Audit of Neonatal Jaundice as Experienced at a Mission Hospital in Western Nigeria

Introduction: Neonatal jaundice (NNJ) is a common disorder in neonates that can impact negatively on the brain and cause death. The peculiarities in aetiology and solutions for different settings are a knowledge gap. This informed the desire to determine local aetiology and solutions for neonatal jaundice in a missionary hospital in Abeokuta, Southwestern Nigeria. Methods: Consecutive consenting babies diagnosed with significant neonatal jaundice were studied between July 2016 and June 2019. Institutional ethical consent was obtained. A proforma was used to obtain socio-demographic data and other relevant information such as age, sex, birthweight, gestational age and history regarding the jaundice. All the information obtained was inputted into a computer and analysed with SPSS version 16. Results: A total of 179 babies with neonatal jaundice comprising of 120 (67.0%) boys and 59 (33.0%) girls with ages ranging between 1 and 12 days (mean 2.7 ± 2.9) were studied. Prematurity, ABO incompatibility, neonatal sepsis and glucose-6-phosphate enzyme deficiency accounted for over 80% of the causes of significant NNJ. Sixty (33.5%) of the 179 babies studied developed acute bilirubin encephalopathy and 11 (6.1%) mortalities were recorded. Higher proportions of babies that were out-born with spontaneous vaginal delivery modes had acute bilirubin encephalopathy (p < 0.05). Mothers with formal education had better outcome compared to mothers without, in terms of mortalities (p < 0.05). Conclusion: Neonatal jaundice is still a significant cause of morbidity and mortality in the neonatal age group. Maternal education is key to good outcome in neonatal jaundice.

A Comparison between Late Preterm and Term Infants with Respiratory Distress Syndrome, Early-Onset Sepsis, and Neonatal Jaundice in Ecuadorian Newborns

Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.

Clinical Study on the Treatment of Neonatal Jaundice with Lidan Tuihuang Formula Combined with Bifid Lriple Viable and Blue Ray Irradiation

OBJECTIVE: To observe the clinical efficacy of Lidan Tuihuang formula combined with Peifeikang and blue light irradiation in the treatment of neonatal jaundice. METHODS: a total of 140 cases of neonatal jaundice were randomly divided into the observation group and the control group, with 70 cases in each group. The control group was treated with blue light irradiation and oral Bifid Lriple Viable, on the basis of conventional clinical interventions. The observation group was treated with Lidan Tuihuang formula on the basis of the control group. After 7 days of treatment, the scores of clinical symptom(skin yellowness, reduced milk volume, constipation, abdominal distension) and level of serum bilirubin before and after treatment were compared between the two groups, and the adverse reactions and clinical recurrence of the 2 groups were statistically analyzed. RESULTS: After treatment, the effective rate was 94.3% in the observation group which was significantly higher than that in the control group(77.1%)(P < 0.05). The degree of yellowing of the skin, the reduction of the amount of milk, the concentration of constipation and the distension of bloating were all significantly reduced in the 2 groups after treatment(P < 0.05), and the improvement of the above indexes in the observation group was significantly better than that in the control group(P < 0.05). The level of serum bilirubin was significantly lower in the 2 groups after treatment and even for 2 weeks after treatment(P < 0.05). The improvement level of serum bilirubin in the observation group after treatment and even for 2 weeks after treatment were significantly better than that in the control group(P < 0.05). The recurrence rate in the observation group was 8.7%, which was significantly lower than that in the control group 22.2 %(P < 0.05); No serious adverse reactions occurred in both groups. CONCLUSION: The combination of Lidan Tuihuang Formular, Bifid Lriple Viable, blue light irradiation for neonatal jaundice can rapidly improve the clinical symptoms of children, reduce the level of serum bilirubin and shorten the treatment time, with no obvious adverse reactions and high clinical safety.

Effects of Yinzhihuang oral liquid and albumin on bilirubin, inflammatory factors, immune indexes and related factors in neonatal pathologic jaundice

