27^th International Conference on Pediatrics, Neonatology and Pediatric Nursing September 24-25, 2018 Tokyo, Japan

Biography:

Maria Clariza A. Coronado, M.D. earned her medical degree from University of the East Memorial Medical Center. She is a graduate of pediatric residency training from St. Luke’s Medical Center, Philippines. She plans to pursue neonatology fellowship training.

Abstract:

Statement of the Problem: The extent to which urinary tract infection (UTI) affects maternal and perinatal health remains indefinite. UTI during pregnancy can lead to preterm birth, low birth weight and even neonatal death. The study aimed to describe the neonatal outcome of women with antepartum urinary tract infection during the 3^rd trimester of pregnancy admitted under social service in a tertiary hospital. The prevalence of maternal UTI and their association to neonatal outcomes were determined. Neonatal outcomes of mothers with UTI and those without UTI were compared. 

Methodology: This was a retrospective cross-sectional analytical study. Medical records of all born neonates and their mothers at St. Luke’s Medical Center Quezon City, Philippines, from January 1 to December 31, 2015 admitted under social service were reviewed. 

Findings: Out of 424 mothers, 148 (34.9%, 95% CI 30.4 to 39.7%) had urinary tract infection on the 3^rd trimester. Mothers with 3^rd trimester UTI and without UTI were similar to outcomes such as Apgar scores of 7 to 9 at 1^st minute (97.3% vs 97.1%) and 5^th minute (99.3% vs 99.6%), intubation (0.7 vs 1.8%), neonatal pneumonia (0 vs 3.3%), neonatal UTI (0.7 vs 0%), clinical sepsis (16.9% vs 16.3%), intrauterine growth restriction (0 vs 0.4%) and neonatal death (0 vs 0.4%). Differences (p-value <0.05) were noted in outcomes such as low birth weight (6.1% vs 19.2%), preterm birth (2% vs 12.7%) and small for gestational age (1.3% vs 5.1%). Mothers who had UTI were significantly less likely to have low birth weight neonates (OR 0.28, 95% CI 0.13 to 0.59) and preterm birth (OR 0.14, 95% CI 0.04 to 0.47).

Conclusion: The prevalence of 3^rd trimester urinary tract infection in pregnancy was 34.9%. Mothers with UTI and those without UTI had almost similar neonatal outcomes.

Biography:

Dr. Meidelin Hoei, MD, earned her Bachelor of Medicine, Bachelor of Surgery degree from Suzhou University, China in 2015. She is currently finishing her residency in Pediatrics.

Abstract:

Multiple births have been associated with increased maternal and fetal morbidity and mortality during delivery. They are associated with higher cases of prematurity and low birth weight. It is important to review trends in multiple pregnancies and their outcomes to be able to identify opportunities for intervention in improving both maternal and neonatal outcomes. The study aims to provide more data on profiles of mothers and infants born with multiple pregnancies, their outcomes providing baseline data for hospital-based protocols and management of future multiple pregnancies. 

Objective: To describe the clinico-demographic profile and outcome of twin pregnancies in a tertiary government hospital

Study Design: Retrospective descriptive cross-sectional study

Setting: Neonatal Intensive Care Unit and Delivery Room of a tertiary government hospital

Study Population: Mother and newborns born at a tertiary government hospital

Results: Among 100 twin births delivered between 2014-2016, 58% were born to the mothers from age group of 20 to <30 years old. Most of the twins were full term and delivered by caesarean section with birthweight of 1000-2000 grams. 45 babies were admitted to NICU mostly due to prematurity with respiratory distress syndrome as number one immediate cause of mortality.

Conclusion: The incidence of twin birth in Philippines is still lower than in other continents. Advanced maternal age and increase gravidity and parity may have a role in increased twinning rates. Prematurity, respiratory distress syndrome still one of the most common complications and cause of death in twin births.

Biography:

Dr. Srijana Dangol Singh is currently working as an Associate Professor at Kathmandu University Hospital, Nepal.

Abstract:

Background

Asthma is one of the most common chronic childhood illnesses with rapidly increasing prevalence in low income countries. For planning effective intervention to reverse this condition we need a better understanding of the risk factors for asthma in early life.

Objectives

This study aimed to identify the risk factors associated with childhood asthma and its morbidity patterns.

