Victoria A. Georgieva, Sevdalina M. Marinova, Nikola K. Popovsky, Stefan I. Ivanov and Lyuben V. Georgiev
We studied the incidence and causes of transition disturbances in the first 30 minutes of life in full-term newborns. This one-year study was retrospective and included 1147 full- term live-born neonates without life-threatening congenital anomalies and surgical complications. They were divided into four groups: 0 (with normal transition), 1 (resuscitated without endotracheal intubation), and 2 (intubated); A (without underlying maternal, obstetric or fetal/neonatal problem, with adequate for GA eight and from single birth) and B (with one or more of following: underlying maternal, obstetric or fetal/neonatal problem, SGA or LGA, from multiple pregnancies).
Of the newborns, 9.1% of required resuscitation and 1.6% - extensive resuscitation with intubation. The groups significantly differed in the incidence of underlying maternal, obstetric, or fetal/neonatal problems. Resuscitated babies were born via Caesarean section (CS), in abnormal presentation (PaN) and by vacuum extraction or forceps (V/F) predominantly. The highest incidence of the small for gestational age (GA) babies – SGA, was detected in Group 2. Twins and large for GA (LGA) had prevalence in Group 1. Resuscitation was necessary for 18.1% of CS-delivered babies. V/F and PaN lead to the highest need for intubation. According to our data, every 10th of the full-term neonates required assistance in the fetal-to-neonatal transition. The causes could be diseases of the mother or fetus/newborn, multiple births, SGA, or LGA. A compromised medical decision about the time and way of delivery may result in iatrogenic transition disturbances.
Tatyana D. Itova, Victoria A. Georgieva and Vanya N. Nedkova
It is believed that 98% of newborns have elevated serum bilirubin levels, but only about 60% have clinic of jaundice. Severe late neurological effects should not be observed if the serum bilirubin levels are well controlled. To follow-up the motor and mental development during the first year of life in infants suffered from neonatal jaundice. The study includes 92 term babies, divided in four groups: A – without jaundice, B – with jaundice treated by phototherapy in the 1st week , C - intensive jaundice during the first 14 postnatal days , D – intensive prolonged jaundice . Studied indicators: birth weight , gestational age, sex, delivery mode, Apgar score, maternal age and education, domicile, bilirubin serum levels during hospital stay, transcutaneous bilirubin levels ambulatory. Neuro-psychological development was assessed monthly until the 1-year-age.We found that groups were comparable across the all indicators except for residence, with significant difference for groups B and D. There was a statistically significant development delay in the Group D compared to the other three groups in the all studied age periods. All the cases of prolonged jaundice were resolved until the age of 3rd month. According to our data, prolonged jaundice compromises the first-year-psychomotor- development of the infants.