Objective: To explore the effects of Yinzhihuang oral liquid and albumin on bilirubin, inflammatory factors, immune indexes and related factors in neonatal pathologic jaundice. Methods: A total of 134 neonates with pathologic jaundice admitted to our hospital from May 2017 to April 2018 were randomly selected as the control group (n=67) and the observation group (n=67), the control group was treated with albumin, the observation group was treated with Yinzhihuang Oral Liquid on the basis of the control group. The bilirubin, inflammatory factors, immune indicators, alpha-fetoprotein (AFP) and transferrin (TRF) were compared and analyzed before and after treatment. Results: After treatment, the levels of TBIL, DBIL and IBIL in both groups were significantly lower than those before treatment (P<0.05), and the levels of TBIL, DBIL and IBIL [(118.60±10.85) μmol/L, (6.95±1.52) μmol/L, (115.30±14.20)μmol/L] in observation group were significantly lower than those in control group;the levels of CRP and IL-6 in both groups were significantly lower than those before treatment (P<0.05), and the levels of CRP and IL-6 [(8.26±2.07) mg/L, (12.69±2.15) pg/mL] in observation group were significantly lower than those in control group (P<0.05);the levels of CD4+, CD4+/CD8+ in both groups were significantly higher than those before treatment (P<0.05), while the levels of CD8+ was significantly lower than that before treatment, the levels of CD4+, CD4+/CD8+ [(47.08±5.70)%, (2.08±0.41)] in observation group were significantly higher than those in control group (P<0.05), and the level of CD8+ [(22.90±2.05)%] was significantly lower than that in control group (P<0.05);the levels of AFP in significantly higher than before treatment (P<0.05), and the levels of AFP [(12.69±3.04)mg/L] in observation group were significantly lower than those in control group (P<0.05), the levels of TRF [(2.02±0.35) g/L] were significantly higher than those in control group (P<0.05). Conclusions: The combination of Yinzhihuang oral liquid and albumin can effectively reduce the bilirubin level in neonatal jaundice, inhibit its inflammatory reaction, enhance the cellular immune function and improve the expression of AFP and TRF, which is of clinical significance.

Assessment of adjuvant ademetionine therapy for the bilirubin metabolism and target organ function of neonatal jaundice

Objective: To study the effect of adjuvant ademetionine (SAMe) therapy on the bilirubin metabolism and target organ function of neonatal jaundice. Methods: A total of 68 children who were diagnosed with neonatal jaundice in Hubei Jianghan Oilfield General Hospital between March 2015 and April 2017 were selected as the research subjects and randomly divided into the SAMe group who received ademetionine combined with blue ray irradiation and the control group who received blue ray irradiation. The serum contents of bilirubin metabolism indexes and target organ injury markers before treatment as well as 3 d and 7 d after treatment. Results: 3 d and 7 d after treatment, serum TBIL, ALT, AST, GGT, TBA, CK-MB, cTnT, MYO, HBDH, NSE, S100B and GFAP levels of both groups were lower than those before treatment, and serum TBIL, ALT, AST, GGT, TBA, CK-MB, cTnT, MYO, HBDH, NSE, S100B and GFAP levels of SAMe group were lower than those of control group. Conclusion: Adjuvant ademetionine therapy can improve the bilirubin metabolism of neonatal jaundice and reduce the central nerve, myocardial and liver injury.

Study on the mechanism of Yinzhihuang granules, Blue light irradiation combined with Bifid Triple Viable Capsules for neonatal jaundice treatment

Objective:To observe the mechanism of Yinzhihuang granules, Blue light irradiation combined with Bifid Triple Viable Capsules for neonatal jaundice treatment and offer clinical help to neonatal jaundice treatment. Methods:80 children with neonatal jaundice were selected and randomly divided into groups:the observation group (40 children) and the control group (40 children). The patient in the control group were treated with blue light and the patients in the observation group were treated with Yinzhihuang granules, Blue light irradiation combined with Bifid Triple Viable Capsules. Biochemical parameters [TBA (total bile acid), TSB (serum total bilirubin), DB (Direct bilirubin) and TCB (Percutaneous jaundice index)], nerve factor [NSE (neuronspecific enolase), Aβ(βamyloid protein) and S100B (Astrocyte derived protein)] and myocardial enzyme spectrum [LDH (lactate dehydrogenase), CK (creatine kinase) and CK-MB (isoenzymes of creatine kinase)], liver function [ALT (Alanine aminotransferase) and AST (glutamic-oxalacetic transaminase)] and renal function (BUN and Cr) were detected and analyzed before and after treatment. Results:The comparison of Biochemical parameters, nerve factor and myocardial enzymes, liver function and renal function in the two groups before treatment were not statistically significant (P>0.05). Biochemical parameters (TBA, TSB, TCB and DB), nerve factor (NSE, Aβand S100B) and myocardial enzyme spectrum (LDH, CK and CK-MB), liver function (ALT and AST) and renal function [BUN (urea nitrogen) and Cr (creatinine)] in both groups after treatment significantly decreased compared with that before treatment. The changes were statistically significant (P<0.05). Biochemical parameters (TBA, TSB, TCB and DB), nerve factor (NSE, Aβand S100B) and myocardial enzyme spectrum (LDH, CK and CK-MB), liver function (ALT and AST) and renal function (BUN and Cr) in observation group after treatment decreased more significantly compared with that in control group. The difference between two groups was considered to be statistically significant (P<0.05). Conclusions:Yinzhihuang granules, Blue light irradiation combined with Bifid Triple Viable Capsules could regulate the Biochemical parameters, protect nerve function and cardiac muscle cells and improve liver and kidney function in newborns with jaundice. So it has a very important clinical significance of the treatment to neonatal jaundice.