Methods

The case control study was conducted in the pediatric department of Dhulikhel hospital, Kathmandu University hospital, Dhulikhel from March 2016 to March 2017. The control group was composed of 175 age matched children attending the outpatient clinic with non pulmonary health problem. Data was collected through Performa and analyzed using SPSS version 23.The association of asthma with genetic and environmental risk factors was evaluated by univariant (chi-square or Fisher’s exact test) and binomial logistic regression.

Results

Childhood asthma was more common in male children between 1-5 years. Majority of children 77(44%) were graded as mild persistent asthma. In multivariate analysis the following factors were associated with asthma: family history of asthma (OR0.06; 95%CI .005-0.94, p=0.04), exclusive breast feeding (OR18.42; 95%CI 2.56-132.3, p=0.004), allergic disorder in children (OR0.003; 95%CI 0.000-0.037, p=0.0001).

Conclusion

Family history of asthma, allergic history in the patient and nonexclusive breast feeding were significantly associated with asthma. Proper treatment and follow up with good drug compliance and avoidance of risk factor can significantly reduce the morbidity pattern of asthma in children.

Biography:

He is a practicing physician in the field of healthcare in the state of Kerala in India for the last 29 years and very much interested in basic research. His interest is spread across the fever, inflammation and  back pain. He is a medical writer and have published nine books in these subject. He wrote hundreds of articles in various magazines. He presented 9 research papers in Indian Science Congress 2008 to 2017 and 2 papers selected for the coming 2018 Indian science congress.

Abstract:

According to the facts of physics, if temperature increases, thermal expansion of an object is positive it will expand and with decrease of temperature it will shrink. Pressure will increase due to increase of temperature. On the contrary, during fever we can see blood vessels and skin are shrunk, pressure decreases, body shivers,   sleep increases, motion decreases, inflammation increases,   body pain increases, blood circulation decreases, dislike cold substances etc. In fever, the firing rate of Warm sensitive neurons decreases, and the firing rate of Cold sensitive neurons increases.

At the same time if we apply hotness from outside by thermal bag or if we drink hot water, our body acts according to the Facts of Physics- increase of temperature  pressure will also increase,  expands blood vessels and skin, body sweats, motion will increase ,  inflammation will decrease , body pain will decrease, blood circulation will increase,  like cold substances etc.

During fever, why our body acts against Facts of Physics? when disease increases, pressure and temperature will decrease. Blood circulation will decrease due to decrease of pressure. If the essential temperature of the  body is going out, essential temperature and  pressure will further decrease. This will further endanger the life or action of organ. When  disease  increase, it is the sensible and discreet action of brain  that tends to act against facts of physics  to sustain life or protect organ .There is no  way other than this for a sensible and discreet  brain to protect the  life or organ. We will get a clear answer if we find out the purpose of fever, sensible and discreet action of brain. No medical books clarify this¹.During fever, if the temperature of fever is not a surplus temperature or if it is not supposed to be eliminated from the body, the shrinking of skin and blood vessels, shivering of body, dislike towards cold substances etc are a protective covering of the body to increase blood circulation to important organs of the body it is against the facts of physics.

Biography:

Dr. Badawy plays an astonishing role in guiding and inspiring general pediatricians, junior residents and medical interns, let alone designing and giving operating teaching sessions directed to seniors. He works for a leading teaching, 500 beds, JCI accredited hospital, located in the southern region of Saudi Arabia. After being granted the Membership of the Royal College of Pediatrics and Child Health from the United Kingdom in 2015, his hospital medical board promoted him to a Neonatal Specialist position in its tertiary care Neonatal Intensive Care Unit (NICU).

Abstract:

Preeclampsia is considered as an obstetric clinical syndrome with an unclear etiology, a genetic component, and a complex pathophysiology, which involves maternal and fetal vascular alterations that could persist and cause diseases in later life.

 Multifactorial polygenic inheritance is presumed, as it shows familial predisposition, geographical and racial variability, as well as, various PE-related genes and polymorphisms that have been identified.

Although its pathophysiology is complex and incompletely understood, it is adopted that placenta (placentopathy) is a triggering organ in the disease development.

Preeclampsia is associated with early and late unfavorable neonatal outcomes, predominantly, due to increasing indications for preterm delivery, which In turn has a major impact on neonatal mortality and morbidity, hence considered as a determinant factor in neonatal prognosis.

