Magnetic resonance imaging scanning susceptibility weighted imaging sequences in the diagnosis and prognostic evaluation of neonatal hypoxic-ischemic encephalopathy

BACKGROUND Magnetic resonance imaging(MRI)scanning with susceptibility weighted imaging(SWI)sequences plays a significant role in the diagnosis and prognostic evaluation of neonatal hypoxic-ischemic encephalopathy(HIE).AIM To observe the role of MRI multi-parameter quantitative indexes in the diagnosis of neonatal HIE.METHODS The imaging data from 23 cases of neonatal HIE admitted to the Imaging Department of Ganyu District People's Hospital of Lianyungang City and 23 neonates without HIE admitted during the same period were analyzed retrospectively from August,2021 to December,2023.The results of clinical judgment were compared with the results of computed tomography(CT)and MRI examinations.RESULTS The degree of cerebral edema(more than moderate),the number of damaged brain regions(>2),the number of cerebral hemorrhages(>2),and the percentage of small venous dilatation detected were higher in MRI than in CT examination,and the differences were statistically significant(P<0.05).The total area of the largest region of cerebral damage and of cerebral hemorrhage observed by MRI examination were significantly larger than those of CT examination(P<0.01).Multiparametric quantitative MRI combined with diffusion weighted imaging and SWI had higher sensitivity and accuracy than CT diagnosis,and the difference was statistically significant(P<0.05).The difference in the specificity of the two modes of diagnosis was not significant(P>0.05).CONCLUSION The use of MRI multi-parameter quantitative indexes can accurately diagnose and evaluate neonatal HIE.

Astrocyte syncytium:from neonatal genesis to aging degeneration

Modern neuroscience began from all reaching and fierce conflict between“neuronismo and reticulismo”——between neuronal and reticular theories of the organization of the nervous system;the conflict culminated in December of 1906 in Stockholm where Santiago Ramon y Cajal(the proponent of the neuronal doctrine)and Camillo Golgi(who advocated the syncytial reticular organization of neural networks)delivered their Noble prize lectures(Verkhratsky,2009).

Impact of Zika virus non-structural protein mutations on hippocampal damage

The Zika virus(ZIKV),a member of the Flaviviridae family,attracted worldwide attention for its connection to severe neurological effects,notably microcephaly in newborns,first reported during the 2015 epidemic in Brazil.Yet,its impact goes beyond fetal and neonatal abnormalities,also affecting the central nervous system(CNS)in both children and adults,leading to enduring cognitive and behavioral impairments.

In vivo direct neuronal conversion as a therapeutic strategy for ischemic stroke

Stroke causes neuronal loss,which ultimately results in persistent neurological dysfunction.Globally,stroke was the third-leading cause of death and disability combined in all ages in 2019,after neonatal disorders and ischemic heart disease.In that year,there were 12.2 million incident strokes,101 million prevalent strokes,and 143 million disability-adjusted life-years due to stroke.

Surgical Repair of Ventricular Septal Defect in Neonates: Indications and Outcomes

Background:The optimal surgical timing and clinical outcomes of ventricular septal defect(VSD)closure in neo-nates remain unclear.We aimed to evaluate the clinical outcomes of VSD closure in neonates(age≤30 days).Methods:We retrospectively reviewed 50 consecutive neonates who underwent VSD closure for isolated VSDs between August 2003 and June 2021.Indications for the procedure included congestive heart failure/failure to thrive and pulmonary hypertension.Major adverse events(MAEs)were defined as the composite of all-cause mortality,reoperation,persistent atrioventricular block,and significant(≥grade 2)valvular dysfunction.Results:The median age and body weight at operation were 26.0 days(interquartile range[IQR],18.8–28.3)and 3.7 kg(IQR,3.3–4.2),respectively.The median follow-up duration was 110.4 months(IQR,56.8–165.0).Seven patients required preoperative respiratory support,andfive had significant(≥grade 2)preoperative valvular dysfunction.One early mortality occurred due to irreversible cardiogenic shock;no late mortality was observed.One reopera-tion was due to hemodynamically significant residual VSD at 103.8 months postoperatively.The overall survival,freedom from reoperation,and freedom from MAE at 15-years were 98.0%,96.3%,and 94.4%,respectively.Pre-operative mechanical ventilation was associated with a longer duration of postoperative mechanical ventilation(p<0.001)and a longer length of intensive care unit stay(p<0.001).Conclusions:VSD closure with favorable outcomes without morbidities is feasible even in neonates.However,neonates requiring preoperative respiratory support may require careful postoperative management considering the long-term postoperative risks.Overall,surgical VSD closure might be indicated earlier in neonates with respiratory compromise.

