Outcome of late preterm newborns in Upper Egypt

El-Hawary, Manal; Amin, Sayed; Elmenem, Marwa Abd

doi:10.1186/s43054-020-00023-1

Cited by 18 publications

(16 citation statements)

References 47 publications

(61 reference statements)

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“…Although PPROM is an indication for NICU admission in our hospital protocol, it should be clarified that our local policy is to admit all infants delivered after PPROM to the NICU for observation immediately after delivery and to be discharged after 48 h if they meet the discharge criteria. The overall rate of NICU admission among the LPIs included in our cohort was 56% which is quite similar to the rate reported from USA (56%) (25) and from Egypt (53%) (26), a nearby Arab country, compared with 30% in Turkey (27). In a previous report, we found that maternal PPROM was the major indication of NICU admission among term infants (28).…”

Section: Discussionsupporting

confidence: 87%

Maternal and Perinatal Determinants of Late Hospital Discharge Among Late Preterm Infants; A 5-Year Cross-Sectional Analysis

et al. 2021

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Background: Although late preterm infants (LPIs) account for the majority of preterm births, they are mistakenly labelled and treated as “near term.” Whether longer initial hospital stay improves their outcomes and lowers readmission is controversial. The aim of this study is to identify maternal and perinatal factors associated with longer hospital stay and to assess the rate of readmission.Methods: The medical records of LPIs delivered at an academic center in Jordan over a 5-year period were reviewed. They were divided according to their initial hospital stay into: Early discharge group (ED, ≤ 3 days) and late discharge group (LD, > 3 days). Maternal and perinatal factors associated with > 3-day hospital stay were reported. The rate of readmission was compared between both groups.Results: 2236 LPIs were included in the analysis representing 13% of total births and 81% of premature births. LD group constituted 54%. A thousand two hundred forty three (56%) required admission to NICU. Factors associated with longer hospital stay included maternal prolonged rupture of membranes (AOR 1.9, 95% C.I 1.5, 2.4, p 0.000), C-section delivery (AOR 2.4, 95% C.I 1.9, 3, p 0.001), <35-week gestation (AOR 3.8, 95% C.I 2.6, 5, p 0.000), small-for-gestational age (AOR 1.9, 95% C.I 1.1, 3.8, p 0.03), birthweight <2,500 g (AOR 1.3, 95% C.I 1.1, 1.6, p 0.02), NICU admission (AOR 6.3, 95% C.I 3.4, 11.5, p 0.000), RDS (AOR 2.3, 95% C.I 1.5, 3.6, p 0.005), surfactant therapy (AOR 5, 95% C.I 1.9, 13.5, p 0.001), use of CPAP (AOR 1.7, 95% C.I 1.2, 2.2, p 0.001), jaundice (AOR 11.2, 95% C.I 7.7, 16.2, p 0.000), and sepsis (AOR 10.3, 95% C.I 4.8, 22, p 0.000). Readmission rate was 19% among the LD group and 13% among the ED group.Conclusion: LPIs are at high risk for developing prematurity-related morbidities and the duration of their initial hospital stay can be anticipated based on certain predisposing maternal and perinatal factors. Late discharge of LPIs does not lower the rate of readmission.

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Section: Discussionsupporting

confidence: 87%

Maternal and Perinatal Determinants of Late Hospital Discharge Among Late Preterm Infants; A 5-Year Cross-Sectional Analysis

et al. 2021

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“…A study by Lavanya et al had shown a similar higher incidence of significant hyperbilirubinemia (57.0%) among the late preterm neonates. 12 Similarly, the incidence of significant jaundice was 59% in a study by Bansal et al and also with other studies by Aziz et al and Algameel et al 14,17,19 Our study showed that significant hyperbilirubinemia was higher among the male child when compared to the female child (74.2% versus 47.1%) and it was found to be statistically significant (p=0.007), which is consistent to the study results of Gupta et al, where the study had reported that males were found to have significantly higher incidence of jaundice when compared to the females among the late preterm group; similar association had been reported by studies conducted elsewhere. 13,21,22 A study by Bansal et al along with other studies have failed to show such association.…”

Section: Resultssupporting

confidence: 60%

“…14,52,59 A study by Lavanya et al showed that large for gestation, gestational age, birth trauma and previous sibling with severe jaundice are the clinical variables significantly associated with significant jaundice. 12 11,14,17,24 A study by Bhutani et al also have concluded that large for gestational age and late preterm infants disproportionately developed kernicterus as compared with those who were appropriate for gestational age and term. 15 In a study by Aynalem et al, Rh incompatibility (p=0.002), ABO incompatibility, perinatal asphyxia and sepsis were significantly associated with hyperbilirubinemia.…”