Prematurity and IUGR are by far the most common implications of preeclampsia. Even though the relation between Preeclampsia and short & long term neonatal outcomes is controversial in the literature, recent studies mostly are supporting, collectively, the unfavorable outcomes.

Biography:

Segundo Mesa Castillo. As Specialist in Neurology, he worked for 10 years in the Institute of Neurology of Havana, Cuba.  He has worked in Electron Microscopic Studies on Schizophrenia for 32 years. He was awarded with the International Price of the Stanley Foundation Award Program and for the Professional Committee to work as a fellowship position in the Laboratory of the Central Nervous System Studies, National Institute of Neurological Diseases and Stroke under Dr. Joseph Gibbs for a period of 6 months, National Institute of Health, Bethesda, Maryland, Washington D.C. USA, June 5, 1990.

Abstract:

There is increasing evidences that favor the prenatal beginning of schizophrenia. These evidences point toward intra-uterine environmental factors that act specifically during the second pregnancy trimester producing a direct damage of the brain of the fetus. The current available technology doesn't allow observing what is happening at cellular level since the human brain is not exposed  to a direct analysis in that stage of the life in subjects at high risk of developing schizophrenia. Methods. In 1977 we began a direct electron microscopic research of the brain of fetuses at high risk from schizophrenic mothers in order to finding differences at cellular level in relation to controls. Results. In these studies we have observed within the nuclei of neurons the presence of complete and incomplete viral particles that reacted in positive form with antibodies to herpes simplex hominis type I [HSV1] virus, and mitochondria alterations. Conclusion. The importance of these findings can have practical applications in the prevention of the illness keeping in mind its direct relation to the aetiology and physiopathology of schizophrenia. A study of amniotic fluid cells in women at risk of having a schizophrenic offspring is considered. Of being observed the same alterations that those observed previously in the cells of the brain of the studied foetuses, it would intend to these women in risk of having a schizophrenia descendant, previous information of the results, the voluntary medical interruption of the pregnancy or an early anti HSV1 viral treatment as preventive measure of the later development of the illness.

Biography:

Dr. Wael Mohamed Abdelaal Egyptian. Senior consultant pediatric graduated 1995, master pediatric 2001, Ph D pediatrics 2009 working Zagazig university hospital Egypt, Alsabal Hospital Kuwait, Hamad corporation Qatar and currently working at NMC hospital UAE.  Alot of researches in neonatal anemia, neonatal sepsis and childhood asthma together with allergic diseases.

Abstract:

Adverse reaction to cows' milk resulting from an immunologic hypersensitivity to one or more milk protein.  the most common food allergy in infants and can affect the quality of life of the whole family

It affects 1.9% - 4.9% of infants. According to the guidelines from the national institute of allergy and infectious disease it classified into.

IgE- mediated CMPA, Symptoms can occur immediately and up to 2 hours after ingestion of cow’s milk., Can affect skin, respiratory system, GIT or severe systemic reactions---- anaphylaxis

Non IgE-mediated CMPA. Manifestations can be delayed up to 72 H after exposure to cow’s milk. Main effects to GIT. Symptoms are non-specific including colic, reflux, diarrhea or constipation, blood in stool and exacerbation of eczema

Cow’s Milk Antigens. More than 25 proteins in cow’s milk can induce antibody production in humans. β-lactoglobulin (in whey), casein, and bovine serum albumin are the most important antigens. Clinical reactions have occurred to all the major cow’s milk antigens

Human Milk Antigens. Human milk is predominantly whey (80% whey and 20% casein) – total casein content varies during lactation (20% in early lactation, 45% in late lactation) . Human milk lacks αs1 and αs2 caseins and β - lactoglobulin

Predisposing Factors to CMPA in Breast-fed Infants. Genetic predisposition – family history of CMA, Early exposure to cow’s milk – in utero – in newborn nursery, Exposure to cow’s milk allergens – in mother’s milk, Feeding of cow’s milk by relatives and caregivers

Clinical presentation of CMPA. CMPA manifestations involves many organs, mostly skin, GIT and respiratory tracts. The involvement of 2 or more systems increases the probability of CMPA

Studies on infants with CMPA showed that half of them have atopic eczema, and 25-50% are affected by GIT manifestations whereas other clinical manifestations are less common

How to diagnose CMPA?

