ve) incompatibility was treated with phototherapy up to 96 hrs of life.Conclusions: Study conveys various risk factors responsible for NNH and treatment with phototherapy given to the affected new-borns. With good clinical history, risk factors involved in new-borns, antenatal counseling is needed to all pregnant women’s it is necessary to check the serum bilirubin levels and treated with phototherapy to avoid further NNH related complications in the new-borns.