exudates and Infant--Newborn--Diseases

Topics: Animals; Boston; Breast Feeding; Cattle; Ethnicity; Female; Gastrointestinal Diseases; Growth; Health Surveys; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male; Milk; Pregnancy; Respiratory Tract Infections; Sex Factors; Socioeconomic Factors; Time Factors; Urban Population; Weaning

DiGeorge syndrome is a genetic disorder that is related to a wide range of defects affecting various parts of the body. The clinical expression shows marked variability making the diagnosis often missed or underdiagnosed. Here, we describe a neonate who presented with loud inspiratory stridor secondary to hypocalcaemia at birth. Physical examination revealed no abnormality other than evidence of congenital cardiac defect. Laboratory evaluations confirmed the diagnosis of maternal vitamin D deficiency that led to symptomatic hypocalcaemia in the newborn infant. The presence of hypocalcaemia coupled with episodes of recurrent infections led to the clinical suspicion of DiGeorge, which was later confirmed by fluorescence in situ hybridisation test.

Topics: DiGeorge Syndrome; Humans; Hypocalcemia; Infant; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Vitamin D; Vitamin D Deficiency

The role of hypoalbuminemia and raised C-reactive protein (CRP) levels in predicting critical prognosis has been described extensively in adult literature. However, there are limited studies in pediatrics, particularly neonates. The CRP/albumin (CRP/ALB) ratio is often associated with higher mortality, organ failure and prolonged hospital stay. We hypothesized that the serum CRP/ALB ratio has a prognostic value in predicting surgery and mortality in neonates with necrotizing enterocolitis (NEC).. Retrospective review of all neonates with clinical and radiological evidence of non-perforated NEC that were treated in a tertiary-level referral hospital between 2009 and 2018. General patient demographics, laboratory parameters and outcomes were recorded. Receiver operating characteristics analysis was performed to evaluated optimal cut-offs and area under the curve (AUC) with 95% confidence intervals (CI).. A total of 191 neonates were identified. Of these, 103 (53.9%) were born at ≤ 28 weeks of gestation and 101 (52.9%) had a birth weight of ≤ 1000 g. Eighty-four (44.0%) patients underwent surgical intervention for NEC. The overall survival rate was 161/191 (84.3%). A CRP/ALB ratio of ≥ 3 on day 2 of NEC diagnosis was associated with a statistically significant higher likelihood for surgery [AUC 0.71 (95% CI 0.63-0.79); p < 0.0001] and mortality [AUC 0.66 (95% CI 0.54-0.77); p = 0.0150], respectively.. A CRP/ALB ratio of ≥ 3 on day 2 is indicative of a critical pathway in neonates with radiologically confirmed, non-perforated NEC. This could be used as an additional criterion to guide parental counselling in NEC for surgical intervention and mortality.

Topics: Biomarkers; Birth Weight; C-Reactive Protein; Enterocolitis, Necrotizing; Female; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male; Prognosis; Retrospective Studies; ROC Curve; Serum Albumin; Survival Rate

Prevalence of depression, anxiety and stress symptoms in gestational diabetes mellitus ranges from 10.2% to 39.9% based on previous studies in Malaysia. Presence of depression, anxiety or stress in pregnancy may increase the risk of neonatal morbidity and mortality. The aim of this study was to determine the prevalence of neonatal outcomes and its association among mothers with gestational diabetes mellitus with and without the presence of depression, anxiety and stress symptoms in Malaysia.. This was a cross-sectional study.. Tertiary hospitals in Malaysia.. Mothers with gestational diabetes mellitus (n = 418) who deliver their neonates at two major tertiary hospitals in Malaysia.. Neonatal outcomes, such as low birth weight, preterm birth, macrosomia, metabolic and electrolyte disorders, neonatal respiratory distress and congenital anomalies were determined.. Prevalence of low birth weight in neonates born to mothers with gestational diabetes mellitus was 14.6%, followed by metabolic and electrolyte disorders 10.5%, preterm birth 9.1%, macrosomia 4.8%, neonatal respiratory distress 5.8% and congenital anomalies (2.4%). Among the adverse neonatal outcomes, neonatal respiratory distress was significantly associated with the presence of depression symptoms in mothers with gestational diabetes mellitus using univariate analysis (p = 0.010). After controlling for confounding factors, predictors for neonatal respiratory distress at delivery were the presence of depression symptoms in mothers with gestational diabetes mellitus (Adjusted OR = 3.87, 95% CI = 1.32-11.35), living without a husband (Adjusted OR = 9.74, 95% CI = 2.04-46.51), preterm delivery (Adjusted OR = 7.20, 95% CI = 2.23-23.30), caesarean section (Adjusted OR = 3.33, 95% CI = 1.09-10.15), being nulliparous and primiparous (Adjusted OR = 3.62, 95% CI = 1.17-11.17) and having family history of diabetes (Adjusted OR = 3.20, 95% CI = 1.11-9.21).. The findings of this study demonstrate the positive association of neonatal respiratory distress with the presence of depression symptoms in mothers with gestational diabetes mellitus.. It is therefore important to identify depression symptoms after a diagnosis of gestational diabetes mellitus in pregnant mothers is made to enable early referral and interventions.