Effects of early postnatal gastric and colonic microbiota transplantation on piglet gut health

Background Diarrhea is a major cause of reduced growth and mortality in piglets during the suckling and weaning periods and poses a major threat to the global pig industry.Diarrhea and gut dysbiosis may in part be prevented via improved early postnatal microbial colonization of the gut.To secure better postnatal gut colonization,we hypothesized that transplantation of colonic or gastric content from healthy donors to newborn recipients would prevent diarrhea in the recipients in the post-weaning period.Our objective was to examine the impact of transplanting colonic or gastric content on health and growth parameters and paraclinical parameters in recipient single-housed piglets exposed to a weaning transition and challenged with enterotoxigenic Escherichia coli(ETEC).Methods Seventy-two 1-day-old piglets were randomized to four groups:colonic microbiota transplantation(CMT,n=18),colonic content filtrate transplantation(CcFT,n=18),gastric microbiota transplantation(GMT,n=18),or saline(CON,n=18).Inoculations were given on d 2 and 3 of life,and all piglets were milk-fed until weaning(d 20)and shortly after challenged with ETEC(d 24).We assessed growth,diarrhea prevalence,ETEC concentration,organ weight,blood parameters,small intestinal morphology and histology,gut mucosal function,and microbiota composition and diversity.Results Episodes of diarrhea were seen in all groups during both the milk-and the solid-feeding phase,possibly due to stress associated with single housing.However,CcFT showed lower diarrhea prevalence on d 27,28,and 29 compared to CON(all P<0.05).CcFT also showed a lower ETEC prevalence on d 27(P<0.05).CMT showed a higher alpha diversity and a difference in beta diversity compared to CON(P<0.05).Growth and other paraclinical endpoints were similar across groups.Conclusion In conclusion,only CcFT reduced ETEC-related post-weaning diarrhea.However,the protective effect was marginal,suggesting that higher doses,more effective modalities of administration,longer treatment periods,and better donor quality should be explored by future research to optimize the protective effects of transplantation.

Nicotinamide adenine dinucleotide treatment confers resistance to neonatal ischemia and hypoxia:effects on neurobehavioral phenotypes

Neonatal hypoxic-ischemic brain injury is the main cause of hypoxic-ischemic encephalopathy and cerebral palsy.Currently,there are few effective clinical treatments for neonatal hypoxic-ischemic brain injury.Here,we investigated the neuroprotective and molecular mechanisms of exogenous nicotinamide adenine dinucleotide,which can protect against hypoxic injury in adulthood,in a mouse model of neonatal hypoxic-ischemic brain injury.In this study,nicotinamide adenine dinucleotide(5 mg/kg)was intraperitoneally administered 30 minutes befo re surgery and every 24 hours thereafter.The results showed that nicotinamide adenine dinucleotide treatment improved body weight,brain structure,adenosine triphosphate levels,oxidative damage,neurobehavioral test outcomes,and seizure threshold in experimental mice.Tandem mass tag proteomics revealed that numerous proteins were altered after nicotinamide adenine dinucleotide treatment in hypoxic-ischemic brain injury mice.Parallel reaction monitoring and western blotting confirmed changes in the expression levels of proteins including serine(or cysteine)peptidase inhibitor,clade A,member 3N,fibronectin 1,5'-nucleotidase,cytosolic IA,microtubule associated protein 2,and complexin 2.Proteomics analyses showed that nicotinamide adenine dinucleotide ameliorated hypoxic-ischemic injury through inflammation-related signaling pathways(e.g.,nuclear factor-kappa B,mitogen-activated protein kinase,and phosphatidylinositol 3 kinase/protein kinase B).These findings suggest that nicotinamide adenine dinucleotide treatment can improve neurobehavioral phenotypes in hypoxic-ischemic brain injury mice through inflammation-related pathways.