Incidence and Risk Factors to Neonatal Jaundice in Jalingo, Taraba State

This cross-sectional study was aimed to determine the incidence and the significant risk factors to neonatal jaundice in FMC, Jalingo. Four hundred and thirty three neonates admitted to special baby care unit (SBCU) FMC, Jalingo with their mothers were surveyed. Data were collected through a data extraction format looking on the medical records of the neonates (from 1st January, 2021 to 31st August, 2021) and interviewing the mothers. Data were transferred to an Excel data sheet and results were summarized by frequencies and percentages (categorical variables). Logistic regression analysis was used to determine the strength of the risk factors to neonatal jaundice while the significance was tested at p-value ≤ 0.05. The findings revealed that the incidence of neonatal jaundice in FMC Jalingo was 40.18% while the significant risk factors were age group 41 - 50 years (I = 15.01%, OR: 2.970 at 95% CI: 1.566 - 5.634, p = 0.000), spontaneous vaginal delivery (I = 18.01%, OR: 1.382 at 95% CI: 0.940 - 2.033, p = 0.000), premature rupture of membrane (I = 24.94%, OR at: 2.252 at 95% CI: 1.520 - 3.337, p = 0.000), hypertension in pregnancy (I = 21.02%, OR: 1.831 at 95% CI: 1.240 - 2.703, p = 0.002). Others were breech fetal presentation (I = 23.33%, OR: 2.689 at 95% CI: 1.809 - 3.995, p = 0.000), birth asphyxia (I = 22.40%, OR: 3.469 at 95% CI: 2.3105.210, p = 0.000), significant bruising (I = 22.86%, OR: 1.705 at 95% CI: 1.157 - 2.513, p = 0.007), neonatal sepsis (I = 21.02%, OR: 1.688 at 95% CI: 1.145 - 2.488, p = 0.008) and congenital hemolytic anemia (I = 21.71%, OR: 1.723 at 95% CI: 1.169 - 2.540, p = 0.006). Therefore, the need for all concerned to ensure the incidence is reduced and the risk factors identified early and tackled.

The Effect of Pomegranate Paste on Neonatal Jaundice Incidence: A Clinical Trial in Women during Pregnancy

Purpose: Some topics such as women’s life style and nutrition and using some special medicines during pregnancy have been discussed and demonstrated as effective factors on infant’ health. Based on recommendations in Iranian traditional medicine, we aimed to evaluate the efficacy of pomegranate paste consumed by women during their pregnancy on the neonatal jaundice incidence. Methods: In this single-blinded controlled clinical trial, 80 healthy pregnant women were randomly divided into 2 groups, as treatment and control. The treatment group members added pomegranate paste to their daily diet from the 34th week of the pregnancy to birth, as administered. The levels of neonates’ bilirubin were checked in the 5th day of the delivery. Results: Both the need of phototherapy and the mean level of neonates’ bilirubin in the group fed with pomegranate paste were significantly lesser compared to control group. The number of neonates who were undergone phototherapy in the pomegranate paste receiving group was significantly lesser than that in the control group (P value = 0.029). By measuring the total bilirubin, statically significant difference between the treatment group and the control group was seen (P value = 0.021). Conclusion: The results of this study suggest the possible effect of adding pomegranate paste to pregnant women’s diet on the incidence of neonatal jaundice.

