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Objective: To compare the effect of suctioning first or drying first on the composite outcome of hypothermia or respiratory distress in depressed newborns requiring delivery room resuscitation., Design: Open-label, randomized, parallel-group, controlled trial., Setting: Delivery room and neonatal intensive care unit of a tertiary-care teaching hospital., Patients: Depressed newborns (n=154) requiring initial steps of resuscitation at birth. Intervention: During delivery room resuscitation eligible new-borns were randomly allocated to receive either suctioning first or drying first (77 newborns in each group)., Main Outcome Measure: Composite incidence of hypothermia at admission or respiratory distress at 6 hours of age., Results: Both groups were comparable with regard to maternal and neonatal characteristics. Composite outcome was similar in both the groups [46 (59.7%) vs 55 (71.4%)] in suctioning first and drying first, respectively [RR (95% CI), 0.84 (0.66-1.05); P=0.13]. Incidence of hypothermia, respiratory distress at admission and oxygen saturation at 6 hours were also similar. On admission to NICU, hypothermia was observed in 26 (33.8%) neonates in suctioning first group and 33 (42.8%) neonates in drying first group but by one hour of age the proportion of hypothermic neonates was 13 (16.9%) and 14 (18.1%), respectively., Conclusion: In newborns depressed at birth, the sequence of performing initial steps, whether suctioning first or drying first, had comparable effect on composite outcome of hypothermia at admission or respiratory distress at 6 hours of age.

Objective: To evaluate the impact of ICDS on maternal nutrition and birth weight., Setting: 28 ICDS and 21 non-ICDS villages in two adjoining blocks of Varanasi., Methods: 5289 pregnancies were registered during 1987-1993 in these two blocks. In the ICDS block 916 and 1453 nutrition supplemented and unsupplemented, respectively and 1748 of the non-ICDS live births with weight recorded within 48 h formed the study subjects., Results: The ICDS supplemented mothers gained 100g more in pregnancy and birth weight was higher by 58 g (p < 0.05) as compared to unsupplemented ICDS mothers. Birth weight in unsupplemented ICDS areas was 25g higher as compared to non ICDS area. ICDS supplemented women had a significantly smaller proportion of low birth weight babies (14.4%) compared to ICDS unsupplemented (20.4%) and non-ICDS women (26.3%). The corresponding prevalence of preterm births was 2.0, 2.4 and 4.3%, respectively (P < 0.001). Multiple regression analysis showed that increased wight gain in pregnancy, length of gestation, caloric intake and term hemoglobin were significantly associated with birth weight. However, the length of gestation was not influenced by factors improving the birth weight., Conclusion: Undernourished pregnant women are benefitted by late pregnancy nutrition supplement