Factors Affecting Early Anemia, Morbidity and Mortality in low birth-weight infants in Maesot,Tak, province
Keywords:
Early anemia, very low birth-weight preterm, retinopathy of prematurityAbstract
The overall objective of this study was to assess the association between early anemia with the neonatal morbidity and mortality in VLBW infants Methods: This retrospective study was conducted on 692 patients with LBW admitted at Maesot Hospital from October 2018 to March 2021. The subjects were divided into two groups: (1) patients with early anemia at admission and (2) patients without early anemia. Their characteristics and outcomes were compared. Statistical analysis was performed using SPSS, version 27.0.1 and a value of p< 0.05 was considered statistically significant. Results: Total of the 692 VLBW, 28 (5.0%) presented with early anemia at admission and 664 (95.0 %) without early anemia. Anemianaive presented mean hematocrit at the admission of 36.24 ± 2.85 vol % and nonanemic 52.67 ± 5.90 vol%, p=0.00), mean hematocrit of mother at 1 st ANC period (34.67 ± 6.47 vs 35.37 ± 3.96 vol%, p=0.409), mean hematocrit of mother at Labour room (33.27 ± 5.13 vs 35.59 ± 4.63 vol%, p=0.011). The early anemic group presented a lower gestational age (33.55 ± 4.26 vs. 35.71 ± 2.78 weeks, p= 0.00),, need invasive mechanical ventilation (39.28 vs. 15.06 %, p=0.002), intraventricular hemorrhage (IVH) (3.57 vs.0.60 %, p= 0.187),bronchopulmonary dysplasia (BPD) (3.0 vs 1.0 %,p=0.336) ,necrotizing enterocolitis (NEC) (7.0 vs 2.0 %,p=0.196),retinopathy of prematurity (ROP) ( 7.0 vs 0.30 % p= 0.00 ),respiratory distress syndrome(RDS) (21.42 vs 9.03 % p=0.042) , Hypotension with used inotropic agent ( 21.0VS 1.0% ; p =0.00) and mortality rate(7.0 vs 2.0,p=0.083 ) ,respectively. The Binary logistic Regression analysis confirmed an association between early anemia and severe ROP(adj OR =19.4; 95% CI: 16.7-20.6,p=0.00) , Hypotension with used inotropic agent (adj OR =2.7; 95% CI: 1.25-2.87,p=0.00) .Conclusion: In this LBWseries, the presence of early anemia group was associated with severe ROP and hypotension . Policies of prevention for early anemia must be considered.
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สหประชาชาติ ประเทศไทย (2566) “เป้าหมายที่ 3 การพัฒนาที่ยั่งยืน สร้างหลักประกันว่าคนมีชีวิตที่ มีสุขภาพดีและส่งเสริมสวัสดิภาพสำาหรับทุกคน ในทุกวัย (Ensure healthy lives and promote wellbeing for all at all ages)” (ออนไลน์) สืบค้นจาก https://thailand.un.org/th/sdgs/3[24เมษายน2566]
Patel S, Clark EA, Rodriguez CE, et al. Effect of umbilical cord milking on morbidity and survival in extremely low gestational age neonates. Am J Obstet Gynecol. 2014; 211(5):519.e1-519.e7.
Lin HJ, Du LZ, Ma XL, et al. Mortality and morbidity of extremely low birth weight infants in the mainland of China: a multicenter study. Chin Med J (Engl). 2015; 128(20):2743-2750.
Strauss RG. Anaemia of prematurity: pathophysiology and treatment. Blood Rev. 2010;24(6):221-225.
Ohlsson A, Aher SM. Early erythropoiesisstimulating agents in preterm or low birth weight infants. Cochrane Database Syst Rev. 2017;11:CD004863.
Aher S, Malwatkar K, Kadam S. Neonatal anemia. Semin Fetal Neonat Med. 2008;13(4):239-247.
Elabiad MT, Hook RE. Lead content of blood transfusions for extremely lowbirth-weight infants. Amer J Perinatol. 2013;30(9):765-770.
Banerjee J, Asamoah FK, Singhvi D, et al. Haemoglobin level at birth is associated with short term outcomes and mortality in preterm infants. BMC Med. 2015;13(1):16.
Alan S, Arsan S, Okulu E, et al. Effects of umbilical cord milking on the need for packed red blood cell transfusions and early neonatal hemodynamic adaptation in preterm infants born 1500 g: a prospective, randomized, controlled trial. J Pediatr Hematol Oncol. 2014;36(8):e493-e498.
Mercer JS, Vohr BR, McGrath MM, et al. Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Pediatrics. 2006; 117(4):1235-1242.