1-Allergy-focused history ( symptoms, underlying immunological mechanisms and linking this to suspected food, family history of atopy).

2- For IgE mediated---- skin prick tests or specific IgE blood tests.

3-For non IgE mediated---- allergy tests have limited value

4- The oral food challenge test remains the gold standard for both types.

Treatment. Strict avoidance of CMP is the safest strategy. Choosing the substitute formula., hydrolyzed formula AAP defines eHF that it is a formula containing only peptides that have a molecular wt <3000Da.Majority of children are tolerating it. Formula containing free amino acids as the only nitrogen source are the best option in infants reacting to eHF

Prognosis. 50% of children develop tolerance by age 1 yr.75% by age 3 yrs.90% by age 6 yrs. Most infants will outgrow milk allergy by 3 years of age, but may become intolerant to other foods.

Biography:

Mostafa Dehghani Poudeh has B.S degree in Nursing and Masters’ in health education. He started his professional work in the field of medical education since 2001 after some nursing clinical experiences and community health education practices. Most of his experiences and publications are in the area of evaluation which he started in Education Development Office (EDO) of Isfahan Medical School, Isfahan, Iran. He was the member of evaluation committee of Medical School. He is also the member of academic committee of CSLC. He was admitted to an Evaluation, Measurement and Research (EMR) course at Western Michigan University, Michigan, USA on 2012. However he did not started his work at that time because of the US sanctions which denied giving him student Visa. After getting the first ranked position in the national entrance exam for PhD degree, he is now a PhD candidate in Medical Education at Tehran University of Medical Sciences. He has been granted a full scholarship from Isfahan University of Medical Sciences.

Abstract:

With a programmatic approach to assessment, leading through teamwork, our pediatrics residency program evaluates and tracks its graduate learners towards an intended destination, Competent Pediatricians. It is accomplished through a well-structured and organized master plan implemented by a rigorous action plan. It consists of various assessment methods using quantitative rubrics as well as qualitative analyses. The prominent feature of such a system includes directing residents to predetermined milestones and entrustability levels in all levels of Miller’s pyramid. The aims and objectives are fulfilled by using concrete objective and narrative feed backs about the results of formal and informal evaluations within various clinical contexts and through daily encounters. All these venues provide rich data points good enough for reliable decisions which are certainly open to objections by residents. These objections are all considered and answered officially.

The other opportunity which makes our assessment system of good quality is a well-equipped clinical skills learning center (CSLC) which is the national center of excellence in learning clinical skills. This center has the roles of both planning and implementing the assessment plans for clinical and preclinical competencies. It is also the center that leads the national high stakes assessments which are mostly conducted electronically. As an instance I can point to recent Key Features examination which was centrally designed and conducted in our CSLC for all of pediatrics residents from all of medical universities.

However our assessment system has very improvement needs. One of them is mentoring the residents by clinical faculties. It is our next plan for upgrading the assessment system so that it could be more “for learning” than “of learning”. The next one includes the encouragement of our residents to be more “Feedback-Seekers” than “Grade-Hunters”.  Of course the latter depends on the national rules and regulations for decision making about the graduate education system.

Biography:

María Camila Mejía is a General practitioner and surgeon of Juan N. Corpas university, specialist in epidemiology, extensive experience in research on topics of interest in public health and publications in international journals, in addition to great interest in pediatrics.

Abstract:

Introduction. Infections Associated with Health Care (IAHC) are all infections contracted by a patient during treatment in a hospital or other health center, and that said patient was not and was not incubating at the time of admission. In the world, 1 in 20 inpatients are affected, and in Colombia the incidence is 5.9% of all hospitalized patients. Objective. To describe the characteristics of IAAS in pediatrics and to characterize the terms used during the care of pediatric patients with IAAS. Date and place. Juan N. Corpas Clinic, July 2016- July 2017. Methods. Descriptive study divided into three phases; Phase 1: A systematic search was performed on IAAS in pediatrics in EBSCO, PubMed and LILACS; Phase 2: clinical cases of infections were designed, which were delivered to health professionals who had contact with the pediatric population, requesting that they make a brief analysis of the cases to make a theoretical model of predictive or present factors at the time of diagnosis, phase 3: the records of patients diagnosed with IAAS during the period between 2014-2016 were reviewed and the demographic, social and clinical characteristics of these patients were identified. Frequencies were calculated and the qualitative data were analyzed Atlas ti 8.0. Results In the systematic search, predictive terms of common IAAS were identified in the three databases as neonates, male sex, surgery among others, terms used by health professionals were obtained that coincided with those found in the scientific literature and finally were identified and analyzed the IAAS cases of a third level clinic, finding an IAAS rate of 0.46 per 100 hospital discharges. Conclusion. There are terms that can be interpreted as predictive factors contributing to the early diagnosis of an IAAS.

