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Background: Hearing loss is one of the most common congenital disorders. The Early Diagnosis and Intervention Process is designed for the early diagnosis and intervention of hearing loss in infants. The present study aimed to examine the results of Early Hearing Detection and Intervention (EHDI) in northeastern Iran from 2005 to 2019. Setting: Northeastern Iran. Methods: In most cases, the two-stage protocol (otoacoustic emissions [OAE] and automated auditory brainstem response [AABR]) has been used. Infant assessment methods included the use of OAE, ABR, auditory steady-state response, high-frequency tympanometry, and behavioral audiometry. Interventions included medical interventions, hearing rehabilitation, hearing aids, and cochlear implants. Results: 1,162,821 infants were screened. The screening coverage increased from less than 1% in 2005 to about 99% in 2018. The referral rate has been about 1%. 2.17 out of every 1000 infants are hearing impaired, and the most common cases are bilateral hearing loss and mild to moderate hearing loss. Conclusions: During 2005 to 2019 the coverage rate reached to more than 95% of live births. To improve the EHDI process in this population, better follow-up of diagnosed neonates and expansion of diagnostic and intervention services are needed. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) is an emerging viral disease with a high rate of transmissibility that has spread and become the first pandemic of the century. There are limited data available regarding COVID-19 during pregnancy. An important question is whether pregnant mothers transmit the virus to their fetuses or newborns. Case report: This study was conducted to investigate the vertical transmission of the COVID-19 virus from pregnant mothers to fetuses. This study reported the case of a preterm newborn admitted to the neonatal intensive care unit of Imam Khomeini Hospital Urmia, Iran, from a COVID-19-positive mother with severe respiratory illness. A preterm female newborn with a gestational age of 34 weeks, 1,800 g weight, and 1-minute and 5-minute Apgar scores of 4 and 5, respectively, was born through the emergency cesarean section from a 39-year-old gravid 1 mother. She was positive for COVID-19, in two consecutive reverse transcription polymerase chain reaction tests which were performed 48 h apart from each other. Conclusion: According to the limited available documents of our case, the researchers claimed that vertical transmission of COVID-19 was possible at this time. [ABSTRACT FROM AUTHOR]

Background: In spite of significant advances in therapeutic, diagnostic and even medical modalities, meconium management continues to be a concern for management. It has been recently assumed that trace of lactate in both serum and urine can be a sign of the asphyxia in neonates. However, no study has been done on the prognostic value of increasing lactate concentration in umbilical cord blood for predicting the outcomes of meconium aspiration syndrome (MAS), which was our aim in this study.Methods: Thin cross-sectional study was performed on 150 neonates suffering meconium aspiration syndrome who were admitted to Akbar Abadi hospital in Tehran between 2016 and 2018. Samples of umbilical cord blood were extracted from neonates and sent to the reference laboratory to measure lactate level as well as arterial blood gas analysis. The neonatal characteristics as well as postdelivery complications were also collected by reviewing the hospital recorded files.Results: Thick meconium stained amniotic fluid (TKMSF) was found in 40.0% and thin meconium stained amniotic fluid (TNMSF) in 60.0%. The mean level of lactate was significantly higher in those neonates with morbidities including pulmonary hemorrhage, persistent pulmonary hypertension of the neonate (PPHN), intraventricular hemorrhage (IVH), and respiratory failure requiring ventilation support. According to the ROC curve analysis, increasing lactate in umbilical cord blood could predict occurrence of pulmonary hemorrhage (AUC = 0.885), PPHN (AUC = 0.832), IVH (AUC = 0.898), and requiring ventilation (AUC = 0.833). Comparing the two groups with TKMSF and TNMSF showed higher gestational age, lower Apgar score, lower BE, higher PCO2, lower PO2, lower PH as well as higher serum lactate. In this regard and using the ROC curve analysis (Table 4), increased lactate could effectively discriminate TKMSF from TNMSF (AUC = 0.998) with the best cut-off value of 4.10.Conclusion: The increase in lactate in the umbilical cord blood (>4.1 mmol/L with high sensitivity and specificity) can distinguish between thick meconium and thin meconium forms in amniotic acid and thus can determine the severity of MAS. Also, increasing serum lactate levels is an accurate indicator for predicting complications such as pulmonary hemorrhage, PPHN, IVH, and need for ventilation in newborns with this syndrome. This diagnostic accuracy is even beyond the usual markers for arterial gas analysis, such as PH, PCO2, PO2 and BE. [ABSTRACT FROM AUTHOR]