Rabe H, Diaz-Rossello JL, Duley L, et al. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev. 2012;8(8):CD003248.
Oh W, Fanaroff AA, Carlo WA, et al. Effects of delayed cord clamping in very-low-birthweight infants. J Perinatol. 2011;31(S1): S68-S71.
Hosono S, Mugishima H, Kitamura T, et al. Effect of hemoglobin on transfusion and neonatal adaptation in extremely low-birthweight infants. Pediatr Int. 2008;50(3):306-311.
Kaempf JW, Tomlinson MW, Kaempf AJ, et al. Delayed umbilical cord clamping in premature neonates. Obstet Gynecol. 2012;120(2, Part 1):325-330.
Backes CH, Rivera BK, Haque U, et al. Placental transfusion strategies in very preterm neonates: a systematic review and meta-analysis. Obstet Gynecol. 2014; 124(1):47-56.
Rocha G, Pereira S, Antunes-Sarmento J et al.Early anemia and neonatal morbidity in extremely low birth-weight preterm infants. THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE.2021,vol 34,No. 22,3697-3703
Matoth Y,Zaizov R,Varsano I, Postnatal changesin some red cellparameters. Acta Paediatr Scand. 1971;60:317-323
Alur P,Devapatla SS, Super DM,et al. Impact of race and gestational age on red blood cell indices in very low birth weight infants. Pediatrics 2000; 106:306-310
Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of respiratory distress syndrome 2016 update. Neonatology. 2017; 111(2):107-125.
Saugstad OD,Aune D. Optimal oxygenation of extremely low birth weight infants: a meta-analysis and systematic review of the oxygen saturation target studies. Neonatology. 2014;105(1):55-63.
Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163(7):1723-1729.
Brady MT, Polin RA. Prevention and management of infants with suspected or proven neonatal sepsis. Pediatrics. 2013;132(1):166-8.
Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am. 1986;33(1):179-201.
An international classification of retinopathy of prematurity. Pediatrics. 1984;74(1):127-133.
International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005;123(7):991-999.
Volpe JJ. Neurology of the newborn. 4th ed. Philadelphia (PA): WB Saunders; 2001. p. 428-493.
ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia Obstet Gynecol .2019 Jan;133(1):1.doi: 10.1097/AOG.0000000000003018
Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-31ol. 2019;133(1):1-25.
Higgins RD, Saade G, Polin RA, Grobman WA, Buhimschi IA, Watterberg K, et al. Evaluation and Management of Women and Newborns With a Maternal Diagnosis of Chorioamnionitis: Summary of a Workshop. Obstet Gynecol. 2016;127(3):426-36.
ACOG Practice Bulletin: Clinical Management Guidelines for ObstetricianGynecologists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol. 2006;108(4):1039-47
พิพัฒ เคลือบวัง การศึกษาภาวะโลหิตจางใน ระยะแรกเกิดกับการเจ็บป่วยของทารกคลอด ก่อนกำาหนดที่มีน้ำหนักน้อยมากในโรงพยาบาลแม่สอด จังหวัดตาก วารสารวิชาการสาธารณสุข สำนักวิชาการสาธารณสุขกระทรวงสาธารณสุข ปีที่ 2566 ปีที่ 32 ฉบับที่ 3 พฤษภาคม-มิถุนายน 2566 (รอตีพิมพ์ )
Duan J, Kong X, Li Q, et al. Association between anemia and bronchopulmonary dysplasia in preterm infants. Sci Rep. 2016;6(1):22717.
Linder N, Haskin O, Levit O, et al. Risk factors for intraventricular hemorrhage in very low birth weight premature infants: a retrospective case-control study. Pediatrics. 2003;111(5):e590-e595.
Ballabh P. Intraventricular hemorrhage in premature infants: mechanism of disease. Pediatr Res. 2010;67(1): 1-8.
Quante M, Pulzer F, Bl€aser A, et al. Effects of anaemia on haemodynamic and clinical parameters in apparently stable preterm infants. Blood Transfus. 2013; 11(2):227-232.
Pourarian S, Farahbakhsh N, Sharma D, et al. Prevalence and risk factors associated with the patency of ductus arteriosus in premature neonates: a prospective observational study from Iran. J Matern Fetal Neonatal Med. 2017;30(12):1460-1464.
Mukhopadhyay K, Louis D, Mahajan G, et al. Longitudinal growth and post-discharge mortality and morbidity among extremely low birth weight neonates. Indian Pediatr. 2014;51(9):723-726.
Mukhopadhyay K, Louis D, Mahajan G, et al. Predictors of Mortality and Major Morbidities in Extremely Low Birth Weight Neonates . Indian Pediatr 2013; 50: 1119-1123.
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