Analysis of TORCH results of retinal exudative changes in neonates

AIM:To explore the relationship between retinal exudative changes in neonates and perinatal toxoplasmosis,others,rubella,cytomegalovirus,and herpes simplex virus(TORCH)infections,as well as the characteristics of TORCH infection in neonates with retinal exudative changes.METHODS:Retrospective study.A total of 612 neonates with retinal exudative changes detected during ophthalmic screening in our hospital from May 2019 to March 2023 were selected.TORCH tests were performed on these neonates,and the results were subjected to statistical analysis to determine the infection characteristics.The neonates with retinal exudative changes were grouped by sex and age,the characteristics of TORCH infection were analyzed,and the positive rates were compared.RESULTS:Among the 612 neonates with retinal exudative changes,the highest positive rate was observed for cytomegalovirus(CMV-IgG)(96.7%),followed by rubella virus(RV-IgG)(73.9%).Mixed infections with two or three viruses were also observed,with the highest positive rate for mixed infection of RV-IgG and CMV-IgG reaching 71.2%.There was no statistically significant difference in TORCH infection among neonates of different sex(P>0.05).However,there were statistically significant differences in RV-IgG and CMV-IgM infections with retinal exudative changes among neonates of different age groups(P<0.05).CONCLUSION:Perinatal TORCH infection may be an important factor causing retinal exudative changes in neonates.The differences in various infections are not related to sex but are related to different age groups.

Detection of LAMA2 c.715C>G:p.R239G mutation in a newborn with raised creatine kinase: A case report

BACKGROUND We report a rare case of primary clinical presentation featuring elevated creatine kinase(CK)levels in a neonate,which is associated with the LAMA2 gene.In this case,a heterozygous mutation in exon5 of the LAMA2 gene,c.715C>G(resulting in a change of nucleotide number 715 in the coding region from cytosine to gua-nine),induced an amino acid alteration p.R239G(No.239)in the patient,repre-senting a missense mutation.This observation may be elucidated by the neonatal creatine monitoring mechanism,a phenomenon not previously reported.CASE SUMMARY We analysed the case of a neonate presenting solely with elevated CK levels who was eventually discharged after supportive treatment.The chief complaint was identification of increased CK levels for 15 d and higher CK values for 1 d.Ad-mission occurred at 18 d of age,and despite prolonged treatment with creatine and vitamin C,the elevated CK levels showed limited improvement.Whole exo-me sequencing revealed the presence of a c.715C>G mutation in LAMA2 in the newborn,correlating with a clinical phenotype.However,the available informa-tion offers insufficient evidence for clinical pathogenicity.CONCLUSION Mutations in LAMA2 are associated with the clinical phenotype of increased neonatal CK levels,for which no specific treatment exists.Whole genome sequen-cing facilitates early diagnosis.

Combination of comprehensive thermal care and detail-oriented nursing care in the operating room for managing gestational diabetes mellitus

