فهرست مطالب abdollah dehvari

 Cognitive development during childhood has significant implications for an individual's cognitive functioning throughout life. Perinatal and postnatal factors may influence this function.

 In this study, we aimed to investigate the relationship between perinatal and postnatal factors and cognitive development in healthy toddlers aged 18 – 22 months.

 In this retrospective cross-sectional study, we examined 50 toddlers born between March 2015 and March 2016 at a teaching hospital in Zahedan, Iran. This study focused on perinatal and neonatal risk factors based on the results of the Bayley-3 test. Data were analyzed using Mann–Whitney U, Kruskal–Wallis, and Pearson correlation coefficient tests.

 Analysis revealed significant correlations between several perinatal factors and subsequent cognitive performance in toddlers. Greater maternal chronological age at the time of parturition, higher levels of mother's attained education, increased neonatal weight at delivery, augmented body weight in the toddler phase, as well as the documented occurrence of neonatal hyperbilirubinemia within the initial postpartum period, demonstrated meaningful associations with enhanced cognitive functioning as assessed during the toddler stage of development.

 Based on the results, it is advised that pregnancy commences at a maternal age that circumvents risks of very young childbearing. Offspring growth should be closely tracked, and neonatal jaundice promptly treated, as these perinatal factors impact cognitive performance. Giving priority to these factors improves a child's chances of healthy cognitive development, which is essential for success in life.

Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) mainly occurs in preterm neonates and is an important cause of brain injury in them. In this retrospective cross-sectional study from march 2017 to march 2018 in our teaching hospitals, we investigated 250 newborns who were admitted to NICU with a birth weight under 1500 grams with ultrasonographic study for presence and grade of GMH-IVH in their first week of life. Risk factors for GMH-IVH were collected from their records and results been analyzed with SPSS software. From 250 neonates who had inclusion criteria of the study, 22 cases had GMH-IVH in ultrasonographic evaluation. 37.6% of all cases and 31.8% of newborns with GMH-IVH had a 5-minute APGAR score of less than six. 91 cases (39.9%) of the control group and 15 cases (68.1%) of the GMH-IVH group need resuscitation at birth. Of 250 cases 54 (21.6%) died, that 14 cases (63.6%) had GMH-IVH. Our study shows significant differences for birth weight, 5 minute APGAR score, and the need for resuscitation at birth as risk factors for the development of GMH-IVH in very low birth weight neonates, but we do not find a significant difference group in terms of gestational age, gender, route of delivery, fetal presentation, maternal parity, CBC parameters, sepsis, RDS, endotracheal tube suctioning and multiple pregnancies for them. In our study, the protective value for antenatal steroid therapy depends on the completion of the course of treatment for mothers.

Arrest of descent is one of the major indications of cesarean delivery and two commonly used methods are Push and Pull methods. In this study, considering the complications and problems caused by cesarean section, and the necessity of an appropriate strategy to reduce these problems, and the problems created for full-arrest neonates, we determined the APGAR score of neonates and compared the maternal and neonatal outcomes in cesarean section by Pull and Push methods in order to improve the quality of life and reduce the neonatal complications. This cross-sectional study was performed on 126 women who had undergone an emergency cesarean section due to arrest of descent in Ali ibn Abi Talib Hospital of Zahedan in 2016-2017. The maternal outcomes (bladder injury, uterine extension, duration of hospitalization) and neonatal outcomes (Apgar score) in cesarean section by Pull and Push methods were collected using the forms containing these information. Data were analyzed by SPSS software (version 21), and descriptive tests, Chi-square and independent t-test. The mean of 1 and 5 minutes Apgar score in Pull method was significantly higher than Push method (p <0.001). Also, uterine extension in cesarean section by Pull method was significantly lower than Push method (p <0.001). The pull method is superior to the push method due to lower complications and better maternal and neonatal outcomes.

Management of hyperbilirubinemia remains a challenge for neonatal medicine because of the risk of neurological complications related to the toxicity of severe hyperbilirubinemia. The purpose of this study was to examine the validity of cord blood alkaline phosphatase level for predicting neonatal hyperbilirubinemia. Patients and Between October and December 2013 a total of 102 healthy term infants born to healthy mothers were studied. Cord blood samples were collected for measurement of alkaline Phosphatase levels immediately after birth. Neonates were followed-up for the emergence of jaundice. Newborns with clinical jaundice were recalled and serum bilirubin levels measured. Appropriate treatment based on serum bilirubin level was performed. Alkaline phosphatase levels between the non-jaundiced and jaundiced treated neonates were compared. The incidence of severe jaundice that required treatment among followed-up neonates was 9.8%. The mean alkaline phosphatase level was 309.09 ± 82.51 IU/L in the non-jaundiced group and 367.80 ± 73.82 IU/L in the severely jaundiced group (P = 0.040). The cutoff value of 314 IU/L was associated with sensitivity 80% and specificity 63% for predicting neonatal hyperbilirubinemia requiring treatment. The cord blood alkaline phosphatase level can be used as a predictor of severe neonatal jaundice.

The readmission rate for neonatal jaundice has been increased in recent years. This has been attributed to shorter length of postpartum hospital stays without comprehensive follow- up. The purpose of this study was to determine the diagnostic value of pre-discharge transcutaneous bilirubin (TcB) levels for prediction of subsequent hyperbilirubinemia in healthy term neonates.
Between October and December 2013, a total of 99 healthy term neonates born at the Babol Clinic Hospital of healthy mother were enrolled in a prospective cross sectional study. The TcB levels were measured in all enrolled neonates between 12 and 24 hours of age just before discharge. All newborns were followed-up for jaundice to 10th day. Newborns with clinical jaundice were recalled and their serum bilirubin levels were measured. Appropriate treatment was performed based on the Amirkola Children's Hospital Protocol. TcB levels were compared between the non-treatment and treatment groups.
The mean age of the TcB measuring was 17.52.6 hours. A total of 18.1% neonates (18 of 99) were developed severe hyperbilirubinemia (need for treatment). The mean of cutaneous bilirubin level in the non-treatment and treatment groups was 5.21.6mg/dl and 6.30.9 mg/dl, respectively. The cutaneous bilirubin level at cut-off 6 mg/dl was associated with 80.0% sensitivity and 63.0% specificity. The negative predictive value was 94.6%.
Single TcB measurements at the first 24 hours predict hyperbilirubinemia with a reasonably high degree of accuracy.