Correlation between Transcutaneous Bilirubinemia and Blood Bilirubinemia in Screening Term Newborn for Neonatal Jaundice at the Essos Hospital Centre (EHC), Yaoundé, Cameroon

Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains critical in dark skinned babies of low resource settings. Objective: To assess correlation/agreement between transcutaneous bilirubin (Tcb) and serum bilirubin (Tsb) values in full term neonates with jaundice. Methodology: An analytical cross-sectional study was conducted at the neonatology unit of the Essos Hospital Centre (EHC) from January to June 2019. All full-term neonates aged 0 to 7 days with suspected jaundice who did not receive phototherapy were eligible for the study. The enrolled neonates in the study were assessed clinically, then with the MBJ20 transcutaneous bilirubinometer (TcB). The MBJ20 transcutaneous bilirubinometer highest measurement over the forehead and the sternum were compared to TsB. Data were entered and then analysed with the CsPro7.2 and R (version 3.6.0) software. Correlation was captured by Bland & Alman plots and Concordance Correlation Coefficient (CCC) estimates. The Pearson correlation coefficient and Student test for paired data were used for descriptions purposes, and the significance level was 5%. Results: We recruited 88 neonates. The sex ratio of the babies included was 1.25 favouring males. Median Post-natal age was 3 days with 62% aged 72 hours or more. The mean TcB corresponding to the maximum average between frontal and sternal measurement was 153 mg/dl ± 48 and the average Tsb was 123.80 mg/dl ± 50.48. A good linear correlation was found between TcB and total serum bilirubin level r = 0.86 [0.80;0.91]. Positive correlation was noted between both (forehead and sternum) TcB measurements sites, namely r = 0.78 and r = 0.86. The Bland & Altman plot measured the bias at -29.68 mg/l (confidence interval at 95%, 21.14 - 80.50). The CCC estimate was 0.2 varying from -0.22 to 0.76 according to TcB measurement threshold and post-natal age. The ROC area under the curve value for a threshold < 100 mg/l equals 90% proving to be a good predictor for this threshold. Conclusion: A good linear correlation was found despite a poor agreement between TcB and Tsb. TcB method systematically overestimated the value of TsB.

The effect of traditional Chinesemedicine washing combined withmassage for neonataljaundice： a meta-analysis

Objective： To systematically assess the effect of traditional Chinese medicine washing （TCM washing） combined withmassage for the treatment of neonatal jaundice.Methods and analysis： Databases, including PubMed, the Cochrane Library, Embase, Web of Science, the ChineseBiomedical Literature Database （CBM）, CNKI, and Wanfang Data were electronically searched for randomizedcontrolled trials （from inception to July 2017）. The methodological qualities of included trials were evaluated by theCochrane risk of bias assessment tool. The meta-analysis was performed by using RevMan 5.3 software.Results： Overall, thirteen trials with a total of 1998 participants were included. The results of meta-analysis indicatedthat TCM washing combined with massage group was significantly superior to the control group in the first meconiumtime （MD, -16.67; 95% CI, -24.59 to -8.74; P〈0.001）, time for transformation of meconium （MD, -15.44; 95% CI,-23.59 to -7.28; P〈0.001）, transcutaneous bilirubin index changes [after treating three days （MD, -1.99; 95% CI, -2.57 to-1.40; P〈0.001）, after treating four days （MD, -1.86; 95% CI, -2.77 to -0.95; P〈0.001）, after treating five days （MD,-2.44; 95% CI, -3.47 to -1.42; P〈0.001）, after treating six days （MD, -2.23; 95% CI, -3.30 to -1.16; P〈0.001）, and thechanges of serum bilirubin levels [after treating five days （MD, -3.17; 95% CI, -5.83 to -0.50; P=0.02）, after treating sixdays （MD, -1.63; 95% CI, -3.10 to -0.16; P=0.03）, after treating fifteen days （MD,-1.20; 95% CI, -1.99 to -0.41; P=0.003）.Conclusions： TCM washing combined with massage may be an effective therapy for the treatment of neonatal jaundice.It can accelerate the excretion of meconium, shorten the time for transformation of meconium, and decreasetranscutaneous bilirubin index and the level of serum bilirubin. But it should be careful to interpreting these findings.Well-designed RCTs are needed to further clarify the conclusion.

Neonatal Graves’ Disease and Cholestatic Jaundice: Case Series and Review of the Literature

Cholestatic jaundice and elevated liver enzymes are uncommon, but recognized, manifestations of neonatal thyrotoxicosis. Current guidelines for evaluation of cholestatic jaundice and reviews in Neonatology literature do not discuss hyperthyroidism in the differential diagnosis of cholestatic jaundice. We report two cases of neonatal thyrotoxicosis secondary to neonatal Graves’ disease that presented with cholestatic jaundice and elevated liver enzymes at birth. Early recognition of thyrotoxicosis as a cause of the hepatic disease in the neonate is crucial to prevent unnecessary diagnostic procedures and to initiate timely treatment.