BACKGROUND As the incidence of gestational diabetes mellitus(GDM)increases,its impact on cesarean sections has attracted widespread attention.Omni-directional,insulated care and detailed care are of great significance in this patient population,as they can effectively improve the quality of care in the operating room.AIM To explore the effect of the integrated use of comprehensive thermal insulation.METHODS Women with GDM who underwent cesarean sections at our hospital between April 2023 and February 2024 were included in this retrospective study.The participants were randomly allocated to two groups:The observation and control groups.An all-around thermal insulation nursing strategy,including preoperative,intraoperative,and postoperative temperature maintenance,was adopted.In addition,detailed nursing care measures,such as blood glucose monitoring,wound care,and psychological counseling,were implemented in the observation group.RESULTS Comparative observation revealed that all-around thermal insulation care can effectively prevent the incidence of maternal hypothermia caused by surgery,reduce the risk of infection,and promote blood circulation.The implementation of detailed care improved maternal satisfaction and reduced the incidence of complications via the appropriate management of fluctuations in the blood glucose levels and optimization of the nursing process before and after surgery according to the patient's characteristics.CONCLUSION The application of a combination of comprehensive thermal insulation and detailed nursing care improved the overall quality of perioperative care.

Transient diabetes mellitus with ABCC8 variant successfully treated with sulfonylurea:Two case reports and review of literature

BACKGROUND Transient neonatal diabetes mellitus(TNDM)is a rare form of diabetes mellitus that usually presents within the first 6 mo of life.Patients often enter remission within several months,although relapse can occur later in life.Mutations in the ABCC8 gene,which encodes the sulfonylurea receptor 1 of the ATP-sensitive potassium channel in pancreatic beta cells,are associated with TNDM and permanent neonatal diabetes.This study describes a novel de novo c.3880C>T heterozygous ABCC8 variant that causes TNDM and can be treated with sulfonylurea therapy.CASE SUMMARY We retrospectively analyzed 2 Chinese patients with TNDM who were diagnosed,treated,or referred for follow-up between September 2017 and September 2023.The patients were tested for mutations using targeted next-generation sequencing.Patients with neonatal diabetes mellitus caused by a c.3880C>T heterozygous missense variant in the ABCC8 gene have not been reported before.Both children had an onset of post-infectious diabetic ketoacidosis,which is worth noting.At a follow-up visit after discontinuing insulin injection,oral glyburide was found to be effective with no adverse reactions.CONCLUSION Early genetic testing of neonatal diabetes mellitus aids in accurate diagnosis and treatment and helps avoid daily insulin injections that may cause pain.

Managing adult-onset Still's disease in pregnancy:A case report

BACKGROUND Adult-onset Still’s disease(AOSD)is a rare systemic inflammatory disorder characterized by fever,arthritis,skin rash,and systemic symptoms.The etiology of AOSD is unknown;however,it is thought to be related to immune dysregulation.Although a rare disease,AOSD can significantly impact reproductive health,particularly during pregnancy.This case study assesses the implications of pregnancy in a patient with AOSD,as well as the potential for heredity of the disease.Neonatal hemophagocytic lympho-histiocytosis(HLH)is a rare and lifethreatening disorder characterized by hyperinflammation and uncontrolled activation of immune cells,leading to multiple organ dysfunction.This case report aimed to introduce neonatal HLH from a mother with AOSD.CASE SUMMARY This case study presents a 29-year-old female with AOSD who became pregnant and gave birth to a premature infant who was diagnosed with neonatal HLH.AOSD can significantly impact pregnancy and childbirth,as it may become more severe during pregnancy,with an increased risk of fetal loss and preterm birth.The management of AOSD during pregnancy involves the use of nonsteroidal anti-inflammatory drugs and glucocorticoids,as well as immunosuppressive agents in severe cases.However,the use of immunosuppressive agents during pregnancy may be associated with potential risks to the fetus.The hereditary implications of AOSD are unclear;however,available evidence suggests that genetic factors may play a role in the disease development.CONCLUSION AOSD can have significant implications for pregnancy and childbirth,including an increased risk of fetal loss and preterm birth.Neonatal HLH,a complication of AOSD in pregnancy,requires prompt diagnosis and management.Women with AOSD who are considering pregnancy should discuss their options with their healthcare provider and develop a management plan that addresses the potential risks to both mother and fetus.

Clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to NICU in a tertiary care center: A cross-sectional study

Objective:To investigate the clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to a neonatal intensive care unit in a tertiary care center.Methods:The prospective observational study was conducted in a tertiary care center in the Specialty Department of Pediatric.196 Newborn babies with blood glucose levels<45 mg/dL were examined with a simple random sampling method between December 2019 and November 2021.Maternal and neonatal risk factors and clinical signs were recorded and compared between symptomatic and asymptomatic cases.Results:The proportion of symptomatic hypoglycemia neonates born to gestational diabetes mellitus mothers was significantly higher(23.4%vs.8.4%)(P<0.05).Small for gestational age,low birth weight,respiratory distress syndrome,hypothermia,and endocrine disorders were risk factors.The death rate in asymptomatic hypoglycemia neonates was significantly higher(58%vs.39%)(P<0.05).Conclusions:The study indicates that maternal gestational diabetes mellitus is associated with symptomatic hypoglycemia and asymptomatic hypoglycemia is associated with neonatal mortality.It is important to take vigilance and timely interventions to address associated symptoms,particularly poor feeding,in the management of neonatal hypoglycemia.

Effects of pulmonary surfactant combined with noninvasive positive pressure ventilation in neonates with respiratory distress syndrome

BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among infants.Additionally,it is a leading cause of neonatal death in hospitals in China.The main mechanism of the disease is hypoxemia and hypercapnia caused by lack of surfactant AIM To explore the effect of pulmonary surfactant(PS)combined with noninvasive positive pressure ventilation on keratin-14(KRT-14)and endothelin-1(ET-1)levels in peripheral blood and the effectiveness in treating NRDS.METHODS Altogether 137 neonates with respiratory distress syndrome treated in our hospital from April 2019 to July 2021 were included.Of these,64 control cases were treated with noninvasive positive pressure ventilation and 73 observation cases were treated with PS combined with noninvasive positive pressure ventilation.The expression of KRT-14 and ET-1 in the two groups was compared.The deaths,complications,and PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2)blood gas indexes in the two groups were compared.Receiver operating characteristic curve(ROC)analysis was used to determine the diagnostic value of KRT-14 and ET-1 in the treatment of NRDS.RESULTS The observation group had a significantly higher effectiveness rate than the control group.There was no significant difference between the two groups in terms of neonatal mortality and adverse reactions,such as bronchial dysplasia,cyanosis,and shortness of breath.After treatment,the levels of PaO_(2)and PaO_(2)/FiO_(2)in both groups were significantly higher than before treatment,while the level of PaCO_(2)was significantly lower.After treatment,the observation group had significantly higher levels of PaO_(2)and PaO_(2)/FiO_(2)than the control group,while PaCO_(2)was notably lower in the observation group.After treatment,the KRT-14 and ET-1 levels in both groups were significantly decreased compared with the pre-treatment levels.The observation group had a reduction of KRT-14 and ET-1 levels than the control group.ROC curve analysis showed that the area under the curve(AUC)of KRT-14 was 0.791,and the AUC of ET-1 was 0.816.CONCLUSION Combining PS with noninvasive positive pressure ventilation significantly improved the effectiveness of NRDS therapy.KRT-14 and ET-1 levels may have potential as therapeutic and diagnostic indicators.

Relationship between neonatal respiratory distress syndrome pulmonary ultrasonography and respiratory distress score,oxygenation index,and chest radiography grading

BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a less harmful method for assessing the health of neonates with RDS is needed.AIM To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS severity.METHODS This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December 2022.The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were collected.Spearman correlation analysis was performed to determine the relationships among these values and neonatal RDS severity.RESULTS The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(P<0.05).Spearman correlation analysis showed that before and after treatment,the pulmonary ultrasonography score of neonates with RDS was positively correlated with the respiratory distress score,oxygenation index,and chest X-ray grade(ρ=0.429–0.859,P<0.05).Receiver operating characteristic curve analysis indicated that pulmonary ultrasonography screening effectively predicted the severity of neonatal RDS(area under the curve=0.805–1.000,P<0.05).CONCLUSION The pulmonary ultrasonography score was significantly associated with the neonatal RDS score,oxygenation index,and chest X-ray grade.The pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.