Topics: Adult; Anxiety; Cross-Sectional Studies; Depression; Diabetes, Gestational; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male; Middle Aged; Pregnancy; Pregnancy Complications; Prevalence; Respiratory Distress Syndrome, Newborn; Stress, Psychological; Tertiary Care Centers

Some anecdotal reports suggest that maternal colonisation with Acinetobacter baumannii during pregnancy is associated with adverse maternal and neonatal effects, including preterm premature rupture of membrane (PPROM). The objective of this study was to compare the maternal and neonatal effects of A. baumannii colonisation in cases with PPROM and those with spontaneous onset of labour at term.. The recruitment of participants' was carried out at Selayang Hospital, Selangor, Malaysia. Vaginal swabs were prospectively taken from 104 patients of PPROM and 111 with spontaneous onset of labour at term. Swabs were also taken from the axillae and ears of their babies. These swabs were cultured to isolate A. baumannii. Maternal and neonatal adverse outcomes were documented.. Sixteen mothers were A. baumannii positive, eight from each group respectively. None of the cases developed chorioamnionitis or sepsis. Those positive were four cases of PPROM and two babies of term labour. None of the babies developed sepsis.. This study does not support the suggestion that A. baumannii colonisation during pregnancy is associated with adverse maternal and neonatal outcomes.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Adolescent; Adult; Case-Control Studies; Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Malaysia; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Prospective Studies; Young Adult

Citrin deficiency is an autosomal recessive disorder caused by mutation in the SLC25AJ3 gene. It has two major phenotypes: adult-onset type II citrullinemia (CTLN2) and neonatal intrahepatic cholestatic caused by citrin deficiency (NICCD). NICCD is characterized by neonatal/infantile-onset cholestatic hepatitis syndrome associated with multiple amino acidemia and hypergalactosemia. NICCD is self-limiting in most patients. However, some patients may develop CTLN2 years later, which manifests as fatal hyperammonemia coma. We report three unrelated Malay children with genetically confirmed NICCD characterised by an insertion mutation IVS16ins3kb in SLC25A13 gene. All 3 patients presented with prolonged neonatal jaundice which resolved without specific treatment between 5 to 10 months. Of note was the manifestation of a peculiar dislike of sweet foods and drinks. Elevated plasma citrulline was an important biochemical marker. NICCD should be considered in the differential diagnosis of cholestatic jaundice in Malaysian infants regardless of ethnic origin.

Topics: Child; Child, Preschool; Cholestasis, Intrahepatic; Citrulline; Citrullinemia; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male; Mitochondrial Membrane Transport Proteins; Mutagenesis, Insertional; Polymerase Chain Reaction

Some of the possible reasons why Singapore's perinatal mortality rate (PMR) is lower than that of many Western countries are examined. The PMR is lower despite the fact that Singapore's economic status is lower than that in most Western countries and the perinatal facilities are not superior. Also considered are the problems associated with perinatal health of the infants in Singapore. In Singapore in 1984 the PMR was 10.6 stillbirths and deaths within the 1st week of life per 1000 stillbirths and livebirths. This is one of the lowest PMR rates in the world. Legalized abortions comprise 50% of livebirths in Singapore. The mothers who choose legalized abortions often are young and members of the lower socioeconomic group, suggesting that if their pregnancies had come to term, many of these babies may have added to the perinatal or infant mortality rate. An assessment of the role of abortions in lowering the PMR of a country might provide some interesting data. Of the 3 major ethnic groups in Singapore -- Chinese, Malay, and Indian, the Indians have the highest proportion of low birth weight (LBW) babies. The Chinese have the least LBW babies with the Malays in between. These differences continued to be evident in 1982. In 1984, the perinatal mortality rates of the Malay and Indian children were higher than that of the Chinese, but there was no difference between that of the Indian and the Malay. In LBW babies (2500 g and less), females predominate in every birth weight category except for 1000g-1499g. After 3000g, males predominate in every birth weight category, so that males predominate as a whole. This male preponderant sex ratio changes postnatally due to a higher death rate in males right up to age 75. As the mortality rate in LBW infants is high, males also will die in greater numbers in this LBW category. An improvement in perinatal care, particularly in the intensive care area, has served to lower mortality rates among both normal birthweight and LBW babies. LBW is the major determinant of neonatal mortality, and in the Singapore context, it is necessary to study survivors with LBW and very low birth weight and to follow them to school and beyond. It is not sufficient to be satisfied with low perinatal mortality rates, as the perinatal mortality rate suggests only the tip to the iceberg, which hides considerable morbidity.