Effect of exchange blood transfusion on oxygen saturation of neonates with severe neonatal jaundice by pulse oximetry

Objective:To determine if there was any difference in SpO2 readings during exchange blood transfusion(EBT).Methods:A prospective cross-sectional study of neonates with severe neonatal jaundice requiring EBT was conducted.Oxygen saturation was recorded before,immediately and 15 minutes after EBT by using a pulse oximeter.Results:This study included 30 neonates with 20 males and 10 females.The age ranged from 1 to 12 days with a mean of(5.4±2.9)days.Pre-EBT SpO2 ranged from 90%to 98%with a mean value of(94.3±2.2)%;SpO2 in the end of EBT ranged from 85%to 99%with a mean value of(94.1±3.2)%;SpO2 at 15 minutes after EBT ranged from 77%to 99%with a mean value of(94.8±4.1)%.There was no significant difference between SpO2 values at onset of EBT and either immediately or 15 minutes after EBT(P=0.770 and 0.422,respectively).SpO2 showed no significant difference between neonates who were infused with blood of different storage times(<24 h or≥24 h)at the onset of EBT(P=0.584),immediately(P>0.999)and 15 minutes after EBT(P=0.887).Besides,SpO2 values were compariable in neonates with hematocrit<45%or≥45%at the onset of EBT(P=0.284),immediately(P=0.118)and 15 minutes after EBT(P=0.868).Conclusions:EBT does not affect SpO2 in neonates.

Efficacy and safety of percutaneous transhepatic biliary radiofrequency ablation in patients with malignant obstructive jaundice

BACKGROUND Percutaneous transhepatic cholangiodrainage(PTCD)and endoscopic retrograde cholangiopancreatography/endoscopic nasobiliary drainage are the most common clinical procedures for jaundice control in patients with unresectable malignant obstructive jaundice,yet the safety and effect of endobiliary radiofrequency ablation(EB-RFA)combined PTCD is rarely reported,in this article,we report our experience of EB-RFA combined PTCD in such patients.AIM To retrospectively study the efficacy and safety of EB-RFA combined PTCD in patients with unresectable malignant obstructive jaundice.METHODS Patients with unresectable malignant obstructive jaundice treated with EB-RFA under PTCD were selected,the bile ducts of the right posterior lobe was selected as the target bile ducts in all cases.The general conditions of all patients,preoperative tumour markers,total bilirubin(TBIL),direct bilirubin(DBIL),albumin(ALB),alkaline phosphatase(ALP),and glutamyl transferase(GGT)before and on the 7th day after the procedure,as well as perioperative complications,stent patency time and patient survival were recorded.RESULTS All patients successfully completed the operation,TBIL and DBIL decreased significantly in all patients at the 7th postoperative day(P=0.009 and 0.006,respectively);the values of ALB,ALP and GGT also decreased compared with the preoperative period,but the difference was not statistically significant.Perioperative biliary bleeding occurred in 2 patients,which was improved after transfusion of blood and other conservative treatments,pancreatitis appeared in 1 patient after the operation,no serious complication and death happened after operation.Except for 3 patients with loss of visits,the stent patency rate of the remaining 14 patients was 100%71%and 29%at the 1^(st),3^(rd),and 6^(th)postoperative months respectively,with a median survival of 4 months.CONCLUSION EB-RFA under PTCD in patients with unresectable malignant obstructive jaundice has a satisfactory therapeutic effect and high safety,which is worthy of further clinical practice.

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).

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.

Factors Associated with Neonatal Sepsis: A Case Study at Chilenje General Hospital in the Neonatal Unit and Paediatric Wards