Transplantation of human placental chorionic plate-derived mesenchymal stem cells for repair of neurological damage in neonatal hypoxic-ischemic encephalopathy

Neonatal hypoxic-ischemic encephalopathy is often associated with permanent cerebral palsy,neurosensory impairments,and cognitive deficits,and there is no effective treatment for complications related to hypoxic-ischemic encephalopathy.The therapeutic potential of human placental chorionic plate-derived mesenchymal stem cells for various diseases has been explored.However,the potential use of human placental chorionic plate-derived mesenchymal stem cells for the treatment of neonatal hypoxic-ischemic encephalopathy has not yet been investigated.In this study,we injected human placental chorionic plate-derived mesenchymal stem cells into the lateral ventricle of a neonatal hypoxic-ischemic encephalopathy rat model and observed significant improvements in both cognitive and motor function.Protein chip analysis showed that interleukin-3 expression was significantly elevated in neonatal hypoxic-ischemic encephalopathy model rats.Following transplantation of human placental chorionic plate-derived mesenchymal stem cells,interleukin-3 expression was downregulated.To further investigate the role of interleukin-3 in neonatal hypoxic-ischemic encephalopathy,we established an in vitro SH-SY5Y cell model of hypoxic-ischemic injury through oxygen-glucose deprivation and silenced interleukin-3 expression using small interfering RNA.We found that the activity and proliferation of SH-SY5Y cells subjected to oxygen-glucose deprivation were further suppressed by interleukin-3 knockdown.Furthermore,interleukin-3 knockout exacerbated neuronal damage and cognitive and motor function impairment in rat models of hypoxic-ischemic encephalopathy.The findings suggest that transplantation of hpcMSCs ameliorated behavioral impairments in a rat model of hypoxic-ischemic encephalopathy,and this effect was mediated by interleukin-3-dependent neurological function.

Monogenic diabetes in children:An underdiagnosed and poorly managed clinical dilemma

Monogenic diabetes,constituting 1%-2%of global diabetes cases,arises from single gene defects with distinctive inheritance patterns.Despite over 50 associated genetic disorders,accurate diagnoses and management of monogenic diabetes remain inadequate,underscoring insufficient clinician awareness.The disease spectrum encompasses maturity-onset diabetes of the young(MODY),characterized by distinct genetic mutations affecting insulin secretion,and neonatal diabetes mellitus(NDM)-a heterogeneous group of severe hyperglycemic disorders in infants.Mitochondrial diabetes,autoimmune monogenic diabetes,genetic insulin resistance and lipodystrophy syndromes further diversify the monogenic diabetes landscape.A tailored approach based on phenotypic and biochemical factors to identify candidates for genetic screening is recommended for suspected cases of MODY.NDM diagnosis warrants immediate molecular genetic testing for infants under six months.Identifying these genetic defects presents a unique opportunity for precision medicine.Ongoing research aimed to develop cost-effective genetic testing methods and gene-based therapy can facilitate appropriate identification and optimize clinical outcomes.Identification and study of new genes offer a valuable opportunity to gain deeper insights into pancreatic cell biology and the pathogenic mechanisms underlying common forms of diabetes.The clinical review published in the recent issue of World Journal of Diabetes is such an attempt to fill-in our knowledge gap about this enigmatic disease.

