Introduction: With better healthcare facilities, despite an increase in neonatal survivor rates, the outcomes in the survivors still remains uknown to a great extent. In overburdened centres following an early discharge policy, a structured follow-up plan to evaluate growth, development and problems faced by the high-risk babies is essential. Aim: To assess the growth, development at 52 and 64 weeks Post Menstrual Age (PMA) and association of postnatal growth failure with developmental outcome in Low Birth Weight (LBW) and Very Low Birth Weight (VLBW) babies. Materials and Methods: This was a prospective cohort study carried out amongst the newborn babies discharged from a tertiary care hospital, Sriram Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India. within 2 months period and followed-up till 64 weeks PMA. Out of 189 newborns discharged during study period, 168 met the inclusion criteria and only 114 babies could complete the follow-up till 64 weeks postmenstrual. The weight, length and head circumference were documented at discharge, 44, 52 and 64 weeks PMA and compared using INTERGROWTH 21st postnatal standards. Denver Developmental Screening Test was used for developmental screening at 52 and 64 week PMA. Descriptive analysis was performed using Statistical Package for Social Sciences (SPSS) version 20.0 and categorical data was compared using Chi-square test in trend using Epi Info software. Results: Out of 114 patients, 51 (44.7%) were females and 63 (55.3%) were males. At birth, 72 (63.16%) of study population was below 10th centile which increased to 77 (67.54%) at 44 weeks PMA. By 64 weeks PMA, 62 (54.39%) infants were showing catch up. Out of total, 18 (15.79%) showed delayed developmental milestones. 11 out of 18 (61.11%) babies were with delayed development, i.e., below 3rd centile of weight for age showing that at lower postnatal weight odds of patients having developmental delay were increased. Conclusion: Postnatal growth pattern of the study population was along the lower centiles of INTERGROWTH 21st chart. Incidence of developmental delay was higher in babies with postnatal growth failure.
Introduction: The oxygen concentration used in neonatal resuscitation has been a matter of debate with higher oxygen concentrations posing many adverse outcomes. Recent guidelines recommend use of blender to titrate FiO2 delivered during resuscitation. However, blender being unaffordable and unavailable at many peripheral institutions, we tried to use a low-flow flowmeter to titrate the oxygen and measure FiO2 delivered at different flow rates. Methods: From a central oxygen supply, oxygen flow was titrated using a low-flow flowmeter which was connected to a self-inflating bag and oximeter. Three variables were taken—volume of self-inflating bag, flow rate, and number of compressions per minute. FiO2 delivered with each variable, keeping the other two constant, was recorded. Results: The data obtained was analyzed by fitting the study variables into a stepwise multiple linear regression model and a linear equation was obtained. The model R square obtained suggested strong linear relationship between flow rate and FiO2 delivered. The model showed statistically significant association between flow rate and FiO2 delivery, whereas association with other variables was statistically insignificant. Discussion: Our study suggests that 76.57% of change in FiO2 is determined by change in flow rate. The major advantage of this study would be at resource poor settings where a low-flow flowmeter which is more cost effective can be used to titrate the FiO2 delivered during neonatal resuscitation.
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