Biography:

Marzieh Heidarzadeh Arani serves as a faculty of Medicine in Pediatric Department at Kashan University of Medical Sciences, Iran.

Abstract:

Asthma is the most common chronic childhood disease, and many of its risk factors have been identified. Although various studies on the link between vitamin D and asthma have been conducted, the role of vitamin D in the onset of asthma as an environmental health problem has not been well identified. This study aims to investigate the link between serum vitamin D level and asthma in children in Kashan, Iran. This case-control study was conducted on the asthmatic (n=99) and non-asthmatic (n=99) children.

Asthma was monitored and examined using spirometry and by an allergy and asthma specialist. The patients were divided into three groups (mild, moderate, or severe) in terms of asthma severity. The age-matched children in the control group were selected from among non-asthmatic children. Serum vitamin D level was measured using radioimmunoassay (RIA) technique.

Results:

The mean serum vitamin D level of asthmatic children and the children in the control group was 14.76±14.19 ng/ml and 30.47±9.7 ng/ml, respectively (p < 0.001). The mean serum vitamin D level of the children with mild, moderate, and severe asthma was 17.6±14.2 ng/ml, 14.6±6.99 ng/ml, and 11.9±4.6 ng/ml, respectively, which was significantly less than the control group (p <0.001). Serum vitamin D levels were not significantly different in terms of asthma severity.

Conclusion: The results of this study showed that serum vitamin D level in asthmatic children is significantly less than in non-asthmatic children.

Keywords: vitamin D, Asthma, environmental health.

Biography:

Medical Doctor and Public Health professional with seven years of extensive experience in Mother Newborn & Child health Care Programs; Nutrition, Immunization, Infectious Disease, and Family Planning. I have strong technical and analytical skills in institutional management, strategic and operational planning, Health System Surveillance, Monitoring, and Evaluation of Health Care Programs.

Abstract:

Low birth weight (<2500grams) is often associated with prematurity (<37 weeks) which is most common cause of neonatal morbidity and mortality in Pakistan. Kangaroo mother Care (KMC) is non-conventional, low cost method intimates skin to skin care between mother and baby, exclusive breastfeeding and early discharge from hospital. PPHI is first organization to initiate KMC intervention in Sindh and established total 150 KMC units out of 300 BHU Plus (24/7 services) Purpose: To determine proportion of low birth weight and prematurity and to evaluate the effectiveness of KMC intervention. Methodology: The retrospective study was conducted in the all health facilities of PPHI Sindh, Pakistan and comprised data from structured registers (DHIS, KMC register and additional summary tools) from July 2017 to March, 2018. Frequencies and proportions were calculated to assess the low birth weight, premature babies versus KMC admission. Results: From July 2017 to March 2018, the total cumulative number of LBW and Premature babies was 6434 respectively among total 110466 live births. Among total low birth and premature babies 3699 were admitted to KMC units. KMC was successful intervention as out of total admission 65% were normally discharged. Conclusion: Though KMC intervention has shown significant results but with proper follow up visits additional results can be achieved. 

Keywords: Kangaroo mother care, low birth weight, premature.

Biography:

Dr. Vasile Valeriu Lupu is a senior in Pediatrics and Lecturer at the Pediatric Discipline, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania; he obtained his PhD degree in 2011 and he has Attestates in Complementary Studies of Pediatric Gastroenterology (since 2012), Pediatric Diagnostic Digestive Endoscopy (since 2010). Dr. Lupu is member of the Romanian Society of Medical Genetics, Romanian Society of Gastroenterology and Pediatric Hepatology, European Pediatrics Association (since 2011), being also the general secretary of the Romanian Society of Pediatrics (2009-2017). He is author of 168 scientific papers communicated at scientific congresses and conferences and 116 articles published in extenso (22 in ISI journals); for his scientific activity he was granted with 3 internationals prizes.