Kleefstra syndrome is a genetic disorder that may involve different parts of the body, but its main characteristics are intellectual disability and childhood hypotonia. We report a 10-yearold mentally retarded male patient who presented with seizure. His medical history revealed recurrent upper respiratory infections, neurodevelopmental delay, and epilepsy. It was also found that he had had a hospitalization in the neonatal intensive care unit for five days due to tachypnea, low APGAR score, and meconium aspiration syndrome. His brain MRI had shown some degree of distension of the lateral cerebral ventricles with the basal cistern. The electromyography and the nerve conduction velocity were however normal. He was diagnosed with Kleefstra syndrome by the loss of the EHMT1 gene. He is now under treatment by piracetam and work-therapy. This is the second case report of this syndrome in Iran. This case presentation aims to improve the diagnosis of Kleefstra syndrome patients, as a rare syndrome with non-characteristic manifestations. [ABSTRACT FROM AUTHOR]

Background: Being obese can lead to various complications during pregnancy, such as Gestational Diabetes Mellitus (GDM), pregnancy induced hypertension (PIH), Pre-Eclampsia (PE), and Large Gestational Age (LGA). Although bariatric surgery is an effective way to treat obesity, it can also result in complications and may be linked to having small for gestational age (SGA) babies. This cohort study protocol aims to compare the maternal and fetal/neonatal outcomes of two groups of Iranian pregnant women: those who have undergone bariatric surgery and those who are obese but have not had bariatric surgery., Methods: In this study Pregnant women (< 14 weeks' gestation) (n = 38 per group) are recruited either from one of the obesity clinic (exposure group = with a history of bariatric surgery) or primary healthcare clinics in Tehran city (comparison group = pregnant women with obesity and and no history of bariatric surgery). Dietary intake and nutrient status are assessed at < 14, 28, and 36 weeks. Maternal and fetal/neonatal outcomes are compared between the two groups, including gestational diabetes, preeclampsia, preterm labor, intrauterine growth restriction, severe nausea and vomiting, abortion, placenta previa and abruption, venous thrombosis, vaginal bleeding, cesarean delivery, meconium aspiration, and respiratory distress. Maternal serum levels of ferritin, albumin, zinc, calcium, magnesium, selenium, copper, vitamins A, B9, B12, and 25-hydroxy Vit D are checked during 24th to 28th weeks. Maternal and neonatal outcomes, including height, weight, head circumference, fetal abnormality, infection, small or large fetus, low birth weight, macrosomia, NICU admission, and total weight gain during pregnancy, are measured at birth. Maternal and offspring outcomes, including weight, height, head circumference, total weight gain during pregnancy, newborn diseases, postpartum bleeding, breastfeeding, and related problems, are assessed 6 weeks after delivery. Child's weight, height, and head circumference are followed at 2, 4, 6, 8, 10, and 12 months after birth. Maternal stress, anxiety, and depression are assessed with the DASS-21 questionnaire, and physical activity is evaluated using the PPAQ questionnaire in the first and third trimesters., Discussion: By assessing the levels of micronutrients in the blood of pregnant women along with the evaluation of pregnancy outcomes, it is feasible to gain a more accurate understanding of how bariatric surgery affects the health and potential complications for both the mother and the fetus/newborn. This information can help specialists and patients make more informed decisions about the surgery. Additionally, by examining issues such as stress, anxiety, and depression in women undergoing surgery, this study can contribute to recognizing these problems, which can also affect pregnancy outcomes., (© 2024. The Author(s).)