Prevalence and Causes of Neonatal Mortality at Chu-Mel, Cotonou in 2023

Introduction: Neonatal mortality represents a global health problem that has been at the core of programs developed by the World Health Organization (WHO) for more than 30 years. In our country, it represents a real scourge and remains high despite the efforts made by the Ministry of Health. The goal of this study was to investigate the prevalence and causes of neonatal mortality at CHU-MEL of Cotonou in 2023. Material and Methods: This was a cross-sectional and descriptive study with retrospective data collection, carried out in the neonatology unit of the Mother and Child Teaching Hospital of Lagune (CHU-MEL) in Cotonou over a period of six months from January 1, 2023 to June 30, 2023. All neonates, premature or full-term, born alive and who died during hospitalization in the unit were included. Results: 211 cases of neonatal deaths were recorded among the 2884 neonates hospitalized in the unit during the study period, representing a hospital prevalence of 7.31%. Early neonatal mortality represented 81.5% of cases. The average age at admission was 4.6 days ± 5.3. The average weight of deceased neonates was 1609.08 ± 798.35 g. The most frequent reasons for hospitalization were represented by prematurity (60.66%) and respiratory distress (23.22%), respectively. Prematurity was the leading cause of neonatal mortality (41.7%), followed by neonatal infections (29.4%) and perinatal asphyxia (10.9%). Conclusion: The prevalence of neonatal mortality in the neonatology unit of CHU-MEL is high. Efforts to improve the quality of perinatal care departments must be intensified to reduce this prevalence.

Determinants of the Low Proportion of Pregnant Women Seen for First-Trimester Prenatal Care at KoudougouUrban Medical Center, Burkina-Faso

Introduction: Antenatal care (ANC) contributes to the reduction of maternal and neonatal morbidity and mortality. The study aimed to investigate the determinants of the low proportion of pregnant women seen for first antenatal care in the first trimester of pregnancy at the urban medical center of Koudougou, Burkina Faso. Materials and Methods: This was a cross-sectional study with data collection from June 08 to August 18, 2021. It involved a sample of 302 participants including 280 pregnant women and 22 maternity providers. Semi-structured individual interviews, non-participant observation, and a literature review were used. Results: Pregnant women age 20 and over, knowledge of the date of their last menstrual period, and knowledge of the antenatal care calendar were associated with coming into contact (1) with Antenatal care in the first trimester of pregnancy. In addition, there was a lack of availability of antenatal care services, inadequate reception of clients, and shortages of health products. Conclusion: There is a need to revisit strategies for communicating with women about ANC, reorganizing ANC services, and improving ANC services.

The Obstetric and Perinatal Outcomes of Adolescent Pregnancies in a Developed Cosmopolitan Middle Eastern Country: A Retrospective Pearl-Peristat Registry

Background: Early marriage is prevalent in Middle Eastern culture. The objective of this study was to investigate the pregnancy outcomes of married pregnant adolescents in a prosperous and highly developed Middle Eastern society, when they receive sufficient prenatal care and social assistance. Methods: A retrospective analysis was performed on the Peristat-based Maternal-Newborn registry utilizing hospital data acquired from four main governmental hospitals in Qatar. The study analyzed the pregnancy outcomes of young adults [ages 20 - 24) who experienced their first pregnancy and compared them to the pregnancy outcomes of adolescents aged 15 to 19 years old. Results: The study comprised a cohort of 3152 pregnant married women. This cohort included 2674 women between the ages of 20 and 24, as well as 478 adolescents aged 15 to 19 years old. In comparison to the young adult group, the non-Qatari population in the adolescent group was significantly higher (78.6% (376/478) vs. 71.5% (1914/2674), p-value = 0.003). Other Arab nationalities accounted for more than half of the adolescent population. All the mothers were married, did not use alcohol, and were nonsmokers. There were no documented mothers under the age of 15. Attending antenatal clinics was significantly higher in the adolescent group (p < 0.001). There was no significant difference in the mean gestational age at birth between adolescents and young adults (38.5 ± 2.3 weeks vs. 38.7 ± 2.1 weeks, p = 0.06). Furthermore, adolescent mothers had a higher rate of low birth weight (13.6% vs. 10.4%, p < 0.001) than young mothers. There was a non-statistically significant rise in pre-eclampsia incidence. Other unfavorable pregnancy outcomes were less common among them, such as diabetes, operative vaginal delivery, caesarean section, stillbirth, NICU hospitalization, and an Apgar score of less than 7 at five minutes. There were no maternal deaths;however, there was a comparable rate of neonatal in-hospital mortality. Conclusion: Pregnancy during adolescence may not relate to significant problems in a well-tolerant culture that ensures dedicated antenatal and social support.