Abstract:

Introduction: Gastritis is associated with multiple etiologies, but in most pediatric cases of gastritis the etiology is unknown. Numerous studies have reported Helicobacter pylori (H. pylori) as etiological factor for mild to severe gastritis. We tried to evaluate the distribution of the infection with H. pylori by gender, age and place of origin.

Materials and Methods: We performed a retrospective study over a period of 3 years, over a  lot of 1757 patients of both sexes, aged between 12 month old and 18 year old, admitted to a regional gastroenterology center in Northeast Romania, with clinical signs of gastritis which underwent upper gastrointestinal endoscopy.

Results: Out of the 1757 children diagnosed with various forms of gastritis, in 30.85% of cases the H. pylori infection was present. Distribution of children with H. pylori infection by gender revealed a frequency of 26.75% in males and 73.25%  in women. In the study group, the average age of children who had H. pylori infection was higher (14.10 + 2.833 DS), compared with children without H. pylori (12.78 + 3.694 SD), an average difference of 1.3 years (95% confidence interval 0.96 to 1.66; p <0.001). Distribution of children with H. pylori infection by place of origin highlighted a frequency of 24.72% in urban and 75.28% in rural areas.

Conclusions: The most important cause of gastritis identified in pediatric age is H. pylori infection. For the identification of H. pylori infection by endoscopy with biopsies, followed by the urease test and / or direct microscopy remains the gold standard.

Biography:

T. Thuileiphy M.Sc. Nursing (pediatric) student at All India Institute of Medical Sciences, New Delhi. Worked as staff nurse for 7 years at AIIMS, New Delhi.

Abstract:

Statement of the problem: A study to assess the effectiveness of an Information, Education and Communication (IEC) package on compliance to Glaucoma medication among the caregivers of children attending glaucoma clinic AIIMS, New Delhi.

Background & Objective: Glaucoma is the leading cause of irreversible blindness worldwide. It is preventable if timely effective and successful treatment is provided. Quality teaching, support and guidance are needed to ensure the compliance to glaucoma medication. The present study was aim to develop IEC package on compliance to glaucoma medication and to assess its effectiveness in increasing knowledge and practice of caregivers of children glaucoma.

Methods: Quantitative research design - pre experimental one group pretest post test was used. Ethical approval was obtained from institute ethical committee. Sixty caregivers of children attending glaucoma clinic in tertiary care hospital were included in the study. Knowledge questionnaire, practice questionnaire observational checklist and medication log sheet are used for pretest and one month after the administration of IEC package (post test) were self-developed, validated and found reliable. One to one teaching, demonstration and return demonstration was provided.

Result: Majority of the caregivers were females, the mean post test knowledge score was increased from 7.3±2.19 to 12.23±1.36 which was significant at p<0.05. There was significant (p<0.05) increase in post test practice score from 11.5±1.91 to 18.08±1.12 The pretest and post test knowledge scores had significant association with educational status and family monthly income (p<0.05) The pretest and post test practice score had significant association with gender and relationship to child (p<0.05). Increase in the knowledge and practice was dependent of caregivers selected variables such as educational status, family monthly income, gender and relationship to child.

Conclusion: The study revealed that an Information, Education and Communication (IEC) package played a crucial role in increasing knowledge and practice regarding compliance to glaucoma medication among caregivers of children with glaucoma one month after the intervention. The most and effective factor identified in the study is the teaching session which takes only 15 minutes in teaching and demonstrating the content in the information pamphlet.

Biography:

Michael Ekholuenetale is currently a researcher and medical statistician in maternal and child health projects. His work focuses on a broad array of multidisciplinary topics in global health. This includes cross-cutting research and publications in disciplines of public-private partnerships and global health intervention. He has a strong interest in large-scale evidence (in particular randomized trials) and analyses of large survey data sets. He has been involved in many research projects in sub-Saharan Africa where he collaborates with international partners to advocate for cost-effective interventions addressing Maternal, Newborn and Child health (MNCH). He has undertaken numerous courses in Epidemiology, Survival Analysis, Advanced Statistics and Ethics in Health Research at the Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria; where he obtained M.Sc. Medical Statistics.