Background: Entanglement of the umbilical cord around fetal neck has been reported to be associated with birth asphyxia. On the other hand, current evidence suggests that umbilical arterial pH analysis provides the most sensitive reflection of birth asphyxia. In this study we aimed to evaluate and compare the umbilical arterial hydrogen-ion concentration (pH) and to analyze the blood gases of neonates with or without nuchal cord. Methods: In this cohort study, 92 newborns with and 95 without nuchal cords were enrolled at Shahid Akbar Abadi Hospital in Tehran, Iran between the years 2009 and 2010. From each newborn an umbilical arterial blood sample was collected to measure pH, base excess and blood gases. Results: There were no statistically significant differences between newborns with or without nuchal cord regarding maternal age, gestational age, and history of pregnancy. The mean pH in the newborns with nuchal cord (7.21±0.1) was significantly less than the value in the newborns without the cord (7.28±0.1), (P<0.001). In contrast, the mean base excess in the newborns with nuchal cord was more than the ones without the cord (P<0.001). Seven newborns (7.9%) in the group with nuchal cord passed meconium during labor while only one (1%) newborn did so in the other group. Conclusion: Our finding showed that nuchal cord had a significant relationship with acidosis in newborns with nuchal cord. However, this finding needs further investigation to reach a common conclusion. [ABSTRACT FROM AUTHOR]

Background: Approximately 15% of all live births are complicated by meconium-stained amniotic fluid. Fortunately, only 5% of neonate born through meconium staining amniotic fluid (MSAF) develop meconium aspiration syndrome (MAS). This study was designed to assess the frequency of meconium staining amniotic fluid, meconium aspiration syndrome and their associated factors. Methods: this cross-sectional study performed during 2004-2005 in Alghadir hospital, which is a charity hospital located in the east part of Tehran with a large number of deliveries annually and also a highly equipped neonatal ICU. All live births newborns in these 2 years included in the study and newborns with MSAF and MAS were evaluated more. Findings: There were 6355 live births in the hospital in this period. Two hundreds and nineteen (3.4%) of them had MSAF and MAS developed in only 12 newborns (0.002 of total births and 5% of MSAF). In MAS group, 7 neonates (58.3%) had low APGAR score (< 8) (P = 0.001) and also, 10 of them (83.3%) had thick meconium (P = 0.017); but there were no relation between MAS and type of delivery, gestational age and birth weight (P > 0.05). Conclusion: There are meaningful relationships between MAS with low APGAR and thick meconium. [ABSTRACT FROM AUTHOR]

This study was designed to investigate the neonates with COVID-19 admitted to two hospitals in Neyshabur and Mashhad, Iran. In this study, 17 neonates are introduced with positive nasopharyngeal COVID-19 polymerase chain reaction (PCR) test who admitted to two hospitals in Iran. Perinatal information, contacts with a person with COVID-19 infection, clinical signs at the time of admission, laboratory tests, radiological evaluations, pulmonary and extra pulmonary complications, and short-term outcome have been reported. 8 neonates had positive COVID-19 PCR test of mothers at the time of delivery in the first 24 hours and subjected to invasive or non-invasive mechanical ventilation due to respiratory distress. 9 neonates on 9–18 days of birth were admitted with pulmonary and extra pulmonary symptoms by fever as a main clinical sign. All of cases except one had a history of contact with the infected person. The treatments were mostly supportive, by the way 6 neonates receiving surfactant treatment and 2 of them receiving systemic steroid therapy. Only one neonate died and the others were discharged without any complications. The results showed that the symptoms and severity of the disease in neonates are milder than adults. The possibility of vertical transmission due to the onset of symptoms immediately after birth is still present in some neonates of affected mothers. [ABSTRACT FROM AUTHOR]