Background: Neonatal sepsis is known to result in 26% of mortalities in children below the age of five worldwide, countries in Sub-Saharan African recording the highest deaths. Although the deaths of neonates have reduced world over up to 3.6 million counts, Chilenje General Hospital continues to register significant numbers of neonatal sepsis. This study aimed at investigating the factors associated with neonatal sepsis at Chilenje General Hospital in Lusaka, Zambia. Methods: An institution based cross-sectional study design was conducted at Chilenje General Hospital. Data were collected by the use of a researcher designed questionnaire and analysed using SPSS version 25. Frequencies were used for descriptive analysis while bivariate analysis was used to establish association among risk factors and outcome variables. Variables with significant association at 5% level were further subjected to multivariate analysis at α ≤ 0.05. Results: The study showed that out of 156 neonates, 40.4% (63/156) developed neonatal sepsis. Maternal factors that projected the incidence of sepsis amongst neonates were distance to nearest health facility [AOR: 6.3 (95% CI: 1.8 - 21.3), p = 0.003], occupation [AOR: 5.8 (95% CI: 1.2 - 27.6), p = 0.026], number of antenatal visits [AOR: 6.3 (95% CI: 1.9 - 21.6), p = 0.003], number of vaginal examinations [AOR: 10.8 (95% CI: 2.8 - 42), p = 0.001], and pregnancy induced hypertension [AOR: 5.4 (95% CI: 1.4 - 20), p = 0.013]. Neonatal risk factor which projected the incidence of sepsis was Neonate’s age [AOR: 18.8 (95% CI: 4.9 - 72.5), p = 0.000]. Conclusions: The chance of developing neonatal sepsis was strongly correlated with both mother and child variables, according to the study. In order to lower the chance of the neonate acquiring sepsis, encouraging maternal antenatal care use would assist to detect risk factors during prenatal, perinatal and postnatal care and apply the proper therapies.

Epidemiological Aspects of Stillbirth and Neonatal Deaths in the Delivery Room at the Libreville Mother-Child University Hospital from 2019 to 2022

Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.

The Diagnostic Validity of Preterm Delivery in Adolescent Girls Based on Neonatal Clinical Assessment

Introduction: Pregnant adolescents are at an elevated risk of premature delivery. In the context of low levels of education and limited resources, several difficulties are encountered in determining gestational age. These include a lack of knowledge of the date of the last menstrual period, failure to perform first-trimester ultrasound, and absence of an electroencephalogram. In such circumstances, the utilisation of a morphological score, analogous to the Finnstrom score, to ascertain gestational age would appear to be a more accessible and straightforward approach. This study aimed to assess the accuracy of the Finnström score in newborns of teenage mothers, where the date of the last menstrual period may be subject to inaccuracy, in order to validate the diagnosis of preterm delivery. Methods: This was an analytical cross-sectional design of 87 newborns of teenage mothers, multicenter, conducted in the city of Kisangani, Democratic Republic of the Congo (DRC) with prospective data collection. Results: This study involved 87 newborns born to adolescent mothers. The incidence of premature delivery, as determined by the date of the last menstrual period, was observed to be 17.6% among teenage girls and 5.3% among adults. As indicated by the Finnström morphological score and early ultrasound dating, the incidence of preterm delivery was notably elevated, at 32.2% and 37.7%, respectively. The correlation between gestational age according to the date of the last menstrual period and gestational age according to early ultrasound dating was low (0.338), while there was a satisfactory correlation between gestational age according to the Finnström morphological score and early ultrasound dating (0.828). Conclusion: The Finnström morphological score represents a valuable tool for accurately determining gestational age, thereby validating the diagnosis of preterm delivery in adolescents, who are prone to inaccuracies in determining the date of the last menstrual period. It is therefore recommended that this score be evaluated in our setting, where access to ultrasound is sometimes still problematic.

Risk Factors for Neonatal Mortality at the Institute of Nutrition and Child Health of the Donka/Guinea-Conakry National Hospital

Introduction: The birth of a baby is a moment of joy and celebration. However, the neonatal period is a very delicate phase of life. Neonatal mortality rates remain high in low-income countries. In Guinea, after 20 years, this rate has fallen from 34.2% in 1998 to 32% in 2018. Objective: To identify the main risk factors for neonatal mortality. Methods: This was an observational, analytical case-control study, lasting 6 months from January 1 to June 30, 2019, conducted at the Institut de Nutrition et de la Santé de l’Enfant (INSE) at Donka National Hospital. Results: We collected 242 cases and 242 controls, i.e. a total of 484 records. 748 patients were registered, with 32.35% deaths. 82.86% of deaths occurred in the early neonatal period. Statistical analysis revealed the main risk factors: prematurity (RQ 7.39 95% CI 3.27 - 16.61 p = 0.0000003), hypothermia (RQ 2.29 95% CI 1.51 - 3.46 p = 0.0001), acute fetal distress (RQ 2.13 95% CI 1.33 - 3.43 p = 0.0016), low birth weight (QR 1.91 95% CI 1.12 - 3.24 p = 0.016), home birth (QR 3.26 95% CI 1.25 - 8.46 p = 0.015). Conclusion: Neonatal mortality is a health problem in the INSE neonatology department. To reduce the mortality rate in this referral facility, it is essential to equip it and provide ongoing training for staff.

Comparative Study of Early Neonatal Complications between the First and Second Twin during Twin Vaginal Deliveries at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital

Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.