Abstract:

Background: Interpregnancy intervals (IPI) are independently associated with perinatal, infant and child health outcomes. Proper birth spacing is a recommended tool to reduce adverse health outcomes especially among children. The study aimed to determine the prevalence of adverse child health outcomes in Sub-Saharan Africa (SSA) countries and to examine the association between the length of preceding birth interval and child health outcomes.

Methods:  Secondary data  from Demographic  and  Health  Survey  (DHS)  in  34  SSA  countries with  299,065  births,  2008-2017  was  used  in  this  study.  The  outcome  variables  were  infant mortality, low birth weight, stunting, underweight, wasting, overweight and anemia. Percentage was  adopted  for  summary  statistics.  Cox  proportional  hazard  regression  was  used  to  examine association  between  preceding  birth  intervals  and  infant  mortality.  Multinomial  and  binary logistic  regression  models  were  used  to  examine  the  association  between  under-five  children adverse health outcomes and interpregnancy birth interval.

Results: Infant mortality was highest in Sierra Leone (9.3%). Comoros (16.8%) accounted for the highest percentage of low birth weight (<2.5kg). Child stunting was as high as 54.6% in Burundi. IPIs of <24 months, 24-36 months, 37-59 months and ≥60 months were 19.3%, 37.8%, 29.5% and 13.4% respectively. Median IPI was 34 months. The prevalence of infant mortality decreased as IPIs increased as infant mortality was 9.3% in short IPIs (<24 months) and 4.2% in long IPIs (≥60 months). Childhood adverse health outcomes were higher with short birth intervals. Results from Cox proportional hazard regression showed that children with preceding birth interval <24 months had 57% higher risk of infant mortality, compared to children with IPI of 24-36 month (HR= 1.57; 95%CI: 1.45, 1.69). More so, there were higher odds/risk of low birth weight, stunting, underweight, wasting, overweight and anemia among children with short birth interval (<24 months) after adjusting for other covariates.

Conclusion: The findings of this study suggest the need for urgent intervention to promote the WHO recommended IPI to reduce adverse child health outcomes. The findings show the importance of exclusive breastfeeding to prolong lactational amenorrhea and enhanced proper nutritional approach.  Stakeholders would find this study interesting as the basis for policy formulation and implementation.

Biography:

Dr. Kyung Hee Park is a Professor at Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine, South Korea. He has more than 10 years of experience in this field and has published many research articles in several reputed National and International journals. He have attended many International conferences and symposia worldwide.

Abstract:

Purpose :

Recently, several studies have reported a correlation of early aEEG parameters with short- and long-term neurological outcome in preterm infants. The aim of this study was to assess characteristics of aEEG in preterm infants with adverse neurologic outcome such as intraventricular hemorrhage, periventricular leukomalacia or death and to evaluate whether aEEG in the early days of life has predictive value of short-term neurologic outcome in preterm infants.

Methods :

This prospective observational study included infants born at less than 32 weeks of gestational age or less than 1500 gm of birth weight who admitted the neonatal intensive care unit of Pusan National University Hospital between December 2016 and November 2017. aEEG were monitored at 12~14 hours (day 1), 46~48 hours (day 2), 70~72 hours (day 3), and 1 week of life (day 7). The aEEG recordings were analyzed using criteria described by Burdjalov et al. Brain ultrasonography was performed before 3 days of life first and then mostly once a week, depending on the clinical course of the patient, until discharged. Based on brain ultrasonography, infants were divided into two groups, which are favorable outcome group and adverse outcome group respectively. We compared characteristics of aEEG between both groups.

Results :

Forty four infants were enrolled. A total of 176 aEEG tracing were analyzed. Twenty seven infants and seventeen infants were identified in favorable outcome group and adverse outcome group respectively. Infants in favorable outcome group showed high scores in almost all components including continuity, cycling amplitude of the lower border, and the bandwidth span and amplitude of lower border. The scores of all components were decreased significantly in day 2 compared to day 1 in adverse group, while the scores was increased as the days went by in favorable group. And total score of day 2 has highest AUC and less than 3 of total score has predictive value of 70.6% of sensitivity and 81.5% of specificity for adverse outcome.

Conclusion :

we evaluated the differences in aEEG during the first week of life in preterm infants between favorable group and adverse group. We demonstrated that preterm infants with lower score of aEEG especially during the second day of life than first day of life or with scores less than 3 duirng the second day of life are more likely to have short term adverse outcome.