Topics: Abortion, Legal; China; Female; Fetal Death; Humans; India; Infant Mortality; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Pregnancy; Sex Ratio; Singapore

Topics: Digestive System Abnormalities; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Malaysia; Male; Postoperative Complications

Topics: Antibodies, Bacterial; Female; Fetal Blood; Humans; Immunoglobulin G; Immunoglobulin M; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Maternal-Fetal Exchange; Orientia tsutsugamushi; Pregnancy; Scrub Typhus

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male; Pregnancy; Streptococcal Infections; Streptococcus agalactiae

Topics: Acidosis; Animals; Cattle; Dietary Proteins; Electrolytes; Humans; Infant Food; Infant Nutritional Physiological Phenomena; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Milk

Topics: Delivery, Obstetric; Female; Folklore; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Medicine, Traditional; Pregnancy; Tetanus; Umbilical Cord

Topics: Age Factors; Anti-Bacterial Agents; Child; Child, Preschool; Diarrhea; Diarrhea, Infantile; Enterobacteriaceae Infections; Escherichia coli; Escherichia coli Infections; Ethnicity; Feces; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male

This study presents clinical observations in pregnancy made on aborigines of the deep jungle and "outside" populations. Migration out of the jungle results in lowered nutritional status as a result of low socio-economic status in the "outside" aborigine. This, together with food habits, increased family size and higher incidence of helminthic infestations, results in lower mean values of Hb, PVC and MCHC and a higher prevalence of anaemia in pregnancy in the migrant aborigine. A higher population density in the "outside" population resulting in frequent intermingling and increased chances of cross-contamination probably explains the increased vaginal bacterial growth in the "outside" Aborigine women. A higher prevalence of vaginal candidiasis in the "outside" aborigine woman is probably related to exposure to oral contraceptives and broad-spectrum antibiotics. On the other hand, better medical and obstetrical services become more readily available to the "outside" aborigine and this results in a favourable influence on perinatal health.

Topics: Anemia; Birth Weight; Candidiasis; Delivery of Health Care; Diet; Ethnicity; Family Planning Services; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male; Native Hawaiian or Other Pacific Islander; Parasitic Diseases; Parity; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Complications, Infectious; Sanitation; Socioeconomic Factors; Transients and Migrants; Trichomonas Infections

Topics: Clostridium Infections; Costs and Cost Analysis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Midwifery; Pregnancy; Prenatal Care; Tetanus; Tetanus Toxoid; Umbilical Cord; Urban Population

Topics: Body Temperature; Chloral Hydrate; Chlorpromazine; Diazepam; Electrocardiography; Humans; Hydrogen Peroxide; Hygiene; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units; Malaysia; Paraldehyde; Phenobarbital; Positive-Pressure Respiration; Tetanus; Tetanus Antitoxin

Topics: Adolescent; Adult; Child; Encephalomyelitis; Encephalomyelitis, Acute Disseminated; Erythema; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male; Middle Aged; Smallpox; Smallpox Vaccine; Vaccination; Vaccinia

Topics: Bacterial Infections; Cross Infection; Disease Outbreaks; Fingers; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Medical Staff, Hospital; Nails; Nurseries, Hospital; Skin Diseases; Veillonella

Topics: Adult; Birth Weight; Dihydrolipoamide Dehydrogenase; Electrophoresis, Starch Gel; Erythrocytes; Humans; India; Infant, Newborn; Infant, Newborn, Diseases; Isoenzymes; Malaysia; Metabolism, Inborn Errors; Methemoglobinemia; Phenotype; Racial Groups

Topics: ABO Blood-Group System; Erythroblastosis, Fetal; Exchange Transfusion, Whole Blood; Female; Humans; Hyperbilirubinemia; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Jaundice, Neonatal; Malaysia; Male; Pregnancy

Topics: Asian People; Blood; Blood Protein Electrophoresis; Female; Hemoglobins, Abnormal; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male; Sex Factors; Thalassemia; Umbilical Cord; White People