Section: Resultsmentioning

confidence: 99%

Pathological jaundice in late preterm neonates admitted in a tertiary hospital, Imphal: a prospective COHORT study

Sharma

Khiangte

Beti

et al. 2022

Int J Contemp Pediatr

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Background: Approximately 85% of all term and most preterms develop clinical jaundice. Hyperbilirubinrmia is defined as a total bilirubin (TB) >95th percentile on the hour-specific Bhutani normogram. Pathological jaundice implies the onset of jaundice before 24 hours of age, rate of rise in TSB of >0.2 mg/dl/hour and jaundice persisting after 14 days in term and 21 days in late-preterms. The aim of this study was to determine the incidence, progression and the predictors of pathological jaundice among the late preterm infants admitted in Paediatrics ward of a tertiary care centre, Imphal.Methods: A hospital based prospective cohort study was carried out in paediatrics department, RIMS during a period of 2 years (September 2019 to August 2022) with approval from research ethics board. Sample size was 100 based on consecutive sampling.Results: Pathological jaundice developed among 65.0% (95% CI: 54.7-74.1%) neonates. The median duration of onset was 47.0 hours. The mean bilirubin at the time of diagnosis of jaundice was 15.5 mg/dl. Three neonates underwent exchange transfusion. Of these 3, one had pre-exchange bilirubin encephalopathy. Male gender, breast feeding, sepsis, infants blood group (B +ve), jaundice among the siblings and birth trauma (birth asphyxia/cephalhematoma) were significantly associated with the development of neonatal hyperbilirubinemia.Conclusions: Jaundice is condition that is often present and constitutes one of the major risks for neurodevelopmental issues in later life and the risk is further compounded by prematurity. Hence further studies with a larger sample size on a multicentric level could add robustness to our study thereby helping in better understanding and management of the condition.

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“…Rates of PTB were 9.6% (n = 84) at less than 37 weeks and 4.5% (n = 43) at less than 34 weeks of pregnancy in a previous study, 10 but our findings were similar to previously reported results in Egypt (28%). 15 Different rates were attributed to the different sample size in both studies. Besides, our data represent PTB rates before the 37th week of pregnancy.…”

Section: Discussionmentioning

confidence: 97%

Uterocervical angle versus cervical length in the prediction of spontaneous preterm birth in singleton pregnancy

Khamees

Khattab

Elshahat

et al. 2021

Intl J Gynecology & Obste

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Objective: To evaluate the predictive role of the uterocervical angle and the cervical length in preterm birth. Methods:This was cross-sectional analytical study, recruiting 167 women at high-risk for preterm birth (delivery before 37 weeks of pregnancy). They had transvaginal ultrasound for evaluation of the uterocervical angle and the cervical length between at 30 and 32, 32 +1 and 34, and 34 +1 and 36 +1 weeks of pregnancy. The primary outcome was to determine the predictive role of the uterocervical angle and the cervical length in preterm birth. Results:The mean uterocervical angle was significantly greater in those who delivered preterm (115.4° ± 9.1° versus 101.1° ± 8.3°, p < 0.001). The cervical length was insignificantly shorter in the same group (27.9 ± 4.0 and 29.1 ± 4.1 mm, respectively, p = 0.067). A uterocervical angle of 105° or more predicted preterm birth with sensitivity and specificity of 86.1% and 60.4%, respectively. A cervical length of 25 mm or less had sensitivity and specificity of 27.8% and 85.8%, respectively. Conclusion:A uterocervical angle greater than 105° poses a high risk for preterm deliveries. It provides a higher diagnostic performance in high-risk patients than cervical canal length measurement.

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Outcome of late preterm newborns in Upper Egypt

Cited by 18 publications

References 47 publications

Maternal and Perinatal Determinants of Late Hospital Discharge Among Late Preterm Infants; A 5-Year Cross-Sectional Analysis

Maternal and Perinatal Determinants of Late Hospital Discharge Among Late Preterm Infants; A 5-Year Cross-Sectional Analysis

Pathological jaundice in late preterm neonates admitted in a tertiary hospital, Imphal: a prospective COHORT study

Uterocervical angle versus cervical length in the prediction of spontaneous preterm birth in singleton pregnancy

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